DIALYSIS PROVIDES LIFE TO MANY WITH KIDNEY PROBLEMS

Katherine Layton of Perryville, relaxed with her television during her dialysis treatment which takes about four hours.

Ernie Poole of Whitewater passes the time watching television or looking at the birds flying past his window. He jokes with the nurses and gives them miniature chocolates.

He doesn't seem to mind being hooked up to a dialysis machine three hours a day, three days a week at the Cape County Regional Dialysis Center at the St. Francis Healing Arts Center. "I guess you could say I'm lazy," he said while reclining in his seat. "I get to lie back in this chair, watch TV. It's not too bad."

He knows he is passing his time for good reason. If he weren't there, he knows he wouldn't be anywhere. "It's the best thing to happen to me under the circumstances," he says. "If I wasn't on dialysis, I wouldn't be here right now."

Poole, 62, who has been on dialysis for 13 months, is one of nearly 100 patients in the Cape Girardeau area and more than 200,000 patients nationwide who are given life through dialysis. The Cape County Regional Dialysis Center sees 250-300 patients yearly from Southeast Missouri and Southern Illinois.

Dr. Ahmed Aboul-Magd of the Regional Dialysis Center says dialysis is a process by which waste, toxins and excess water are removed from a person's body and exchanged for some materials the body needs. Patients who undergo dialysis are those who experience a significant loss of kidney function.

Aboul-Magd says the kidneys' main function is to remove waste and excess water from the body. The kidneys also maintain the body's balance of salts, such as sodium and phosphate, as well as acids.

When the kidneys fail, usually due to high blood pressure or diabetes, he says a person loses the function to remove the toxins and excess water and has to either be put on dialysis or have a kidney transplant.

There are two types of dialysis a person may undergo. An article from "The New England Journal of Medicine" said hemodialysis is the most common dialysis procedure. In this process, a machine is used to draw a person's blood through a shunt, most commonly in the upper forearm, joining a vein with a larger artery. The vein then gets larger and thicker, making it easier to access with a needle.

Waste is then exchanged for needed materials between the blood and a dialysis solution through a special membrane. The process takes from two to four hours, and patients undergo this three times a week.

A machine is not necessary for the other type of dialysis, peritoneal dialysis. Instead, a dialysis solution is infused into the abdominal cavity, or the peritoneal cavity, through a catheter. The exchange of waste for the needed materials occurs between the blood and the solution through the natural membrane of the abdominal cavity. The waste is then drained after about 45 minutes, and the process is repeated.

Aboul-Magd says there are risks and side effects to dialysis. There is a loss of appetite due to the process, and this often leads to malnutrition. Dialysis doesn't perform all the functions of the kidneys. It doesn't stimulate the bone marrow to produce red blood cells, leaving many patients anemic.

High blood pressure is another effect of the treatments, and he says a long-term effect is the disposition of protein in the joints, causing pain.

Dialysis also has an effect on a person's way of life. Gary Baker, 54, of Pocahontas, has been on dialysis for 28 months and misses his landscaping work. "You're not able to work anymore," he says. "You just get too tired."

Dan Young, 58, of Cairo, Ill., has been on dialysis for 29 months. He says he gets depressed sometimes because he is on dialysis. "It's about confinement," he says, but he is quick to point out that the staff at the dialysis center cheer him up.

"The people here are the most wonderful people in the world," he says. "They pick me up. They help me keep my focus."

The other alternative for people with kidney failure is a kidney transplant. The nearest cities that provide transplants are St. Louis and Memphis. Aboul-Magd says there are advantages to kidney transplants as well as problems. The overall quality of life is better after a kidney transplant, and it is cheaper in the long-run.

A kidney transplant operation costs $150,000 plus additional doctor visit costs compared to $40,000 to $50,000 a year to be on dialysis.

Aboul-Magd warns of some problems with transplants. Some patients' bodies reject the new kidney. To protect from rejection, a patient is given medication to suppress the immune system and, therefore, a patient becomes more susceptible to infection and illness.

Poole knows about the risk of kidney rejection. He remembers a fellow patient at the center who died after receiving a kidney transplant. "He was a happy guy," Poole says. "He wanted a kidney, and they don't pass those things out at Wal-Mart, so he had to wait." The man received the call one day, and his wife took him up to St. Louis for the operation.

"But his body didn't accept it," Poole says, "and he isn't around anymore. Those are the risks you need to take." He looks at it as dialysis and kidney transplants are necessary to be living.

So Poole passes time watching birds and television, joking with the nurses, enjoying the life he has been given.

"You lose three days a week out of life," he says, "but at the same time you gain life."