Long-Term Complications of Hemodialysis (Ⅰ)

Depending on hemodialysis, some patients with end stage Renal Failure can have obvious treatment effect and their symptoms of end stage Renal Failure can be remitted immediately. However, besides some short-term complications, there are many long-term complications after hemodialysis.
Ⅰ High blood pressure:
This complication is related to retention of water and sodium, increased activity of rein-angiotensin system as well as excitability of sympathetic nervous system going up, etc.
ⅡLeft heart insufficiency:
Besides high blood pressure and retention of water and sodium, this complication is also associated with anemia, acidosis, internal fistula, electrolyte distribute and malnutrition, etc.
Ⅲ Coronary Disease:
Based on coronary arteriesarteriosclerosis, excessive ultrafiltration which can lead to coronary ischemia, is main cause of this complication
Ⅳ Pericarditis:
Pericarditis occurs two weeks after dialysis, which is called early stage Pericarditis, and if this complication appears after two weeks’ dialysis, we ordinarily calls it delayed Pericarditis.
ⅤPulmonary Edema:
Overloaded water causes this complication, and occasionally Congestive Heart Failure, Hypoproteinemia and increased permeability of capillary in lung play a role in arousing Pulmonary Edema.
Ⅵ Pleural effusion:
This complication is primarily exudative, which results from Heart Failure, retention of water and sodium, Nephrotic Syndrome and infection, etc.
Ⅶ Digestive tract disease:
This complication includes Esophagitis, Gastritis, Gastric Ulcer, delayed gastric emptying and gastrointestinal hemorrhage, etc.
Ⅷ Intestinal ischemia and intestinal infarction:
Patients with Hypertension, hyperlipidemia, Heart Failure or Diabetes Mellitus often have this complication.
Ⅸ Liver disease:
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Complication of Peritoneal Dialysis

In clinic, peritoneal dialysis can delay the loss of surviving renal function, and improve the quality of patients’ life. The indications of peritoneal dialysis include Acute and Chronic Renal Failure which are caused by all kind of kidney disease. In addition, liver failure and acute toxic diseases also can be treated by peritoneal dialysis. However, there are some complications which may occur during peritoneal dialysis.

Complications of peritoneal dialysis

ⅠPeritonitis

According to improvement of connection technology and attaching importance to nursing exit, infections which are related to peritoneal dialysis have been well controlled, the incidence of which obviously decreases. Peritonitis can lead to severe loss of protein, peritoneal adhesion, peritoneal thickening and peritoneal dialysis failure as well as blocking catheter, which can threaten life.

ⅡAbdominal pain

Abdominal pain may result from high hypertonicity dislysate, high or low temperature of dislysate, excessive dialysate and celiac infection as well as catheter movement.

ⅢObstructed drainage and blocking catheter

Warping, movement, and blocking by fibrin, blood clot can lead to this complication. What’s more, too much gas in enteric cavity or abdominal cavity is another cause.

Ⅳ Swelling and pulmonary edema

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Sexual Life and Dialysis

Can Patients who undergo dialysis have sexual life? This is a common question we often meet. Generally, patients with stage 4 Renal Failure will have hyposexuality, because the pituitary gland can not receive the signals from testes and ovaries to produce sex hormones. And patients with end stage Renal Failure often have impotence and infertility in men, premature menopause in women, and low or totally absent sex drive in both genders. In addition, most patients with end stage Renal Failure have anemia, which is another negative influence on libido.

Large amount of toxins and excessive water can be discharged when patients just begin to take dialysis, so that physical function may return to normal level, which will be accompanied with normal physiological requirement. However, this condition will change during long term dialysis. In general, 35% male patients who are taking dialysis will have further decline of sexual function, the proportion of female patients is 25%. Only 9% male patients and 6% female patients will improve their sexual function.

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Announcements of Peritoneal Dialysis

Contrast to medical condition of end stage Renal Failure in China, in western countries patients will just wait for dialysis and kidney transplant. And depending on the development of technology more and more patients with end stage Renal Failure accept peritoneal dialysis, which is easy to be operated and be taken at home. What kinds of patients are suitable for peritoneal dialysis? And what should we pay attention to the place of peritoneal dialysis?

Peritoneal dialysis should be as the first choice of them who are corresponding with one or more condition.

Ⅰ Patients who are older than 65 years old

Ⅱ Patients who have cardiovascular diseases, such as Angina Pectoris, Old Myocardial Infarction, Cardiomyopathy and arrhythmia, etc.

Ⅲ Patients who have Heart Failure, low blood pressure or uncontrolled high blood pressure

Ⅳ Patients who once had cerebrovascular accident such as cerebral hemorrhage and cerebral infarction

Ⅴ Patients with Diabetes Mellitus, especially accompanied with ocular fundus changes or peripheral neuropathy

Ⅵ Children

Ⅶ Patients who had fistulation failure for several times

Ⅷ Patients who have obvious bleeding tendency.

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