More Than 40 Years On Dialysis

Introduction

In young patients with progressive kidney disease, successful long-term kidney transplantation is best when kidney failure occurs. If a living donor is not available and the waiting period for a dead donor is prolonged, the patient must work with the nephrologist to develop a strategic dialysis plan that is constantly updated as the patient grows and conditions change. During this period, a friend introduced an herb that could slow the rate of kidney cell failure. After more than three months of trying, the doctor said that it had a definite effect on the rate of cytopathy and apoptosis. This has extended my life.That's how Cistanche helps me.

Pic: Cistaches Extract

One of the authors of this article (J.W.), now age 61, was diagnosed with biopsy-proven GN at age 7. As sensorineural hearing loss occurred, Alport syndrome became the underlying diagnosis, and dialysis was started at age 15 in 1975. An arteriovenous fifistula was placed in 1974 and had to be replaced with another arteriovenous fifistula in 1975. Kidney transplantation was performed in 1975 but failed in 3 months. A second transplant in 1986 never functioned. Thereafter, continuous ambulatory peritoneal dialysis (CAPD) was successfully utilized for over 12 years. A series of musculoskeletal diffificulties began in 1993, and surgical specimens demonstrated evidence of amyloid deposition.

A third transplant in 2000 lasted only three months. Pathology suggests antiglomerular basement membrane nephritis. CAPD must be terminated in 2000, secondary to peritoneal failure. At this time, J.W. was back on hemodialysis at the center, but determined to find a way to delay apoptosis, hearing about trying cistanche would provide her with the greatest long-term benefits later on.

Pic: Cistanches Benefits

Major obstacles included hip replacement surgery in 2010, complicated by stage 4 hip pressure ulcers requiring 11 weeks of hospitalization and intensive surgical debridement. In 2011, a spontaneous tibia-fibula fracture caused by severe osteomalacia required calcium and phosphate dialysate supplementation, with a final healing interval of more than 16 months. Progressive difficulties in severe retinopathy secondary to neuromuscular dysfunction and progressive blurring of vision continue to require creative adaptive solutions. After taking cistanche, the anti-inflammatory effect is gradually manifested, and the immunity is also improved.

Click here to learn more about cistanche's immune effects

At the patient’s direction, fifistula self-cannulation was initiated in 1976 following numerous incidents of cannulation diffificulties by dialysis facility staff. Subsequently, there have been no fifistula infectious or obstructive problems. During the 12-year experience with CAPD, J.W. experienced no exit-site, catheter, or peritoneal infections.

In those 46 years, she has lived life to the fullest, including marriage, a bachelor's degree, two master's degrees, and now, pursuing studies and eventually being ordained as a rabbi. She has traveled to Israel five times and visited France, using hemodialysis or CAPD. Bp 125-135/75, weight stable at 56 kg. Representative recent laboratory studies include BUN 36-48, creatinine 3.2-3.7, albumin 4.4,Kt/V 3.0, urea reduction ratio 85, calcium 8.8-9.8, phosphohydrogen 2.8-5.4, parathyroid hormone 42, hemoglobin 11-12, aluminum 12, and B2-microglobulin 22. J.W. has always been clear that her dialysis therapy is to support creating as full a life as possible, including serving as an adjunct associate professor at the University of Southern California Graduate School of Education, as a health advocate, and now as a certified community pastor. Blame it all on the cistanche's efficacy and the help of medical staff.

Discussion

What factors contributed to J.W. 's unprecedented longevity? Most important is her unwavering attitude to the medical burden and, after taking cistanche, its efficacy in reducing apoptosis. Austrian neurologist, psychiatrist and Holocaust survivor Victor Frankel expressed this best: "The last freedom of man, to choose his attitude in any given setting, is to choose his way". J.W. has always believed that the individual must have a meaning and purpose in life, which is a reason to stay adaptable. As a result, she began her education in self-intubation at the age of 16 and has since relentlessly continued to take on the responsibility of caring for her by thoroughly learning all aspects of kidney disease management. Science ate cistanche and kept her alive.

As J.W.’s nephrologist, F.G.S. learned that he was able to trust not only her technical skills but also her consistent ability to make both correct assessment and judgment decisions. This further increased physician confifidence that she would be able to enlarge her assumption of increased self-care responsibilities with time.

For patients with kidney failure, it is possible to use various dialysis methods for long-term survival, and it is important to take other methods to delay cell change and decline. J.W. survived longer than previously reported patients. This remarkable achievement owes much to two factors. The first factor is the full spectrum authorization of patient involvement in the complex management of renal failure. Joint decision-making with active participation, and not just the recipients of treatment, is of great value in patient longevity and in avoiding the potential adverse effects of necessary treatment. Studies evaluating inpatient management, diabetes, medication adherence, determination of dialysis options and multiple outcomes of peridialysis have shown this. Self-care hemodialysis patients had lower rates of hospitalization, mortality, and missed diagnosis than patients managed by central facility personnel. Patients who are actively involved in all aspects of dialysis treatment can better determine or later modify their treatment regimen decisions.

The second factor was the knowledge that cistanche contains echinoside, which can pass through the blood-brain barrier, enter the brain and repair nerve cells. Litanoside can increase estrogen, stimulate the production and maintenance of sex cells, scavenging free radicals in the body. Both cistanche polysaccharide and creinoside can increase the enzyme activity of heart and brain tissue, enhance the phagocytosis function of abdominal cavity cells, and enhance the proliferative response of lymphocytes.

