Dialysis most common complications

The procedure known as dialysis has been created so that the elimination of toxins and the excess of liquids in the body is possible; a function that, in healthy patients, carries out the renal system (kidneys, in particular.) Even though dialysis is so far the best-known option to treat kidney disease, and despite the fact that the biomedical technology makes all its efforts in considerably improving this system, it is still not possible to execute processes of error-proof dialysis. Unfortunately, complications can occur during the process, which can even negatively affect the health condition of patients. In this post, we will talk about the most frequent complications that can occur during dialysis.

In extracorporeal dialysis, the processes in which blood is removed from the body, complications are not as common. However, it is possible that an arteriovenous fistula infection may occur. Since the fistula is punctured three to four times a week to purify the blood, the risk of infection by bacteria in the puncture site is high. In addition, there is the possibility that thrombi form that obstructs the blood vessel and renders it unusable for dialysis. However, as a general rule, a surgical intervention allows the thrombus to be removed and the fistula to be unblocked.

In peritoneal dialysis, in which the blood is purified inside the body, there is a risk of inflammation of the peritoneum. Bacteria enter the peritoneal cavity through the catheter and cause a painful infection that, under certain circumstances, may endanger the life of patients. Normally, this inflammation responds well to treatment with antibiotics, but sometimes it is not that simple.

People with severe kidney disorders and kidney failure must pay great attention to their diet since many of the complications suffered by dialysis patients are related to food. Since the kidneys are not able to carry out their function of purification and excretion, in many cases those affected can only drink a limited amount of liquid. In addition, they must be careful with the contribution of protein and potassium, since an excess of these substances may lead to serious metabolic disorders in dialysis patients.

Read also: Baxter ShareSource System: A New Dialysis Option for You, by Joe Cosgrove

People with impaired renal function often have a high concentration of phosphate in the blood which may cause damage to blood vessels, such as arteriosclerosis. When the concentration of this is too high, despite having a low phosphate diet, so-called phosphate binders are helpful, they bind to the phosphate ingested with food in the gastrointestinal tract and are subsequently excreted. There are various types of phosphate binders, for example, containing aluminum or calcium, or free of both, which effectively improve the altered balance of minerals in dialysis patients. According to recent scientific findings, it seems that calcium-free phosphate binders are the ones that cause fewer side effects. Nowadays, the use of phosphate binders with aluminum content is no longer recommended due to the adverse effects that they may cause. A treatment with this type of medicine – for many years – may produce an accumulation of aluminum in the brain and bones which leads to worsening brain function and movement limitations.

In order to prevent possible infections of hepatitis B and C, and even HIV, through dialysis, the medical centers in which this treatment is carried out meet the strictest hygienic standards for the cleaning of dialysis machines. People suffering from these type of infections are treated in their own dialysis machines which are not used with any other patients. In addition, active vaccination against hepatitis B is recommended to all dialysis patients.

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Image courtesy of Pixabay at Pexels.com

There are other complications related to hemodialysis. Intradialytic arterial hypertension is less frequent than arterial hypotension, but it has relevant prognostic implications. Fever and chills in patients on hemodialysis should be attributed to endovascular infections, especially in those who have vascular access through a high-flow venous catheter. Likewise, fever at the end of the hemodialysis treatment is suggestive of endovascular infection.

On the other hand, hypervolemia is a complication that occurs regularly. This happens when the patient consumes more fluid than the one he manages to eliminate thanks to dialysis. Hypervolemia can also develop in response to sodium retention in the body due to impaired electrolyte excretion. In nephrological practice, hypervolemia due to sodium retention is observed in acute ophthalmic syndrome, in the oliguric phase of acute renal failure, due to the consumption of large amounts of fluid and obstruction of the urinary tract with volume-dependent hypertension. This problem usually leads to weight gain, and, when not treated in time, can be deadly because heart failure may occur.

Taking into account that during the last decades there has been an increase in cases of renal replacement therapy for different diseases, and, additionally, considering the increase in infections that are difficult to treat, mainly due to the widespread abuse of analgesics by professionals and patients who self-medicate (and who do not know how to differentiate a virus from a bacterial infection,) it is vital to know the different treatment modalities in these patients as well as the complications that can occur in practice.

