Learn more about the basic dialysis medicines and cares

Chronic kidney disease is not only a major concern for many countries around the world because of the increase in patients suffering from this illness, but also because the public spending involves billions of dollars, both in research and in dialysis treatments per year. However, the main concerns are related rather on the individual than on the collective level. The sufferings of dialysis patients, as well as the limitations that this treatment implies, mean a great change for the patients themselves as well as for the families, which, although it may be an opportunity to overcome obstacles and overcome oneself, it is still a tough situation to deal with.

For this reason, the basic care and medications of dialysis patients improve permanently. Let us know what these basic nursing care are, as well as the medicines that a patient must take in hemodialysis therapy. Do not forget to share this information with your contacts if you are aware of their interest in this sensitive subject.

The basic medicines of a patient undergoing dialysis are basically six. First off, iron. This element, which is so important in our diet, is a crucial aid for the organism because, thanks to it, the body can produce hemoglobin, and this means to counteract a possible anemia derived from a food deficiency or a significant blood loss. Since dialysis patients have particularly strict diets, and, in them, the consumption of red meat is especially restricted – an important source for the supply of iron in the bloodstream – patients undergoing dialysis should consume iron capsules. In a complementary way, the possible anemia in patients is treated with the consumption of Epogen, which is always present in the basic medicines that nephrologists prescribe.

On the other hand, vitamin D is a must. It provides, in turn, a series of necessary nutrients which the body eliminates as a side effect during dialysis sessions. Normally, vitamin D deficiency is related to sedentary lifestyle, low exposure to sunlight, and, in general, to inadequate nutrition habits.

Similarly, due to the amount of medication a patient with chronic kidney disease should take, doctors usually prescribe feces softeners to relieve the constipation that normally occurs in these patients. Due to the low intake of liquids, as well as sedentary lifestyle, and the consumption of other drugs, the body hardly eliminates the feces, and that makes it necessary to relieve the constipation that is commonly present in these cases.

Read also: Exercise during dialysis: an option you should really consider, by Joe Cosgrove

Additionally, dialysis patients should regularly consume a phosphate binder, which greatly facilitates the absorption of phosphorus from foods that the dietitian prescribes for the patient’s diet. One of the main functions of the kidney must be fulfilled by compounds like this.

Finally, as a measure to avoid an irremediable problem, the patient is given heparin. This prevents the formation of blood clots in the dialysis equipment. This was, it is worth clarifying, one of the most frequent problems when this therapy began in the forties, and, actually, it was the cause of several deaths. As it usually happens in medical science, sometimes only the efficient results come after a long series of failures. This is an example of it.

Now, the most basic nursing care has to do especially with the ability of nursing diagnoses in subjects undergoing dialysis. The main ones are related to the excess of fluids, with the poor elimination of urine, with the significantly decreased physical mobility, as well as hypothermia, fatigue, erectile dysfunction, deterioration of the sensory perception, and insomnia. Nurses specialized in dialysis patients must learn to identify the symptoms of a worsening in the quality of life of the patient immediately. The notification of these symptoms to specialists, when done on time, is key to avoid subsequent problems that may be simply irreversible.


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In addition, nurses must learn to identify signs of depression in patients, and thus help them to undergo dialysis when they show no interest in the therapy whatsoever. To educate them to be diligent in the consumption of medicines, as well as to make some physical activity on a regular basis, it is another of the fundamental tasks of a nurse.

As long as the conditions allow it, it is really helpful that the attention of the nurses to the patients is personalized. When the nurses know the patients under their care more closely (taking into account that each organism and patient is different,) the attention that may be given to them will be of a higher quality. This personalized treatment is not limited to the patient but should be extended to the relatives, indeed. For this reason, the nurse must be available to any report made by the family members regarding the patient’s health status. Considering that doctors have several patients under their care, nurses could be the first choice of the family members (and, of course, of patients) when there is an urgent contingency to be resolved.

