Quote from mrs.captain.kangaroo
Thanks for all the help. It seems pretty difficult and would require a lot of monitoring day to day with your diets and fluids.
25 years! I didn't think anyone could survive much longer than 5-10 years on hemodialysis?
survival on dialysis is 5 years, which means that many of these pts don't even live this long due to their comorbidities (uncontrolled HTN and/or diabetes leading to cardiac complications, CVA, or other problems). A few, however - the very compliant ones in general - do live much longer. We have a pt in the clinic where I used to work who has been on hemo for some 30 years (she chose not to get a transplant, she manages just fine on dialysis). There are a few others as well.
As for fluid restrictions, the dieticians help to explain this to the pts (how much they should drink based on their individual residual function - how much they still urinate - and other factors). They also suggest ways to cut fluid intake (e.g., ice chips). Nurses, of course, reinforce this teaching.
Fluid non-compliance is a huge problem for many pts, as pp pointed out. Nursing staff must explain the reasons for this; I like to use the garden hose analogy ("Picture your blood vessels as a garden hose. The more fluid it contains, the higher the pressure inside the hose/vessel. This increased blood pressure damages organs and causes the heart to enlarge and eventually fail"). Pts can usually relate to this (which doesn't mean they'll be compliant