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HAEMODIALYSIS

Haemodialysis is a process by which excess waste products and water are removed from the blood. This process requires an access to the patient's blood stream and the use of a haemodialysis machine. An access is a specially created vein in the arm known as arterio-venous (AV) fistula.

In haemodialysis, the blood channels through plastic tubings (blood lines) to the dialyser which is a bundle of hollow fibres made up from semi-permeable membrane. Here the exchange (diffusion) takes place from blood to the dialysis solution (dialysate) and vice versa. The dialysate has a salt composition similar to blood but without any waste products. Usually one dialysis session takes about four hours to complete and patient requires dialysis three times a week.

Patients admitted into our subsidised haemodialysis programme will dialyse at the dialysis centre located nearer to their homes, depending on availability of dialysis equipment at the centre.



 
PERITONEAL DIALYSIS
Peritoneal dialysis is a form of dialysis that occurs inside the body.

Dialysis solution will flow into the peritoneal (abdominal) cavity through a silastic catheter. The peritoneal membrane (petrionuem) acts as a filter. Waste products and excess water pass from the body through the membrane into the dialysis solution. When the filtering process is completed, the waste filled solution is to be drained from the peritoneal cavity into a bag and is then discarded.

Fresh dialysis solution is drained into the abdominal cavity through the catheter again. Each exchange takes about 45 minutes.

There are two forms of peritoneal dialysis:






CAPD or Continuous Ambulatory Peritoneal Dialysis - The patient will performfour
exchanges during the day.

APD or Automated Peritoneal Dialysis - The exchanges are performed by the machine during the night while the patient is asleep.
 

KDF’s subsidised medications programme offers subsidies for three medications:

a) Erythropoietin
b) Calcijex
c) Venofer

As part of KDF’s efforts to provide holistic care to the patients, it initiated the ‘Subsidised Erythropoietin Injection Programme.’ This programme helps alleviate the associated problems of anaemia such as fatigue, poor appetite and insomnia, enabling patients to lead a normal lifestyle. To date, over 70% of KDF’s patients have benefited from the programme. In 2005, it introduced two more medications – Calcijex and Venofer.

In chronic renal failure, the kidneys produce insufficient Vitamin D. Calcitriol (Calcijex) is a man-made form of vitamin D.  Vitamin D is necessary to maintain the right calcium level in the blood for strong bones.  Venofer is a type of iron sucrose used in the treatment of iron deficiency in dialysis patients. 

 

With the support of the Ministry of Health, the Share a Life initiative was launched jointly by the Society of Transplantation, Kidney Dialysis Foundation and the Khoo Foundation on 12 November 2005. Share a Life aims to build support for live donor kidney transplantation by educating the public on the needs and benefits of live donor transplants.

In the programme, KDF has committed to provide funds for

a) Grant for donors’ surgery
b) Bridge to Transplant programme
c) Publicity and Education.

KDF contributes to help donors pay for their hospitalisation for the donor surgery. In the Bridge to Transplant programme, KDF provides interim care for patients who are waiting for kidney transplant from a living relation to ensure that proper dialysis treatment is given to them in preparation for transplant. The Foundation will provide fast track subsidised dialysis to these patients from restructured hospitals.

 

PUBLIC EDUCATION
KDF's life-saving mission goes far beyond providing quality dialysis. Its function includes programmes to increase public awareness and understanding. Since its beginning, KDF has organised regular public forums to provide valuable yet commonly ignored information on kidney-related issues. Health talks can also be arranged for corporations that request them for the benefit of their employees.

In 2004, KDF commissioned the production of New Lease of Life to highlight the turbulent experiences and emotions of patients and family members struggling to cope with kidney failure and dialysis treatment. The all-new info-educational programme was telecast on Channel U, from 10 February till 31 March 2005 on every Thursday at 8:30pm and repeated in June 2005.

New Lease of Life featured eight episodes of real-life stories portraying KDF’s patients who are battling with life-threatening kidney diseases and financial difficulties. But with the high quality and low cost kidney dialysis treatment, and holistic medical care rendered by KDF, these patients managed to rise above their problems, and still strived to pursue their hopes and aspirations.

New Lease of Life also sought to educate the public on various aspects of kidney diseases – putting the spotlight on causes of kidney failure (e.g. diabetes, high blood pressure), how kidney failure can be prevented, the availability of options for treatment and transplantation – delivered by the volunteer nephrologists.

PATIENT EDUCATION
\In order to clearly advise pre-ESRD patients and their family members on treatment options available to them, a treatment options VCDs are produced. These VCDs are usually used by the attending doctors, medical social worker (MSW) and co-ordinators in the restructured hospitals.

PROFESSIONAL EDUCATION
Constant training of dialysis technicians and nurses helps to improve and upgrade their skills. Medical courses are also organised to help keep kidney specialists at the forefront of advancements in the medical field.

KDF conducts the Basic Renal Nursing Education Course to provide the fundamental theories and practices of renal care to nurses.

Part of professional education is the biennial State of the Art Nephrology Course (SOTANC) organised by the Foundation to update participants in the practice of state-of-the-art nephrology. It prepares them for clinical comprehension, analysis and translation of the burgeoning knowledge base in basic science, clinical trials and global clinical experience into immediately applicable tools in the management of patients with kidney disease and associated complications. The faculty often consists of renowned international and Asian clinicians, teachers and researchers.

 

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 KIDNEY DIALYSIS FOUNDATION. Blk 333 Kreta Ayer Road #03-33, Singapore 080333. Tel: (65) 6559 2630    Fax: (65) 6225 0080