A new exercise program unique to us and designed by a multidisciplinary team at the Washington University Dialysis Center is riding the wheels of success. More than one-third of those on dialysis at the center are exercising during hemodialysis by pedaling a bicycle. The exercise program has resulted in multifaceted benefits including better mental function, increased endurance, improved sleep and positive effects on blood pressure.
Home Dialysis Modalities
The full spectrum of home dialysis modalities is offered including peritoneal dialysis, short daily and nocturnal dialysis.
In Center Nocturnal Dialysis
In Center nocturnal dialysis is offered at the Washington University Davita West Dialysis Center.
Transonic Vascular Access Monitoring
The Washington University Dialysis Center and the Chromalloy American Kidney Center offer transonic vascular access monitoring for their patients, which often preempts graft clotting and the need for extra procedures for patients. Transonic monitoring measures the amount of blood flow through a patient’s access. Patients with fistula access are measured annually and patients with a graft are measured quarterly. Patients who fall below a standard measurement of blood flow receive a fistulagram, a test that checks for the presence of stenosis or closing of a graft.
Education and Support
Peritoneal Dialysis Support Group
A monthly support group is offered for peritoneal dialysis patients. The informal, small group generally meets the first Tuesday of every month from 10:30 a.m. to Noon at the Washington University Dialysis Center, 4205 Forest Park Blvd. The group’s purpose is to provide time for people, who are oftentimes isolated, with a place to create friendships and share helpful hints, problems or concerns. Typical sessions include a speaker, discussions or games. For more information, call 314-286-0822.
Two staff nurses are trained as diabetes educators and provide comprehensive diabetes education to all diabetes patients during dialysis. Along with the social worker and dietitian, these nurses regularly evaluate patients on their knowledge of the disease and provide helpful information.
The Dialysis Center provides a monthly foot clinic for diabetes patients. During dialysis, diabetes patients are seen by foot care nurses to check for problems and address any concerns. Nurses also recommend follow-up foot care.
Inpatient Dialysis Unit
Barnes-Jewish Hospital proudly opened an expanded, state-of-the-art acute dialysis unit for inpatients who require dialysis. With 12 stations, two satellite stations and "bedside" capabilities, the unit provides 24-hour coverage and support for dialysis services. To provide care for patients in areas such as Surgical, Burn and Trauma ICU, Medical ICU and Cardiothoracic/Transplant ICU, highly specialized registered nurses perform the dialysis treatments as part of the multidisciplinary team.
The Acute Dialysis inpatient unit offers continuous venous-to-venous hemofiltration (CVVH) or continuous renal replacement therapy. This advance in the treatment of renal failure offers several advantages over traditional dialysis methods when used in critically ill, unstable patients. Like its predecessor, continuous arterio-venous hemofiltration (CAVH), CVVH provides continuous renal replacement therapy, thus allowing removal of solutes and modification of the volume and composition of the extracellular fluid to occur evenly over time. Unstable patients, who are often intolerant of the abrupt fluid volume and solute concentration changes that accompany standard hemodialysis treatments, can usually be treated safely with CAVH or CVVH.
Therapeutic Plasma Exchange
This therapy is for patients who require plasma separation. Therapeutic plasma exchange (TPE) is a process to separate plasma from whole blood and is exchanged with an equal amount of a replacement fluid. This process is used to treat hematological and oncological disorders such as Waldenstrom’s macroglobulinemia, idiopathic thromocytopenic purpura and systemic lupus erythematosus. Neurological disorders such as Goodpasture’s syndrome, anti-GMB nephritis and Guillain-Barre syndrome also respond to this therapy. The Acute Dialysis unit is one the few facilities in the St. Louis and surrounding area to provide this procedure.
End-Stage Renal Disease Pre-Treatment Planning Program
Barnes-Jewish Hospital offers a comprehensive educational component for patients newly diagnosed with end-stage renal disease. Social workers present an array of educational tools specially designed for patients. Patients learn about their kidneys, and are taught how to evaluate their own lab values. Staff members discuss insurance issues and emotional needs as well as information about the Missouri Kidney Program and other local resources. Patients tour the dialysis center and have the opportunity to schedule appointments with the center’s dietitians.
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