In July 2015 during my annual physical, my GP noticed something not quite right with my EKG. He passed me on to a cardiologist who ordered a stress test followed by a dye test that uncovered blockage. Within three days of my GP’s initial prognosis, I was in the ICU recovering from triple bypass surgery. Bear in mind that as a person I did not feel anything to be out of order. I was not overly tired nor did I present, and MDs like to phrase it, any other outward discernable symptoms.
As a result of this history, I have been prescribed baby aspirin by both the cardiologists I have been associated with, one in Corpus Christi, TX, and one here in Granbury, TX where I now live. Other than bruising and marginally thinner blood, I have observed no other effects of taking the prescribed aspirin.
Now to the story. Recent research has found that “taking 100mg of aspirin every day could lower the risk of people aged 65 and over developing type 2 diabetes…” The research also noted previous researchers have found that aspirin use was associated with a significantly increased risk of bleeding, primarily in the gastrointestinal tract. Since CKF is strongly correlated with the presence of diabetes, this finding has merit for those experiencing kidney degradation and/or failure.
I used Poe to construct a 500-word summary of the article cited above which follows:
A recent study suggests that taking a daily dose of 100mg aspirin may reduce the risk of developing type 2 diabetes in individuals aged 65 and older. Led by Professor Sophia Zoungas from Monash University, the study involved over 16,000 participants who were either given aspirin or a placebo. The results indicated that the group taking aspirin experienced a 15% reduction in type 2 diabetes risk and a slower increase in fasting plasma glucose levels. However, the study’s authors emphasize that further research is needed before any changes are made to current clinical guidelines regarding aspirin use in older adults. It’s worth noting that a previous trial called ASPREE, published in 2018, found that taking aspirin led to an increased risk of major bleeding without a reduction in cardiovascular disease incidence. Thus, while the recent findings are interesting, they do not alter the current clinical advice on aspirin use in older individuals.
Starting Sunday and for a week, my wife are I are traveling to Indiana via our BMW X5 to visit with family. She has three sisters living there. This is our first trip since I started Peritoneal Dialysis on 9/30/2023 and we’re probably over preparing in the face of so many unknowns.
One of the first things we accomplished was to borrow from our local Fresenius group the travel case for the Cycler. The picture at lead is of our Cycler with the case to the right of it. It is the HUGE black blob to the right of the picture. I mean as in enormous. It has a large yellow sign on it stating “Medical Device” I assume for shipping on airlines etc.
In addition to our normal luggage for a week’s travel to a foreign land, we will have eight boxes devoted solely to dialysis supplies. Four of the boxes contain one night’s supply of Dialysate ( one 5L and one 3L bag), trash bag, sta-keeper, etc. Two boxes double this up. The strategy here is we will spend one night going and coming on the road (staying over in Springfield, MO) and two nights in Lafayette, IN for a total of four nights. The other boxes with dialysate are backups. We have one box of cassettes, and one box containing all the other supplies required for dialysis such as 2x2s, tape, cleaning liquids, towels, heparin, syringes, etc.
It is going to end up being quite a bit of “stuff” but needed for a week’s trip. Even if we had arranged for dialysate to be shipped to our hotel in Lafayette, we would still need the bulk of supplies to conduct PD on the road. Another thing, each night we use one of the single boxes it is one less box we have to haul in the BMW.
The picture at the end (our golden Dickens had to supervise the taking of the picture) shows where we stand at packing out some 4 days in advance. I will share our traveling experiences when we return. Meanwhile, I have written a week’s worth of blogs which will continue automatically (aren’t computers wonderful) while we journey up to our Nation’s Breadbasket.
In this modern-day world, we all are a function of numbers. Be they income qualifications for SNAP or a home loan, or the amount of taxes on income. We live in a swirl of numbers; how tall we are, what our BMI is, what our blood pressure is, and during the phases of CKF, what our eGFR is.
