For family, friends and caregivers of a patient with kidney failure in the Medical Surgical Intensive Care Unit (MSICU)

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1 Form: D-8711 Kidney Failure For family, friends and caregivers of a patient with kidney failure in the Medical Surgical Intensive Care Unit (MSICU) This brochure will give you more information about: The causes and symptoms of kidney failure How kidney failure is treated in the MSICU What you can do to help

2 What is kidney failure? The kidneys help filter waste products out of your blood and remove fluid from your body They also help to control blood pressure, electrolyte balance, and red blood cells being made in the body. Kidney failure, also known as renal failure, happens when one kidney or both kidneys don t filter waste products from the blood as they should. kidneys There are 2 main types of kidney failure: 1. Acute kidney injury: a sudden loss of kidney function that is usually reversible 2. Chronic kidney disease: long-term kidney damage that usually is not reversible Recovery from kidney failure depends on many things. Please talk with your MSICU health care team about the causes of kidney failure for your loved one. 2

3 What are the signs and symptoms? Decreased or no urine output Swelling called edema Irregular heart rate Fatigue or feeling very tired Changes in breathing because of extra fluid in the lungs, or acid build up in the blood stream What can cause kidney failure? Long-term high blood pressure Very low blood pressure High blood glucose (sugar) levels Dehydration Medications that are toxic to the kidneys Drug overdoses Infections Conditions like lupus or scleroderma A block in the flow of urine from the kidneys or bladder 3

4 How is kidney failure treated in the MSICU? Before treatment begins, several tests will be done. These tests may include: Blood tests Urine tests An ultrasound of the kidneys or bladder A biopsy of the kidneys Some medications that may be used to treat or support the patient with kidney failure are: Diuretics to remove fluid Vasoactive drugs to help with blood pressure Beta-blockers to lower blood pressure and control the heart rate Insulin to control blood sugar levels Erythropoietin to help make red blood cells Blood pressure medication What we do to treat kidney failure: 1. First we lower the amount of fluid intake and remove extra fluid using medications 2. If medications cannot remove enough of the fluid or toxins from the body, the next treatment would be hemodialysis To begin hemodialysis, a hemodialysis line is inserted into one of the larger blood vessels in the neck or groin. This is usually done in the MSICU. 4

5 There are 2 types of dialysis that are used in the hospital: Slow Low Efficient Dialysis (SLED) which is usually done 3 to 6 days a week for 8 hours a day. SLED is only done in the MSICU. If the patient is stable on SLED, Intermittent Hemodialysis may be started, usually done 3 times a week for 4 hours a day. Other treatments that may also be used to treat kidney failure are: Changing the diet to help balance electrolytes in the body Lowering high blood sugar levels Correcting blood pressure problems What can I do to help? Substitute Decision Maker It is important for one family member to act on behalf of their loved one as a Substitute Decision Maker (SDM). An SDM is usually the next of kin, unless the patient chooses someone else. As an SDM, you are responsible for giving accurate and honest information about your loved one to the health care team. You also: Partner with the health care team to make sure you understand what is happening with your loved one Work together with the team to decide about the care and treatment of your loved one Please look for the brochure Substitute Decision Makers and Naming an Attorney for Personal Care in the MSICU waiting room. Comfort and support Although sometimes patients in the MSICU are on sedating medication, they do still need emotional support from their friends or families. Talk to them like you would at home. Bring toiletries, familiar pictures, books and comforting items from home. 5

6 Visiting hours Visiting hours are from 9:00 am to 11:00 pm every day, but we have a flexible visiting policy. Please talk to your nurse. Make sure only 2 people visiting your loved one at a time. Please try to keep your visits short and remember to let other family members in to visit. Consider limiting the number of visitors until your loved one is in stable condition. Hand washing You can help the health care team, your loved one and yourself by washing your hands often during your visits to MSICU. Please follow all isolation instructions or talk to your nurse if you are not sure what to do when visiting an isolation room. Who can I talk to if I have questions? Do not be afraid to ask questions. Ask any member of the health care team to repeat or say information in a different way. You can talk with any of the medical staff caring for your loved one about any concerns you may have. 6

7 More information about kidney failure Organization: Medline Plus Kidney Failure MedlinePlus Interactive Health Tutorial from the Patient Education Institute Organization: The Kidney Foundation of Canada Organization: National Kidney and Urologic Diseases Information Clearinghouse (NKUDIC) My questions Visit for more health information. Contact us to provide feedback or request this brochure in a different format, such as large print or electronic formats: pfep@uhn.ca 2018 University Health Network. All rights reserved. Use this material for your information only. It does not replace advice from your doctor or other health care professional. Do not use this information for diagnosis or treatment. Ask your health care provider for advice about a specific medical condition. You may print 1 copy of this brochure for non-commercial and personal use only. Form: D-8711 Author: Ingrid Daley, Dr. John Granton, Elke Ruthig Created: 09/2018