Monthly Archives: October, 2020

Sleep disorders are extremely common among dialysis patients. The most commonly reported complaints are excessive daytime sleepiness, sleep apnea syndrome, restless legs syndrome, snoring and intermittent limb movement disorders. Clinical studies have found that sleep apnea syndrome (SAS), restless legs syndrome (RLS) and recurrent limb movement disorder (RLMD) are much more common in dialysis patients than among the general population. Undoubtedly, these sleep problems have a significant negative impact on quality of life, as they are often mentioned as the main sources of stress.

Sleep apnea is a chronic disease that is a repeated respiratory arrest during sleep, the consequences of which is low level of oxygen in the blood. Conducted researches show that sleep apnea may lead to increased levels of cardiovascular events and to the accelerated development of atherosclerosis in patients with chronic kidney disease.

In Bulgaria, no specific studies have been conducted based on the problem of sleep disorders in patients with CKD. However, global research has shown that problems with these disorders occupy a significant part in systemic history of patients with CKD.

Uremia is a clinical syndrome characterized by elevated blood urea levels. It is based on metabolic abnormalities, fluid imbalance, electrolytes and hormones associated with the deterioration of renal function.
Uremia is more common in patients with chronic kidney disease (CKD), especially in the later stages of CKD or in acute kidney damage if the loss of kidney function is rapid. Urea itself has both direct and indirect toxic effects on a number of tissues.

Urea is synthesized in the liver and is the end product of protein metabolism. It is transmitted from the liver through the blood to the kidneys, where it is excreted in the urine. However, when kidney function is impaired, waste products and toxins such as creatinine and urea accumulate in the blood and cannot be effectively filtered and removed. If uremia is left untreated, this condition is life-threatening.

Symptoms:

Tingling and numbness of the hands and feet – neuropathy

General fatigue and low energy

Nausea, vomiting and loss of appetite

High blood pressure

Swelling of the ankles

Dry skin and itching

More frequent urination

Chronic kidney disease and factors leading to kidney failure and uremia are:

Congenital anomalies of the kidneys

Polycystic kidneys

Diabetic nephropathy

Congestive heart failure and arrhythmias

Chronic pyelonephritis

Kidney stones, enlarged prostate

Taking certain medications and corticosteroids

The presence of too much water in the blood and the overload of the body with fluids is called hypervolemia.

One of the main functions of our kidneys is to balance fluids in the body. However, for dialysis patients, it is unable to regulate the required ratio of salts and fluids in the body. Hypervolemia is usually the result of a health problem. However, its mild form can occur after consuming foods with too much sodium or during hormonal changes. That is why it is so important to follow a diet plan that limits the amount of sodium (salt) and fluid intake for patients with kidney problems.

The most common symptoms include:
• unexplained and rapid weight gain
• swelling of the arms and legs
• abdominal bloating
• shortness of breath

Treatment

The condition of hypervolemia is managed in several ways. The most commonly used is with diuretics (drugs that increase the amount of urine that the body produces).
It is important to note that the basis of prescribed treatment is according to the specific health problem. For example, for patients with heart failure, beside taking diuretics, additional therapy will be given.

Clinical studies have shown that in patients with severe kidney problems, diuretics do not lead to the desired result so the necessary therapy is renal replacement, such as dialysis. If you are already on dialysis, longer or more frequent dialysis procedures might be needed to remove excess fluid from your body.
People with heart, kidney or liver disease may also need a diet low in salt. This will help keeping the sodium levels within normal limits, which in turn will avoid the condition of hypervolemia.