It seems to me that medical personnel are relying more on numbers and less on the patients as an individual. They spend less time getting to know the patient and more on lab results. Is this a good or bad thing? I don’t really know but I do know that this model of operation by medical personnel, has by its very nature, made patients become more in tune with their numbers, be they biometric or lab-based.
It is conjectured that being human, some patients obsess over their numbers, and this is especially so when small or random changes in their lab results occur. In this setting, I have never had a conversation with medical personnel about how accurate the presented lab results are. What is the margin of error? How repeatable are the results? Do they depend on the time of day taken? Do they vary significantly from lab to lab? Do the lab results in fact measure what they proport to, or are they a proxy? Instead, they are taken prima facia as factual and direct explicit health regimens.
Patients can use philosophical help in dealing with the deluge of lab-produced numbers they are by their very nature forced to live with and by. I turned to my AI assistant, Poe seeking help in this area with the following prompt and results. Hopefully, it will help readers deal with the number onslaught.
Poe Prompt: Increasingly patients are subjected to numbers in their care, especially lab results. This is especially true of those of us on peritoneal dialysis. We live and die by these numbers. It can become an obsession with patients that is not constructive. Write a brief blog entry targeting peritoneal patients and their caregivers on how to deal with pressure from lab numbers.
Assistant Poe
Title: Navigating the Pressure of Lab Numbers: A Guide for Peritoneal Dialysis Patients and Caregivers
Introduction:
Living with peritoneal dialysis brings about a unique set of challenges, and one of them is navigating the pressure that often comes with monitoring lab numbers. While these numbers are crucial indicators of your health, it’s essential to maintain a balanced perspective and avoid becoming obsessed with them. In this blog entry, we’ll discuss some practical strategies for peritoneal dialysis patients and their caregivers to cope with the pressure of lab numbers and promote a healthier mindset.
Understand the Purpose of Lab Numbers:
First and foremost, it’s crucial to understand the purpose and significance of lab numbers. They provide valuable information about your health status and help healthcare professionals make informed decisions about your care. Recognize that these numbers are tools to guide your treatment, and they should not define your self-worth or overall well-being.
Establish Open Communication with Your Healthcare Team:
Developing a strong, communicative relationship with your healthcare team is vital. Regularly discuss your lab results with your healthcare provider and ask questions to gain a better understanding of what each number means for your health. This collaborative approach will foster trust and empower you to actively participate in your own care.
Focus on Trends, Not Isolated Results:
Lab numbers can fluctuate from time to time, and it’s important to remember that isolated results don’t always tell the whole story. Instead of fixating on individual values, pay attention to the trends over time. This will provide a more accurate reflection of your health and help you and your healthcare team make more informed decisions about your treatment plan.
Seek Emotional Support:
Living with the pressure of lab numbers can sometimes lead to anxiety and stress. It’s crucial to seek emotional support from loved ones, support groups, or mental health professionals. Sharing your concerns, fears, and frustrations with others who understand your situation can be immensely helpful in navigating this journey.
Focus on Overall Well-being:
Remember that your overall well-being extends beyond lab numbers. While they are essential, they are just one piece of the puzzle. Maintain a holistic approach to your health by focusing on other aspects such as maintaining a balanced diet, engaging in regular physical activity, managing stress, and getting adequate rest. Taking care of your mental and emotional well-being is equally important.
Celebrate Small Victories:
Lab numbers may not always be perfect, but it’s essential to celebrate the small victories along the way. Recognize and appreciate the progress you make, regardless of whether it matches your ideal expectations. Celebrating achievements, no matter how small can help shift your focus from solely relying on lab numbers and promote a more positive outlook.
Conclusion:
Peritoneal dialysis patients and their caregivers face the pressure of lab numbers, which can sometimes become overwhelming. By understanding the purpose of these numbers, maintaining open communication with your healthcare team, focusing on trends rather than isolated results, seeking emotional support, prioritizing overall well-being, and celebrating small victories, you can navigate this pressure more effectively. Remember, you are more than just the numbers on a lab report, and your well-being is a holistic journey encompassing both physical and emotional aspects.
