Proposal on Kidney Failure:

Introduction:

The issue we chose to discuss is the treatments for kidney failure. Kidney failure

occurs when the kidneys can no longer remove the harmful particles from the blood while

keeping the essential ones, as well as regulating the concentration of the blood. Particles

such as hemoglobin are essential to the human body, while waste products such as urea

should be removed to maintain the body’s normal processes. Basically the kidneys serve

three functions in the body: filtration, reabsorption, and secretion. When the kidneys fail

to function properly one must resort to dialysis. Dialysis is necessary for survival

because the build up of toxins in the blood and tissues can no longer be filtered out

naturally by the kidneys. “Uremia, which literally means “urine in the blood”, will occur

and eventually cause death.” There are two types of kidney dialysis. Hemodialysis uses a

machine with a filter that allows blood to flow through while removing waste products.

Afterwards, the clean blood is then pumped back into the body. When doing peritoneal

dialysis, instead of using an artificial membrane the process involves using the lining of

the patient’s abdominal cavity as a dialysis membrane. The patient’s abdominal cavity is

injected with fluid and solutions diffuse into this fluid from the blood. This fluid is then

removed after several hours, and the patient is injected with new fluid. Patients suggest

that except for the initial stick of the needle, dialysis is not painful. Approximately

217,000 Americans receive dialysis, which costs an estimated $11.1 billion nationwide.

“Dialysis is an option for those whose kidneys temporarily do not function, until the

patient receives a transplant, or for years if those options are not available. Many patients

receiving dialysis can still live normal lives, although research has shown that American

dialysis patients do not live as long as patients receiving dialysis in other countries. This

is partly due to the fact that Americans are impatient and do not want to sit out the

lengthy time needed to receive full treatment. What we propose is to hold an annual

kidney run to raise money for further research. Eventually, we would hope it would be

possible to successfully create an artificial kidney. Our kidney run would be something

similar to the Relay for Life, or March of Dimes. We did a little research and found that

Amarillo already holds a walk to help raise money for this cause, as we would like to do

here. Amarillo’s yearly run helps fund this cause. Not only does the money that we get

from the run go to researching the problem but it also helps make people aware of this

problem making this idea of a run serve a purpose in more than one way. Our proposal is

to host a kidney run similar to that of the run in Amarillo in order to help educate the

residents of Lubbock and raise money for further research.

.

Description of the problem:

Kidney failure is a bigger issue than what people think it is. Although there are

three affective methods of treatment, there is not a great method as of now. The three

types of treatments for kidney failure are hemodialysis, peritoneal dialysis, and kidney

transplant. With all of these treatments there is not a way yet that they can guarantee will

work. We are proposing that we raise, and collet donated money from UMC for a kidney

run in Lubbock, Texas to raise money for research on kidney failure. We are thinking

that if there is an artificial kidney made, it will save a lot of time, money, and give people

the quality of life they deserve, with that in mind our proposal of making this kidney run

happen would help fund research for this cause. Making something for a kidney like a

pacemaker is to the heart will benefit all patients facing this illness. As you read into the

paper you will find out that dialysis takes a lot of time and money and it decreases the

quality of life. So if research is funded properly it is possible that we could help aid

doctors and researchers find an artificial solution for this ongoing problem.

Research:

A lot of people don’t realize what a kidney actually does. Without a kidney you

couldn’t live. Its main job is to clean the blood. It acts as a filter and filters the bad stuff

out of your kidneys. Another function of the kidney is to remove waste and fluid out of

your blood. The kidney also tells the body to make red blood cells (erythrocytes). These

are the cells that are in the blood that carry oxygen. The kidney helps control blood

pressure, and it helps keep bones strong. Without the kidney you would have very high

blood pressure and you would die. There are a lot of things that can go wrong with the

kidney.

The worst thing that can happen to your kidney’s, is that they can fail. You can

go into renal failure. If the Kidneys fail then the blood is no longer filtered. If this

happens this is when waste and extra fluids build up in the body and chemicals become

out of balance. This will make you very sick and even cause death. There is no cure for

renal failure, but there are three different treatments to help control kidney failure. You

can control it with either dialysis or a complete kidney transplant. There are two types of

dialysis; hemodialysis or peritoneal dialysis.

Hemodialysis is a very effective way to control kidney failure. Hemodialysis uses

a machine that holds a filter called a dialyzer. The dialyzer does what the kidney is

supposed to. Hemodialysis is done in a special dialysis center. If you decide to leave

town, you have to find a dialysis center near where you are going or you can’t go on your

vacation. Hemodialysis is done by inserting 2 needles are into a special blood vessel

(called an access), usually in your arm. Each needle is attached to a tube. One tube

carries your blood into the dialyzer, where it is cleaned. Clean blood returns to your

blood through a 2nd tube and needle. There are a few things that you will experience

while doing the treatment. Hemodialysis is done three times a week for about three to

five hours a day. Most dialysis centers work in the evenings and weekends for the

convenience of the patients. A nurse or technician connects the patient up to the machine

and keeps a close eye on it to make sure that there are not any complications. During

treatment there is only about a cup of blood that is out of your body at one time. Also

during or after the first few times of treatment you might have headaches, muscle cramps

or feel nauseated, but that should go away when your body gets used to the treatment.

