A
Nephrologist, often called a kidney doctor, is a specialist in Internal
Medicine who has received additional training in the medical treatment
of patients with kidney disease. This training qualifies the
Nephrologist to treat kidney disease in a comprehensive way, since
diseases of the kidney may affect the function of other body organs.
The
diagnosis and treatment of kidney disease includes the treatment of
conditions that these diseases can produce, such as high blood
pressure, as well as the treatment of other diseases that can cause
kidney failure, such as diabetes mellitus and polycystic kidney disease.
Dr.
Chawla, Medical Director of Sun Health, was the first Board Certified
Nephrologist in Joliet. He introduced Nephrology to Provena Saint
Joseph Medical Center in 1981.
Dr. Chawla sees patients with
kidney disease in the Chronic Kidney Disease Clinic. He monitors bone
disease, offers anemia management with an on-site lab and Procrit
therapy, recommends Medical Nutrition Therapy, and prepares patients
for dialysis or transplantation.
Based on years of nephrology
experience, Dr. Chawla envisioned a dialysis unit equipped with the
latest technology and certified staff offering quality dialysis
treatments. Sun Health Dialysis Unit was established in 1991, and
remains the only physician owned and operated unit in the area.
Chronic Kidney Disease Clinic
What is Chronic Kidney Disease?
Chronic
Kidney Disease is damage to the kidneys, which prevent them from doing
their jobs. Common causes of kidney disease include:
¨ High blood pressure ¨ Excessive or diminished urination ¨ Foamy urine ¨ Swelling of ankles, feet or fingers ¨ Shortness of breath ¨ Funny taste in mouth ¨ Nausea, vomiting, lack of appetite
Diagnosing Chronic Kidney Disease
A
blood test called a GFR (Glomerular Filtration Rate) can determine if
you have kidney disease. The National Kidney Foundation has categorized
chronic kidney disease into stages based on GFR and recommends
treatments for each stage.
Stage 1: GFR is normal or slightly
increased. The National Kidney Foundation recommends that you be
followed by your primary doctor. It is very important to have your
cholesterol, blood pressure, and blood sugar under control. Your doctor
may have diet and exercise recommendations for you. One of the most
important things you can do is stop smoking.
Stage 2: GFR is 60
- 80. The National Kidney Foundation recommends that your primary
doctor continue to manage your cholesterol, blood pressure and blood
sugar.
Stage 3: GFR is 30 - 59. The National Kidney Foundation
recommends referral to a Nephrologist (kidney specialist) at this point
for management of complications including bone disease and anemia.
Recommendations also include Medical Nutrition Therapy with a dietitian
to slow the progression of kidney disease. In addition to Medical
Nutrition Therapy, Sun Health offers Kidney Classes for people in Stage
3 of Chronic Kidney Disease. These classes review kidney function,
diet, exercise and help you manage your disease.
Stage 4: GFR is
15 - 29. At this stage the Nephrologist continues to work with you to
slow the progression of kidney disease and manage any complications you
may have from kidney disease. He or she will also begin to prepare you
for kidney dialysis or transplant. The National Kidney Foundation also
recommends referral to a surgeon for placement of dialysis access.
Sun
Health offers Therapies Classes for people in Stage 4. This class
reviews treatment options for kidney failure, including hemodialysis,
peritoneal dialysis, or transplant.
Stage 5: GFR less than 15. When the GFR falls below 15, it is time to start dialysis.
Sun Health Chronic Kidney Disease Clinic
Patients
are referred to the Sun Health Chronic Kidney Disease Clinic anytime
between Stage 3 and 5. Dr. Chawla, a nurse, dietitian and social worker
will work with you and your primary doctor to slow the progression of
kidney disease and treat any complications that can develop.
People
in the early stages of kidney disease may only be seen in the Chronic
Kidney Disease Clinic once a year. As kidney disease progresses, you
will be seen more frequently, depending on your needs. Between the
stages of 4 and 5, you will be seen in the office weekly to help
prepare you for dialysis. The first dialysis treatment is always done
in the hospital with a short admission stay. Patients who are followed
in the Chronic Kidney Disease Clinic are usually in the hospital a day
or two. However those who have not been followed in a clinic can expect
a hospital stay of a few weeks to initiate dialysis.
Please call Diane Barnes MS RD CSR @ 815-744-9300 for additional information.
Dialysis Unit
Sun
Health Dialysis is dedicated to providing excellence in patient care.