It may be constructive if readers of this blog have an opportunity to compare lab readings from two different individuals. We are each unto our own, and lab readings follow this discourse. But, if we look at lab readings as “how are we doing vis-a-is “the competition,” perhaps insights are derivable that would not be apparent by just comparison with what labs state are goals.
A respondent to blog posts on this blog and I have developed rapport due to our common interest in peritoneal dialysis employing the Fresenius Liberty Cycler. He recently shared his lab readings and I constructed the table below so our readings may be compared side-by-side and with stated lab goals where established. See the table below and the comments following.
Reading
Him
Me
Goal
Albumin
3.9
3.4
=>4.0
Potassium
4.0
4.2
3.5-5.5
wKt/V
1.87
1.86
=>2.0
Calcium
9.2
8.5
8.5-10
Phosphorus
5.5
5.4
3-5.5
IPTH
206
380
100-720
Hemoglobin
10.2
10.9
10-11
BUN
68
52
Not Established
Creatinine
8.98
7.27
Not Established
Comparison His labs to mine
Pulling out some numbers now. Neither of us are where we should be regarding Albumin. I’m always low regardless of how much red meat I ingest. Low Albumin is a plague for those of us on dialysis.
His Calcium is much better than mine but this could be due to his younger age (74 versus 84.) My IPTH is much higher. IPTH indicates a balance of calcium and phosphorus in our blood. High phosphorous can cause high IPTH which can lead to bone and heart damage.
Both of us are down on wkt/V which measures whether or not we’re getting enough dialysis to adequately clean our blood. However, at least from my dialysis team’s perspective, we are close enough to keep on doing what we are doing without alteration of our dialysis prescription.
For kicks, I calculated eGFR for both of us using my Android App for this purpose. For him I used age = 74 and the Creatinine value of 8.98. His eGFR is 6. For me, I used age = 84 and a Creatinine value of 7.27 and obtained an eGFR of 7. So we’re both in the tank from an eGFR perspective as should be expected since both of us are on PD.
Bottom line: As the table above suggests, although we are two entirely different individuals, our labs don’t really vary that much, given that we are both on dialysis.
One of the tantamount aspects of successful dialysis is for patients to one way or the other get enough physical exercise. Granted, this can be difficult, at times downright painful, but a central necessity for us to keep everything going in the right direction. It is too easy to just pay lip service to this requirement and to hide our heads in shame when asked about our exercise regimen by attending physicians.
Don’t go there. I don’t and you shouldn’t. While it can be a pain, some wonderful things can happen while involved in exercise if you just are in tune with nature.
As I have stated several times on this blog, my wife and I are the proud keepers of a Golden Retriever named Dickens. He is, at 15 months, a 76.2-pound bundle of energy that we do our best to see that he gets a daily walk around Pecan Plantation where we live. Dickens is in the lead picture. You can easily see his muscular structure. He is strong in muscles but stronger in his innate desire to please us and the people he meets. For the record, he is 75% English golden and 25% American golden, thus the unique mixture of colors. We are seriously considering training him as a therapy dog he is so good and well-mannered.
Back to my story. While on our morning walk on Saturday, 9/16/2023 Dickens and I came upon Fairy Rings that were not there yesterday on our walk. Typically we see herds of deer, Egyptian Geese, ducks, snakes, and other creepie-crawly things. After all, we do live in Texas.
These growths are the epitome of Nature at its best and well worth viewing despite the slight discomfort walking for exercise might entail. I have embedded a picture of the Fairy Rings we saw followed by a background on the Fairy Ring phenomena for those interested in how they came to be from Poe.
Poe Assistant:
Title: The Enchanting World of Fairy Rings: Nature’s Mystical Circles
Introduction: Nature has an uncanny ability to surprise and mystify us with its wonders. One such enchanting phenomenon that has fascinated people for centuries is the fairy ring. Also known as elf circles, fairy circles, or pixie rings, these mysterious formations capture our imagination and evoke a sense of magic and folklore. In this blog, we will delve into the captivating world of fairy rings, exploring their origins, formation, and the folklore surrounding these whimsical natural wonders.
