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Dale Calibaba wants to tell you that it's possible to live a healthy and active lifestyle with kidney disease.
But he'd rather show you.
Dale, a chronic kidney disease patient, is nearing the halfway mark of a cross-Canada ride to raise awareness of home dialysis. By day, he cycles about 120 km. By night, he receives dialysis through a portable peritoneal dialysis (PD) machine.
"The goal of this ride is to educate and empower patients so they learn to live successfully as renal dialysis patients through physical fitness," Dale told UHN News during his meet and greet at Toronto General's Home Peritoneal Dialysis Unit on July 8.
Born with kidney disease
Dale was born with Alport Syndrome, a genetic condition that causes numerous ailments including kidney failure. As a teenager, he began peritoneal dialysis (PD), a form of home dialysis where the dialysis occurs through the patient's abdominal cavity. After experiencing complications with the catheter, Dale switched to hemodialysis (HD), where dialysis takes place through the patient's vein.
During PD, clean fluid is instilled into the abdominal activity, collects toxins and is then drained. During HD, blood is taken out of the patient, cleaned by an artificial kidney, and returned to the patient.
The PD machines provided currently to UHN dialysis patients are portable, while HD machines are not. As for training, PD patients require about a week of training, while HD patients require about two months.
Following stints with both forms of dialysis, just shy of his 19th birthday, Dale received a kidney transplant.
Back on dialysis
The transplant was a success until 18 years later, in 2005, Dale's body began to reject it, placing him back on PD. By then, dialysis technology had advanced from the manual dialysis of PD, and Dale was introduced to the portable Automated Peritoneal Dialysis Cycler Machine. The PD cycler machine can perform dialysis overnight while the patient is asleep.
"I was in awe of this machine, it's brilliant to be able to sleep at night and have it do all the dialysis for you," explains Dale. "When you have to do PD four times a day manually you basically don't have a life, so when the cycler came out, I was like 'I can do whatever I want!'"
Due to the portability of the PD cycler machine, Dale says he prefers PD over HD.
Dr. Joanne Bargman, Director of the Peritoneal Dialysis Program at UHN, explains that there are three dialysis options for patients with chronic kidney disease: HD at home, HD in the hospital or PD.
"I always feel peritoneal dialysis is a bit of the underdog so I think it's fantastic that Dale is raising awareness of this," says Dr. Bargman. "We really try to promote home-based dialysis whether it be HD or PD. We think it's the best thing for the patient to be at home."
Dr. Bargman adds that a quality of life comparison study shows the quality of life is the same between home HD and home PD. Currently, 40 per cent of UHN dialysis patients are receiving PD or HD home therapy, and the remaining 60 per cent are receiving hospital HD.
An active lifestyle for kidney patients
Dale strongly emphasizes how much a healthy diet and an active lifestyle can improve the quality of life for individuals living with renal disease. In 2005, when Dale had to go back on PD, he felt himself sink into depression. A grant received by The Shad Ireland Foundation a year later had a recumbent stationary bike delivered directly to his house.
"I got the bike, and I haven't stopped being physically active since," says Dale, adding that he started seeing results in his physical and emotional state within one day of using the bike.
"I am doing this bike ride to reach more patients," he explains. "Hopefully I will get my message across that you can absolutely live a healthy lifestyle with renal disease."
Editor's note: Dr. Joanne Bargman was recently awarded the Lifetime Achievement Award in Peritoneal Dialysis at the 36th American Annual Dialysis Conference.