We offer the latest technology available in a friendly and
compassionate environment. Special attention is placed on patient
education and support.
Dr. Chawla, Medical Director of Sun
Health, was the first Board Certified Nephrologist in the Joliet area.
Sun Health Dialysis Unit was established in 1991, and remains the only
physician owned and operated dialysis unit in the area.
A one
to three staff to patient ratio ensures individualized, quality care.
Each patient has a primary nurse who will review monthly lab values,
medications, provide educational information, and help make the
transition to dialysis as smooth as possible. The dietitian and social
worker also see each patient on a regular basis.
Sun Health
has the highest percentage of certified renal staff in Will and Grundy
Counties. A majority of our nurses are Certified Nephrology Nurses
(CNN), which involves continuing education in the renal field. Our
technicians are also dedicated to the highest quality patient care and
many are certified in hemodialysis (CHT). Sun Health also has the
highest percentage of RN staff in the area. Nurses and technicians
regularly attend education seminars.
Our dietitian, Diane
Barnes, is also a Certified Specialist in Renal Nutrition. Diane meets
with patients on a regular basis, usually monthly or as often as
needed. She offers assistance with dietary questions, teaches the
importance of potassium, calcium, and phosphorus, and helps patients
understand the complicated renal diet. Diane is also available for
family members who are at a loss on what to cook for their loved one
receiving dialysis treatments!
Social Services are very
important at Sun Health. Judy Munoz, our Social Worker, is available to
help with transportation and medication needs. She also has access to
community services and is able to access help from the National Kidney
Foundation or The Sun Health Kidney Foundation. Patients and family
members are welcome to talk to Judy about any support they may need.
Renal
rehabilitation is also an important part of the dialysis process. Sun
Health offers patients the opportunity to participate in a bike program
and attend educational workshops and support programs. This program
received national recognition at the National Kidney Foundation?s
annual meeting and is showcased on the Life Options Renal
Rehabilitation website (www.lifeoptions.org).
Kidney transplant
is encouraged to all who are eligible and Sun Health offers literature
and listings of all Illinois and Wisconsin transplant centers and
educational workshops for patients and family members.
In
order to keep patients as healthy as possible, the Sun Health staff
pays close attention to grafts and fistulas, a patient's lifeline.
Venous pressures are monitored with each treatment as elevated
pressures may indicate narrowing of the vessel. Sun Health also has a
special computer device that shows any blockages in the graft or
fistula during a dialysis treatment. The device is called a Transonic
and is performed during dialysis with results available immediately.
Finding problems before an access clots helps reduce missed treatments
and hospitalization for vascular access repairs.
Dry weights
are also very closely assessed at Sun Health. If a patient has too much
fluid removed during treatment, he or she may feel washed out, have
blood pressure problems, and not feel well in general. On the other
hand, not enough fluid removal can result in excessive coughing, only
being able to sleep in a sitting up position, and many hospital
admissions. A patient?s primary nurse will monitor his or her dry
weight during treatment with a device called a crit line. This machine
shows when too much or too little fluid is being taken off during
dialysis. Another technology, called a Bio-Z, measures fluid in the
chest.
The dietitian monitors dry weights with a very
specialized piece of equipment called a BIA. This test gives a very
detailed account of body composition, including fluid status. Using a
combination of these techniques, the patient, physician, nurse and
dietitian can decide on the best dry weight for each person.
Many
dialysis units will re-use the artificial kidney, or dialyzer, many
times. To ensure the highest quality treatments, Sun Health Dialysis
gives patients a new dialyzer each treatment.
Patients are
welcome to make use of the library stocked with books, magazines,
movies and tapes or play bingo during treatment. With our 13 stations
including cable TV, access to VCR, comfortable recliner chairs, and
friendly staff, we make you feel at home. Please call 815-744-9300 for
additional information.
Renal
Rehabilitation Award for Excellence in Education, Encouragement, and
Exercise. Presented at the Annual Meeting of the National Kidney
Foundation, November 1998.
National Kidney Foundation "Loving Care Award" Top 5 Finalist in Illinois. Presented in Chicago, September 2000.
Dialysis
Access Planning and Management Award, top 3% of 428 dialysis programs
located in a four state region (Illinois, Indiana, Ohio, and Kentucky).
Presented at the Annual Convention of the Renal Network in
Indianapolis, May 2003.
