kidney care

Dialysis treatment time—every minute counts! A message from our CMO.

Education - , -

For most in-center patients, hemodialysis means three treatments per week, each four hours in duration. The weekly total of 12 hours represents a small fraction (less than 10%) of the round-the-clock work normally performed by healthy kidneys to continuously clean the blood. Removing the toxins and excess fluid that accumulate in-between treatments requires maximizing every minute of your treatment time.

It is not uncommon that patients may wish to come off dialysis early for a variety of reasons—fatigue, muscle cramping, even boredom, to name a few. While they may not feel any immediate symptoms, shortening treatment time can have a negative long-term impact on overall health. Coming off early once can easily become a recurring pattern of behavior.

Raghu Durvasula, MD, MHA
Chief Medical Officer

Finishing dialysis even five minutes earlier than prescribed would result in 13 hours of missed dialysis time over the course of the year, the equivalent of more than three skipped treatments!

As a result, wastes inevitably begin to accumulate leading to patients feeling unwell, with reduced energy, poor appetite, chronic nausea, shortness of breath, and worsening blood pressure control.

Furthermore, a reduction in treatment time is known to be associated with increased risk of emergency department visits and hospital admissions, while ultimately reducing long-term survival.

If you are having difficulty completing your full treatment, be sure to discuss it with your care team. It is important to figure out why, then find solutions that could help you get through the entire treatment as prescribed.

Every minute counts, so don’t cut yourself short. Staying well-dialyzed will keep you healthy and energetic, so that you are better able to enjoy those activities and life pursuits that matter most to you!

The incredible impact nutritional supplements can have on people with kidney disease

Health - , , -

Each year, donations and financial support received at our Gift of Life helps us provide nutritional supplements for patients who can’t afford them and will truly benefit from them. These patients may be struggling with food insecurities, are recovering from surgeries or illnesses, or need extra calories to maintain their nutrition health.

Our dietitians have several options for patients that qualify: Nepro, Boost, LPS (liquid protein supplement), protein bars, and protein powders. Each of these nutritional supplements help patients get the calories, protein and nutrients they need to heal and survive. Our patients have expressed great gratitude for having these available. Here are words of appreciation from just a few of them:

• A 90-year-old veteran of the three military branches had been underweight and was not able to make a meal before coming to dialysis. Jennifer, his dietitian, started him on Nepro every day to increase calories. She says: “He has gained three kilograms and is now having an English muffin with peanut butter, with his morning coffee. It has stimulated his appetite and his energy levels. He is still able to walk himself to and from his dialysis chair, which has been an encouragement to younger patients.”

• Kathryn, one of our dietitians, recalls how grateful one of her patients that lives in a nursing facility was to get protein bars. “I had tried getting the facility to provide the bars for her, but that wasn’t an option. She is appreciative of all we do to help her.”

• Lilly, another one of our dietitians, remembers how some Nepro and Boost supplements provided by PSKC helped a patient get through these hard times. “I have a patient who recently had hip surgery and has been dealing with the pain, which affects her appetite a lot. She has so many medical bills in the past few months, and she is not able to afford any protein supplements.”

A big thank you to all donors who have helped fund our nutrition supplement program! Your support has a major impact on the patients we serve.

Kidney care comes full circle

Patient stories, Staff - , , , -

Jacee Numbrado, dialysis tech at the Cogen Center in Bremerton.

At the young age of 18, while living in the Philippines, Jacee Numbrado was diagnosed with glomerular nephritis, resulting in end-stage kidney disease. He had been experiencing gouty arthritis symptoms for a week when he awoke one night with such intense pain, he was taken to the hospital where lab studies revealed a high creatinine level. He was given the choice of treating his condition with medication or starting dialysis. Jacee opted for medication which sadly did not help— he ended up going on dialysis two times a week while living in the Philippines.

Jacee and his family moved to the United States in 2019; he started dialysis at Olympic Peninsula Kidney Center (now Puget Sound Kidney Centers-Cogen Bremerton) that June. Soon after, with the support of clinic staff—who Jacee says “were always positive, made him feel comfortable and hopeful”—Jacee decided to pursue a kidney transplant.