What are Fairy Rings? Fairy rings are circular patterns of mushrooms that appear in grassy areas, forests, and meadows. They consist of a ring or arc of mushrooms, often with a bare patch of ground in the center. These rings can range in size from just a few feet to several meters in diameter. They are most commonly found in temperate regions around the world.
Formation and Growth: The formation of fairy rings is attributed to a fascinating natural process. It begins when a mushroom spore lands in the soil and germinates, producing a network of underground fungal threads called mycelium. The mycelium grows outward in a circular pattern, feeding on decaying organic matter in the soil. As the mycelium expands, it releases enzymes that break down organic material, making nutrients more available for the fungus. This enhanced nutrient availability creates a visible ring of mushrooms above the ground, as the mycelium reaches the outer edge of the circle.
Folklore and Legends: Throughout history, fairy rings have been steeped in folklore and legends. They are often associated with supernatural beings such as fairies, elves, and spirits. In European folklore, it was believed that these rings were formed by dancing fairies or elves who left behind a ring as evidence of their revelry. Stepping inside a fairy ring was said to bring good luck or grant wishes, but it was also considered risky, as it could anger the fairies and bring about their mischief.
Scientific Explanations and Ecological Significance: While the folklore surrounding fairy rings is captivating, science provides a more rational explanation for their formation. The circular shape of the rings is a result of the outward growth of the mycelium, which expands radially in search of nutrients. Over time, the mycelium depletes the organic matter in the center of the circle, causing the mushrooms to appear more abundant at the outer edges.
Fairy rings also play a crucial ecological role. The mycelium in the soil acts as a decomposer, breaking down dead plant material and recycling nutrients. This process contributes to the overall health of the ecosystem. Additionally, the bare patches in the center of the rings can create microhabitats for other plants and organisms, adding to the biodiversity of the area.
Variations and Similar Phenomena: While the classic fairy ring consists of a circular formation of mushrooms, variations, and similar phenomena can also occur. Some fairy rings form arcs or incomplete circles, while others can form multiple concentric rings. In certain instances, the mycelium may colonize the roots of grass, causing a lush, vibrant ring of grass to appear. These variations add to the intrigue and diversity of fairy ring formations.
Conclusion: Fairy rings continue to captivate our imaginations, blending nature and folklore into an enchanting tapestry. Whether you see them as mystical portals or simply fascinating natural phenomena, there’s no denying the allure of these circular formations. The next time you stumble upon a fairy ring, take a moment to appreciate the intricate beauty and ecological significance they hold. Within these rings, there is a reminder that the natural world is full of wonders that can transport us to a realm of magic and mystery.
On Friday, 9/15/2023 at 0900 I attended my monthly Dialysis Team Meeting. Present were my nephrologist, my dialysis nurse, my dietitian, and my social worker. The purpose of this blog is to provide readers insight into the workings of the dialysis process from a ground level.
We started off with just my dialysis nurse and myself. I had requested enough heparin to last me until my surgery with Dr. Tan on 10/4/2023 and she provided me with this. We went over a Fresenius form that is required annually that covered the particulars of my mental health, our dialysis setup at home, and other such issues. She also injected me with an iron fusion to keep my labs up to snuff.
By this time the doctor came, along with the rest of the team and we got to it promptly at 0900. I’m always glad to see the team runs on Navy time. If a meeting is scheduled for 0900, it starts at 0900. The doctor asked how I was doing, went over my labs, checked my stomach port, listened to my heart, felt my ankles for swelling, and we discussed my new meds (K2 and D3) for osteoporosis.
