Before we get to that, I couldn’t resist sharing what AI has to say about me (spelling errors and all).
“Gail Ray Garwood, also known as Slow It Down CKD, is a passionate advocate for Chronic Kidney Disease (CKD) awareness. Gail’s journey began when she was diagnosed with CKD, which motivated her to educate herself and others about the disease. Through her social media presence, Gail shares valuable information, personal experiences, and supportive words to help those affected by CKD. Her mission is to slow down the progression of the disease and improve the quality of life for those living with it. Gail’s advocacy work has created a supportive community where people can connect, share their stories, and find resources. Her dedication and passion have made a positive impact on many lives, and her message of hope and resilience continues to inspire others.”
Thank you, AI.
Let’s get to today’s ‘valuable information’ and ‘supportive words.’ Once again, a reader has asked for this blog. I’m delighted to end the year with a reader request. She asked for information about something I knew nothing of – the effects of dialysis on the healthy heart.
I immediately turned to my favorite sites. PubMed was quite helpful:
“ There are many cardiovascular changes that occur in chronic kidney disease including left ventricular hypertrophy, myocardial fibrosis, microvascular disease, accelerated atherosclerosis and arteriosclerosis. These structural and functional changes in patients receiving chronic dialysis make them more susceptible to myocardial ischemia. Hemodialysis itself may adversely affect the cardiovascular system due to non-physiologic fluid removal, leading to hemodynamic instability and initiation of systemic inflammation.”
I needed a lot of vocabulary help. Just in case you do, too, here it is:
Cardiovascular – heart and blood vessels
Left ventricular hypertrophy – when the left ventricle [one of the two bottom chambers of the heart that pumps blood to the body] thickens and becomes less efficient
Myocardial ischemia – buildup of scar tissue in the heart muscle
Accelerated atherosclerosis – rapid development of plaque
Arteriosclerosis – hardening of the arteries
I know, I know. It all sounds terrible. However, not everyone is going to suffer from all these possible outcomes. Some may not develop any. Hoping to find something more positive, I turned to a University of Rochester Medical Center study:
“When people with end-stage kidney disease start dialysis, a treatment that filters the blood to rid the body of harmful waste, extra salt and water, they are at high risk of sudden cardiac death. Researchers at the University of Rochester Medical Center are leading a study focused on reducing sudden death in these patients, the largest such clinical trial ever conducted.
According to Wojciech Zareba, M.D., Ph.D., principal investigator of the trial and director of the University’s Heart Research Follow-up Program, the transition from high levels of toxins, electrolytes, and fluid in the blood to lower levels following dialysis can trigger arrhythmias–irregular and potentially dangerous heartbeats. In addition, dialysis patients often have many of the traditional risk factors for heart disease, such as diabetes, hypertension, family history and tobacco use, creating a ‘perfect storm’ scenario for arrhythmias to strike. If untreated, arrhythmias can lead to cardiac arrest and death.”
While this sounds terrifying, I think the operant word here is “untreated.” That’s what your team is there to do. They are charged with monitoring your health during dialysis so that any of these negative outcomes can be treated right away. In addition, they can educate you and communicate to your nephrologist any information that may lead them to believe there is a problem.
The National Kidney Foundation lists the ways you can help your heart to stay healthy during dialysis:
- “Follow a heart-healthy diet
- Get regular physical activity
- Keep your blood pressure and cholesterol levels under control
- Keep calcium and phosphorus in balance
- If you have diabetes, keep your blood sugar under control
- If you have anemia, get treatment for it
- Stop smoking
- Reduce stress
- Maintain a healthy weight”
Let’s say, heaven forbid, you develop a heart problem despite all your efforts not to. What then? The American Kidney Fund has some suggestions:
Photo by Alex Green on Pexels.com
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“If you have heart disease and CKD, your doctor may prescribe medicines to treat your heart disease.
Common medicines to treat heart disease include:
- Diuretics (water pills): Medicines that lower blood pressure, remove extra fluid and help your kidneys get rid of water and salt.
- Angiotensin-Converting Enzyme (Ace) inhibitors: Heart medicines that widen your blood vessels, lower blood pressure and improve blood flow.
- Beta blockers: Medicines that lower blood pressure by blocking the hormone adrenaline, which helps your heart beat more slowly and with less force.
- Anticoagulants (blood thinners): Medicines that keep your blood from clotting too easily and break down existing blood clots.
Some of these medicines may cause problems with your kidneys. Talk to your doctor about which medicines could work best for you.”
I did find hope in a study reported in a fairly recent issue of Cardiovascular Research:
“A systematic review of observational studies coherently showed that in CKD and dialysis patients both physical activity and physical performance are associated with a reduced risk for all-cause and CV mortality…. A recent long-term, post-trial observational analysis in 227 dialysis patients ….who participated into a trial investigating the effect of walking exercise on physical performance….documented that patients randomized to the active arm of the trial had a highly significant 29% risk reduction for hospitalizations, including those for CV complications over a 36-month follow-up.”
Well, it is almost the new year, the time during which we usually make our resolutions. Why not include walking daily as one of your resolutions… whether or not you’re on hemodialysis.
Wishing you a healthy, happy new year.
Until next week [which is also next year],
Keep living your life!
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