Before you can start hemodialysis, you have to have an access put in so that you can

receive the dialysis. This is what lets blood leave and inter you body. There are two

different types of access’ that you can use. The first access is a fistula and the other is a

graft. A fistula can be made by connecting one of your veins to a nearby artery. Blood

flows rapidly from the artery into the vein, enlarging it. It may need weeks or months

before it is ready to use. A graft is a piece of manmade tubing that is sewn between an

artery and a vein. This allows blood to flow rapidly through the graft from the artery to

the vein. A graft is usually ready to use in a few weeks. While your new access heals,

you may need a temporary one. This is called central vein access. This is a soft tube that

is usually placed into a neck vein. There are a few different precautions you need to take

when on hemodialysis. First thing is to not drink to much fluid between treatments.

Another is to make sure and keep your dialysis appointments and be on time. The last

thing is a medication that you take during this process will make you bleed more so you

have to avoid anything that might cut you or you might bleed to death. This medication

is called heparin. There are a few different complications that you could come across

when doing hemodialysis. You could get an infection, you could have high blood

pressure, you could lose a lot of blood and you can have an allergic reaction to the

dialyzer. Although hemodialysis is a good treatment you also have the chose of doing

peritoneal dialysis.

Peritoneal dialysis (PD) is another form of dialysis that is very effective. It uses a

natural membrane inside your body and a special solution, dialysate, to cleanse the

blood. This solution needs to be changed several times a day. You usually don’t have to

go to a clinic for this procedure, you can usually do it yourself. You will be trained by a

nurse or technician on how to change the PD. PD uses the natural lining in your

abdomen called the peritoneal membrane. This is what holds organs such as your

stomach and intestine. When the abdominal cavity is filled with dialysate, the lining and

dialysate work together to clean the blood. This has to be changed every couple of hours.

Each day, 4 to 5 changes need to be done and it takes about 30 minutes each change.

With peritoneal dialysis you also have to have an access. This is a small soft tube that is

placed in your abdomen just below your belly button. This is called a catheter. One end

of the catheter sits just inside your abdominal cavity while the other end extends a few

inches from your skin. During treatment, dialysate drains through the catheter into and

out of you abdomen. The catheter is capped off and taped to your skin until the next time

you have to do a treatment. The catheter is never removed. There are a couple of things

you need to watch out for when taking this type of dialysis. The first thing that you need

to watch for is that dialysate contains sugar which your body absorbs. This can make you

gain weight. One of the most important things to remember about peritoneal dialysis is to

never skip a treatment. This could cause major damage to your body. There are a few

complications that can occur while doing the treatment. You can get an infection in your

abdomen called peritonitis. You could get an infection around the catheter site,

sometimes requiring moving the catheter to a different place. The catheter could get

blocked and the solution will not be able to go in and out of the body. The last thing is

that you could have blood sugar problems if not careful. This is really important for

people with diabetes. Dialysis is a good treatment for kidney failure, but you can also get

a kidney transplant.

If being hooked up to a machine is not an option you want to take then you can

look into getting a kidney transplant. A kidney transplant is a surgery to place a donated

kidney into your body. This will do what your own kidney used to do. This is the closest

thing to having your own kidney. A kidney transplant is not for everyone. There are

only a couple of different was to get a kidney donated to you. You can either get a

kidney from a close relative or a friend that have the same blood type as you or you can

get put on a waiting list to get a kidney from someone that has past away. The wait can

range from months to years depending on your blood type. The surgery usually takes

about three to six hours. All of the kidneys are screened for disease before they are

transplanted into the body. The new kidney is placed in the lower part of your abdomen

near your groin. Here it is protected by your pelvic bone. It is attached to nearby blood

vessels so the blood can flow through easily to be filtered. The kidney’s ureter is also

connected to your bladder to allow urine to flow out. After the surgery it will take a

while to recover. You and your donor will recover in the hospital after surgery. The

donor may stay in the hospital for up to a week and you might stay longer. The kidney

might start right away or it might take up to two weeks to start, so you will have to stay

on dialysis until the kidney starts to work. After the transplant the kidney will work like

your own kidney. You won’t need dialysis with the transplant, but you will need to take

a lot of medication to make sure that the new kidney will work properly. Your body has

an immune system that will reject this new kidney, so you will have to take the proper

medications to help keep this from happening. If rejection does happen and you don’t

control it then the kidney will stop working. If this happens you will have to go back on

dialysis. The medications that you will take can have many side effects. It will weaken

the immune system and this will make the new kidney fail. So this is a very high risk

treatment. You don’t want anything to go wrong with these treatments so you will have

to take great care of yourself from here on out.

No matter which treatment you choose you will have to change your lifestyle.

You will have to change anything from your diet, daily activities, and your family

lifestyle. All of these treatments will make you very sick for a while until your body gets

used to all of the changes. Kidney failure will change a lot about your emotional state as

well. They can affect the way you feel about your sexuality as well as your sex drive. So

you will have to look to your family for support.

Interviews:

Manny, David. Personal interview. 20 March. 2005.