There is a Fresenius-sponsored program in Fort Worth that addresses all aspects of dialysis with current and potential patients and their associates. A representative from this effort came in and made a pitch to me to join the group in October and be on a panel to make a short presentation and field questions about treatment modalities. Seems that this blog has made a positive impression on those involved in such matters and I agreed along with my wife, to attend.
By 0920 or so the meeting was concluded and I was on my way to pick up take-out breakfasts for my wife and me at the 19th Hole here where we live in Pecan Plantation. The secret to having a good meeting is to be prepared. Pour over your lab results and know the wheat from the chaff. Consult with your dialysis nurse prior to the meeting with any questions you might have. 99% can/should be answered by your nurse. Consult with your caretaker/wife/spouse/? prior to your meeting and be prepared to discuss any concerns. Same for input from your GP.
It boils down to the team is there for you; you have to come to the table prepared and be there for your team.
This past Tuesday a new book titled “Elon Musk” by Walter Isaacson was released. In it, Isaacson attempts to explain those personal traits that have helped (or hindered) Musk to become the world’s richest man.
I have embedded an interview with Isaacson from the 9/13/2023 WSJ. At first blush, this blog post may seem not to apply to those of us on dialysis. Nothing could be further from the truth. As we are still learning and profiting from the wisdom of Steve Jobs at Apple, so will the influence on all of us from the wisdom and quirks of Musk pervade business thinking for decades to come. His five principles of developing new products can and should be applied to the design and manufacture of improved dialysis equipment. By the way, Jobs was a first-class jerk as is Musk.
There is a thread on Facebook from Peritoneal Dialysis patients citing drain problems where they drain their PD drain line. Most problems occur in showers, bathtubs, or sinks and NOT toilets. The problem is manifested by a slowdown in drainage and even blockage. Plumbers have reported a gelatine mass in the drains thus impacted. Also described as a glob of stuff.
For the record, we drain our Cycler into our shower drain and are starting to see drainage slowing down indicating blockage. I quizzed my local dialysis nurse about this and was told she had not experienced it as of yet.
It is conjectured that the stoppage is caused by the chemical compounds in the solution itself, coupled with an ideal growing climate in the drains. Keep in mind that the effluent coming out of the PD catheter is basically a sugar solution now mixed with many of the chemicals found in urine. The whole PD game is to act in place of our kidneys so we would expect much of the “stuff” removed to be common to the urine it replaces. So we have dextrose and urine-based whatever plus warmth in the shower drain equals virus or whatever growth in the drain. Not too hard to imagine is it?
The solution most offered in the Facebook thread was to generously apply a bleach solution to the drain. Respondents did not agree on either the frequency or potency of the bleach but most often cited a 1% solution, 1/2 a cup, ranging from daily to weekly administration.
Those who dumped into their toilets did not report having drainage problems. This is most likely the result of two things: 1. The drain pipes for the toilet are larger than the pipes for the other drains, and 2. The force of water during a flush is much greater than the more gentle drains in sinks, showers, or tubs.
So now along with cleaning our shower head once a month (don’t ask why, it’s a Fresenius inspection thing), we have now added maintenance on our drains. Maybe you should too? By the way, the picture at lead IS NOT OF OUR SHOWER DRAIN! It is from Bing Illustrator.
On Tuesday 9/12/2023 I had my quarterly visit with my GP. We all have these meetings, some more frequently than not. For me, I meet with my GP quarterly, my Nephrologist monthly, my dentist three times a year, my podiatrist quarterly, have a retinopathy check once a year, etc. I am a system of doctor’s appointments.
While we discussed many things, like how many pets we both have, here are the most salient points:
I agree to change the tolerance on the bounds in my CGM to 150 hi and 70 low from 170 hi and 70 low. This puts a tighter upper bound on my Time in Range readings imputing tighter diabetic control.
I have not had an eye exam for glasses or a hearing exam (I use hearing aids) for approximately three years. He chided me and we agreed that I have to start having these exams yearly. The problem for me is that I go to the VA for eyes and ears and it involves a long drive into Dallas/Fort Worth traffic, long queues to even obtain an appointment, and in general being treated with total indifference once there. The VA is not a nice place in my experience, regardless of what politicians would lead you to believe.
