My father has kidney failure. What can we do to support him?

[Rindercella]

My DF has gone through so much recently. He is 76 years old and initially went into hospital with prostrate problems around August last year. He was given a catheter and a few weeks later had his prostrate removed. He still couldn't pee, so he was given another catheter and then had his hernia operated on. This was at the end of november. He still couldn't pee, so they decided to leave the catheter in until after Christmas in case he had any problems over the Christmas period. Catheter was then removed about 2 weeeks ago.

DF then had the worst week of his life. The hospital (private) where he'd had all of his previous operations basically said, not our problem, you'd best see your GP. GP gave him some antibiotics. Another GP was called out over the weekand and prescribed him with some painkillers. DF didn't eat or drink for nearly a week. Then on Monday he was finally admitted into hospital, put on a drip, had lots of tests and was diagnosed with kidney failure (apparently his kidneys were functioning at 10%). He's now been transferred to a specialist unit and is receiving dialysis twice a day. They are now trying to find the cause of the failure - whether it's an infection or disease.

Thankfully he is in the best place now and getting the treatment he so badly needs. What can we expect though? What can we do to help him? What would make him feel more comfortable? I just feel so bloody useless at the moment.

[PuzzleRocks]

So sorry to hear your sad news. Bumping for you.

[Rindercella]

Anyone?

[stanausauruswrecks]

Am no expert on renal things, but have a little bit of knowledge. What the docs will be rying to establish is whether the renal failure is reversible - some types of acute renal failure can be a temporary blip - (usually those caused by an extrinsic factors) Dialysis can help to rest the kidneys and they then regain their function.
It really is a case of wait and see. They may do a renal biopsy, to see if there is any scarring of the kidney which could be causing the problem. He'll be having regular bllods taken to assess his renal function and they should be able to see from these if his kidneys are showing any sign of recovery.
In terms of making him feel better, talk to the nurses on the ward about drinks and snacks that are appropriate for him to have -he may well be on a potassium restricted diet, as well as fluid restricted. Make sure he has plenty of books/magazines, lip balm, walkman/porable DVD player - anything that will alleviate the boredom of dialysis and being in hospital!!
Sorry it's so long winded, I really hope things pick up for him soon x

[wrinklytum]

Hi Rindercella.

Fiirstly,I used to work on a dialysis unit many moons ago.

Basically there are 2 types of renal failure

Acute renal failure
Chronic renal failure.

If it is an acute renal failure this can be because something has temporarily stopped blood flow to kidney be it infection or some intrinsic kidney failure that can be resolved.

If it is a chronic failure by some kidney condition then lifetime dialysis is required to maintain life.Unless a transplant can be found.

My own dp recently required temporary dialysis due to a large blood clot to the main vein in his kidney being blocked.He had concurrent prostrate trouble.

Until you get a definitive dx you will not know what your dad has.Usually to determine the cause they will do a scan of the kidneys and then a biopsy.

Often people will be on a restricted diet (Low potassium and phosphate) and restricted fluid so they don't get overloaded with fluid which can put stress on the heart.

Hugs,Wrinkly xxx

[Rindercella]

Thanks Stan! Funnily enough, I bought him loads of magazines, some lip balm & some hand cream today. The DVD player is a great idea - will mention it to my mother when I see her tomorrow. I think at the moment one of the big problems is that they don't know what the cause of the failure is. Hopefully it will turn out that it has been due to an infection rather than something more chronic.

My parents have both always been so strong and well (Dad is an old skool farmer - nothing hurts him). I am so looking forward to seeing them both tomorrow (we're taking Mum out for a nice lunch before we go & see Dad - she needs something nice after the last couple of weeks).

Thanks again for your help.

[Rindercella]

Thank you too Wrinkly! (bet my tum is more wrinkly than yours!!). Yep, have been warned about the low potassium diet, so I won't be taking him any bananas into hospital tomorrow!

I don't know what I would do without my Dad. It has really, really hit me this week that my parents are now elderly and more than ever anything could happen at anytime.

It's hard being 100 or so miles away from them at the best of times. Just now it is especially tough.

[wrinklytum]

//hUGS]

I am sure you are doign your best for him.It is very hard.And scary.

[WobblyPig]

I am haemodialysis doctor looking after chronic patients with renal failure.
Can I answer any specific questions for you?

[Rindercella]

Thanks again Wrinkly.

Wobbly, I haven't seen Dad since he was admitted earlier in the week. I know that he has had 2 days of dialysis and will now be having a break until Monday. Because this is the first time renal failure has come up in my life I am finding it really difficult to know what to expect - both with the current treatment, and also long-term. I guess until the doctors treating him know the cause, a long term diagnoses is difficult.

What actually is dialysis? What impact does it have on the body? If you have to have dialysis for the rest of your life, how easy is this to manage?

Thanks Wobbly ;o)

[Rindercella]

diagnosis

[WobblyPig]

The outlook really depends on he cause but also on how long h has had kidney failure. Most people needing dialysis have had some form of kidney failure for a while.

it is typical for the dialysis to be perfomed every other ay whilst he still needs it.

Dialysis is a way of removing toxins and salt and water that accumulated when your kidneys aren't working and replacing some of things you are lacking when this happens. Kidneys are complex organs bu basically keep the amount of salt, water, and various chemicals in your body at a healthy level. When your kidneys stop working the body can't get rid of salt, water, potassium, acid and various other nasties.

