Contents:
- Medical Video: Stages of Kidney Disease
- Anemia and Erythropoietin (EPO)
- Renal osteodystrophy
- Gata-itch (Pruritus)
- Sleep disturbance
- Amyloidosis
Medical Video: Stages of Kidney Disease
Your kidneys not only throw away waste and extra fluids. They also make hormones and regulate the balance of chemicals in your body's system. When the kidneys stop working, you may have problems with anemia and conditions that affect bones, nerves and skin. Some of the more common conditions are caused by extreme kidney failure such as fatigue, bone problems, joint problems, itching, and "restless legs" aka restless leg. Restless feet will keep you awake because you feel your legs twitching and soaring.
Anemia and Erythropoietin (EPO)
Anemia is a condition where the volume of red blood cells is low. Red blood cells carry oxygen to cells throughout the body. Without oxygen, cells cannot use energy from food, so someone with anemia can get tired easily and look pale. Anemia can also contribute to heart problems.
Anemia is common in people with kidney disease because the kidneys produce the hormone erythropoietin, or EPO, which stimulates the bone marrow to produce red blood cells. Diseased kidneys often do not make enough EPO, and the bone marrow makes fewer red blood cells. EPO is commercially available and is generally given to dialysis patients.
Renal osteodystrophy
The term "renal" describes things related to the kidney. Renal osteodystrophy, or renal bone disease, affects 90 percent of dialysis patients. This causes the bones to become thin and weak or improperly formed and affect children and adults. Symptoms can be seen in the growth of children with kidney disease before they even start dialysis. Older patients and women who have gone through menopause have a greater risk for this disease.
Gata-itch (Pruritus)
Many people treated with hemodialysis complain of itchy skin that often gets worse during or after treatment. Itching is common even in people who don't have kidney disease, however, itching can be made worse by waste in the bloodstream where the dialyzer membrane is currently unable to clear it from the blood.
The problem can also be related to high levels of parathyroid hormone (PTH). Some people feel better after their parathyroid glands are removed. Four parathyroid glands are located on the outer surface of the thyroid gland, which is located in the throat at the base of your neck, just above the collarbone. Parathyroid glands help control levels of calcium and phosphorus in the blood.
But the medicine for itching that works for everyone has not been found. Phosphate binders seem to help some people; these drugs act like sponges to absorb, or bind, phosphorus while in the stomach. Some people feel better after being exposed to ultraviolet light. However, some other people also feel better with EPO injections. Some antihistamines (Benadryl, Atarax, Vistaril) can also help, capsaicin creams applied to the skin can reduce itching by turning off nerve impulses. In any case, treating dry skin is important. Applying a cream with lanolin or camphor can help.
Sleep disturbance
Dialysis patients often have insomnia and some people have certain problems called sleep apnea syndrome which is often characterized by snoring and cessation of snoring. When apnea occurs because of the cessation of the breathing process during sleep. Over time, this sleep disorder can cause a day-night reversal "(nighttime insomnia, daytime sleepiness), headache, depression, and decreased alertness. Apnea which may be related to the effects of kidney failure on respiratory control. Effective treatment for people who have sleep apnea, depending on whether they have kidney failure or not, including losing weight, changing sleeping positions, and wearing a device that pumps continuously soft air into the nose (nasal continuous positive airway pressure, or CPAP).
Many people on dialysis have difficulty sleeping at night due to illness, discomfort, anxiety, or restless leg syndrome. You may feel a strong urge to kick or stomp your feet. Kicking may occur during sleep and disturb your partner to sleep all night. Causerestless leg syndrome may include nerve damage or chemical imbalance.
Light exercise during the day may help, but exercising a few hours before going to bed can make it worse. People withrestless leg syndrome must reduce or avoid caffeine, alcohol and tobacco; some people can also be helped by a massage or a warm bath. A class of drugs called benzodiazepines, often used to treat insomnia or anxiety, can help this condition as well. Prescription of these drugs includes Klonopin, Librium, Valium, and Halcion. A newer and sometimes more effective drug is levodopa (Sinemet), a drug used to treat Parkinson's disease.
Sleep disorders may seem insignificant, but they can interfere with your quality of life. Do not hesitate to tell this problem to nurses, doctors, or social workers.
Amyloidosis
Dialysis-related amyloidosis (DRA) is common in people who have been dialyzed for more than 5 years. DRA develops when proteins in the blood settle in joints and tendons, which cause pain, stiffness, and the presence of fluid in the joints, as is the case with arthritis. The kidneys work to filter this protein, but the dialysis filter works ineffectively.
