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1 Winter 2017 Do you want to improve the lives of dialysis patients? Ask your facility if they participate in the Facility Peer Program. To be a part of this program contact The Renal Network at 1(800) and ask for Quin Taylor. How Does Your Facility Measure Up? Learn how to find their star rating! -p6 This newsletter, Renal Outreach, is one way patients can stay up to date on Network activities and projects. If you are not already on our mailing list, you may sign up to receive Renal Outreach free of charge. To subscribe, call the Network at 1(800) and ask for Katie Stark. Or visit Resources/newsletters.html In This Issue... p2 Holiday Recovery p3 Recipe p4 Exercise & Diet p6 How is Your Facility Doing?

2 Wow, 2017 is here! By Annette Montalbano Time seems to fly as we are enjoying all the holidays that occur during this winter season. If you are like most people you celebrated the winter holidays with food feasts. That can mean you have added some excess weight and this is the time to try to get rid of it. That is easier said than done in the Midwest winter! Outdoor walks are not very appealing. So what can we do? Find an indoor walking track, climb the stairs in your home 10 times a day, exercise in front of the TV, find a buddy and go to the local gym and ride the stationary bike.use your imagination, the important part is to keep moving on a regular basis. I have found that my local public library has several renal/ diabetic renal recipe books available for checkout. Try something new, but tasty. I often make kidney friendly dinners and desserts for guests at my home. It helps keep me on track and we get to share delicious food together. Sometimes I find a recipe for a kidney friendly snack. I prepare it and bring it to the dialysis clinic and share it with other patients as we wait our turn. Small portions are always the key, as we are just looking to taste not overindulge. Sharing and tasting some new and kidney friendly food is always a delightful experience. The recommended renal diet can become repetitive and somewhat boring if we are not careful and creative. Often, that s when we fall off the kidney diet wagon and consume foods not recommended for us to eat. Sharing recipes and tasty items with your fellow dialyzers, friends and family really helps us stay healthy. Sometimes I go online and just google Kidney friendly diet. I have discovered many interesting facts about what excess potassium, salt and phosphorus can do to our kidneys. I am always happy when I learn something new about renal disease. January 28 begins the Chinese Year of the Rooster. To celebrate that, I am sharing a recipe for chicken that is renal friendly, very delicious and easy to prepare. I make this for my family often. Although I am the only one in my household who needs to follow a renal diet, they love it as well! Stay healthy, eat judiciously, exercise and above all, laugh often! Annette Montalbano is a member of the Patient Advisory Council for Network 10, and also acts as a Peer Representative for her dialysis unit. She works continuously to help her fellow patients become more knowledgeable about their kidney disease. 2

3 Chicken With Caper Sauce Serves 2 1 tablespoon lemon juice 1 teaspoon dried rosemary 1 garlic clove, minced 8 ounces of boneless chicken breast, cut into ½ inch strips Cooking spray 2 tablespoon olive oil, separated 2 tablespoons of chopped onion ½ cup chopped green pepper 2 teaspoons cornstarch ¼ cup of low sodium chicken broth ¼ cup of white wine ¼ teaspoon of poultry seasoning 2 teaspoons of capers, rinsed and drained Nutrients per serving Calories 234 Protein 26 g Carbohydrates 5 g Fat 10 g Cholesterol 69 mg Sodium 286 mg Potassium 256 g Phosphorous160 mg Renal and Renal Diabetic Food Choices 3 meat 1 vegetable, low potassium 1. Combine lemon juice, rosemary, 1 tablespoon of oil, and garlic in Ziploc bag. Add chicken and coat with marinade on all sides. Refrigerate for 30 minutes. 2. Spray a non stick frying with the cooking spray. Add chicken and fry until partially cooked, about 5 minutes. Remove and set aside. 3. In the same frying pan, add one tablespoon of oil, and sauté vegetables until tender crisp, Combine corn starch, broth, poultry seasoning, wine and capers. Add to vegetables and bring to a simmer. Add chicken and stir until the chicken is fully cooked, about 3 minutes. 3

4 Exercise Consult your doctor before beginning any exercise routine. Exercise is an important part of any lifestyle, but especially for patients with kidney disease. Exercise has many physical and emotional benefits. It can help you maintain your strength and reduce the risk of other health complications. Exercise can also improve your mental health by reducing stress and anxiety. Many dialysis patients feel like they re too tired to exercise, but beginning an exercise routine can actually increase energy levels. Boost Your Mood Exercise can greatly improve mental health. In general, people who regularly exercise experience less stress, anxiety, and depression. Exercise elevates your mood and can also improve sleep. With the mental and physical stress of kidney disease, physical activity is an important tool to improve emotional well-being. Maintain Strength Patients with kidney failure often experience muscle loss due to the toxins and acids in the blood. Exercise is key to gaining or maintaining muscle strength. Having the strength and energy to accomplish daily tasks will help you have a better quality of life and more independence. Other Health Benefits Physical activity can help control weight and reduce the risk of heart disease and stroke. It also helps to lower blood pressure and control blood sugar levels. Start Slow Start out slow and gradually increase your activity level. Even 15 minutes of activity a day can be helpful. Walking is a great way to get moving and has proven health benefits. 4