If soneone needs dialysis long term it really can be coped with but may seem daunting at the time.
Typically a person needing dialysis will come up to a hospital unit 3 times a week to receive their treatment which involves cleaning the blood for about 4 hours. This will be the same type of dialysis that your Dad is receiving now. Many of my patients lead full lives; they travel; work ahve families. But there are restrictions . Many people feel that it is the end of their lives but it is more like the end of the life they used to know and the start of soemthing different. it is a challenge. Special diets, medications are part of it but don't need to dominate your life.

There is another way of receiving dialysis called peritoneal dialysis which is done by the patient at home using a tube going into the tummy. In some places home blood dialysis can also be done - you hae hte machine at home.

Lots of info and support around. look up the KPA.

Hope this helps. CAT me for more.

[Rindercella]

Thanks Wobbly. Fingers crossed that the doctors will know more in the next few days. I think that perhaps his previous problems prostrate, hernia masked the kidney trouble and it's been a little like revealing Russian dolls over the last few months.

I may well CAT you to ask more after the weekend. Thank you so much.

[noddyholder]

rinder I have had chronic kidney failure twice and amon my second transplant.As the others have said it really depends on the cause how he gets treated.I agree ie is a challenge but some dialysis patients have it well under control and live ok with it.Also older patients are more readily considered for transplant and the ones I have met are doing well

[WobblyPig]

Generally speaking a 76 year old will not normally be considered for transplantation.

[noddyholder]

I know that but it is on the increase according to my doctors.I know a couple.

[Northernlurker]

I work in a renal unit too and there are some older people on the transplant list. It isn't age alone that's the deciding factor. More that older people have co-existing conditions which rule them out - such as cardiac problems.

Dialysis is not an easy treatment. It dominates the lives of our patients - but they still lead full lives. You can even go on cruise holidays should you want to - there are dialysis cruises!
From what I've seen it's not a good idea to get to fixed on what could happen - every dialysis patient is different. The art of the nephrologist is in keeping the patient as stable as they can and as well as they can.

Talk to your dad's nurses on the dialysis unit - renal nurses are amazingly skilled and have a wealth of knowledge. Just don't try to second guess the future too much.

[noddyholder]

Agree totally with northern this is definitely a condition where no 2 cases are the same.I was so lucky with the nurses on my unit they had the knowledge of the doctors but the patience of saints and now 8yrs after I last had dialysis a few of them are still my friends.He will need lots of support at this time as it is very tiring but the staff can advise on diet etc.Hope things go well for him

[WobblyPig]

Not directed at OP or meant to be negaitve :
Generaally speaking transplantation over hte age of 70 years is uncommon. in our unit we rarely transplant the over 70s because of much poorer outcomes. I do have 1 patient age 70 on the transplant list.
A transplant is not necessarily the easy option and is physically difficult in the more mature patient. As an older patient it is unrealistic to pin hopes on transplantation. it is more important to comes to terms with the problems at hand and adapt to the new lifestyle. There is life after kidney failure but it is different.

( At any one time only about 35-40% of my patients are on the transplant waiting list .In non-urban units this is probably higher)

[Rindercella]

Just an update on this. Firstly, many thanks to you all for responding - I really, really appreciate it.

My father is doing well and is no longer critical. I know he is feeling better as he is moaning about being bored! (this time last week he was far too ill to even consider whether or not he might be bored) He is still in hospital, unfortunately in an isolation room as he has C Diff . He was told yesterday that he will have to have dialysis 3 times a week indefinitely, which he is coming to terms with. Someone said on this thread that it probably won't be the end of his life, rather the end of the life that he knew. I think that comment has been incredibly helpful.

So, thank you all. Fingers crossed that Dad continues to make a good recovery, and if he needs dialysis 3 times a week then so be it. At least we have him alive & well.

[plum100]

Hi Rindercella,

So glad you have good news about your dad and I just wanted to share my story with you.

My mu was diagnosed with chronic renal failure in jan 06. She had been in and out of hospital for months and they couldnt find out what was wrong with her. They took monthly blood tests from her because she has arthritis and one month all was fine, then the next month the results showed she has complete kidney failure! I mean how does that happed - why didint it slowly degenerate?

Anyway she was 69 then. She is now almost 72 and saw her renal doctor on Wed who said she was one of their success stories. She does her peritoneal dialysis at home 4 times a day, it takes about 30 mins, but it means she doesnt have to do a very long trip to the hospital 3 times a week. She leads a normal life and every year in the summer she goes to Ireland for a month - the nhs ship all her supplies out there for her.

Renal failure is hard to get you head around - one day mums dialysis will stop working for her. Nut for now all is good and I wish you and your dad all the very best and hope it works for you too.

[Northernlurker]

plum - my understanding is that renal failure is a very unpredicatable thing. Some people go on fine for years with very low function, for others everything goes wrong and it's a lot quicker. There are some patients who thought they were perfectly fine until they have a collapse and then they turn out to be in complete renal failure. It's really good that peritoneal dialysis is working so well for your mum. If she gets to a point where it's not working so well she should then be able to go on to haemodialysis so she's got plenty of options.

Rindercella - glad your dad is doing ok.

[Podrick]

Rindercella I just had similar news about my dad...how is your dad doing?