Kidney failure, or End-stage renal disease (ESRD), also known as chronic kidney disease stage 5 (CKD 5), has been the most uprising disease in the recent times. The failure of the vital organ develops severe health complications, as its failure leads to the accumulation of metabolic waste, retention of fluid within the body and cessation of other vital kidney functions. The kidneys not only filter out the waste from the body but also plays other vital functions like regulation of hypertension, secretion of essential blood cells stimulating hormone (ERYTHROPOIETIN), regulation of blood pH, etc. The severe complications because of kidney dysfunction includes uremia, hypertension, anemia, electrolyte imbalance, metabolic acidosis, cardiovascular complications because of fluid overload, edema, etc.
There isn’t any permanent treatment of kidney failure apart from kidney transplant, so dialysis plays most important role in the kidney failure patients as dialysis alters the filtrating function of the kidney. Dialysis is the process by which the accumulated metabolic waste and the retained fluid within the body is removed. Dialysis is mainly of two types: peritoneal and haemodialysis, in peritoneal dialysis the peritoneal cavity is used as the medium of filtration, while in hemodialysis the blood is used as the medium of filtration. Hemodialysis is commonly used dialysis technique than peritoneal dialysis. Mostly the patients require two to three sessions of hemodialysis in a week. In hemodialysis the blood is drawn out from the patient and allowed to pass continuously through the dialyzer, also called an artificial kidney, which is placed in dialysis machine, after going through different processes within the dialyzer like diffusion, osmosis, ultrafiltration, and convection (depends on the type of haemodialysis) the filtered blood is returned to patients, this process lasts for 3 to 4 hours in traditional hemodialysis till the waste and fluid gets eliminated from the body. Apart from other conditions, the mental distress is largely seen in dialysis patients, which eventually leads to psychosomatic disorders.
The mental distress may include:
Anxiety: stimulated by fear of treatment, complications, and dependency.
Stress: from managing the disease, like by fluid/diet restrictions, vascular access care, financial burden.
Social isolation: Being bound to the dialysis sessions increases the isolation.
It is important to manage the mental distress of the dialysis patients equally, like other issues. If we talk about our valley, the patients lag the mental preparation and mental training to cope with the dialysis. The first step towards managing the mental distress is, society must treat patients equally the patients shouldn’t be considered as the burdens either in hospitals, dialysis centres, or at any other place. The patients should also accept the disease and the method of the procedure, adapting to the dialysis sessions is very important as the body adjusts with time, dialysis gets easier session by session, making it as the normal routine is vital, as the imagined complications like “today I’m having a session—what will happen, how it will go, etc.—will cause the mental distress and will affect the patient.
For medical professionals it is important to treat patients professionally and politely. Properly handling the hyperactive patients is important, as hyperactivity disorder and Impulsive behaviour is widely seen in dialysis patients. Developing a therapeutic environment within the dialysis unit is necessary because the patient has to bear the session of 4 hours, and the patients must be treated equally and unbiasedly not like “They are already the kidney failure patients; let it be.”
The family and caretakers should not let the patients feel that they are different, helping the patients to adapt the dialysis is vital. The patients should be allowed to do activities as well, making them bed bound creates a lot of psychiatric pressure. Being involved in religious and spiritual activities helps the patients to cope with the mental trauma, as by practicing religious activities the acceptance develops within the patients as well. Besides mental distress, the dietician Consultation is also being taken for granted by dialysis patients, although it is equally necessary as the nephrology consultation, as the most dialysis patients lack proper diet, which leads to malnutrition, and it debilitates the patients.
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