This will show the opposing view of the problem with renal failure. This shows the

reader that I am concerned with all aspects of the problem. The first source that will be

used is, “Several risk factors for patients treated with peritoneal dialysis (PD) have now

been identified. These include age, comorbid disease, nutritional status, loss of residual

renal function (RRF) and high peritoneal solute transport.” This will be used to show that

there are many problems that come along with renal failure. This shows that the funds

used might be going to bad use. The next quote is, “This is not the same, however, as

knowing what actually happens to these patients, particularly in the long-term. The

purpose of this interview was to give as complete a description as is currently possible of

the long-term renal failure patient.” This quote will provide the reader with information

that the renal failure affects you in the long run. The third quote is, “ In my practice

numbers show one case of death, both cause and mode of death; two technique failures,

with reference to peritoneal function and how the cause of technique failure related to

patient survival; and three evolution of clinically relevant parameters of patients with

renal failure, such as nutrition and peritoneal function. Without the research necessary,

these problems will continue to happen.” The quote provides the reader with the

information that is needed to show that there are problems, but not many. The Doctor is

a reliable source. Dr. Manny has been in practice for twenty two years and has seen many

renal failure patients. He also has been performing many procedures on the patients and

has not had many deaths, which shows that he is reliable an creditable. The audience is

the interviewer.

Rodgers, Charles H, Ph.D. Research Updates in Kidney Urologic Health: DKUHD

Program Initiatives. New York: 2004.

This source will give information to support the reasons that renal failure is one of the

growing problems in the United States. One quote that I plan to use is, “Each year,

DKUHD works with NIDDK's Advisory Council—representing a broad range of non-

Federal scientific, educational, and medical institutions—to plan and develop a set of

program initiatives designed to yield fundamental, innovative, and valuable contributions

to human health.” I will also use the quote, “Polycystic Kidney Disease (PKD). In the

past few years, much progress has been made in understanding the genetic mechanisms

that underlie the development of kidney disease, but research has been cut short because

of the lack of funds.” These sources will proves useful because there is evidence that the

research can be done, but the researchers are stagnant due to the lack of funds. The

DKUHD are working with the NIDDK to create organizations that will broaden the

horizon of break through research for renal failure. I will use this source to prove that

with more funds research can be done and will help people with renal failure. I will also

quote, “Other potential markers of progression, such as cells found in the urine, will also

be tested as potential diagnostic tools to cure renal failure, but without the proper funds

will not be pursued.” This is a quote that will use to prove that there are progress that is

on the verge of curing renal failure and with the funds that are needed will prove money

well spent. This site will also show that the author is creditable and is considered top in

his field of study. The author of the source has a Ph.D and is a doctor of medicine. This

makes him a very creditable and reliable source. This source helps people understand

what renal failure is and what is going on with it. The audience of this book is any one

that is suffering from renal failure or knows someone with renal failure. The audience is

also anyone that is concerned with renal failure and the problem with lack of funds for

renal failure.

Wilcox, Rhonda V. "Studies of Medicine: The Next Generation." Studies and

Research 13.2 (2005): 53-65.

This site will give the reader information the help them understand what renal failure is

and what dialysis treatments are. The first quote that will be used is, “Chronic kidney

disease and acute renal failure cause the kidneys to lose their ability to filter and remove

waste and extra fluid from the body. Hemodialysis is a process that uses a man-made

membrane (dialyzer).” The second quote that might be use is, “A hemodialysis session

usually lasts from 3 to 5 hours and must be done 3 times per week. You can read, watch

television, or sleep during your dialysis sessions.” The third quote that will be used is,

“Most complications that occur during dialysis can be prevented or can be easily

managed if a person is monitored carefully during each dialysis session. These treatments

are only to prolong the disease and will not be held accountable to cure renal failure,”

These quotes will be used in the paper to help the people to better understand what is

dialysis treatments and what they used for this journal is current. While the author is not

the authority on the subject he is leader for the research for The Study of Medicine. The

author has a great deal of knowledge on the subject and is a very reliable source.. The

journal will be used to provide the reader with a description of how the renal failure will

affect a victim. The journal has accurate information because it is out of the Studies of

Medicine Journal, which is a subscription for doctors. These sources are important for the

paper to have an understanding of what is going on in the United States with renal failure.

Without this information provided by the sources, the reader will have no understanding

on the issue. The author writes to inform doctors of what is going on with the study of

renal failure.

Holgan, Peter H. "Renal Failure Victims." Health Support. 24 July-Aug. 2005. 24

July-Aug. 2005 <www.google.com>.

The first quote is, “This critique of 48 research and anecdotal reports published since

1967 summarizes current understanding about the effects on family members assisting

with home dialysis.” The next quote is, “Psychological perspectives have provided

descriptions of how these family assistants cope with the stresses associated with

dialysis.” The third quote is, “important societal, gender, and economic factors affecting

people with end stage renal disease (ESRD) and their families have been overlooked.”

This quote will provide the reader with how the families are coping with renal failure and

how they are being helped. The author is a reliable source to the extensive research the he

has done in his field. He is also on to of the leading researchers in the nation. The author

is a creditable and reliable source. The audience for this source is the families of renal

failure patients or victims.

Gonzalez, Karen M. Renal Failure. 1st ed. Vol. 1. Upper Saddle River, NJ07458:

New Jersey, 1999. What to Do. 19 June-July 2005 <http://vadilzap.edu>.

The first quote is, “Hospital based cohort study of all patients starting dialysis over a

4 year recruitment period (follow up 15-63 months). Groups were defined on the basis of

age, comorbidity, functional status, and whether dialysis initiation was planned or

unplanned.” The next quote is, “292 patients, mean age 61.3 years (18-92 years, SD

15.8), of whom 193 (66%) were male, and 59 (20%) were patients with diabetes. Dialysis

initiation was planned in 163 (56%) patients and unplanned in 129 (44%) in suburbs of

NJ.” This will show the numbers of patients that were in need of help for renal failure and

how large they were in one city. The author is not authority of the subject she is reliable

due the fact that she has experience renal failure and has studied it for twenty-three years.

