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Dialysis Case Study of Mandi’s
Long Battle with Lupus

Dialysis Case Study

By Edgar Rider

Many may not know that Lupus is one of the common reasons for developing  kidney disease and other health problems. 

It can be a lifetime of terrible discomfort, pain and deteriorating health conditions. Kidney disease is one of the biggest health concerns. 

Patients are usually subjected to two kinds of treatments. These patients are placed on one of two kinds of dialysis. It is a regular treatment which could be three days a week or 5 days a week and some cases more or even daily.

We will use the Case Study of a patient known as Mandi to explain the process. 

What exactly is Lupus?  Lupus is a chronic (long-term) disease that can cause inflammation and pain in any part of your body. It’s an autoimmune disease, which means that your immune system — the body system that usually fights infections — attacks healthy tissue instead.

There are two kinds of lupus:

  • Discoid lupus erythematosus.
  • Systemic lupus erythematosus.

Lupus most commonly affects things such as skin, joints and internal organs like kidneys and heart.

Mandi has had symptoms of both Discoid and Systemic Erythematosus.

Patient Mandi has been struggling  with being diagnosed with Lupus since 2001. It has sometimes been dormant or in remission but has resurfaced to attack specific organs.  In particular, her kidneys and her brain were affected in one particular occasion.

In 2006, she developed symptoms such as  joint pain and she also developed what is called a butterfly rash.  A butterfly rash is a reddish rash on the face that spreads over the bridge of the nose and across the cheeks, making the shape of a butterfly

Some of the Treatments consisted of steroids off and on for many years after. She was also prescribed Plaquenil which is a name brand of  Hydroxychloroquine. In  2006, she had a  major flare up that attacked her kidneys which also caused her hair to fall out.

There are two types of dialysis she has received. One is called Hemodialysis and the other is Peritoneal dialysis. She now is on the latter at her own home.

She began to go on Hemodialysis. This is a treatment at a dialysis center where a dialysis technician hooks the patient up to a machine which starts the process taking at least three hours.

Hemodialysis is a treatment to filter wastes and water from your blood. It helps control blood pressure and balance important minerals, such as potassium, sodium, and calcium, in your blood

Blood is taken out of the body and then it is returned back into the patient's body after a filter process. The exit site is usually in the arm or upper chest close to the shoulder area.

As she went through this process several times, she got the diagnosis that both kidneys had been damaged and were  inflamed and scarred. Dialysis treatment of hemodialysis consists of a three hour session in her case but most important it must be at a treatment center. There is a port of two tubes coming out of chest area - one has the blood going in the body and the other tube out of the body.

Dialysis Case Study

During this time, Lupus attacked her brain, a condition known as cerebritis, which is simply an inflammation on the brain.

She also developed lupus nephritis as a result of her lupus.  lupus autoantibodies affect structures in your kidneys that filter out waste. This causes kidney inflammation and may lead to blood in the urine, protein in the urine, high blood pressure, impaired kidney function or even kidney failure

She was instructed to go on Kidney dialysis for  nine months.

She has spent time in a couple of different treatment centers such as Provo Dialysis, Fresenius, Davita and that cater to hemodialysis treatments.

There were periods she was taken off that type of dialysis but was told to go back on it in 2016. Because she had another flare up in which kidneys were attacked again, she was placed back on it for an indeterminate amount of time.

After spending a couple of years at the center, she then became a candidate for a convenient home dialysis treatment program. For this she would use a  Peritoneal dialysis machine. It is called CCPD and it stands for Continuous Cycling Peritoneal Dialysis.

This type of Peritoneal dialysis uses the inner lining of your belly (peritoneum) as a filter to clean your blood.

The difference is the patient gets to do this at home and have more flexibility in the schedule of treatment sessions. In her case, the process is longer; it is about 7 hours an evening. But she can do the process while sleeping. Many patients choose their time to complete treatment. The patient does not have to get up and do anything to the machine at night. If there are any issues an alarm will sound. 

This machine is convenient and easy to move around the room. It comes on a moving stand where dialysis where the patient can put it close to bed or designated comfortable treatment area. 

This Continuous Cycling Peritoneal Dialysis machine is what Mandi uses on a nightly basis 6 nights a week. The first process of the evening is Drain, Fill, Dwell and Drain. That can take two hours depending on the dwelling period. The next are Fill and Dwell and then Drain. She has three sessions. 

In her case, she has been instructed to use the machine 6 days a week. 

She goes through this process as she waits with the donor process. She is now waiting to hear back on possible donors such as members of her family.

The dialysis process for Mandi has been a long tough road full of different treatment programs, some for a short amount of time and others for a much more extended amount. Mandi is optimistic after qualifying for a kidney transplant and she is eagerly awaiting a donor. She is hopeful because many in her huge family have agreed to be a donor if they are a match.

The likelihood of a family match is usually the best chance.

The CCPD machine has made managing her time much easier. 

It is now just a waiting game, she has been through much of this process several times before. 

Treatments have been working and she has remained productive during the day with her regular activities.


About the author:
Edgar Rider has written articles on Education, Social Media and Marketing topics. He has recently become a care partner for a dialysis patient on a Continuous Cycling Peritoneal Dialysis Machine. Mandi, the patient in this article, asks that her story be told.

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