(soothing guitar music)
>> Welcome, my name is Kaylee,
and I'll be taking you on a tour
of the Pediatric Outpatient Dialysis Clinic,
here at Johns Hopkins.
We have a whole team of people here
who take care of patients who receive
hemodialysis and peritoneal dialysis.
Come on in.
Now we're in the dialysis clinic.
Did you know that we have
the only pediatric dialysis clinic in Maryland?
Johns Hopkins hospital has the largest
pediatric transplant center in the state.
So what is dialysis and why do you need it?
You need dialysis because your kidneys have stopped working
or are not working well.
Kidneys are important because they clean the toxins,
waste, water, and other yucky stuff
we don't want in our bodies out of our blood.
Since your kidneys can't do that right now,
the dialysis machine acts like your kidneys
and cleans your blood for you.
Every time I come to dialysis, I see familiar faces.
There's a nurse, a dialysis tech,
a child life specialist, a social worker,
a behavioral psychologist, and a registered dietician.
I also see a nurse practitioner and a doctor on most days.
Everybody takes great care of me and puts me at ease.
>> Coming here, sitting in the chair,
watching my child go through this,
it's very hard.
It's scary.
But the staff here,
they just embrace you
and they give you that love and support that you need
to show you that your child is gonna be fine
and they are gonna take very good care of them
and that gives you a lot of ease.
The staff here made us feel very comfortable.
They answered any questions or concerns that we've ever had.
They're very, very friendly.
They're like family.
>> There are two different types of dialysis,
hemodialysis, or HD, and peritoneal dialysis, or PD.
I get hemodialysis.
Here's one of our doctors to explain more.
>> For people who are on hemodialysis,
blood is removed from the body
and passed through an artificial kidney or a filter
in order to remove the toxins, waste products, and water.
The blood can be removed through a catheter
or through a special artery and vein
that are created under the scan,
called an AV fistula or a graft.
Which type of access you have
will be decided by you and your care team.
A typical dialysis procedure occurs over three to four hours
and most people require three to four treatments per week.
How much dialysis you need will depend on you,
your blood work, the chemicals in your body.
And those things will be monitored by your healthcare team
and shared with you when deciding
how much dialysis you need.
>> When you first get to the clinic,
you will get your weight checked.
This helps your team to see if you have
any extra fluid on you
since your kidneys are not working well.
You will learn that your dry weight means
the weight your body's at
when it does not have any extra fluid on it.
If it has extra fluid, the dialysis machine helps it
take that extra fluid off.
Your team will also talk with you
about ways to prevent this from happening.
Next you go to your dialysis chair.
Most dialysis chairs recline
and have a heat and vibration setting.
I like to put mine on the highest heat setting possible.
>> Hi Kaylee,
how are you today? >> I'm good.
>> I'm gonna go and take your blood pressure,
okay? >> Okay.
This is where you get your blood pressure
and your temperature taken.
Then it is time for dialysis.
There are a lot of things to do
when you are getting dialysis.
Some of my favorite things to do are
color, read, talk, and listen to music.
Check out all the other fun things
that you can do while you are getting dialysis.
(hopeful instrumental music)
Some kids get the other kind of dialysis
I mentioned earlier, called peritoneal dialysis, or PD.
That is done in the patient's home.
>> For people who received peritoneal dialysis,
the toxins and waste products and water
are actually removed from the blood vessels
that line the abdominal cavity.
In this procedure, fluid is instilled
into the abdominal cavity,
the waste products and water pass into that fluid,
and then the fluid is drained.
The filling and draining of that fluid is usually done
with the assistance of a machine called a cycler.
In addition, the people doing the procedure
are actually the person with end-stage renal disease
or their caregivers, their parents or other caregivers.
The person who has end-stage renal disease
and their caregivers receive extensive training
so that they can perform this procedure at home.
In addition, the team is always available
if they have questions when they're
doing the procedure at home.
The procedure is usually done at night
so that the person can sleep while it's happening.
And then they can go on their daily activities,
school or work or other activities,
without needing to be on dialysis.
If you are on peritoneal dialysis,
you will come to the unit at least once a month.
At that time, you'll have blood work done,
you'll get your height checked,
your blood pressure checked, your weight checked.
And you'll see a doctor, a dialysis nurse,
a dietician, social worker,
child life specialist, and behavioral therapist.
>> This is one of the PD clinic rooms
and this is what a PD dialysis machine looks like.
There's a whole lot of equipment
that needs to go in your house if you're on PD
and a lot of training involved.
Your team will talk with you about
which type of dialysis is best you and your family.
Thanks so much for joining me
on a tour of our dialysis clinic today.
I know that learning about something
so big and new like this can feel scary and overwhelming.
But just remember, there is a whole team here
dedicated to taking the best care of you,
just like they do for me.