YourHealth: Binge on weekends, death on MondayBy ANNIE FREEDA CRUEZ
2009/02/22
The tendency to overindulge on food and drinks over the weekends are affecting the health of kidney patients negatively, writes ANNIE FREEDA CRUEZ.
BLAME it on the overloading of food and drinks over the weekend.
Studies have shown that kidney patients receiving dialysis treatment on Monday, Wednesday and Friday are more likely to die on Monday while those receiving treatment on Tuesday, Thursday and Saturday die on Tuesday.
This is because when patients are not on treatment, especially over the longer weekend interval, they tend to eat and drink more, thus increasing potassium accumulation and fluid retention in the body.
The increased risk of sudden death and possibly death from cardiac causes is also due to the development of post-dialysis hypotension from the removal of large amounts of fluid.
Tropicana Medical Centre consultant nephrologist and physician Dr Soehardy Zainudin says kidney patients must learn to control their food and drink intake during the weekends or else their body will get overloaded by Monday.
He says haemodialysis patients are at an increased risk of sudden death as many suffer from coronary artery disease and cardiomyopathy, well-known risk factors for sudden death.
In addition, these patients have unique problems that put them at high risk -- volume overload and metabolic abnormalities such as hyperkaelemia -- that affect cardiac function and may lead to sudden death.
Peritoneal dialysis patients dialyse continuously and maintain a relatively stable volume and electrolyte status but haemodialysis patients have large swings in volume level and serum potassium because of the intermittent nature of dialysis.
"These swings are more prominent over the weekend interval when patients have three days, rather than the customary two days, without dialysis."
And during the festive season, especially Chinese New Year, many patients come in with hyperkaelemia or high potassium in the blood because of the high intake of oranges.
Dr Soehardy says kidney patients must refrain from eating fruits such as oranges and bananas which are high in potassium as they can suffer from arrhythmias (abnormal electrical in the heart), which can cause death.
"It's important for kidney patients to be disciplined and take care of themselves, whether or not they are on dialysis."
Some of the most common causes for kidney failure are diabetes, high blood pressure and a painless inflammation of the kidneys called glomerulonephritis, where there is a progressive loss of filtering units (nephrons) in the kidney.
Other common causes are the inherited condition of cysts in the kidneys (polycystic kidney disease); repeated kidney infections (pyelonephritis) or infections during childhood; and obstruction to the urine flow.
Dr Soehardy says damaged kidneys may carry on producing urine but become less efficient at removing waste products from the blood, which then continue to circulate and build up in the bloodstream.
"People with chronic kidney disease are in the highest risk group for heart disease."
Latest statistics show that 25 per cent of dialysis patients die of cardiovascular diseases.
In 2007, 1,678 dialysis patients died due to various complications, compared with 1,673 in 2006.
Dr Soehardy says at least 50 per cent of the more than 15,000 kidney patients on dialysis are diabetics and many die of heart attack although they normally do not suffer chest pains.
Those suffering from kidney failure must learn to control their diabetes and high blood pressure, get treatment for urinary tract infections, correct any problems in urinary system and avoid medicines that may damage the kidneys, especially over-the-counter pain medications.
SYMPTOMS OF KIDNEY DISEASE
General feeling of illness, lacking interest in everyday activities, difficulty in concentrating or relaxing, tiredness and loss of energy, shortness of breath, altered taste sensation/appetite, increased night-time urine production, sickness and nausea, loss of libido/sex drive, itch, swelling of the legs.
SIGNS OF KIDNEY DISEASE IN DIABETICS.
Albumin/protein in the urine, high blood pressure, ankle and leg swelling, leg cramps, going to the bathroom more often at night, high levels of blood urea nitrogen and creatinine in blood, less need for insulin or antidiabetic medications, morning sickness, nausea and vomiting, weakness, paleness and anaemia.
WHAT IS DIALYSIS
Dialysis is a treatment that removes water, salts, and waste products (from the body's normal metabolism), which build up in patients with failing kidneys.
There are two forms of dialysis.
- Haemodialysis (HD), done in a hospital or special clinic, is where the blood is cleaned by a machine and then returned to the body. The process takes about four hours each time and is done three times a week. Access to the patient's blood is done by inserting two needles into blood vessels on the forearm.
- Peritoneal dialysis (PD) is where a dialysis solution is always inside the "belly" and cleansing the blood in a continuous manner. The solution exchanges are done manually at home four times a day, every day by the patient.
http://www.nst.com.my/Current_News/NST/Sunday/Focus/2484947/Article/index_html
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