Frequently Asked Questions


Nephrology


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:

¨ Diabetes
¨ High blood pressure
¨ Arteriosclerosis
¨ Infections
¨ Heredity

Symptoms of Kidney Disease:

¨ 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.


 



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