In August 2021, Jacee received a kidney transplant at Virginia Mason. He did well during his weeklong stay in the hospital and was then released for observation at home for a month.

In July 2022, Jacee was hired as a dialysis technician at Puget Sound Kidney Centers-Cogen Bremerton. He is now helping provide care where he himself received care—a true full circle. Jacee wants to bring back what he received as a patient—hope and positivity.

“Every day is a new day and the staff at PSKC made this possible for me,” he says, “so I hope to do the same for patients I care for.”

Evolution of Life-Saving Dialysis

History - , , -
Kathy Harvey

Kathy Harvey
Director, Renal Nutritional Services

In 1980, I was working as a new dietitian in Seattle at one of the very few dialysis centers in the Northwest. My patients traveled from all over the Puget Sound to get their dialysis treatments, coming from Snohomish, Skagit and Island counties. I remember one patient who drove down Whidbey Island, took the ferry and then drove into Seattle for dialysis. The journey took all day, she did it three days each week, and it was totally exhausting for her and her husband!

When the people of Snohomish County suggested building a dialysis clinic nearby, the Seattle provider offered to open one in that area. But the locals said “no thank you, we want our own.” They worked together to gather community support and funding from local businesses, the State of Washington and the federal government. In April 1981, Puget Sound Kidney Centers was open for business.

From the beginning, PSKC had a reputation for being innovative and independent. Because it was community based, small and locally managed, its staff could quickly research, discuss and make decisions about dialysis treatments, therapies and medications. When I toured the clinic in those early days, I was impressed by the newer, more efficient dialysis machines and water treatment system. The clinical practices and policies were also cutting edge. PSKC seemed to go above and beyond to provide the best patient care. They didn’t wait to follow the leader—they became the leader.

Naturally, when I was offered the opportunity to join PSKC in 2001, I was thrilled since I had always admired the organization. One of the first things I recognized was how smoothly things got done, especially when it came to bringing in a new therapy. It was researched and discussed by many, with medical staff, clinic staff and patients giving their opinions, but the final decision always focused on “patients first.”

After my 20 years here, PSKC continues to provide cutting-edge dialysis services and treatments. Due to generous donations and grants, it is one of the only providers to offer free nutrition supplements to patients in need. PSKC’s education program ‘Survive and Thrive’ uniquely targets people with early-stage kidney disease, teaching them how to stay healthy and keep their kidneys working. After all these years at PSKC, I can still say I am proud to be part of this great team and privileged to work with the brave dialysis patients who choose to live every day.

March is National Kidney Month!

Education - , , , -

One of our free, virtual ‘Survive and Thrive’ classes about chronic kidney disease. Sign up for ​classes at www.pskc.net/classes.

March is National Kidney Month, a time to raise awareness of kidney disease. Learn more about chronic kidney disease — commonly called CKD — and just how vital your kidneys are in making your body function.

What kidneys do

Kidneys filter blood and remove waste. They also control blood pressure, produce red blood cells, balance electrolytes, and help you maintain healthy bones and a normal pH level.

One fifth of the blood pumped by your heart goes to the kidneys, where it is processed and filtered. Excess water, salt, minerals and waste are sent to the bladder as urine and ‘clean’ blood is returned to circulation. It takes just five minutes for all of your blood to be filtered by the kidney which means in 24 hours, your kidneys will filter all of your blood 288 times!

Watch the video below to learn more about these incredible organs.

About chronic kidney disease

Chronic kidney disease happens when your kidneys lose function over time. Although chronic kidney disease is irreversible, it can be slowed. If your kidney function drops to a certain level, dialysis or a kidney transplant is necessary.

The two main causes of chronic kidney disease are diabetes and high blood pressure. Other causes of CKD include inherited diseases, inflammatory diseases and infections.

How to keep your kidneys healthy

1. Keep your salt intake to a minimum. Foods high in salt can put a strain on your kidneys. Try to keep your sodium intake to less than 2,000 milligrams per day. Avoid high-sodium restaurant meals and processed foods. Instead, make meals at home, with healthy ingredients.

2. Watch your blood pressure. Controlling your blood pressure is the single most important thing you can do to help prolong the life of your kidneys.

