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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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.

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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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Tips On How To Treat Children With Kidney Disease: A Parental Approach

Many children are diagnosed with some degree of kidney disease every day. Given the nature of this disease, as depicted in previous articles by Joe Cosgrove, it is quite hard for parents to digest such complication when kids are the ones affected. Their concerns about the whole thing are no less than legitimate; and feelings such as stress easily tend to appear; however, it is quite normal. When it comes to children suffering from chronic kidney disease, parents are somewhat forced to accept such reality without hesitation; nonetheless, they can also develop a practical way to cope with the daily complications and the very nature of the disease. The following words of advice were developed in hopes of providing families with helpful elements so that they can keep moving forward irrespective of the nature of their kid’s disease:

Get Familiar With What The Disease Is About

Learning about the disease, getting acquainted with the complication and its possible treatments is key. The basic word of advice would be: learn as much as possible about the disease and how it has been treated. Moreover, it is of high importance to convey this information to children: they actually understand a lot—and they are more receptive than the vast majority of adults.

Aside from the aforementioned idea, parents should spare no efforts in encouraging their children to ask questions to their doctors and nurses and pretty much every other health professional involved in the treatment. There is a myriad of aspects parents can learn from this, as they often abstain themselves from asking some questions just because they think they sound somewhat dumb. Having children ask whatever comes to their minds embodies a source of information and ideas that often go unnoticed by both parents and physicians.

In that sense, kids should not be given more than what they can handle and understand. This does not suggest, however, that parents should lie to their children. Be clear about the procedures and the treatments they are about to undergo. Therefore, try to help children understand that all the people—doctors, nurses, dietitians, nephrologists, social workers, etc.—are on their side. That all they want is to help them get better and healthier, even if it involves nagging treatments that may cause a certain degree of discomfort.

Be Proactive And Get Involved In the Kid’s Care

As a parent, it is not easy to see children suffer. Most parents tend to engage in pointless discussions with health professionals simply because they refuse to accept reality and the nature of the treatments that should be followed. Parents, the vast majority of times, are led by emotions—and all they want is for their children to get healthier. Thus, in order to more easily achieve the latter, parents should develop a sense of respect and cooperation with physicians. A good idea is to keep a detailed track about the kid’s medical history, paying special attention to dates. This comes in handy whenever children are referred to a new doctor. The idea is to make things easier.

Additionally, although seeing children suffer from chronic or any type of kidney disease is stressful and discomforting enough, parents should strive to be with their children as much as they possibly can during both treatments and possible hospitalization. Make sure kids are surrounded by their favorite things: books, toys, a special cushion or blanket, etc.

Teach Children How To Take Control Of Their Illness

Even though these might seem the worst days ever—and they possible are—, the idea is to keep a daily routine even during possible hospitalization. In the meantime, it is important to help children understand what doctors, nurses, machines are supposed to do and that they are for. For a kid, it can get really annoying to be in a room full of people and intimidating machines. By clearly explaining and helping them get acquainted with their surroundings, parents can help eliminate a part of their children’s legitimate fears. For such matter, it is quite useful to come up with a creative way to have children participate in their own care. By having them feel more in control they provide them with a sheer array of opportunities.

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Strive To Be Clear About Food Restrictions From The Very Beginning

Many children are forced to make drastic changes in their nutrition, and many just refuse to easily accept them. Kids are not used to the word «diet»; however, by developing a creative way to explain to them that they must adapt to a new nutritional plan, the likelihood of them accepting these changes is far higher than in the vast majority of adults. Have children make a list of their favorite foods and they assess it with a dietitian to determine whether they can be included in the new plan. Be that as it may, avoid forcing children to unquestionably accept these changes: this tactic rarely pays off.

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