2015年8月20日星期四

Hemodialysis in Kidney Failure: How do I Reduce Complications and Sufferings

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Background: hemodialysis indeed has helped a lot in lowering high toxin levels in kidney failure patients; however, there are many complications that patients need to take care to prevent.
In the passage, we will introduce common symptoms and complications of hemodialysis, and corresponding measures to reduce your sufferings:
Imbalance syndrome-seen in patients do first times of hemodialysis
It often occurs during hemodialysis, or several hours after hemodialysis.
﹡Slight symptoms: patients will present headache, throwing up, sleepiness, muscle cramps.
﹡Moderate: asterixis, intermittent muscle cramps, unorientation, drowsiness, etc.
﹡Severe: physiological problem, systemic muscle cramps and coma.
In some rare cases, patients are manifested as difficult breathing, fever or sudden heart arrest.
Prevention: in many slight cases, the symptoms will gradually disappear. Washing the dialyzer carefully before dialysis will help prevent the symptoms. In some conditions, the patient may have to stop dialysis due to severe reactions.
Hypotension
Symptoms of hypotension: nausea, vomiting, severe sweats, paleness, difficulty breathing, abdominal pains, back soreness, sudden and sharp BP decline
Prevention:
﹡Positive treatment for anemia and hypoproteinemia with medications and dietary supplement.
﹡Ultrafitration amount should be limited within 5% ratio of the body weight.
﹡Active treatment for cardiovascular complications and infections.
Arrhythmia- more common in elderly patients
Causes of arrhythmia include:
﹡Changes of serum potassium and calcium
﹡Decreased coronary blood circulation speed due to decreased BP
Preventive measures:
﹡Preserve serum erythrocyte balances
﹡Medicines to extend coronary arteries are needed for patients with arterialsclerosis.
Hypertension.
Hypertension can occur both during and after dialysis.
Clinical manifestations can be dizziness, headache, palpation, blurry vision, short breath, angina, pulmonary edema and consciousness disturbance.
Preventive measures include: first, adjust anti-hypertensive medicines; avoid excess dehydration; balance the intake of sodium from daily diet.
Muscle cramps
Causes of muscle cramps include: low blood volume, imbalances of erythrocytes, fast ultrafiltration and low sodium dialysate. Muscle cramps should be treated based on the specific inducing factor.
Vomiting and nausea
Common inducing causes are imbalance syndrome, severe hypertension and cerebral accident. Coffee addiction will also give rise to vomiting during hemodialysis. The treatment is based on analysis of the real inducement.
Chest and back pain
This is often seen in case of cardiac ischemia, hemolysis, pericarditis and aeroembolism.

Besides the above, hemodialysis will also cause some long-term complications, such as heart failure, coronary arterial disease, beta2 MG associated amyloidosis and malnutrition, which will pose life risks to the patients. Active measures to control dry body weight, prevent infections and intensify nutrition support will help to lower risks.
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