Medical problems in patients with chronic kidney disease undergoing hemodialysis and their therapy

Abstract

Background It was reported that hemodialysis (HD) with either a new or reused dialyzer raises medical problems that require therapeutic regimens. This study aimed to investigate the medical problems and their management in patients undergoing HD. Methods This study was conducted by prospectively observing patients with chronic kidney disease undergoing HD. The incidence of medical problems and the treatment given were recorded. Results Among 351 cases of HD, medical problems occurred in 15.7% of cases, including hypotension as the most dominant, followed by muscle cramps, shivering, headache, asphyxia, fever, chest pain, and pruritus. Hypotension was ameliorated with intravenous 40% dextrose and normal saline. Muscle cramps were overcome with 40% dextrose, normal saline, methampyrone, and calcium gluconate. Shivering was managed by warming the patients followed by intravenous methampyrone, 40% dextrose, and normal saline. Meanwhile, headache was reduced by paracetamol or intravenous methampyrone and 40% dextrose. Fever was treated by intravenous methampyrone or oral paracetamol. Pruritus was managed by intravenous dexamethasone and diphenhydramine. Conclusions Medical problems occurring during HD are prevalent and need immediate therapy. Pharmacists and clinicians should work in collaboration to improve the patients’ quality of life.

Dialysate Magnesium and Coronary Artery Calcification, Bone Mineral Density, and Cramping in Maintenance Hemodialysis: A Quasi-experimental Study

“…The discomfort produced by these intradialytic symptoms could be the cause of early cessation of HD session in up to 30% of patients. 32 , 33 In the present study, the number of patients and episodes of muscle cramps during HD were remarkably lower among those who received the high dialysis magnesium concentration. In a small observational study, increasing the dialysis magnesium concentration from 0.5 to 1 mEq/L resulted in a lower frequency of and less severe muscle cramps.…”

“…Muscle cramping is the second most common intradialytic symptom after hypotension. The discomfort produced by these intradialytic symptoms could be the cause of early cessation of HD session in up to 30% of the patients 32,33 . In the present study, the number of patients and episodes of muscle cramps during HD were remarkably lower among those who received high dialysis magnesium.…”

Mucocutaneous manifestations of patients with chronic kidney disease under hemodialysis: A cross‐sectional study of 49 patients

“…The severity of pruritus is examined in patients using VAS 22 . Intravenous dexamethasone and diphenhydramine are used to treat this condition 23 …”

“…22 Intravenous dexamethasone and diphenhydramine are used to treat this condition. 23 A study examining the relationship between xerosis and pruritus found that itching increased dramatically with the severity of dry skin. 24 Another common skin manifestation in patients undergoing hemodialysis is subungual hyperkeratosis.…”