My wife has noticed that around the house I tend to shuffle when walking. Not picking my feet up. I discussed this with my GP and he diagnosed this tendency as potentially the start of Parkenson’s Disease. I explained that it is only around the house, and not while on my daily dog walk, etc. We agreed to continue to watch and report on this new portal into my life. He did say there are no magic bullets in this area.
Since I am now under the shadow of Parkinson’s along with all my other baggage, I felt it necessary to learn more about this ailment. I queried my AI assistant Poe with the following results:
Poe Assistant
Title: Understanding Parkinson’s Disease: A Guide to the Neurological Disorder
Introduction: Parkinson’s Disease (PD) is a chronic and progressive neurological disorder that affects millions of people worldwide. Named after Dr. James Parkinson, who first described the condition in 1817, Parkinson’s Disease primarily impacts the part of the brain responsible for movement. This blog entry provides a concise overview of Parkinson’s Disease, its symptoms, causes, and available treatment options.
What is Parkinson’s Disease? Parkinson’s Disease is characterized by the gradual degeneration of specific brain cells that produce dopamine, a chemical messenger involved in controlling movement. As dopamine levels decrease, the brain’s ability to regulate and coordinate body movements becomes impaired, resulting in a wide range of motor and non-motor symptoms.
Common Symptoms: The most recognizable symptoms of Parkinson’s Disease include:
Tremors: Involuntary shaking or trembling, often starting in the hands, fingers, or limbs.
Bradykinesia: Slowness of movement, making simple tasks more time-consuming and challenging.
Rigidity: Stiffness of muscles, leading to limited range of motion and difficulty with mobility.
Postural Instability: Impaired balance and coordination, increasing the risk of falls. Other non-motor symptoms may include depression, anxiety, sleep disturbances, cognitive changes, and gastrointestinal issues.
Causes and Risk Factors: The exact cause of Parkinson’s Disease remains unknown, but a combination of genetic and environmental factors is believed to play a role. Some risk factors associated with the development of Parkinson’s Disease include advancing age, family history of the condition, exposure to certain toxins, and certain genetic mutations.
Treatment Options: While there is no cure for Parkinson’s Disease, various treatment options aim to manage symptoms and enhance quality of life. These may include:
Medications: Dopamine replacement therapies and other medications help alleviate motor symptoms and manage dopamine levels.
Deep Brain Stimulation (DBS): Surgical implantation of a device that delivers electrical impulses to targeted areas of the brain to control tremors and other symptoms.
Physical Therapy: Exercises and movement techniques that improve flexibility, strength, and balance.
Occupational Therapy: Strategies to enhance daily living activities and maintain independence.
Lifestyle Modifications: Regular exercise, a balanced diet, and stress management can help manage symptoms and improve overall well-being.
Conclusion: Parkinson’s Disease is a chronic neurological disorder that affects movement and quality of life. While there is no cure, early diagnosis, and a comprehensive treatment approach can significantly improve symptom management and help individuals with Parkinson’s Disease lead fulfilling lives. As ongoing research continues to deepen our understanding of the condition, it is crucial to raise awareness, support those affected, and promote advancements in treatment and care for individuals living with Parkinson’s Disease.
During my last scheduled visit with my GP, he suggested due to my age and dialysis status it was prudent that I have a bone density test conducted which I did. You can view the result below:
As you may ascertain, the bottom line is that the results of my bone density test indicate that I indeed am experiencing Osteoporosis. This phenomenon is a lot like diabetes; in my case, you can’t see it or feel it, it’s just there for a doctor’s prognosis. So the question becomes, in the pickle that I am currently in with dialysis, what can be or should be done about it? And just what is this ailment that I have now been flagged with? It can’t cause my hair to fall out because that has already happened – like when I was but sixteen.
So the first thing let’s look at is the measurements used in flagging me with this fragility, and what does WHO have to do with it?