Recommended: Patient education: Hemodialysis (Beyond the Basics)

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Let’s talk about Kidney Cell-Based Therapy

One of the biggest public health problems at the moment is the increase of the number of patients suffering from kidney disease. It is a sad reality that even preventive treatments and campaigns to reduce the rates each year are not enough to keep numbers in a certain balance. For this reason, dialysis treatments are also on the rise, considering that other options, such as kidney transplantation, are usually complicated.

Likewise, medical science is always in search of alternative therapies, taking into account that dialysis, although it is the best option so far, also represents many problems for patients, starting with the fact that dialysis is essentially a control treatment, not a cure. One of the options that are currently being developed is stem cell therapy. The great genetic discoveries regarding stem cells could be one of the main areas of development in the future of nephrology.

One of the great hopes in this field is cell regeneration. The possibilities offered by this therapy are countless because the renal function is not being carried out by a machine, as in the case of hemodialysis, nor is necessary to transplant an organ from a human being to another, but rather the objective is to regenerate the damaged organ, so that it recovers its functions completely, following a natural process. The idea with this therapy, in a nutshell, is to perform a transplant of renal precursor cells, so that, they become perfectly functional in the kidney tissue, so that a satisfactory recovery is achieved.

This treatment has not been reached yet. It is still in the experimentation stage, despite the fact that great advances have been made in this subject. In ideal conditions, renal precursor cells could be transplanted directly into the renal parenchyma, and this means a great challenge in medical terms. Some think that the precision that must be obtained for this procedure could only be really achieved through the use of robots, which is a strong trend in the research of biomedical engineering right now. Kidneys are very complex organs, which, in addition to the complications they may have – which are innumerable, by the way – have quite solid tissues that make it hard to transplant cells. The kidney is composed of groups of cells called nephrons. The nephrons are organized in clusters, and each of them fulfills a function of filtering the blood.

Read also: An Alternative To Dialysis: The Nanofiber Web, by Joe Cosgrove

Well, what happens when a patient suffers from kidney disease, is that the speed with which these cells die is much faster than the ability of the kidney to recover them. In this way, while the time progresses, kidneys lose the ability to perform their functions, and because they cannot regenerate, the body no longer finds a way to filter the blood and eliminate excess fluid. It is at this point that cell regeneration therapy comes into play. Because hemodialysis and other medical treatments cannot do much to prevent the death of the nephrons, it is necessary to find a way in which the kidney of the same patient recovers effectively.


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Another major challenge with this therapy is that it is not easy to get enough precursor cells for a single treatment. Not only because stem cell treatments have huge policy obstacles in several countries, but it is expensive to isolate these cells for keeping them alive in the lab.

The experiments behind the development of this therapy have been carried out, first of all, in mice. What the researchers have done is to transplant kidney precursor cells at specific points in the kidney tissue. The kidneys of rats are very similar to ours, especially when they suffer from critical kidney damage. What has been seen is that, although the transplanted cells are not fully integrated into the tissues of the kidney, the organs manage to recover the replacement rate of useless nephron cells with new ones somehow. This prevents the occurrence of necrosis, and, therefore, a series of harmful consequences for the organism.

In this regard, one of the fundamental points to develop these therapies is to identify exactly which stem cells are useful for the tissue of the kidneys to regenerate. That is why it is key to know the repair processes that the body carries out naturally, o that researchers can just boost them up.

One of the observations which has drawn the attention of the medical community is that the kidneys of mammals, compared with those of other animals, have a lower regeneration capacity. However, it has been noted that both in mice and in humans, the organism has a small stock of stem cells in case the kidney is not able to balance the loss of nephron cells. To this extent, medical science has focused on enhancing this process in the body. For many people, stem cell treatments are controversial. However, what science has shown in recent years is that it is a natural process that does not interfere with the way in which it works and balances in our body.