She has also wrote a book on renal failure with show she has great knowledge on the

subject. The primary audience is anyone who read fiction books or problematic books.

Smith, Ann N. Personal interview. 18 July-Aug. 2005.

The first quote is, “Factors affecting survival in the Cox's proportional hazard model were

Karnofsky performance score at presentation (hazard ratio 0.979, 95% confidence interval

0.972 to 0.986), comorbidity severity score (1.240, 1.131 to 1.340), age (1.036, 1.018 to

1.054), and myeloma (2.15, 1.140 to 4.042). She has provided evidence of number that

she has experienced that will prove helpful. The next quote is, “The Karnofsky

performance score used 3 months before presentation was significant (0.970, 0.956 to

0.981), as was unplanned presentation in this model (1.796, 1.233 to 2.617). Using these

factors, a high risk group of 26 patients was defined, with 19.2% 1 year survival.” The

last quote is, “Denying dialysis to this group would save 3.2% of the total cost of the

chronic programmed but would sacrifice five long term survivors. Less rigorous

definition of the high-risk group would save more money but lose more long-term

survivors. This shows that the numbers of the research that has been done and has shown

proof to support claim. Ann Smith is a very creditable source because of her status of

being a Dialysis nurse for over seventeen years. She is a authority of the issue. She is a

reliable source and can help the creditability of the paper. The audience of the paper is

dialysis patient and family.

J. B. Levy, E. J. Chambers, and E. A. Brown Supportive care for the renal patient

Nephrol. Dial. Transplant., June 1, 2004; 19(6): 1357 – 1360

The first quote is, “Diabetic nephropathy is a serious complication of diabetes that can

lead to end stage renal failure (ESRF) the lack of funds have been creating more

problems for helping people.” The next quote is, “It is now the most common cause of

ESRF in patients accepted onto renal replacement therapy (RRT) programmers in the US

and if research funds are not available than the outcome is fatal.” These sources will

prove valuable in the future for the reader to makes the decision. \The authors are the

authorities on the subject and have great creditability and reliability that come along with

that. The authors have spent a tremendous amount of time researching the subject. The

audience for this subject is people who are suffering from renal failure and loved ones.

The second audiences are those who have concern about the issue.

Diaz, Eric F. "Renal Failure." Newton Local New 7 Nov. 2003, One ed., sec. 2: 2.

Academic Search Premier. EBSO. Lubbock. 25 July-Aug. 2005.

The first quote is, “Acute renal failure (ARF) due to ischemic1 or toxic renal injury, a

clinical syndrome traditionally referred to as acute tubular necrosis (ATN), is a common

disease with a high overall mortality of ~50%.” The next quote is, “Little progress has

been made since the advent of dialysis more than 30 years ago in improving this outcome

because of the lack of funds.” The next quote is, “During this same period, a considerable

amount of basic research has been devoted to elucidating the pathophysiology of ATN.”

The author is creditable because of the long research that has been done for the topic. The

author has been in this field for over eleven years and has found great information. The

main audience for this topic is the people who are unfamiliar with dialysis research.

Davis, Brent M. Personal interview. 18 July-Aug. 2005.

The first quote that will be used is, “The ultimate goal of this research is to facilitate the

development of therapeutic interventions that either prevent ARF, ameliorate the severity

of tubular injury following an acute ischemic or toxic renal insult, or accelerate the

recovery of established ATN.” The second is, “This research endeavor has been highly

successful in elucidating many vascular and tubular abnormalities that are likely to be

involved in ischemic and toxic ARF but without funds the research can only go so far.”

The last quote that will be used is, “The Kidney is a highly complex organ consisting of

well-defined components that function in a highly coordinated fashion to allow for fine

regulation of a myriad of interdependent processes.” The author is reliable because of her

practice of medicine at UMC of Lubbock This provide useful information. The primary

audience are those who show interest for renal failure.

Alvarado, Lupe M. Personal interview. 18 July-Aug. 2005.

The first quote is, “Studies have shown the important concept that has greatly enhanced

our understanding of the pathophysiology of ischemic ARF is that sublethal and

reversible injury to renal tubular cells contributes substantially to renal tubular

dysfunction.” The next quote that will be used is, “Prior to the development of this novel

concept, it was generally believed that tubular dysfunction was predominantly the result

of tubular cell necrosis, but cant be research further until funds are generated .” The last

quote that might be used is, “The concept that sublethal injury can contribute to renal

dysfunction is a novel paradigm that provides an excellent example of how the exchange

of ideas between clinical investigators and basic research, as well as the use of a number

of different research models, can complement each other in advancing our understanding

of human disease.” Lupe provides great information for the reader to understand what is

happening and how funds are needed for further research. She is a creditable source

because of her title as the director of dialysis of Covenant Hospital of Lubbock. The

primary audience is the interviewer, the renal failure patients and fund providers.

Problem Solution:

We are going to direct all of our attention to a fundraiser to support research for an

artificial kidney. Our proposal is that we are going to start by using money donated by

University Medical Center to fund the kidney run. The money that is donated by UMC

will be used for the DJ, shirts, food, water and other materials needed for the kidney run.