3. Stop smoking. Smoking substantially increases your risk for all kidney-related problems, including heart disease.

4. If you have diabetes, control your blood sugars. For more than 40 percent of people with kidney failure, diabetes is the cause. Work with your doctor to help control your blood sugar.

5. Exercise regularly. Exercise helps you maintain a healthy weight and controls your blood pressure. Walking, light weights, yoga, gardening — all of these are great ways to get exercise.

6. Avoid over-the-counter anti-inflammatories. If you have chronic kidney disease, avoid anti-inflammatory medications like ibuprofen, Advil and Motrin. If you do not have chronic kidney disease, use these medications only as needed.

7. Have your kidneys checked on a regular basis. Kidney disease is often silent, showing no symptoms until you approach the need for dialysis or transplantation. Having your kidneys checked on a regular basis can help identify problems earlier.

Learn more ways to keep your kidneys healthy

Interested in learning more about kidney health? Consider taking one of our free classes! Our virtual classes include one-hour free webinars on kidney health eating, exercising and more. Visit www.pskc.net/classes to sign up for one of our upcoming sessions!

Our Lakewood center opens its doors, a beautiful new facility to serve Pierce County patients

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About the state-of-the-art center

On Oct. 3, 2019, over 100 people came out to celebrate the opening of our new dialysis center in Lakewood, WA. Guests enjoyed tours and refreshments at this beautiful facility. At full capacity, this new 29-station dialysis center will accommodate up to 174 in-center dialysis patients. The center, designed by Botesch, Nash & Hall, was created to be a warm, welcoming and comfortable environment for patients and visitors.

“This new facility reflects our ongoing desire to provide a high quality and beautiful care environment for our patients, all in an effort to enhance their quality of life,” says Harold Kelly, PSKC president and CEO.

The 18,150 square foot facility includes three isolation rooms and a permanent bed for patients who need to lie down during dialysis. The facility will house a specialized training area for home dialysis patients, and the center will host free kidney health education classes for patients and the broader community.

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Left: Harold Kelly, president and CEO at PSKC, addresses the crowd at the opening ceremony. Right: Our Lakewood staff are ready to serve our new patients in the area.

Introducing our Lakewood medical director

Dr. Ramon Anel has practiced for over 24 years, specializing in critical care medicine and nephrology. He graduated from the University of the Philippines Manila College of Medicine and completed his residency at Advocate Illinois Masonic Medical Center in Chicago. Dr. Anel currently practices with the Providence Medical Group in Olympia.

Medical directors are an important part of the Puget Sound Kidney Centers team as they are responsible for assuring the safety and quality of care patients receive at each unit. They are also responsible for implementing the quality advancement projects that assure PSKC continues to identify areas for improvement and innovation. In this capacity, Dr. Anel serves along with a team of professionals that include nurses, technicians, renal dietitians and social workers.

“Dr. Anel has been instrumental in introducing PSKC to the Lakewood community,” says Jenni Tyner, director of nursing at PSKC. “We are delighted to partner with him as we serve the dialysis community of Lakewood.”

Welcome, Dr. Anel, and thank you for your leadership.

Puget Sound Kidney Centers has seven dialysis centers in Washington state. See where we’re located and learn more about us. You can even follow us on social media – we’re on Facebook, Instagram, Twitter and Pinterest.

Kidney-Friendly Summer Recipes

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It’s now officially August, and that means it’s the hottest time of year for many of us. Whether you’re planning on having friends and family over, or simply cooking for one, the recipes below are absolute musts. They’re packed full of flavor and low in salt — the perfect combination for people with kidney disease (and their friends and family too)! Here’s a brief look at our top summer foods, with links to the full recipes as well.

Chili Lime Dip With Veggies

The perfect appetizer for any summer meal, this Chili Lime Dip recipe is just as scrumptious as it is easy. Limes are a great way to add flavor and acid to a dish, and they really come through in this one. Chop up some carrots and peppers and you’re good to go!

 

Chicken ‘n’ Grape Salad Sandwich

With both celery and grapes included in this recipe, you’ll have plenty of crunch when you sink your teeth into this delicious sandwich filling. Not only is this one kidney-friendly, it’s easy to whip up as well! Check out the full Chicken ‘n’ Grape Salad Sandwich recipe to see just how simple it is to make.