5 Diet Tips These tips are basic guidelines. Your needs may vary. Always check with your dietitian before making any changes to your diet. Protein Protein is an important nutrient that s especially important for dialysis patients, because it aids in the growth and repair of muscles and other tissues that can be damaged due to kidney disease. The amount of protein you need can depend on the type of dialysis you receive. Potassium Potassium helps your heartbeat stay regular and controls your muscle function. Too much potassium can cause heart problems and muscle failure. Rinsing canned fruits and vegetables can remove some excess potassium. Also try replacing dairy with non-dairy substitutes. Try to avoid nuts since these are a high potassium snack. Sodium Limit the amount of sodium you eat to help control your blood pressure and prevent heart problems. A diet high in sodium can cause swelling and fluid build-up. Too much sodium can also make your thirsty and push you over your fluid restriction. Avoid table salt and opt for fresh or frozen vegetables to limit excess sodium intake. If you use canned vegetables, choose low sodium options. Avoid too many processed foods since these are also high in sodium. Phosphorus Too much phosphorus buildup in your body can cause serious health problems. Avoid foods high in phosphorus, such as dairy, soda, organ meats, poultry, nuts, and processed foods. Make sure you read labels since phosphorus can be hidden in the ingredients. Keep Track Consider keeping a food journal to help you keep track of nutrient intake. 5

6 How do patients rate your dialysis center? Check out the website. Dialysis Facility Compare allows patients and their caregivers to search for dialysis centers, compare them side by side, and find the right one for them. Patients who are currently receiving dialysis, can use the site to understand how Medicare measures the quality of care dialysis centers provide. The Centers for Medicare and Medicaid Services (CMS) has calculated Star Ratings for every Medicare certified dialysis center, with five stars as the highest rating. The Star Ratings combine nine clinical quality measures of how well dialysis centers care for their patients and how often each center uses best practices to care for its patients and keep them healthy. Dialysis Facility Compare also contains the results of patient experience of care survey which includes information about how well staff listen and how clean the facility is. Visit to see how patients rate the quality of care your dialysis center provides. The information on Dialysis Facility Compare includes: Dialysis center contact information and services offered Clinical quality of care Star Ratings Clinical quality information Patient experience of care survey results 6

7 Have You Seen This Certificate? The ESRD QIP is designed to provide better care to patients with ESRD. It is possible that your facility will receive a payment reduction if it does not perform well enough. You will not be impacted financially by the ESRD QIP. You can use the ESRD QIP to see how your facility's performance under the ESRD QIP compares to the performance of facilities nationwide in the same program. CMS requires facilities to post certificates describing how they performed on the ESRD QIP. You can also find this information on Dialysis Facility Compare, available for free at Medicare.gov. You can ask your facility about its ESRD QIP scores, including its Total Performance Score. This information can be used as one tool among many when making choices about your care. It is important to note that the ESRD QIP is not the only method for evaluating quality care at a facility; you should consider other factors as well. For more information visit: or Have you been vaccinated? As a dialysis patient, it s important that you keep your vaccinations up to date to ward off illnesses. It s likely your immune system is weakened due to kidney disease so vaccinations will help you be as healthy as possible. You should be vaccinated for: Influenza (flu) each year Hepatitis B A series of four shots Pneumococcal Pneumonia Every 5 years Check with your dialysis care team for details and make sure you are up-to-date! 7

8 The Renal Network 911 E. 86th Street, Suite 202 Indianapolis, In The Renal Outreach is a publication by The Renal Network and is a newsletter for individuals and their families living with chronic kidney disease. The Renal Network works to facilitate the achievement of optimal wellness for renal disease patients, including those on dialysis or who have received a kidney transplant. The Role of The Renal Network The role of The Renal Network is to promote and support quality dialysis care and outcomes of ESRD patients and kidney transplant patients in Network 10 (Illinois). Through patient services, patient/professional education, quality improvement practices for providers, and the collection, analysis and exchange of relevant data, The Renal Network works to achieve optimal wellness and a better quality of life for renal disease patients. To file a grievance, patients may call 1(800) or download forms from our website: and send to The Renal Network at the contact information listed. Contact Us Give us a call for more information about our services and resources. The Renal Network 911 E. 86th Street, Ste. 202 Indianapolis, In (800) info@therenalnetwork.org Visit us on the web at Published under CMS contract HHSM C.

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