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  • ETNA is a referral practice, which means that you were sent to us by another physician.


  • Please bring your medicines or a complete written list of your medicines to each of your office appointments.
  • Inform the doctors of any medicine changes you have had since your last visit.
  • Inform the doctors of any health changes since your last visit.
  • Bring any records you keep, such B/P and/or blood sugar readings so that they can be reviewed.
  • Have your lab work done 7 days before your scheduled appointment to give us time to get the results on your


  • Prescription refills are handled daily.
  • The best procedure is to call your pharmacy when you need a refill.
  • Since the doctors have to validate all refills, our policy is to hold all requests until 4:00 P.M.
  • All refills are daily.


It will take the partnership of you, the patient; nephrologists; nurses; social worker; dietician and other dialysis team members to help you adjust to this new and to face the challenges associated with this change. You can do it. We want to let you know the following: 

A) Your dry weight, i.e., good weight, needs to be established and this may take a few weeks to months. During you may experience cramps, and low blood pressure, which can result in dizziness. established, you should not feel discouraged about dialysis treatments, this is normal.  

B) We do have an office, but our nephrology practice is primarily hospital based. Our office is not equipped to take care of your routine medical problems, i.e., sore throat, colds and bladder infections. Therefore, you should keep the relationship with your primary physician and contact him if you need to. Nephrologists support your medical care as consultants to your primary care physician. Medicare requires a yearly history and physical done by the Nephrologist.  

C) We will see you at least twice a month. During the nephrologists are always available through the dialysis units or our office 936.634.2227 or 866.245.6998. Dialysis concerns can be handled more efficiently by contacting the dialysis unit first. The dialysis personnel access to your dialysis chart. Our office staff does not. After hours the nephrologists can be reached through the Memorial Hospital operator 936.634.8111.   

D) Prescription refills are best handled by calling your pharmacy. The pharmacist will be responsible for getting your medicines ordered.

E) In order to feel better and to have a good quality of life, stay active and do your treatments as prescribed on a regular basis.

DO NOT MISS YOUR TREATMENTS OR CUT DOWN YOUR TREATMENT TIME. For situations that arise and can=t be rescheduled, the dialysis treatment can be rescheduled so that the treatments will not be missed.

The following OTC (over the counter) drugs you can take for general complaints CKD and ESRD patients

  • Constipation: Colace or Pericolace twice daily.

                            Metamucil or Citrucel 1 tbsp. Daily. 

Caution: Magnesium and phosphorous containing laxatives and enemas are NOT recommended (because of both Mag and levels are usually high in CKD and ESRD patients)

  • Fever or Pain: Tylenol 325mg to 650mg up to four times daily.

  • Cough / Sore throats: or Robitussin (plain)

    DO NOT TAKE decongestants as found in flu and cold remedies -these medicines will cause your B/P to go up ( like D with different medicines) e.g Robitussin DM etc

Use diabetic formulas of or Robitussin if you are diabetic.

  • Rx for itching           Benadryl 25-50mg every six hours

    It can also help with sleeping:             (can make you drowsy, do not drive) 

  • Take your vitamins (dialysis vitamins) after each dialysis and on non-dialysis days.  

  • Phosphorous Control: dialysis patients must take their phosphorous binders daily with your meals. The dietician and dialysis team will help you to know how many to take and when.

Points about dialysis access:

Infections cause high mortality in dialysis patients.

Don't scratch your catheter or fistula site when wounds are fresh.

Keep sites clean.

Good hand washing technique at all times.