There is a kidney run that is held in Amarillo, TX that is run by Convenient Medical

Center Dialysis unit. Trent Lee went to Convenient hospital to speak to the Dialysis unite

and gather information about kidney failure in witch the information of the kidney run in

Amarillo was found. They said, “We will do anything to support you so we can further

funds needed for your project.” This will be very beneficial in organizing and promoting

the Lubbock kidney run, because they have already done one and can lead us in the right

direction so that our kidney run will be beneficial. We plan on utilizing the local news

stations and Texas Tech University sports media so that we would be able to inform the

audience which is the local survivors, friends and family of kidney failure patients would

be able to participate. All the money that was raised from the kidney run will be used for

research for an artificial kidney that will help patients in need. There are a number of

patients that need a kidney that are not eligible for one because that have a pre-existing

condition such as high blood pressure or diabetes. Not only will this save patients time

and energy but allow them to live life and not worry what is going to happen to them in

the future as well as their family. This will also save live for people that have a care crash

and need a kidney right away because of server trauma. Our proposal is something that is

practical and can save many lives when complete.

Budget

Budget and cost for the different treatments along with the proposed solution:

Although kidney failure does a rough toll to a body it also can put a dent into the patient

and the family’s bank account. Since there are many routes and various treatments for

this illness the patient then gets a choice in deciding what is going to be done treatment

wise and with the choice at hand, money is also a large deciding factor. To look at all the

treatments that are available and compare them with quality of life and initial cost can,

and will show the cost effectiveness of a proposed artificial kidney.

Treatment #1: Kidney Dialysis (Short Term)

Is used when a patient either is repairing their kidneys, or on a waiting list for a

transplant. The time amount that is considered short term is less than 90 days. When 90

days rolls around the patient then has the choice to either follow through with the

treatment making it a now long term dialysis while getting on a transplant waiting list, or

they can deny treatment altogether. The cost for this short term dialysis at the 90 day rate

is $62,578.

Treatment #2: Kidney Dialysis (Long Term)

Long term dialysis is a process that can last for the duration of the patient’s lifetime.

After making the choice to go ahead and switch to long term dialysis from short term a

patient is most commonly waiting on an available kidney for a transplant. The cost for

this long term dialysis treatment is $144,810 per year of treatment.

Treatment #3: Kidney Transplant

Patients that are on kidney dialysis (long term) are usually on a waiting list for a kidney

transplant. When and if a kidney becomes available the patient then goes through

rigorous medical exams to make sure that the kidney will take to the patient’s body. The

patient then goes into surgery and a new kidney replaces the old. The patient then can

return to a normal life for the cost of $133,199.

Proposed Treatment: Artificial Kidney

The proposed treatment of an artificial kidney would be a solution similar to a kidney

transplant. Although there would be no waiting list and could not only reduce the cost of

treatment but would also cost about a sixth of the cost of a kidney transplant. This figure

is based off the cost of a pacemaker device. The total cost of this solution would cost

right at $26,368 plus operational cost which vary from doctor to doctor.

With cost so high in the treatments areas and quality of life being so low, the solution of

inserting an artificial kidney into these patients would be the utmost quality and feasible

alternative. In order to help fund research for this solution our proposal wants to have a

kidney run take place in Lubbock, TX. The cost for this run is as follows.

Cost for artificial kidney research run:

The plan to start a kidney walk would need to start first in the media for advertisement to

the citizens of Lubbock County. The media in Lubbock agreed to support this charity and

the AM radio station for Texas Tech Baseball donated a time slot while broadcasting the

Raider games for advertisement. The Lubbock Avalanche Journal would let the

foundation run a week long ad for $35.00 a half page layout. T-shirts for participants and

donors would also need to be made in order to spread the word for the years to come,

with color and a logo the shirts could be printed at $5.95 per shirt with a minimum order

of 100, the more participants and donors the more shirts and a larger discount. Catering

would also need to be provided in order to refuel the participant’s tanks while on this 24

hour walk a thon. For entertainment reasons more than any other a DJ would also need to

be provided to keep the up beat atmosphere and make it a walk that people would want to

come back and participate in the years to follow. So if we could have UMC fund a

ballpark figure of $5,000 it would cover expenses and would help get this run put into

action.

References

Manny, David. Personal interview. 20 March. 2005.

Rodgers, Charles H, Ph.D. Research Updates in Kidney Urologic Health: DKUHD

Program Initiatives. New York: 2004.

Wilcox, Rhonda V. "Studies of Medicine: The Next Generation." Studies and

Research 13.2 (2005): 53-65.

Holgan, Peter H. "Renal Failure Victims." Health Support. 24 July-Aug. 2005. 24

July-Aug. 2005 <www.google.com>.

Gonzalez, Karen M. Renal Failure. 1st ed. Vol. 1. Upper Saddle River, NJ07458:

New Jersey, 1999. What to Do. 19 June-July 2005 <http://vadilzap.edu>.

Smith, Ann N. Personal interview. 18 July-Aug. 2005

J. B. Levy, E. J. Chambers, and E. A. Brown Supportive care for the renal patient

Nephrol. Dial. Transplant., June 1, 2004; 19(6): 1357 – 1360

Diaz, Eric F. "Renal Failure." Newton Local New 7 Nov. 2003, One ed., sec. 2: 2.

Academic Search Premier. EBSO. Lubbock. 25 July-Aug. 2005.

