Dialysis Services at Guthrie

Types of Dialysis/Services Provided

Guthrie offers dialysis in two locations – the Paul Gerry Dialysis Center at Robert Packer Hospital in Sayre, PA, and at a satellite location at 603 Williams Street in Towanda, PA. The Sayre center can be reached by phone at 1-800-880-4431 and by fax at (570) 882-5879. The Towanda location can be reached by phone at (570) 265-2209 and by fax at (570) 268-0197. Dialysis patients who are traveling or on vacation are welcome to receive dialysis services at either Guthrie location. Click here for Robert Packer Hospital's transient dialysis form.

Services Offered in Sayre:

Acute Inpatient Hemodialysis
Acute Inpatient Therapeutic Apheresis
Chronic Staff Assisted Hemodialysis
Home Training and Support for CAPD and CCPD
Outpatient Therapeutic Apheresis, Platelet Depletion, White Blood Cell Depletion
Peripheral Blood Stem Cell Transplantation

Services Offered in Towanda:

CAPD and CCPD
Chronic Outpatient Hemodialysis
Home Training and Support for

Hemodialysis

Hemodialysis means filtering of the blood. An access to the patient’s bloodstream is obtained through needles or a catheter. The blood then circulates through a filter and returns to the patient. Hemodialysis mimics the functions of the kidneys, but does not restore kidney function.

Acute Hemodialysis

Acute hemodialysis may be temporary. It is provided when the kidneys stop functioning suddenly. As the reason for the decline in kidney function is treated, kidney function may return.

Chronic Hemodialysis

Chronic hemodialysis is a form of treatment for patients with end-stage renal disease (ESRD). ESRD is usually a gradual decline in kidney function, until the kidneys are no longer able to support life. Hemodialysis is provided in a hospital or an outpatient dialysis center. The minimal frequency is three times a week. The duration of each treatment is determined by the nephrologist. It is based on laboratory results which measure the adequacy of treatment.

Platelet Depletion

Platelet depletion is a procedure used in treatment of patients who have an excess of platelets. Removal of te excess platelets may help prevent the complication of thrombosis such as heart attack or stroke.

White Blood Cell Depletion (Leukapheresis)

This procedure is utilized for patients who are diagnosed with leukemia with very high white blood cell counts. Removal of the excess white blood cells may help prevent complications of thrombosis.

Peripheral Blood Stem Cell Transplantation

Lisa Vanderhoof, RN, CNN, therapeutic apheresis.

Some of the diseases treated with stem cell transplant at Guthrie are breast cancer, multiple myeloma, non-Hodgkins lymphoma and leukemia. Stem cells, the "parent" cells from which all other blood cells develop, are found in the spongy tissue inside the bones called bone marrow. The highest number of stem cells is found in the bone marrow, but stem cells are also found in the blood. Stem cells can be collected from the blood by a cell separation machine in a process called apheresis, or stem cell collection. The cell separation machine uses a centrifuge to separate and collect a certain type of cells, which include stem cells, from the other blood components. It generally takes two or more stem cell collection sessions to collect an adequate amount of stem cells. These cells will be transfused back to the patient after a high dose course of chemotherapy.

The effectiveness of your treatments is determined by how much the waste products in your blood are reduced from the beginning to the end of your hemodialysis treatment. Blood work is drawn the beginning of every month. Your Urea Reduction Rate (waste product) is calculated by measuring how much your BUN (waste product) is reduced from the beginning of the treatment to the end of the treatment. Your URR should not be less than 65%. If your URR is less than 65%, the staff will determine with the physician what treatment and/or diet changes need to be made in order to reach your goal. The higher your URR, the better you will feel and the longer your life expectancy will be. Those patients who continue to produce a lot of fluid will be instructed to perform 24-hour urine collection as well as have their URR done. Another form of measurement used to determine the quality of your dialysis is KT/V. This measurement determines creatinine (another waste product) clearance. Your KT/V should not be below 1.4.

Peritoneal Dialysis

Peritoneal dialysis is another treatment option for patients with end-stage renal disease. It is designed for patients who wish to maintain as high a level of independence as possible. Peritoneal dialysis uses a natural filter within the abdomen, called the peritoneal membrane. This membrane is a thin stretchy sac with multiple blood vessels. These blood vessels act to filter the waste products which build up when the kidneys do not function. Peritoneal dialysis is a slow, gentle form of dialysis. A fluid, called dialysate is always in the peritoneal cavity. When it has absorbed all of the waste products it is able to, it is drained and fresh fluid is instilled. This process of draining and replacing the fluid takes place 4-5 times every 24 hours. The patients are taught to do this themselves at home. A dialysis nurse will teach you this process and ensure you feel comfortable with the procedure before you go home. They will teach you how to keep an inventory of your supplies and how to order the supplies which will be delivered to your home. Training for home dialysis may take place either in the outpatient dialysis center, or the patient’s home. Peritoneal dialysis is a form of treatment which allows patients to maintain an active lifestyle, and adapts readily to work and school schedules. A dialysis nurse will meet with you and help you determine if peritoneal dialysis is an option for you.

Therapeutic Apheresis

Therapeutic apheresis is a process which is used to separate and remove specific parts of the blood. Generally, this is plasma which contains antibodies which play a role in certain diseases. The diseases which may be treated with apheresis are often diseases of the neurologic or blood systems. Some of the diseases treated with therapeutic aphere, or plasmapheresis are Guillian-Barre, myasthenia gravis and thrombolytic thrombocytopenic purpura.