Recommended: Challenges and opportunities for stem cell therapy in patients with chronic kidney disease

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The Correlation Between Dialysis And Psychological Problems

As per discussed in a previous article by Joe Cosgrove, renal and chronic kidney disease is a motley, often multi-sphered issue which the vast majority of times, to say the least, affects patients in both physical and psychological ways. In fact, many things have been said about the correlation between the existent treatments for kidney disease and a sheer array of the aforementioned connotations. Actually, the scientific community stresses the importance of developing a multidisciplinary approach in order to manage these patients properly. Mental health professionals and nephrologists are now compelled to work hand in hand more than ever in order to come up with a somewhat holistic management approach for individuals suffering any degree of kidney disease.

As said earlier, a staggering amount of individuals suffering from renal and kidney disease oftentimes depict several psychological problems, most of which require individualized and non-systematic treatment. The most plausible reason behind the existence of these psychological issues might be related to the fact that patients and individuals suffering from renal failure find themselves dependant on a machine, a treatment or procedure and, additionally, a group of highly qualified health professionals for the rest of their life. In fact, no other medical condition depicts such a high degree of dependence for the treatment to be effective. It is no secret that a procedure such as dialysis is no less than stressful due to its nature, and it actually worsens every time patients do not have at hand proper education regarding the procedure and the possible aftermath. Besides, there is also a considerable amount of restrictions when it comes to foods and fluids, which, of course, contributes to the development of the aforementioned mental and psychological problems.

Individuals with kidney and renal disease often times also suffer from other conditions, which forces them to be on a sheer array of additional medications. The vast majority of these medications have been traditionally linked to causing psychiatric and mental issues: confusion and agitation, for example, have been linked with other medical conditions such as electrolyte imbalances, hypertension, hypoglycemia, aluminum poisoning, dialysis dementia and so on.

But be that as it may, the most common, sometimes traditional, psychiatric issue and complication occurring due to the pre-existence of renal failure is depression in the individual and anxiety, of course, in an associated partner should they have them. The vast majority of individuals undergoing dialysis who still keep their jobs rarely regain their full-time work schedule and activity. Psychologists often assert that work, or any similar activity, in addition to being the basic source of income, is often associated with a higher feeling such as accomplishment, self-esteem and other positive connotations in the vast majority of patients. The current, and widely accepted, treatment for something like depression would obviously include therapy, psychotherapy, and antidepressants. There are some special considerations when it comes to dealing with patients suffering from end-stage renal disease, as the use of antidepressants might interfere with the treatment.

Today’s pharma industry has managed to create a sheer array of antidepressant medications for the proper management of a condition such as depression; however, each of these may end up having different effects on an individual’s renal function, although the vast majority of these meds are safe to some extent. Likewise, no studies have compared depression in patients with ambulatory peritoneal dialysis and hemodialysis; but it seems that those undergoing the former experience milder depression symptoms.

If one were to explore the correlation between dialysis and depression much further, the subject of an existing suicidal behavior tendency would definitely appear. Several studies have found and subsequently shown that those individuals undergoing dialysis have higher suicide rates unlike the normal healthy population. It is also important to say that, when feeling the nagging discomfort of depression, those people on dialysis have at their disposal the most effective method of escaping such scenario: suicide. Just by missing several dialysis sessions or ingesting higher quantities of potassium can result in an inexorable death.

pharmaceutical_pills_Dialysis And Psychological Problems

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Aside from suicidal behavior, the second most common phenomenon observed in people undergoing dialysis is delirium, mostly explained by the existing electrolyte imbalance that often times occur after a dialysis session, often dubbed as the “dialysis disequilibrium syndrome”. The causes may definitely also include anemia, uremia, amongst others. As with depression, the adequate management depends on each case. Case-by-case allows physicians, psychologists, and psychiatrists to detect the existence of delirium much earlier. Some ameliorative medications and benzodiazepines are, to some extent, useful in this scenario.

Alongside delirium and suicidal behavior, dialysis patients also experience extreme anxiety—especially somatic symptoms such as faster palpitations, chest pain, shortage of breath, intense sweating and the known fear of dying; however, many times the aforementioned symptoms are not systematically related with a special trigger and may, on the contrary, occur all of a sudden.

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