I asked Poe to provide insight in this area with the following results:
The criteria for osteoporosis diagnosis are primarily established by the World Health Organization (WHO) and are commonly referred to as the “WHO criteria.” The WHO criteria for osteoporosis are based on bone mineral density (BMD) measurements obtained through dual-energy X-ray absorptiometry (DXA) scans. The criteria are as follows:
Normal: A T-score of -1.0 or above indicates normal bone density. A T-score compares a person’s BMD to the average BMD of young, healthy adults of the same sex.
Osteopenia: Osteopenia refers to low bone mass, which is a precursor to osteoporosis. Osteopenia is diagnosed when the T-score is between -1.0 and -2.5.
Osteoporosis: Osteoporosis is diagnosed when the T-score is -2.5 or below. This indicates significantly low bone density and an increased risk of fractures.
It’s important to note that the WHO criteria are primarily focused on postmenopausal women and men aged 50 and older. For individuals under the age of 50, other criteria may be used, such as the Z-score, which compares the BMD to the average BMD of individuals of the same age, sex, and ethnic background.
Lastly, I queried Poe about the relationship between dialysis and osteoporosis with the following results:
Poe Assistant
Osteoporosis and dialysis are two separate medical conditions that can often coexist or be linked in certain individuals. Let’s discuss each condition individually and then explore their potential relationship.
Osteoporosis: Osteoporosis is a skeletal disorder characterized by low bone mass and microarchitectural deterioration of bone tissue, leading to increased bone fragility and susceptibility to fractures. It is a common condition, particularly among postmenopausal women, but it can affect both men and women of all ages.
The development of osteoporosis is influenced by several factors, including genetics, hormonal changes, lifestyle choices, and certain medical conditions or treatments. Risk factors for osteoporosis include advanced age, female gender, low body weight, sedentary lifestyle, smoking, excessive alcohol consumption, family history of osteoporosis, and the long-term use of certain medications like corticosteroids.
Dialysis: Dialysis is a medical procedure used to artificially replace some of the kidney’s functions in individuals with end-stage renal disease (ESRD) or severe kidney failure. ESRD occurs when the kidneys are no longer able to effectively filter waste products and excess fluid from the bloodstream. Dialysis helps in removing waste products, regulating electrolyte balance, and managing fluid levels.
Now, let’s explore the potential relationship between osteoporosis and dialysis:
Chronic kidney disease (CKD), which often leads to ESRD requiring dialysis, can be associated with an increased risk of osteoporosis. Several factors contribute to this increased risk, including hormonal imbalances, reduced vitamin D activation, impaired calcium-phosphate metabolism, and the use of certain medications like corticosteroids during dialysis treatment.
Moreover, individuals on long-term dialysis may experience mineral and bone disorders (MBD), which encompass a spectrum of bone-related abnormalities. MBD in dialysis patients is characterized by alterations in bone turnover, mineralization, and volume, leading to various bone disorders, including osteoporosis.
The management of osteoporosis in individuals undergoing dialysis involves a multidisciplinary approach. It may include optimizing dialysis treatment, ensuring an adequate intake of calcium and vitamin D, encouraging weight-bearing exercise, and, in some cases, prescribing medications to improve bone density.
It’s important to note that the relationship between osteoporosis and dialysis is complex, and not all individuals on dialysis will develop osteoporosis. However, if you or someone you know is undergoing dialysis and has concerns about osteoporosis, it is advisable to consult with a healthcare professional for an accurate assessment and appropriate management plan.
My GP recommended that I start on a regimen of OTC drugs Vitamin D3 and K2 along with Ca. My nephrologist vetoed calcium as my current dialysis labs indicate I’m doing OK in this area.
So what’s the bottom line? Seems that If dialysis, then Maybe/Perhaps Osteoporosis, and the link is casual but not inclusive. But it got me, didn’t it?
Poe Assistant:
Poe Assistant
Poe Assistant