Renal Services

Chronic-Disease-Prevention-and-Management-Program-crop

The Thunder Bay Regional Health Sciences Centre North West Regional Renal Program provides a wide range of services to people living in Northwestern Ontario with renal (kidney) disease.  This includes education, decision making support and treatment provided in the Kidney Clinic, in the dialysis units, as well as pre and post transplant, and living kidney donation care. The goal is to provide the right care at the right time for our patients, knowing that their needs will change at different stages of kidney disease.

For that reason, our services are customized to each person’s needs based on a variety of factors including disease stage, where he or she lives, and type of supports needed. This page will provide you with a general overview of the Regional Renal Program. The care team within the Renal Program will give you specific information you need to know about your own treatment plan.

Moving Forward

Life with Kidney Disease

Follow the lives of two patients who are living with kidney disease. Mona Hardy and Harvey Kakegamic share their stories about diagnosis, living with kidney disease and their treatment choices.

Click to read more and watch the video.


The Care Team

The Renal Program takes an interdisciplinary approach to renal care using a team of healthcare professionals, each specializing in one area of kidney disease care to provide you with the best possible service and care. This team includes:

Nephrologist (Kidney Specialist)

The doctor who monitors your kidney disease and creates a care plan with you based on your medical needs as well as your life circumstances to ensure you receive the best care possible.

Renal Nurses

Renal nurses have specialized training in renal care and have a special understanding of kidney disease.  Nurses help with all aspects of your care from “hands on” needs to education to performing dialysis treatment.

Dietitians

Those with kidney disease (pre-dialysis, dialysis, and post-transplant) will benefit from making changes to their lifestyle including what they eat and drink. Dietitians can help patients plan healthier choices to better manage their disease.

Renal Pharmacist

Has specialized training in renal care. The pharmacist will make suggestions about your medications plan, help to monitor the effectiveness of those medications and answer any questions you may have.

Renal Pharmacy Technician

– Works closely with the Renal Pharmacist to keep accurate records of your medications, investigates drug coverage issues, manages refill Prescriptions, prepares medications and many other jobs.

Social Workers

Being diagnosed with kidney disease and undergoing treatment for it is a life-changing event for individuals and their families. Not only does it affect your physical health, but the emotional and social side of life is greatly impacted as well.  Your social worker will help you understand and access what services may be available to help you during what may be a difficult time.

Indigenous Liaison

People of Indigenous descent, especially those coming from remote communities across Northwestern Ontario, may have special needs and questions. The Indigenous Liaison with the Renal Program can help you with all aspects of your renal care from interpretation services and helping you understand your disease to supporting you throughout treatment.

Dialysis Access Coordinator

– The coordinator works closely with many professionals to assist patients to choose, create and maintain appropriate body access for the patient’s choice of dialysis.

Independent Dialysis Coordinator

The independent dialysis coordinator assists with developing strategies and partnerships to allow you to be on “Home Dialysis” if this is your treatment decision.

Transplant Coordinator

Transplants do not occur in Northwestern Ontario.  The Renal Service Transplant Coordinator will liaise with you and the transplant program to organize your assessments and follow up needs required for kidney or kidney/pancreas transplantation.

Clinical Nurse Specialist

The Clinical Nurse Specialist provides educational and operational support to the Renal Interprofessional Team.

Volunteers

A number of volunteers help out in the Renal Program, mostly in dialysis, to ensure you are as comfortable as possible during treatment.

Reception Staff

This is usually your first contact in the Renal Program. The welcoming and friendly reception staff help make you feel comfortable when you arrive and can answer many questions about the Renal Program or direct you to someone who can help.

You Are Part of the Care Team

The most important thing to remember is that patients and family members are an important part of the care team. Doctors, nurses, and other healthcare professionals can provide you with a care plan and recommendations to help you manage your disease. However, deciding to follow that care plan is up to you. We understand that facing kidney disease is difficult. That’s why we provide you with the medical, emotional, spiritual, mental, and other supports to assist you along the way.

Here are a few ways you can stay involved in your own care:

  • Ask questions if you are unclear about instructions or the information being given to you
  • Talk to family members, and bring a family member or trusted friend to appointments
  • Come to all appointments including dialysis
  • Follow all recommendations for taking medications, eating and drinking, exercise, etc.
  • Stop smoking or using tobacco
  • Take advantage of our support systems (see “Supports” below)

What to Expect

Everyone’s disease and life circumstances are different, and your renal care will be customized to your needs. Below is a basic overview of our care services at the Health Sciences Centre.

Diagnosis

In most cases, your primary care provider (family doctor, nurse practitioner, etc.) will refer you to a nephrologist (kidney specialist) if he or she suspects that you may have chronic kidney disease (CKD). You may also be referred by doctors in the Emergency Department or another doctor or specialist who may be treating you. The nephrologist will order tests for you, and if you are diagnosed with kidney disease, will refer you to the Renal Program for your continuing care.

