Rehab Cell

Physical Medicine and Rehabilitation

Pediatric Outpatient Dialysis Clinic

Pediatric Outpatient Dialysis Clinic

(soothing guitar music)>>Welcome, my name is Kaylee, and I’ll be taking you on a tour of the Pediatric
Outpatient Dialysis Clinic, here at Johns Hopkins. We have a whole team of people here who take care of patients who receive hemodialysis and peritoneal dialysis. Come on in. Now we’re in the dialysis clinic. Did you know that we have the only pediatric dialysis
clinic in Maryland? Johns Hopkins hospital has the largest pediatric transplant center in the state. So what is dialysis
and why do you need it? You need dialysis because your
kidneys have stopped working or are not working well. Kidneys are important because
they clean the toxins, waste, water, and other yucky stuff we don’t want in our
bodies out of our blood. Since your kidneys
can’t do that right now, the dialysis machine
acts like your kidneys and cleans your blood for you. Every time I come to dialysis,
I see familiar faces. There’s a nurse, a dialysis tech, a child life specialist, a social worker, a behavioral psychologist,
and a registered dietician. I also see a nurse practitioner
and a doctor on most days. Everybody takes great care
of me and puts me at ease.>>Coming here, sitting in the chair, watching my child go through this, it’s very hard. It’s scary. But the staff here, they just embrace you and they give you that love
and support that you need to show you that your
child is gonna be fine and they are gonna take
very good care of them and that gives you a lot of ease. The staff here made us
feel very comfortable. They answered any questions or
concerns that we’ve ever had. They’re very, very friendly. They’re like family.>>There are two different
types of dialysis, hemodialysis, or HD, and
peritoneal dialysis, or PD. I get hemodialysis. Here’s one of our doctors to explain more.>>For people who are on hemodialysis, blood is removed from the body and passed through an
artificial kidney or a filter in order to remove the toxins,
waste products, and water. The blood can be removed
through a catheter or through a special artery and vein that are created under the scan, called an AV fistula or a graft. Which type of access you have will be decided by you and your care team. A typical dialysis procedure
occurs over three to four hours and most people require three
to four treatments per week. How much dialysis you
need will depend on you, your blood work, the
chemicals in your body. And those things will be
monitored by your healthcare team and shared with you when deciding how much dialysis you need.>>When you first get to the clinic, you will get your weight checked. This helps your team to see if you have any extra fluid on you since your kidneys are not working well. You will learn that your dry weight means the weight your body’s at when it does not have
any extra fluid on it. If it has extra fluid, the
dialysis machine helps it take that extra fluid off. Your team will also talk with you about ways to prevent this from happening. Next you go to your dialysis chair. Most dialysis chairs recline and have a heat and vibration setting. I like to put mine on the
highest heat setting possible.>>Hi Kaylee, how are you today?
>>I’m good.>>I’m gonna go and take
your blood pressure, okay?
>>Okay. This is where you get your blood pressure and your temperature taken. Then it is time for dialysis. There are a lot of things to do when you are getting dialysis. Some of my favorite things to do are color, read, talk, and listen to music. Check out all the other fun things that you can do while
you are getting dialysis. (hopeful instrumental music) Some kids get the other kind of dialysis I mentioned earlier, called
peritoneal dialysis, or PD. That is done in the patient’s home.>>For people who received
peritoneal dialysis, the toxins and waste products and water are actually removed
from the blood vessels that line the abdominal cavity. In this procedure, fluid is instilled into the abdominal cavity, the waste products and
water pass into that fluid, and then the fluid is drained. The filling and draining of
that fluid is usually done with the assistance of a
machine called a cycler. In addition, the people
doing the procedure are actually the person
with end-stage renal disease or their caregivers, their
parents or other caregivers. The person who has end-stage renal disease and their caregivers
receive extensive training so that they can perform
this procedure at home. In addition, the team is always available if they have questions when they’re doing the procedure at home. The procedure is usually done at night so that the person can
sleep while it’s happening. And then they can go on
their daily activities, school or work or other activities, without needing to be on dialysis. If you are on peritoneal dialysis, you will come to the unit
at least once a month. At that time, you’ll have blood work done, you’ll get your height checked, your blood pressure checked,
your weight checked. And you’ll see a doctor, a dialysis nurse, a dietician, social worker, child life specialist,
and behavioral therapist.>>This is one of the PD clinic rooms and this is what a PD
dialysis machine looks like. There’s a whole lot of equipment that needs to go in your
house if you’re on PD and a lot of training involved. Your team will talk with you about which type of dialysis is
best you and your family. Thanks so much for joining me on a tour of our dialysis clinic today. I know that learning about something so big and new like this can
feel scary and overwhelming. But just remember, there
is a whole team here dedicated to taking the best care of you, just like they do for me.

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