Recommended: Infections in Patients Undergoing Chronic Dialysis

* Featured Image courtesy of Pixabay at Pexels.com

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Some of the trends we can expect for dealing with chronic kidney disease

It’s sad but true: Chronic kidney disease progressively increases. In fact, in the registers of all countries, there is a constant increase in the population of patients who need dialysis as a substitute for their useless kidneys. The magnitude of this problem is serious when it comes to social health and, therefore, the finances of society. The reasons for this high mortality are indeed diverse but a significant factor here is the age of patients (considering that the population of old people is growing,) as well as a restoration with any kind of dialysis treatments of only fifteen to twenty milligrams per minute of renal function. Despite the advances that have been made in hemodialysis and peritoneal dialysis, there has not really been a clear improvement in the progress of patients’ conditions.

Considering the few advances in this field, but the accelerated pace of technology in general, the question that arises is very simple: What trends in terms of dialysis can we expect to treat (and, perhaps, eradicate) chronic kidney disease?

The conditions of patients on hemodialysis, in general, represents a tremendous sacrifice for relatives and close people, mostly because of all the physical and emotional suffering they experience and the constant traveling to dialysis centers three times (or more) per week. In addition, the amount of deadly cases, not too different than those of metastatic carcinoma of the breast, to carcinoma of the colon or to that of prostate cancer, this forces the medical community to move towards other ways to solve this problem.

Although there have been many cases of progress in the health of patients thanks to the effective implementation of traditional methods of dialysis, especially in what has to do with the quality of life of patients, dialysis is not it ceases to be a control procedure, which only keeps an impossible problem at bay. This is what has set in motion the gears of science to find definitive solutions.

Read also: Dialysis: Almost 70 decades of hard work and progress, by Joe Cosgrove

It is undeniable that peritoneal dialysis is a very practical method for the life of patients since they do not depend so much on contact with professionals, as well as on the displacement to dialysis centers. In particular, peritoneal dialysis, which has been working with intelligent mechanisms connected to the Internet, is one of the most recent advances and the most beneficial for the work of medical science, thanks to the constant monitoring, and, consequently, to the constant production of data, research in this field can go a long way to find definitive solutions, in which dialysis as such is no longer necessary.

On the other hand, there is another effective method. Online hemodiafiltration it’s a new dialysis system that allows a greater filtration than what is usually achieved with conventional hemodialysis. It is one of the techniques that aroused greater interest in patients nowadays, and the use of it will surely grow. It is a modality of dialysis that maintains the diffusion levels of hemodialysis by increasing the convection, so that, by infusing a greater quantity of water, a higher level of solutes can be carried from the blood to the dialysis fluid. The clearance that is obtained is greater.

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Image courtesy of Frank DiBona at Flickr.com

In hemodiafiltration, it is necessary to infuse a liquid of greater purity than that used for conventional modalities. This leads to using machines with very clean filters that, of course, are much more expensive. Although conventional hemodialysis guarantees very good results in the short term, in the long term it is a difficult experience for both patients and people around them. So this can be an excellent alternative.

However, hemodiafiltration online is not yet a widespread technique, and to make it massive is not a simple matter. Because there is still no study that states with total certainty that this option has clear advantages over conventional hemodialysis, there is still not much support from the governments of many countries. Although it is a technique that has shown advantages in some fields, It is very risky to consider that, definitely, it is the perfect replacement for the other types of dialysis.

The future of dialysis does not have much to do with the reduction of filtering times to which patients must submit. The current trend is to encourage techniques such as peritoneal dialysis, which dialyze more hours and more frequently since it is the way of working more similar to that of the kidney.

Embryonic stem cells could be an important trend too. These are undifferentiated pluripotent cells, isolated from the inner layer of the blastocyst, have the ability to differentiate into cells of different types: Mesodermal, endodermal, and ectodermal, depending on the culture conditions. It is, therefore, a type of cells that have a potential possibility of tissue regeneration.

It is necessary to be optimistic and continue investigating. If dealing with chronic kidney disease is a medical priority in several countries, the future of patients will be promising.

Recommended: Changes in the worldwide epidemiology of peritoneal dialysis

* Featured Image courtesy of scribbletaylor at Flickr.com

Baxter ShareSource System: A New Dialysis Option for You

Chronic kidney disease is a quite underestimated subject by ordinary people. This issue is much more socially extended than many people believe, and, in fact, statistics suggest that one in every hundred people may be suffering from this terrible illness today. This problem is one of the main public health issues in several countries, not only because of its disastrous health consequences and because of its high frequency in the population, but because the treatments (dialysis, eminently) to respond to this issue are usually expensive. The main consequence when it comes to chronic kidney disease is that the patient must depend on a kidney transplant or a machine to survive in his or her remaining time of life.

The only option for thousands of people around the world is to sit or lay for three or four hours connected to a machine that removes toxins from the blood system. This is the only way to filter out a series of toxins as well as the excess of fluids in the body, which the kidneys eliminate in normal conditions. This is the normal life situation of millions of patients diagnosed with renal failure who cannot afford a kidney transplant, or who, although they can actually afford it, must wait for a donor for years. The process of dialysis, in any of its forms, must be carried out for life. The body has no vacations, after all.

This therapy has two modalities: hemodialysis, which can be performed three times a week in a health center, and peritoneal dialysis, which is done daily from the home of patients, four times a day. Each month, the specialist in charge of the process monitors the treatment and the condition of each patient and, if something is not going well, he or she makes the appropriate changes to improve the therapy.

Since the end of last year, a new technology allows doctors and patients to change that traditional way of doing dialysis (in any of both ways.) We are talking about the ShareSource platform of Baxter International, a system that automatically transmits (in real time) the data on what is happening with each patient throughout the dialysis therapy. This system not only saves time and money for patients, who no longer have to travel to hospitals or other places where their therapy is carried out, but doctors permanently know if one of their patients stopped using the dialysis system at home, as well as the frequency of use and if it is working properly.

Read also: Great Alternatives to Perform Dialysis at Home, by Joe Cosgrove

This technology for remote patient management was created to improve the patient’s treatment in peritoneal dialysis, in addition to significantly increase the efficiency of hospital centers. This bidirectional communication platform is based on the cloud and is incorporated into the automated peritoneal dialysis system. It not only offers physicians a more accurate and timely visibility of the compliance of the therapy by their home patients, which, in turn, allows the identification and early intervention of possible complications, but it also allows collecting important data that can be later become useful information for new researchers on chronic kidney disease. After all, this system monitors patients permanently. Perhaps, the most positive thing about this technology is the possibility of accessing the patient’s compliance data in time, and thus manage possible clinical complications in advance.

The most common drawbacks that usually occur with dialysis are problems with the catheter performance, which is the hose used for fluid exchange. This is the main cause that usually spoils dialysis treatments. When this kind of issues are identified, the doctor has the possibility of making a prescription to solve what is going wrong with the dialysis on time and avoid hospitalizations or other health complications that may be derived from a poorly carried therapy. This also means saving money to the health system since patients get sick much less.

This may be a good option for those patients who live in remote areas and who find it difficult to travel frequently to health centers to carry out their dialysis therapies or to be checked by their doctors. Actually, thanks to this intelligent system, it is possible to reduce the frequency of medical check-ups to one every two months. This gives patients much more freedom and saves doctors a lot of time.

Video: Connectivity Platform Provides Telemedicine Capabilities for Remote Patient Management

Actually, it is a simple platform to manage, that even works like any smartphone app. There is a main menu which shows a list of patients and what has happened during the last week of treatment with each one of them and generates alerts in case of trouble (if a patient skipped a dialysis session, if there was a problem with the connection, or if there were complications in the process of eliminating toxins, for example.)

Internet and Big Data technology has revolutionized all aspects of human life, including health. In this case, it has meant a great advance, which, in an intelligent and practical way, can help to improve the quality of life of patients, as well as the job of millions of doctors.

* Featured Image courtesy of EdTech Stanford University School of Medicine at Flickr.com