This can be an emotional time, so you are encouraged to bring along a family member or trusted friend to your appointments with the nephrologist for support and to listen to the information the doctors are giving you.

Kidney Clinic

People who have kidney disease but are not requiring dialysis attend our Kidney Clinic following a referral by one of the Nephrologists. During this time, their kidney disease can be treated with medications, diet, exercise, and lifestyle changes including stopping smoking/tobacco use.  During the clinic, the care team will support you through the above care plan as well as provide information and decision support as you make treatment decisions.
You are encouraged to bring a family member or trusted friend to your first appointment (and any other appointment, if it will make you feel more comfortable).

The goal of the Kidney Clinic is to monitor your condition to better manage your disease, and to slow the speed at which your disease is progressing. Depending on your condition, you may be able to avoid dialysis for some time. Following your care plan is an important part of this. Attending all appointments, keeping to your dietary restrictions, exercising, and stopping smoking/tobacco use will all help you.

Dialysis/Treatment

Kidneys act as a type of filter for the body, removing toxins from the blood. When kidneys fail due to disease or injury, they no longer clean the blood, and these toxins build up causing a number of medical conditions, eventually leading to death.

However, modern medicine has come up with a number of ways to help remove these toxins from the blood, and avoid further medical conditions. The list below is a general overview of the treatments available in the Renal Program. Note that not all treatment methods are available to all patients. Your care team will discuss which treatment options will work best for you.

Dialysis is a life support treatment. It’s important that you follow your care plan closely, including attending all dialysis appointments.

Hemodialysis – The person’s blood is fed through an IV tube into a dialysis machine that cleans the blood of toxins. People undergo this treatment three times per week for approximately four hours per session.

Hemodialysis is available at the Renal Program here at the Health Sciences Centre, or at one of our threesatellite sites in Fort Frances, Sioux Lookout and Kenora.

You may want to rest or even sleep during hemodialysis, though you may wish to bring a book, knitting, or some other type of quiet activity. You are encouraged to bring a family member or trusted friend to your first appointment.

Peritoneal Dialysis – Special dialysis fluid is infused via a thin plastic tube into the peritoneal cavity. This peritoneal cavity (is a sac in your abdomen) that holds many of your abdominal organs. This special dialysis fluid absorbs toxins and extra unwanted water from the blood.  After a pre-determined amount of time, the fluid is drained out of the peritoneal cavity taking the toxins and water with it. Peritoneal dialysis is a home treatment done during the day or night which people undergo every day. There is a 5-10 day training period to learn how to safely perform this treatment at home.

Home Hemodialysis – This method is exactly like hemodialysis, except that it takes place in the person’s home. The home must have access to a constant supply of water and electricity.  It takes approximately eight weeks of training to learn how to safely do your own hemodialysis at home.

Transplant – Kidney transplantation is also a treatment for kidney disease.  It is not a cure.  Thunder Bay Regional Health Sciences Centre does not perform kidney transplantation.  Instead, the Renal Program team will liaise with the referral transplant centres on your behalf and will assist with the assessment process. They will continue to follow you post transplant as well, decreasing the travel outside Northwestern Ontario.

Living Kidney Donation– People interested in living kidney donation can contact the Renal Program to learn more about this option.  As with kidney transplantation, the person interested in kidney donation would be required to travel to the transplant centre for the donation.  The renal team will assist and support you through the process from learning about donation through post operative care.

Conservative Treatment – Some people choose not to undergo dialysis of any type. The Renal Program provides monitoring services through the Kidney Clinic to help people maintain their health and manage their symptoms.

Supports

The North West Regional Renal Program is committed to helping patients in all aspects of their care, not just their medical symptoms. There are a number of supports built into the program to help you throughout your treatment.

All staff in the Renal Program are specially trained in renal care. They are available to help answer any questions you may have about renal disease in their specific area of care. In the case of social workers and the Indigenous Liaison, they can help you connect with other services to help you deal with how your kidney disease affects other areas of your life.

Staff will provide you with information about your kidney disease throughout your treatment. There are also a number of brochures and other reference materials available to all who need it.

Kidney Disease Support Group – This group is made up entirely of renal patients who are going through similar experiences you are, and understand the physical, emotional, and mental issues that go along with kidney disease. Patients can join one of two groups that meet once per month, coinciding with treatment times for the convenience of patients. Nothing is expected – you can drop in on as many or as few meetings as you like, ask questions, relate your story, or simply just listen to others talk. For most, the Kidney Disease Support Group is a way to feel connected to other people who understand what you are going through, and can help provide you with support during your own treatment.

Family members are also encouraged and welcomed at our gatherings, particularly in the early days of diagnosis, to gain knowledge and a better understanding about the disease and how it affects the family.

The Kidney Disease Support Group is sponsored by the Kidney Foundation of Canada.

Online Help – There is a wealth of information online to help you find answers to your questions about kidney disease and treatment. The two best sources are: