What risks may happen during dialysis treatment?

The limitations of medical science in the field of dialysis are still quite notorious. Although giant steps have been taken to carry out the therapies that we currently have to treat patients with chronic kidney disease, every day, great research and experimentation efforts are made to reduce the risks. Sadly, patients undergoing dialysis have many potential risks that could worsen their health situation. If we add some of the problems of contemporary medicine, such as antibiotic-resistant bacteria, things can get even worse. In this post, we are going to analyze some risks that have recently been discovered.

Low Uric Acid

There is not only a directly proportional relationship between uric acid levels and chronic kidney disease but with something even worse. It has been found that the significant decrease in uric acid levels in the body of patients undergoing dialysis is directly related to the risk of death. The uric acid is a residual substance, product of the processing of the purines which are that eliminated by the liver, by the intestines, and by the renal function of the body through the kidneys in form of urine. It is known that when the glomerular filtrate decreases, the concentration of uric acid tends to rise. However, Japanese researchers have also discovered that low uric acid aggravates the symptoms of chronic kidney disease to very dangerous levels. It is still an unresolved mystery, but statistics don’t lie.

High Iron levels

Likewise, an imbalance in iron levels may also mean a high risk for patients with chronic kidney disease subject to both peritoneal dialysis and hemodialysis. The main reason for this is that there is a direct relationship with cardiovascular problems that can trigger a cardiac arrest. It is an undeniable fact that patients have problems with normal iron levels in the blood. Naturally, due to the drastic change of diet and a decreased absorption of the intestines, the lack of this mineral in the body is just evident and expected. To prevent anemia and weakening of the immune system, doctors generally prescribe iron supplements. The problem occurs when the side effects of it are seen in the body. This is known as oxidative stress, and it means a direct and serious impairment of kidney function.

Read also: Learn more about the basic dialysis medicines and cares, by Joe Cosgrove

Sudden cardiac death

There is an alarming issue here. Of, approximately, half a million patients who must be treated for chronic kidney disease, almost two hundred and fifty thousand of them die from problems related to the cardiac system. Although no conclusive answers have been reached about why this phenomenon happens, doctors know that it is important to take care of the cardiovascular health of patients on dialysis because there is a high rate of sudden cardiac deaths among them. However, there are several ongoing investigations that seek to unravel this mystery of the human body to find effective solutions.

The most difficult thing is that sudden cardiac death has no clear early symptoms that can lead to a successful prevention so that doctors can act with enough anticipation. In addition, when the first symptoms of an imminent cardiac death appear, there is very little time to take actions to stop it. Actually, patients who show symptoms of sudden cardiac death (such as arrhythmias and ventricular tachycardia) die almost in an hour.

One of the known facts about this mysterious correspondence is that the risk of heart failure is closely related to the age of the patients and the time during which they have been undergoing dialysis therapy. This is one of the reasons why many doctors invest so much money and time in researching alternative means to treat chronic kidney disease or to improve dialysis failures and allow patients to have a better standard of living after they have lost their kidney function.

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Phosphates

Another major risk experienced by patients undergoing dialysis is the eventual presence of phosphate in the bloodstream. This is the cause of vessel damage due to the buildup of plaque, fats, and cholesterol in the arteries, which can harden and partially or completely block them. For this reason, when the amount of phosphate in the blood is high, doctors prescribe phosphate binders, which allow a later elimination of this compound, so that the organism of the patients remains in balance. Nevertheless, it is known that these phosphate binders may produce side effects in the patient’s body, such as the accumulation of aluminum in the brain and the bone system, which means a loss of mobility.

Peritonitis

Peritonitis is the inflammation of the lining of the abdominal cavity (or peritoneum) that occurs in those who receive peritoneal dialysis. The main cause of peritonitis related to this therapy is the presence of bacteria during the dialysis procedure in the place where the procedure is conducted. For this reason, patients, doctors, and nurses should be very careful with the disinfection of the area and their own hands, and, on the other hand, patients should not abuse antibiotics so that the bacteria do not generate tolerance to these measurements.

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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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