Dialysis Day has arrived!

The day for dialysis has arrived... December 1st, 2018!  During our normal morning call to the NICU, among many encouraging news updates, the day shift nurse stated that Nephrology has decided that today would be the day to start dialysis.  The nephrology team did consult pediatric surgery to evaluate Channing’s surgical wounds and after a wound check, cleared nephrology to begin dialysis. The team waited for Vanessa and I to arrive to his room to start the process of dialysis.  The nephrologist thoroughly informed us of the process Channing was about to begin--a remarkable life saving process of dialysis.
His dialysis catheter was flushed by a nurse that specializes in peritoneal dialysis (PD), cultures were proactively taken to test for possible infection, and the first round of dialysis  began without complication.

10 milliliter per kilogram are given by a gravity drip system into Channing’s peritoneal cavity.  Based on Channing’s weight, 30 mL is used and will increase as his weight increases as well as the space in his abdomen grows.  Additionally, the concentration of the fluid used for his dialysis, essentially sugar water, can change as well.  We are learning that this is a very slow and particular process ,patience is a virtue.

 To sum up the process simply:  30 mL of solution is given to Channing by gravity drip, which should be under 5 minutes to compete.  The solution "dwells or stews" for 45 minutes in his peritoneal cavity, which by osmosis draws fluid/toxins in his blood away from his body.  After the 45 minutes, the fluid is allowed to drain for 10 minutes.  The goal is to have more fluid than what is given (30 mL), which is fluid taken away from his body.  This process is acting like kidneys... what comes out is essentially urine, and the amounts will increase with time

Today’s first round:
30mL of dialysis fluid (sugar water) after 45 minutes, it was drained and 33 mL of fluid exited his catheter. 3mL of fluid was pulled from Channing.  Another round followed and 7 mL was pulled off, and another followed and 4 mL was pulled.  Many adjustments in the future will take place, however this is ONE AMAZING START.

Lastly, a very important piece of this process Vanessa and I learned today is that the kidney’s produce a protein to stimulate bone marrow to make red blood cells.  In Channing’s case, he does not have kidneys and will not be making the protein, epoetin.  He is now being supplemented with this as well and will be for the rest of his life; more to follow as we progress.

Positive quote of the day:  "Look for something positive each day, even if some days you have to look a little harder". -Anonymous