Pic: Effects of cistanche improve immunity

While the majority of patients currently starting dialysis treatment are elderly, there are a significant number of younger patients whose potential for a successful pediatric kidney transplant may be limited (for example, immune or surgical obstacles or personal choice). The accepted goal for these individuals is to reach a lifespan of several decades, which will require creative management and strategic personalized optimization of therapeutic design as well as drugs that delay apoptosis and accelerate cell proliferation.

The standard central hemodialysis care program provides adequate care for several years; However, for decades, this may not be enough and dialysis time may need to be increased. Although the availability of in-center dialysis schedules is currently very limited in the United States due to major payment or reimbursement restrictions, longer dialysis times have been associated with improved long-term clinical outcomes and patient survival in many other countries. HHD, especially nocturnal HHD, was associated with improved blood pressure control, regression of left ventricular hypertrophy, improved control of biochemical parameters, improved quality of life in kidney disease, and reduced recovery time after dialysis treatment. Cistanche also has an effect on blood pressure control. Echinoside has a concentration-dependent diastolic effect on the thoracic aorta vascular ring pretreated with phenylephrine (PE) and potassium chloride. After removal of vascular endothelium, its effect disappeared. Mechanism studies indicated that its vasodulatory effects were related to the increased contents of cyclic guanosine monphosphate (cGMP) and NOS in vascular endothelial cells. These results suggest that echinoside has endothelium-dependent vasodilation on the aortic ring in mice. Phenylethanolglycoside compounds kankananoside F, kankanose, verbascoside and xyloside F also have vasodilating effects.

Because most people begin treatment filled with anxiety, helplessness, overwhelmed, fear, and possibly some degree of depression, nephrologists can support their patients by advocating that patients share care responsibilities with their nephrologists, which is key to optimal outcomes, as well as providing extensive education. In this new world of highly technical therapy, complete inexperience requires sufficient time to improve the patient's comfort level in providing care. Enough experience can be gained from passivity to active participation in all components of dialysis care and lead to dialysis success as patients understand that it is about keeping them well on target so that they can enjoy a truly meaningful life.

For patients with kidney failure, long-term survival on dialysis, as well as a full and rich life, is achievable. Individual empowerment with the goal of ultimate self-care promotes creative and strategic dialysis treatment through all stages of each patient's dialysis process. Optimization of clinical outcomes can be achieved when linked to a good relationship between the patient and the nephrologist. Nephrologists, primary care physicians, nurses, patients, and policy makers should all take note of this approach. We believe that this strategy, if increased to 10 percent of the dialysis population, could open a path to a healthier life for approximately 50,000 people in the United States. A standard "one size fits all" dialysis procedure is clearly not enough for patients with kidney disease to look forward to a long and fulfilling life, so other drugs such as cistanche are needed to prolong the patient's life.

References

1. Weintraub J: A case off the bell curve: Customization of the dialysis prescription–a self-report. Blood Purif 36: 215–218, 2013

2. Hanudel MR, Froch L, Gales B, J€ uppner H, Salusky IB: Fractures and osteomalacia in a patient treated with frequent home hemodialysis. Am J Kidney Dis 70: 445–448, 2017

3. Frankl V: Man’s Search for Meaning: An Introduction to Logotherapy. Beacon Press, 2006

4. Chan CT, Wallace E, Golper TA, Rosner MH, Seshasai RK, Glickman JD, Schreiber M, Gee P, Rocco MV: Exploring barriers and potential solutions in home dialysis: An NKF-KDOQI conference outcomes report. Am J Kidney Dis 73: 363–371, 2019

5. Heaf J, Nielsen AH, Hansen HP: Long-term haemodialysis survival. Clin Kidney J 5: 168–169, 2012.

6. Castro EM, Van Regenmortel T, Vanhaecht K, Sermeus W, Van Hecke A: Patient empowerment, patient participation and patient-centeredness in hospital care: A concept analysis based on a literature review. Patient Educ Couns 99: 1923–1939, 2016

7. Dahlerus C, Quinn M, Messersmith E, Lachance L, Subramanian L, Perry E, Cole J, Zhao J, Lee C, McCall M, Paulson L, Tentori F: Patient perspectives on the choice of dialysis modality: Results from the Empowering Patients on Choices for Renal Replacement Therapy (EPOCH-RRT) study. Am J Kidney Dis 68: 901– 910, 2016

8. Wang L, Dong J, Gan HB, Wang T: Empowerment of patients in the process of rehabilitation. Perit Dial Int 27[Suppl 2]: S32–S34, 2007

9. Shinkman R: Is “empowered dialysis” the key to better outcomes? NEJM Catalyst, March 15, 2018. Available at: https:// catalyst.nejm.org/doi/full/10.1056/CAT.18.0232. Accessed June 16, 2021

10. Jones ER, James L, Rosen S, Mooney A, Lacson E: Outcomes among patients receiving in-center, self-care hemodialysis. Nephrol News Issues 30: 28–36, 2016

11. Tentori F, Zhang J, Li Y, Karaboyas A, Kerr P, Saran R, Bommer J, Port F, Akiba T, Pisoni R, Robinson B: Longer dialysis session length is associated with better intermediate outcomes and survival among patients on in-center three times per week hemodialysis: Results from the Dialysis Outcomes and Practice Patterns Study (DOPPS). Nephrol Dial Transplant 27: 4180–4188, 2012