Holiday help for kidney patients

Holiday help for kidney patients
By Diana Washington Valdez / El Paso Times
Article Launched: 11/19/2007 12:00:00 AM MST

The busy holiday season presents extra challenges for people who suffer from chronic urinary tract infections or those on dialysis for advanced kidney disease.

But whether it's cutting down on restricted goodies or traveling to be with friends and relatives, a little planning can reduce the stress and health complications that can be part of the Thanksgiving and Christmas holidays.

Dr. Alfonso Chavez and Dr. German Hernandez, both nephrologists in El Paso, have plenty of holiday tips for kidney patients.

"Many kidney patients also have diabetes and high cholesterol levels, so they get it from all ends," said Hernandez, assistant professor of internal medicine at Texas Tech University Health Sciences Center. "They're told to watch their sugar intake, their fat intake and their salt and potassium intake. Some people throw their hands up, go crazy during the holidays and forget about their restrictions."

Chavez, a founder of the Amigo Kidney Foundation, said this is dangerous because patients with serious kidney diseases can end up in a hospital emergency room if they ignore the dietary advice.

"People on dialysis must avoid excess water," Chavez said. "If they eat a lot of food, they can exceed their potassium level, which is toxic to some of them. This can lead to muscle weakness and cardiac arrest. These patients must also restrict their protein consumption. Their systems can't handle the excesses like other people can."

The doctors advise avoiding red meats. Turkey and fish in small amounts are OK. It's also safe to eat pasta and rice in moderation.

Kidney patients also need to watch certain fruits and juices, including citrus, because they contain high levels of potassium.

"It's all right to have a drink, beer or wine but not in excess," Chavez said. "They overdo it, then they are going to pay the price."

Many people travel during the holidays, and people who are on dialysis don't have to avoid out-of-town visits because of this.

Hernandez and Chavez said patients who have home dialysis kits can send their supplies to their destinations, and those who receive dialysis at a center can arrange for a center in another city to treat them.

"The holidays are very busy times, so they must make plans for (out-of-town) dialysis treatments way in advance," Hernandez said.

Health professionals recommend avoiding ham because of its high salt content, using dressing that's made from scratch, cooking meats to the right temperature to avoid food-borne illnesses, avoiding raw egg products (eggnog and cream pies made with unpasteurized eggs), eating fruit pies instead of pumpkin, using only small gravy servings and coleslaw instead of potato salad.

"If you're invited to eat at someone else's home, it's advisable to eat a bit at home before you go, so you don't have to rely entirely on what they serve," Hernandez said.

During the holidays, some people can develop urinary tract infections while traveling, while others have recurring infections and may experience a bout during a trip.

For these people the advice on water intake is the opposite of what it is for people with chronic kidney diseases.

"UTI's (urinary tract infections) usually have bad timing, striking either on a holiday when it's hard to see a doctor, or when you're traveling," said Larrian Gillespie, a retired urogynecologist and author of the book "You Don't Have to Live with Cystitis."

She too offers several tips for the holiday season:
# Increase your water intake since holiday traveling, decorating and shopping can dehydrate the body.
# Try not to "hold it," and instead use the restroom whenever you feel the urge.
# For women who are susceptible to or have already experienced such an infection, buy an over-the-counter medication like Cystex in case you get an infection.

Cystex is a nonprescription product that eases pain and stalls the progression of the infection until you can get to the doctor's office, Gillespie said.

Chavez said it's important not to use such products in lieu of an antibiotic, which is the only way to get rid of a bacterial infection.

"You use it (Cystex) to mitigate the pain, but it will not eradicate the source of the infection," he said.

People with UTIs are advised to drink plenty of water and to use the restroom as often as needed because stagnant urine in the bladder is what leads to infections.

The old notion about using cranberry juice or other foods to avoid urinary tract infections no longer holds up.

"Clinical studies show cranberry doesn't help or hurt," Hernandez said.

Diana Washington Valdez may be reached at dvaldez@elpasotimes.com; 546-6140.

Urinary tract health
Some holiday tips from experts for people with kidney and urinary tract problems:
# Dialysis patients who are going to travel should discuss plans with their doctor and arrange in advance for dialysis treatment in another city.
# Follow diet restrictions carefully to avoid health complications. Most holiday meals are OK if consumed in moderation.
# People who develop urinary tract infections while traveling can take nonprescription medications for pain, but should not let them take the place of a doctor's prescription for antibiotics; they also should not "hold it" for long periods and stay hydrated.
# For more information, visit www.kidney.org.