What are the Long Term Effects of Dialysis?
Are you or a close one on dialysis? Do you not know the long term effects of dialysis? Well, there are four major long-term dialysis problems namely heart disease, bone disease, amyloidosis and nerve damage or neuropathy. Read the following article to know more about these problems.
The 4 Long Term Effects of Dialysis are:
Heart Disease from Dialysis
The prime cause of death for people on dialysis is heart disease. When the kidneys fail, fluid accumulates in the body in spaces like between and inside the cells and the bloodstream. Dialysis removes fluid from the bloodstream. Only around 15% of the fluid in the body is present in the blood. Simultaneously, some fluid is present in and between the cells which also slowly moves into the bloodstream to replace the fluid that gets extracted through dialysis. Dialysis can extract fluid from the blood faster than from in and between the cells. So, even after a treatment, extra fluid may still remain in and between the cells.
Pulling out a lot of fluid in a short duration of time can trigger a drop in blood pressure, which can further result in headaches, painful cramping, fatigue, nausea, stomach problems and vomiting. When excess fluid is extracted from the body, the individual may take more time than usual to feel better. On the other hand, presence of excess fluid in the body proves to very harmful, especially for the heart as it is made to work much harder. Additionally, if the individual also suffers from high blood pressure, their blood vessels become stiff making the heart work even more. This overdrive functioning of the heart makes the left ventricle become enlarged and thick. This is known as LVH or left ventricular hypertrophy. The flabby heart muscle in LVH consumes the space that would otherwise be used for pumping the blood. This hinders the hearts ability to pump out all the blood effectively and as a result the blood backs up into the lungs. Keeping the blood pressure in control is the ideal way of avoiding this condition. Also keeping fluid levels in the body close to normal all the time during dialysis is equally important to keep cardiac ailments at bay.
Bone Disease from Dialysis
Some long term effects of dialysis on the bone health are calcification and renal osteodystrophy. Calciphylaxis and calcification occurs when high calcium-phosphorus products present in the blood start to crystallize. This can happen in blood vessels, eyes, lungs, heart or other organs. It may appear as lumps or knobs on the tendons, in the joints and atop bones. Moreover, these crystals can damage blood vessels and also disturb the blood flow to a toe or finger, an entire limb or a soft tissue. This is an extremely painful and potentially fatal problem. Calcification begins with the appearance of bruise like purple or red marks on the skin, which turns black as the skin dies. These further turn into difficult to heal, large ulcers. A skin biopsy is the best way to diagnose the presence of calcium in the skin. When excess calcium is extracted from the bones over a long period of time in order to balance the high phosphate levels of the body, renal osteodystrophy occurs. Common symptoms of this illness are pain in the bones and joints and frequent fractures as renal osteodystrophy makes the bones brittle and weak.
The ideal way of avoiding skeletal or bone diseases during dialysis is consumption of a low-phosphorus diet, raising the intake of phosphate binders with every meal, and increasing the frequency of dialysis if possible. One should also increase the intake of active vitamin D, orally or via vein. A surgery to remove the parathyroid gland can also prove to be useful in treating these bone issues which occur as a long term effect of dialysis.
Amyloidosis from Dialysis
One of the most common problems that can result with dialysis is dialysis-related amyloidosis (DRA). This condition is characterized by the accumulation of protein beta-2-microglobulin (ß2m) in the tendons, joints, and around the bones. DRA can cause joint damage, carpal tunnel syndrome, bone cysts, arthritis like pain and even fractures. DRA can be prevented by choosing the right ß2m removal treatment like high flux dialyser and nocturnal haemodialysis. Using ultra pure water for haemodialysis also proves effective in avoiding DRA as this water contains lesser endotoxins and thus decreases the risk on inflammation in the body during dialysis.
Nerve Disease or Neuropathy from Dialysis
Neuropathy or nerve damage can alter sensation causing numbness, tingling, burning or pain. Around 60% to 100% dialysis patients have some degree of nerve damage. Studies have shown that neuropathy primarily occurs when the GFR is below 12ml/min. Further, it is more likely to occur in people who stay longer on standard in-centre HD and lower dose of treatment. Since men require more blood cleaning, they face more nerve problems than women. One can avoid neuropathy by ensuring that the blood stays clean and by preventing the deficiency of vitamin and mineral, especially Vitamin B and zinc which are removed in dialysis, in their body. These nutrients promote efficient nerve functioning. However, before taking any nutrient supplement, dialysis patients should consult a nephrologist, as these supplements can result in increased toxicity in the body.
Whether you are already dealing with or trying your best to protect yourself from these long-term problems caused by dialysis, always remember that knowledge is power! By making informed choices about your health, you can not only improve the quality of your life but also live it to the fullest.