Complication: Sleeping and Bleeding Problems

CKD patients respond poorly to sleep medications. Sleeping problems are really common among people with kidney failure. Although, more researches are needed in order to better understand the theoretical underpinning of sleeping irregularities among these patients. This may further worsen if the patient sleeps during dialysis. However, sleeping problems may improve with a more intensive dialysis as in nocturnal dialysis.

Bleeding problems are also very common among people with chronic kidney disease. This is because of the complex blood factor changes that happens in the patients' body. Symptoms include easy bruising, prolonged clotting time, gastrointestinal bleeding, blood in stools and nose bleeding.

Complication: Neuropathy

In the long run, some patients, especially those with diabetes may result in a condition known as peripheral neuropathy or nerve damage. The classic symptom is the "pins and needles" feeling. Other symptoms include restlessness in the legs. This condition may make it hard for patients to walk. However, the real cause is really unknown. There may just be contributing factors for the occurence of this specific disorder such as sodium imbalance, high calcium levels, secondary hyperparathyroidism, and also retention of other toxins which are not not efficiently removed through dialysis.

Complication: Amyloidosis

There is a protein called the beta2- microglobulin that is normally found on the surfaces of cells an in the body fluids. The excess of this protien is usually excreted by the healthy kidneys. If you have kidney failure, the excess of this specific protien is accumalated in the body and is converted to amyloid resulting in the condition known as the "Amyloidosis". By definition, amyloidosis is a condition where a waxy protien is deposited in the soft tissues, bones and joints. Deposits of amyloid can cause a lot of disturbing complications such as carpal tunnel syndrome (painful compression of a nerve in the wrist), bone cysts, joint pain, and fractures. Amyloid is found in 20% of patients who have been undergoing hemodialysis for 10 years. And the longer years of dialysis, the more increasing number of patients who will have the disorder. Again, the very simple but effective prevention is to have a a more freqent dialysis in order to remove excess beta2 microglobulin.

Pericarditis: Complication of CKD

If you are not dialyzing as often as you should have been, you may develop pericarditis or the inflammation of the membrane or sac around the heart. Of course, poor dialysis may be one of the causes, other causes would be infection, surgery or any other acute illnesses. It usually manifests with a constant pain in the center of the chest. Other symptoms are hypotension or low blood pressure and fever. You may also have irregular heartbeat. There is also the presence of a pericardial friction (heart sound) that is heard using a stethoscope. Treatment of pericarditis includes having yourself dialyzed as often as you could and adherance to medications and diet as prescribed by your doctor.

IF YOU ARE EXPERIENCING HEAVINESS ON THE CHEST OR ANY PAIN ON THE CHEST, REPORT IT IMMEDIATELY!!!

Secondary Hyperparathyroidism: Complication of CKD

The overproduction of parathyroid hormone in the parathyroid glands in the neck is also known as Hyperparathyroidism. An active form of Vitamin D is produced by the healthy kidneys. This hormone is called "calcitriol". Its main responsibility is to help absorb calcium from the food that we eat. When you have chronic kidney disease or when your kidneys fail, you produce less calcitriol therefore, less calcium can be absorb by the body. At the same time phosphorus can also build up which we also get from the food that we eat. It builds up because the kidneys are already unable to excrete them. Less calcium in the body triggers the parathyroid gland to release parathyroid hormone (PTH). The main responsibility of PTH is to make sure that the levels of your calcium and phosphorus are within normal. Remember that because of the failure of your kidneys, you have less calcitriol hence low calcitriol level and because of this less calcium is absorbed therefore you have low calcium level and finally since you are unable to excrete phosphorus, you will then have a high phosphorus level. In the long run, the overactivity of the parathyroid gland in a long span of time will cause it to become big that it can not be shut down. This is what you call the cycle of the Secondary Hyperparathyroidism. The condition can also lead to bone problems since you're very deficient with calcium. Renal osteodystrophy is one bone problem which you can have. This may also lead to stroke and other heart problems since experts say that secondary hyperparathyroidism is related to calcium deposits in the heart and blood vessels .
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Core Curriculum for Dialysis Technician