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Samaritan Dialysis Services

Program Overview

Samaritan Dialysis Services is a multi-disciplinary dialysis facility, offering the expertise of registered nurses, dialysis technicians, social worker, dietitian and secretarial staff. The outpatient dialysis service includes 12 hemodialysis stations in Corvallis and eight stations in Lebanon. Each location also offers peritoneal dialysis training.

The facilities provide local, professional, compassionate care for people who need hemodialysis and peritoneal dialysis. In addition, Samaritan Dialysis Services staff are available by appointment to provide education about kidney failure. They also provide on-site training, depending upon job openings, for medical personnel interested in entering the dialysis field.

The dialysis facilities are designed for patient comfort, with aesthetic touches that include: comfortable furnishings and attractive colors; individual TV/VCRs; home-like waiting areas; and gorgeous mountain views through the expansive windowed walls.

Treatment Options

When your kidney function reaches 20 percent or less of what is normally required, your kidney doctor (called a nephrologist) must decide how soon you will need additional treatment. This stage in kidney failure is called End Stage Renal Disease (ESRD). At this point, you will need to select a treatment method for cleaning the toxins and water that your kidneys were once able to remove from your body. Your doctor will help you choose the treatment that will work best for you. When selecting your treatment, remember you may change your choice at any time, even after many years on one kind of treatment.

There are two major types of treatment choices: dialysis, and transplantation.

Option one: Dialysis

Dialysis is a mechanical filtering process used to cleanse the blood of waste products, remove excess fluid and also regulate body chemistry when your kidneys fail to work properly. You will also need to modify your diet and take certain medications to help you make up for the loss of the kidney function. There are two types of dialysis: hemodialysis and peritoneal dialysis. Both choices require a surgical procedure to establish a connection between the dialysis equipment and your body. That connection can be made through a graft, using a fistula or catheter, each of which provides "access" to the blood. One that connection is made, it can be used each time you receive dialysis treatment. Hemodialysis can even be done from your home.

Hemodialysis In Center

This type of treatment is done at a dialysis unit. Staff nurses or technicians provide the treatment. In hemodialysis, the blood itself is cleansed with a machine which pumps the blood out of the body, then through a filter and back into the body. Two needles are placed in the "access" to connect the tubes to the blood system in the body. A numbing medication is given before inserting the needles so the procedure will not be uncomfortable. The treatment takes between three and five hours, three times a week, when the kidney function is completely gone. At the end of the treatment, the needles are removed and bandages are placed over the needle sites.

Hemodialysis At Home

If your dialysis treatments at the center are stable and without complications, you may choose to have hemodialysis at home. In order to choose this option, you must have a partner who is willing to complete a six- to eight-week training session to learn how to assist in your treatment. The training is done at the dialysis center at Good Samaritan Regional Medical Center under the direct supervision of a nurse instructor. This option can only be successful with a strong commitment from both you and your partner. This choice is a demanding one, and can be stressful for your partner. At the end of the training, both you and your partner will be evaluated to ensure you are ready to begin your in-home treatments.

In addition to the training, your home also needs to have enough space for a dialysis machine, water treatment equipment and numerous supplies. There also needs to be sufficient water pressure and electrical outlets to run the dialysis machine. Staff from the dialysis center will visit your home to determine if treatments can be successfully given there. Once treatments begin, the staff will also visit periodically to see how things are going. You will also need to visit the center each month so the staff can check your blood chemistries and medications. The other option is Peritoneal dialysis.

Peritoneal Dialysis

This type of treatment is done at home. Instead of using an artificial filter such as that used in hemodialysis, your own peritoneum is used. The peritoneum is a thin membrane that lines the abdominal cavity. To access the peritoneum, a flexible tube called a catheter is placed in the lower abdomen. This tube is about 12 inches long, but only a few inches actually lie outside the body. This tube is used to connect the equipment to the body.

Peritoneal dialysis uses multiple bags, or "exchanges," of special fluid. Each bag is placed into the abdomen through the catheter and allowed to sit, or "dwell," for a period of time. During this time, the toxins and excess water are drawn across the peritoneal membrane out of the bloodstream and into the special fluid. After a period of time, this fluid is drained out of the abdomen and replaced with fresh fluid. This process continues throughout the day and night, depending on which type of peritoneal dialysis you choose. There are two options: Continuous ambulatory peritoneal dialysis and continuous cycling peritoneal dialysis.

Continuous Ambulatory Peritoneal Dialysis

This is the most common type of peritoneal dialysis, and does not require any machines. Exchanges are done between four and five times a day. The last exchange of the day remains in the abdomen overnight and is removed by the first exchange of the next day. It takes 20 to 40 minutes to complete each exchange (draining the old fluid and replacing it with the new fluid). It takes one to two weeks of training to learn how to do CAPD, and the treatment can be done without a partner.

Continuous Cycling Peritoneal Dialysis (CCPD)

This type of dialysis can be done independently or with a partner. It is similar to CAPD in that it uses the peritoneum as a filter. The difference is that it uses a machine called a cycler. The cycler circulates the cleansing fluid, called dialysate, in and out of the peritoneal cavity at regular times throughout the night for eight to ten hours. In the morning you disconnect from the machine, and reconnect at night for another treatment. For patients who have lost all kidney function, both CAPD and CCPD may be needed.

Option 2. Transplantation

Transplantation is the placement of a health kidney into a person with kidney failure. The healthy kidney can come from a living donor (either relative or unrelated donor) or a nonliving donor. Only one kidney is needed for transplantation, since a person can maintain a normal life with one well-functioning kidney.

Any transplantion will be referred to an outside transplant center.

Option 3. No Treatment

As a patient, you also have a choice of "no treatment." This decision should be made after consulting your family and your nephrologist. You may also want to talk with your family physician, clergy, dialysis social worker and nurse. It is important that you have as much information as possible about your condition so you can make an educated and well-informed decision.

As with the other treatment options, you may opt for no treatment after undergoing dialysis and/or transplantation. The dialysis staff has a binding responsibility to ensure patients are well educated about the treatment options. Once the information is given, the staff will support your decision about treatment.

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