Davis, Brent M. Personal interview. 18 July-Aug. 2005.

Alvarado, Lupe M. Personal interview. 18 July-Aug. 2005.

Santiesteban, Hector L. “Treatment Options for Kidney Failure” San Bruno, CA

2002

FINAL REVISED PROPOSAL

Introduction:

The issue we chose to discuss is the treatments for kidney failure. Kidney failure

occurs when the kidneys can no longer remove the harmful particles from the blood while

keeping the essential ones, as well as regulating the concentration of the blood. Particles

such as hemoglobin are essential to the human body, while waste products such as urea

should be removed to maintain the body’s normal processes. Basically the kidneys serve

three functions in the body: filtration, reabsorption, and secretion. When the kidneys fail

to function properly one must resort to dialysis. Dialysis is necessary for survival

because the build up of toxins in the blood and tissues can no longer be filtered out

naturally by the kidneys. “Uremia, which literally means “urine in the blood”, will occur

and eventually cause death.” There are two types of kidney dialysis. Hemodialysis uses a

machine with a filter that allows blood to flow through while removing waste products.

Afterwards, the clean blood is then pumped back into the body. When doing peritoneal

dialysis, instead of using an artificial membrane the process involves using the lining of

the patient’s abdominal cavity as a dialysis membrane. The patient’s abdominal cavity is

injected with fluid and solutions diffuse into this fluid from the blood. This fluid is then

removed after several hours, and the patient is injected with new fluid. Patients suggest

that except for the initial stick of the needle, dialysis is not painful. Approximately

217,000 Americans receive dialysis, which costs an estimated $11.1 billion nationwide.

“Dialysis is an option for those whose kidneys temporarily do not function, until the

patient receives a transplant, or for years if those options are not available. Many patients

receiving dialysis can still live normal lives, although research has shown that American

dialysis patients do not live as long as patients receiving dialysis in other countries. This

is partly due to the fact that Americans are impatient and do not want to sit out the

lengthy time needed to receive full treatment. What we propose is to hold an annual

kidney run to raise money for further research. Eventually, we would hope it would be

possible to successfully create an artificial kidney. Our kidney run would be something

similar to the Relay for Life, or March of Dimes. We did a little research and found that

Amarillo already holds a walk to help raise money for this cause, as we would like to do

here. Amarillo’s yearly run helps fund this cause. Not only does the money that we get

from the run go to researching the problem but it also helps make people aware of this

problem making this idea of a run serve a purpose in more than one way. Our proposal is

to host a kidney run similar to that of the run in Amarillo in order to help educate the

residents of Lubbock and raise money for further research.

.

Description of the problem:

Kidney failure is a bigger issue than what people think it is. Although there are

three affective methods of treatment, there is not a great method as of now. The three

types of treatments for kidney failure are hemodialysis, peritoneal dialysis, and kidney

transplant. With all of these treatments there is not a way yet that they can guarantee will

work. We are proposing that we raise, and collet donated money from UMC for a kidney

run in Lubbock, Texas to raise money for research on kidney failure. We are thinking

that if there is an artificial kidney made, it will save a lot of time, money, and give people

the quality of life they deserve, with that in mind our proposal of making this kidney run

happen would help fund research for this cause. Making something for a kidney like a

pacemaker is to the heart will benefit all patients facing this illness. As you read into the

paper you will find out that dialysis takes a lot of time and money and it decreases the

quality of life. So if research is funded properly it is possible that we could help aid

doctors and researchers find an artificial solution for this ongoing problem.

Research:

A lot of people don’t realize what a kidney actually does. Without a kidney you

couldn’t live. Its main job is to clean the blood. It acts as a filter and filters the bad stuff

out of your kidneys. Another function of the kidney is to remove waste and fluid out of

your blood. The kidney also tells the body to make red blood cells (erythrocytes). These

are the cells that are in the blood that carry oxygen. The kidney helps control blood

pressure, and it helps keep bones strong. Without the kidney you would have very high

blood pressure and you would die. There are a lot of things that can go wrong with the

kidney.

The worst thing that can happen to your kidney’s, is that they can fail. You can

go into renal failure. If the Kidneys fail then the blood is no longer filtered. If this

happens this is when waste and extra fluids build up in the body and chemicals become

out of balance. This will make you very sick and even cause death. There is no cure for

renal failure, but there are three different treatments to help control kidney failure. You

can control it with either dialysis or a complete kidney transplant. There are two types of

dialysis; hemodialysis or peritoneal dialysis.

Hemodialysis is a very effective way to control kidney failure. Hemodialysis uses

a machine that holds a filter called a dialyzer. The dialyzer does what the kidney is

supposed to. Hemodialysis is done in a special dialysis center. If you decide to leave

town, you have to find a dialysis center near where you are going or you can’t go on your

vacation. Hemodialysis is done by inserting 2 needles are into a special blood vessel

(called an access), usually in your arm. Each needle is attached to a tube. One tube

carries your blood into the dialyzer, where it is cleaned. Clean blood returns to your

blood through a 2nd tube and needle. There are a few things that you will experience

while doing the treatment. Hemodialysis is done three times a week for about three to

five hours a day. Most dialysis centers work in the evenings and weekends for the

convenience of the patients. A nurse or technician connects the patient up to the machine

and keeps a close eye on it to make sure that there are not any complications. During

treatment there is only about a cup of blood that is out of your body at one time. Also

during or after the first few times of treatment you might have headaches, muscle cramps

or feel nauseated, but that should go away when your body gets used to the treatment.

