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Tuesday, November 26, 2019

My Hemodiafiltration Experience at The Dialysis Co in Cebu City

I have been on hemodialysis in Cebu for more or less 7 years already and in the course of dialysis, I have been to different dialysis centers and have experienced low and high flux dialysers with the conventional hemodialysis. When the opportunity presented itself that I would be able to try a relatively more advanced form of renal replacement therapy known as hemodiafiltration (HDF) here in Cebu, I grabbed the chance. And here is the account of my experience.

the HDF machine

For starters, hemodiafiltration (for those curious) is a form of renal replacement therapy which combines diffusion (what happens in hemodialysis) and convection to enhance removal of solutes at a wider range of molecular weight including middle molecular weight ones not effectively removed by usual hemodialysis. This convection removes these solutes through fluid flow and involves the use of replacement fluid to reach target fluid balance. What does this mean? Greater clearance of urea, phosphate (one of the major concerns of dialysis patients) and Beta2- microglobulin. Beta2 microglobulin is implicated in a disabling condition for chronic dialysis patients known as dialysis-related amyloidosis where patients experience among others, joint pains and pathologic fractures as a result of accumulation of beta2 microglobulin deposits. Others would have carpal tunnel syndrome.  The heart is also believed to be involved in cardiac amyloidosis typically associated to use of low flux dialysers.

Now back to my experience. 

The Dialysis Co (TDC) is a new free-standing dialysis center in Cebu City located on the Upper Ground Floor  of the MDCT Building, Leyte Loop, Cebu Business park just near the Ayala Center mall Cebu which offers hemodiafiltration. This is where I tried hemodiafiltration.

On the way to the center, I passed by Camotes Road then parked on the 2nd floor of the said building where there are reserved spots for TDC near the ramp. The where there is an elevator going to the upper ground floor where the dialysis center is situated.

This is what will greet you on the entrance. A very refreshing atmosphere which does not have a hospital vibe. Well, it's more of a spa vibe that can be felt here. See for yourself.

The waiting area is very spacious and has a TV screen where netflix shows are played.

Inside the actual treatment area has the same relaxing feel.



Does not look like a dialysis facility, right?

So it was time to take my weight to know how much fluid will be taken from me.

A visual inspection of the facility reveals the presence of several equipments including emergency equipment. One could not help notice the unique chairs which do not appear to be like the usual Lazy Boy type chairs in dialysis centers.



The special chair which has movable arms is "armed" with what appears to be a Digital TV with ABS CBN TV plus box for each chair and a food tray. One could bring ear phones or even a USB to play your favorite movie in this TV.


The "dialysis chair" has controls where you can set the inclination of the chair, the height and the length of the lower part of the chair to achieve the best comfortable position for you.

Notice also the brown button for calling the nurse in the station. You won't need to shout or fling up your arms to get noticed when you need to call a nurse. By the way nurses to my knowledge have  1 year to 7 years experience as a dialysis nurse.

And now to the hemodiafiltration itself. For my sessions the dialyser is a special one considered to be a "super hi-flux" dialyser capable of relatively better clearance.

Based on company dialyser information provided online, it is considered highly biocompatible Polysulfone membrane allowing high clearances.

My blood flow was set at 300 and Nadroparine, a low molecular weight heparin was used for my case to keep the blood from clotting in teh dialyser and the tubes during the therapy.

The duration was also 4 hours like the usual dialysis but time just flew by fast since you won't feel the time really as you are either entertained by what's showing on the TV screen or you are preoccupied with what's online as one can access the internet via wifi.

I had no cramps during and after the session and I did not feel weak afterwards. You may have a different experience but I am just relaying mine. In fact I was able to drive, fetch my wife from work then drive home.

Here is the "tape" they used on my access puncture site.
Notice the round thing underneath that applies pressure to the site to prevent bleeding. And by the way, appropriate blankets are provided for the very cool facility and in case it is really cold, there are goose neck lamps and hot water bag available. 

Overall, the experience was very nice and went without incident. I even had a bonus body composition monitor or body water analysis which I am told is offered by this center as additional service.

I was also told they offer various packages which come with free B.Braun Nexadia Patient Data Therapy Card.

If you want your questions about them answered, you may contact (032) 254 8501. If you want to check the facility yourself, they are located at Unit 2, U/GF MDCT Building, Leyte Loop Cebu Business Park Cebu City. 

As for me, I want to do research about HDF and its impact on the patient. I hope to be able to see for myself actual blood test results some length of time after hemodiafiltration. I hope to have that opportunity soon. 

NOTE: Photos of the dialysis center taken with permission from the medical director and owners of the facility.



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