2013年8月30日星期五

Chronic kidney failure

Chronic kidney failure, also called chronic kidney disease, describes the gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney failure reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can accumulate in your body.
How does kidney failure affect the blood?
In addition to uremia, kidney failure can also cause anemia, a condition in which the red blood cells are fewer or smaller than normal, which means less oxygen is carried to the body’s cells. Anemia can cause extreme fatigue and can worsen existing heart problems.
Anemia is common in people with CKD, as well as those on dialysis, because the damaged kidneys slow the production of the hormone erythropoietin (EPO), which helps the bone marrow make red blood cells. Less EPO means the body has fewer red blood cells, resulting in anemia. A synthetic form of EPO is commonly prescribed for people on dialysis.
How does kidney failure affect the appetite?
People who have uremia often lose their appetite. Some people find that food tastes different. Some no longer like foods they once craved. In fact, many people feel sick to their stomach at the thought of eating. But getting enough protein and calories is important for staying healthy. People with kidney failure should talk with the renal dietitian at their dialysis clinic or transplant center to find foods that are appealing and provide needed nutrients.
How does kidney failure affect mental health?
Many people feel depressed when starting dialysis, or after several months of treatment. Adjusting to the effects of kidney failure and the time spent on dialysis can be difficult. People on dialysis also have less energy. They need to make changes in their work or home life, giving up some activities and responsibilities. Keeping to a schedule can be difficult when kidneys fail. Accepting this new situation can be hard. A mental health counselor or renal social worker can help people who are approaching total kidney failure and those starting dialysis. People who have kidney failure and depression should not keep their depression to themselves or assume they can handle their problems on their own. They should tell their health care provider because depression can often be treated with adjustments to the diet and dialysis dose, medications, and counseling. Scientists are also studying the use of cognitive behavioral therapy—a way of correcting harmful thought and behavior patterns—to treat depression in people with total kidney failure.

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