Before you can start hemodialysis, you have to have an access put in so that you can

receive the dialysis. This is what lets blood leave and inter you body. There are two

different types of access’ that you can use. The first access is a fistula and the other is a

graft. A fistula can be made by connecting one of your veins to a nearby artery. Blood

flows rapidly from the artery into the vein, enlarging it. It may need weeks or months

before it is ready to use. A graft is a piece of manmade tubing that is sewn between an

artery and a vein. This allows blood to flow rapidly through the graft from the artery to

the vein. A graft is usually ready to use in a few weeks. While your new access heals,

you may need a temporary one. This is called central vein access. This is a soft tube that

is usually placed into a neck vein. There are a few different precautions you need to take

when on hemodialysis. First thing is to not drink to much fluid between treatments.

Another is to make sure and keep your dialysis appointments and be on time. The last

thing is a medication that you take during this process will make you bleed more so you

have to avoid anything that might cut you or you might bleed to death. This medication

is called heparin. There are a few different complications that you could come across

when doing hemodialysis. You could get an infection, you could have high blood

pressure, you could lose a lot of blood and you can have an allergic reaction to the

dialyzer. Although hemodialysis is a good treatment you also have the chose of doing

peritoneal dialysis.

Peritoneal dialysis (PD) is another form of dialysis that is very effective. It uses a

natural membrane inside your body and a special solution, dialysate, to cleanse the

blood. This solution needs to be changed several times a day. You usually don’t have to

go to a clinic for this procedure, you can usually do it yourself. You will be trained by a

nurse or technician on how to change the PD. PD uses the natural lining in your

abdomen called the peritoneal membrane. This is what holds organs such as your

stomach and intestine. When the abdominal cavity is filled with dialysate, the lining and

dialysate work together to clean the blood. This has to be changed every couple of hours.

Each day, 4 to 5 changes need to be done and it takes about 30 minutes each change.

With peritoneal dialysis you also have to have an access. This is a small soft tube that is

placed in your abdomen just below your belly button. This is called a catheter. One end

of the catheter sits just inside your abdominal cavity while the other end extends a few

inches from your skin. During treatment, dialysate drains through the catheter into and

out of you abdomen. The catheter is capped off and taped to your skin until the next time

you have to do a treatment. The catheter is never removed. There are a couple of things

you need to watch out for when taking this type of dialysis. The first thing that you need

to watch for is that dialysate contains sugar which your body absorbs. This can make you

gain weight. One of the most important things to remember about peritoneal dialysis is to

never skip a treatment. This could cause major damage to your body. There are a few

complications that can occur while doing the treatment. You can get an infection in your

abdomen called peritonitis. You could get an infection around the catheter site,

sometimes requiring moving the catheter to a different place. The catheter could get

blocked and the solution will not be able to go in and out of the body. The last thing is

that you could have blood sugar problems if not careful. This is really important for

people with diabetes. Dialysis is a good treatment for kidney failure, but you can also get

a kidney transplant.

If being hooked up to a machine is not an option you want to take then you can

look into getting a kidney transplant. A kidney transplant is a surgery to place a donated

kidney into your body. This will do what your own kidney used to do. This is the closest

thing to having your own kidney. A kidney transplant is not for everyone. There are

only a couple of different was to get a kidney donated to you. You can either get a

kidney from a close relative or a friend that have the same blood type as you or you can

get put on a waiting list to get a kidney from someone that has past away. The wait can

range from months to years depending on your blood type. The surgery usually takes

about three to six hours. All of the kidneys are screened for disease before they are

transplanted into the body. The new kidney is placed in the lower part of your abdomen

near your groin. Here it is protected by your pelvic bone. It is attached to nearby blood

vessels so the blood can flow through easily to be filtered. The kidney’s ureter is also

connected to your bladder to allow urine to flow out. After the surgery it will take a

while to recover. You and your donor will recover in the hospital after surgery. The

donor may stay in the hospital for up to a week and you might stay longer. The kidney

might start right away or it might take up to two weeks to start, so you will have to stay

on dialysis until the kidney starts to work. After the transplant the kidney will work like

your own kidney. You won’t need dialysis with the transplant, but you will need to take

a lot of medication to make sure that the new kidney will work properly. Your body has

an immune system that will reject this new kidney, so you will have to take the proper

medications to help keep this from happening. If rejection does happen and you don’t

control it then the kidney will stop working. If this happens you will have to go back on

dialysis. The medications that you will take can have many side effects. It will weaken

the immune system and this will make the new kidney fail. So this is a very high risk

treatment. You don’t want anything to go wrong with these treatments so you will have

to take great care of yourself from here on out.

No matter which treatment you choose you will have to change your lifestyle.

You will have to change anything from your diet, daily activities, and your family

lifestyle. All of these treatments will make you very sick for a while until your body gets

used to all of the changes. Kidney failure will change a lot about your emotional state as

well. They can affect the way you feel about your sexuality as well as your sex drive. So

you will have to look to your family for support.

Problem Solution:

We are going to direct all of our attention to a fundraiser to support research for an

artificial kidney. Our proposal is that we are going to start by using money donated by

University Medical Center to fund the kidney run. The money that is donated by UMC

will be used for the DJ, shirts, food, water and other materials needed for the kidney run.

