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Dieting not so hard when compared to dialysis

Dr. Anis A. Rauf medical director U.S. Renal Care Oak Brook Dialysis. | Neil Steinberg photo

Dr. Anis A. Rauf, medical director of U.S. Renal Care Oak Brook Dialysis. | Neil Steinberg photo

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Updated: November 15, 2012 6:30AM

After I wrote about an obese Wisconsin TV newscaster who took to the air to defend herself against a viewer who criticized her for being a poor role model, a number of readers accurately pointed out that being overweight is not merely a matter of aesthetic judgment or self-esteem.

“Fat/obese/overweight people should not be mocked,” observed one. “But I think encouraging fitness and eating right can be distinguished from ridiculing someone’s appearance, and we have to do much more of the former before that obesity rate hits 50 percent.”

Many outlined the undeniable dire medical consequences of being fat, and shared personal stories of losing weight themselves to stave off sickness. “I was fat,” wrote one. “My mother was obese and diabetic, and passed away due to complications of diabetes when I was 31.”

Obesity is particularly tied to high blood pressure and diabetes, so is “an important and potentially preventive risk factor for chronic renal failure,” according to the American Society of Nephrology, which estimated that being obese quadruples the chances of kidney failure.

Given that, you would expect that a nation continually growing fatter and fatter would need more dialysis centers to handle skyrocketing kidney disease, and that is indeed the case. By coincidence, just after I got all these emails about the medical risks of being overweight, I visited U.S. Renal Care’s brand new Oak Brook Dialysis Center, part of the Texas-based company’s aggressive expansion in the Chicago area — it opened a facility in Streamwood last July, and has centers opening in Bolingbrook later this month and in Villa Park in February.

“Kidney disease is a silent disease,” said Dr. Anis A. Rauf, the Oak Brook center’s medical director. “Patients often don’t know they have it until it’s too late.”

A kidney is a mass of blood vessels, and high blood pressure basically breaks kidneys down, like a balloon that’s been inflated and deflated too many times. As kidneys weaken and fail, they lose their ability to remove the toxins that build up in the body, and dialysis — hooking you to an artificial kidney — is necessary to keep a patient alive until they can get a transplant — or don’t; 20 percent of dialysis patients die in the first five years.

The coincidence that brought me to Bolingbrook to visit Dr. Rauf’s new clinic is that 20 years ago, when he was a 17-year-old valedictorian at Mather High School, I interviewed him for the Sun-Times.

“A life-changing article,” said Dr. Rauf, who had come from Pakistan with his parents when he was 4, and went on to earn a full scholarship to Northwestern and later trained in critical care at the Mayo Clinic.

Despite the flurry of letters regarding health risks and fatness, and my brush with Dr. Rauf in the early 1990s, I might have resisted the temptation to ballyhoo U.S. Renal Care, except that I had wanted to look at dialysis — a procedure that everybody knows exists, but few know any specifics.

For instance: “dialysis” is not a single process, but two. There is hemodialysis — blood is taken out of your body, filtered and put back — and peritoneal dialysis, where fluid drips into your abdominal cavity and uses your body’s own membrane, the peritoneal wall, to filter your toxins — wash your stomach, spleen, liver and intestines, using an IV drip, then draining the waste liquids.

That second process, peritoneal dialysis, is often done at home — half the Oak Brook center is designed to support home dialysis patients who, rather than come in three times a week to sit for four hours, manage their dialysis at home, often while they sleep. “It’s a lot of work,” said Deb Engler, an RN at the center. “But patients are very independent. They come in twice a month.”

Gerald Milligan was having his blood dialyzed while I was at the Oak Brook center. A former truck driver — sitting for long periods also increases your risk of kidney disease — his was brought on, not by obesity or diabetes, but heart failure. A few years ago he noticed fluid collecting in his legs, “I looked like an elephant,” he said.

While Dr. Rauf is trying to make dialysis more pleasant — his new facility has attractive stonework, wavy ceiling panels and an aquarium in the lobby — a person who doesn’t have to be there doesn’t want to be there, and any obese person who has trouble motivating for weight loss might consider sliding by to see the permanent stent grafted into Milligan’s arm to allow for dialysis, or the catheters inserted into the bellies of patients receiving peritoneal dialysis. Dieting is not so hard when compared to dialysis.

Not that you have to lose 50 pounds to reduce your risk of kidney disease. You can take steps immediately, right now, at lunch.

“Cut down on salt,” said Dr. Rauf, who said that for those with high blood pressure, “salt is the root of all evils.”

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