 

Thai Shrimp Kebabs
Thai shrimp kebabs
Looking for a way to mix up your barbecue menu? Look no further than this recipe for Thai Shrimp Kebabs! Like spicy foods? Load on extra marinade for a bigger kick, then pair with our next recipe for a balanced bite.

 

Asian SlawcoleslawThis Asian Slaw recipe could be included in just about any meal, especially one served in summer. The classic cabbage, grapes, carrot and apple combination is tasty and crunchy, especially when drizzled with such a light dressing.

 

Lemon Loaf
Lemon loaf
Every summer meal needs a light and refreshing dessert, and we strongly recommend considering this Lemon Loaf recipe. With bright, citrusy notes, this dessert is easy to make ahead of time and slice up on demand.

 

Want more kidney-friendly, low sodium recipes for summer, and every season? Check out our recipe page for more!

Kidney-Friendly Superfoods

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Should you choose natural foods over processed or packaged foods? Yes and here’s why! Many fruits and vegetables have antioxidants, vitamins and other nutrients that help keep your body strong and healthy. Although some of the healthiest choices are high in potassium, smaller servings can usually be added if you need to limit potassium. Ask your dietitian if these kidney-friendly superfoods are right for you.

Apples are a good source of fiber, which can lower cholesterol and blood sugar. The apple peel has extra antioxidants, which can help protect brain cells.

Blueberries are high in antioxidants that help protect against cancer and heart disease. They also have fiber and vitamin C, good for immune health and digestion.

Fatty fish like salmon and albacore tuna are good sources of omega-3 fatty acids. These can help control clotting, improve heartbeat and blood pressure, and lower triglyceride levels.

Kale is packed with vitamins A and C, calcium and other minerals that support eye-health and have anti-cancer benefits.

Strawberries are loaded with fiber, vitamin C and antioxidants that help protect your heart, prevent cancer and fight inflammation.

Spinach is high in vitamins A, C, K and folate, nutrients that help boost your immune system and protect your vision.

Sweet potatoes are full of beta-carotene, vitamins A, C and B6, and fiber. These nutrients boost your immune system and help your vision, red blood cells, cholesterol and digestion.

Look for recipes that include these superfoods for delicious and healthy eating, and make sure to try this delicious recipe for fruit salsa!

Want more kidney-friendly, low sodium recipes? Check out the recipe section of our website!

Survive and thrive with Tena!

Patient stories - , , , -

Happy World Kidney Day! Whether you’ve just been diagnosed with chronic kidney disease, have been on dialysis for some time or are waiting for a transplant, there are a number of ways to prolong the life of your kidneys and improve your overall health.

Two years ago, Tena saw a brochure at her nephrologist’s office for PSKC’s Survive and Thrive with Chronic Kidney Disease program, a free community class hosted by PSKC year round. The goal of the program is to teach people with early kidney problems about making successful lifestyle changes. Subjects covered include healthy eating, exercise, blood pressure management, coping with kidney disease and treatment options. In class, participants meet with a doctor, physician assistant, social worker, dietitians and patient mentors.

Tena H. learned more about dialysis through our Survive and Thrive program.

Tena was newly diagnosed with stage three CKD and had a lot of questions and concerns about living a healthy, happy life. After attending the first class, Tena started to feel that “this disease is not a death sentence and there’s a lot of hope.” Specifically, Tena found hope and support hearing from members of the patient organization, The Road Back to Life. “They really make you listen and know you’re not alone.”

After completing the classes, Tena said she learned many new skills to promote her health or, as she calls it, develop a “new normal.” She learned that the nutrition piece and social work piece are just as important as the nephrology visits. She also learned how to appropriately read food labels, cook with different herbs and spices, and plan ahead to carry out a fulfilled life. Tena’s support network expanded as well. She said she walked away from the class feeling that “when you share, you can connect.”

Now Tena is taking what she learned in class and bringing it to her community. Most recently she connected with PSKC social workers to talk with her peers about advance care planning. Thank you, Tena, for sharing your story and helping us ignite new conversations about health and wellness!

Learn more about our free classes at www.pskc.net/classes.

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