There is a kidney run that is held in Amarillo, TX that is run by Convenient Medical

Center Dialysis unit. Trent Lee went to Convenient hospital to speak to the Dialysis unite

and gather information about kidney failure in witch the information of the kidney run in

Amarillo was found. They said, “We will do anything to support you so we can further

funds needed for your project.” This will be very beneficial in organizing and promoting

the Lubbock kidney run, because they have already done one and can lead us in the right

direction so that our kidney run will be beneficial. We plan on utilizing the local news

stations and Texas Tech University sports media so that we would be able to inform the

audience which is the local survivors, friends and family of kidney failure patients would

be able to participate. All the money that was raised from the kidney run will be used for

research for an artificial kidney that will help patients in need. There are a number of

patients that need a kidney that are not eligible for one because that have a pre-existing

condition such as high blood pressure or diabetes. Not only will this save patients time

and energy but allow them to live life and not worry what is going to happen to them in

the future as well as their family. This will also save live for people that have a care crash

and need a kidney right away because of server trauma. Our proposal is something that is

practical and can save many lives when complete.

Budget

Budget and cost for the different treatments along with the proposed solution:

Although kidney failure does a rough toll to a body it also can put a dent into the patient

and the family’s bank account. Since there are many routes and various treatments for

this illness the patient then gets a choice in deciding what is going to be done treatment

wise and with the choice at hand, money is also a large deciding factor. To look at all the

treatments that are available and compare them with quality of life and initial cost can,

and will show the cost effectiveness of a proposed artificial kidney.

Treatment #1: Kidney Dialysis (Short Term)

Is used when a patient either is repairing their kidneys, or on a waiting list for a

transplant. The time amount that is considered short term is less than 90 days. When 90

days rolls around the patient then has the choice to either follow through with the

treatment making it a now long term dialysis while getting on a transplant waiting list, or

they can deny treatment altogether. The cost for this short term dialysis at the 90 day rate

is $62,578.

Treatment #2: Kidney Dialysis (Long Term)

Long term dialysis is a process that can last for the duration of the patient’s lifetime.

After making the choice to go ahead and switch to long term dialysis from short term a

patient is most commonly waiting on an available kidney for a transplant. The cost for

this long term dialysis treatment is $144,810 per year of treatment.

Treatment #3: Kidney Transplant

Patients that are on kidney dialysis (long term) are usually on a waiting list for a kidney

transplant. When and if a kidney becomes available the patient then goes through

rigorous medical exams to make sure that the kidney will take to the patient’s body. The

patient then goes into surgery and a new kidney replaces the old. The patient then can

return to a normal life for the cost of $133,199.

Proposed Treatment: Artificial Kidney

The proposed treatment of an artificial kidney would be a solution similar to a kidney

transplant. Although there would be no waiting list and could not only reduce the cost of

treatment but would also cost about a sixth of the cost of a kidney transplant. This figure

is based off the cost of a pacemaker device. The total cost of this solution would cost

right at $26,368 plus operational cost which vary from doctor to doctor.

With cost so high in the treatments areas and quality of life being so low, the solution of

inserting an artificial kidney into these patients would be the utmost quality and feasible

alternative. In order to help fund research for this solution our proposal wants to have a

kidney run take place in Lubbock, TX. The cost for this run is as follows.

Cost for artificial kidney research run:

The plan to start a kidney walk would need to start first in the media for advertisement to

the citizens of Lubbock County. The media in Lubbock agreed to support this charity and

the AM radio station for Texas Tech Baseball donated a time slot while broadcasting the

Raider games for advertisement. The Lubbock Avalanche Journal would let the

foundation run a week long ad for $35.00 a half page layout. T-shirts for participants and

donors would also need to be made in order to spread the word for the years to come,

with color and a logo the shirts could be printed at $5.95 per shirt with a minimum order

of 100, the more participants and donors the more shirts and a larger discount. Catering

would also need to be provided in order to refuel the participant’s tanks while on this 24

hour walk a thon. For entertainment reasons more than any other a DJ would also need to

be provided to keep the up beat atmosphere and make it a walk that people would want to

come back and participate in the years to follow. So if we could have UMC fund a

ballpark figure of $5,000 it would cover expenses and would help get this run put into

action.

References

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Research 13.2 (2005): 53-65.

Holgan, Peter H. "Renal Failure Victims." Health Support. 24 July-Aug. 2005. 24

July-Aug. 2005 <www.google.com>.

Gonzalez, Karen M. Renal Failure. 1st ed. Vol. 1. Upper Saddle River, NJ07458:

New Jersey, 1999. What to Do. 19 June-July 2005 <http://vadilzap.edu>.

Smith, Ann N. Personal interview. 18 July-Aug. 2005

J. B. Levy, E. J. Chambers, and E. A. Brown Supportive care for the renal patient

Nephrol. Dial. Transplant., June 1, 2004; 19(6): 1357 – 1360

Diaz, Eric F. "Renal Failure." Newton Local New 7 Nov. 2003, One ed., sec. 2: 2.

Academic Search Premier. EBSO. Lubbock. 25 July-Aug. 2005.

Davis, Brent M. Personal interview. 18 July-Aug. 2005.

Alvarado, Lupe M. Personal interview. 18 July-Aug. 2005.

Santiesteban, Hector L. “Treatment Options for Kidney Failure” San Bruno, CA

2002