Kidney disease and artificial kidneys have become diseases that are no longer just chronic diseases of the elderly. It is currently found that kidney disease patients are also in the younger age group.
From the last episode, we saw the work of the last line of defense doctors, doctors who do not prescribe drugs or treat people to revive them, but who maintain the right to bring what the corpse wants to communicate into the justice process. For the things that the corpse does not have the chance to say, the forensic doctor will be the one to speak on their behalf.
Now, I will take everyone back to the working process of the hospital that treats people to have good health again. This time, it is the turn of the treatment center that everyone has heard of often, the 60th Birthday Anniversary Dialysis Center of Her Royal Highness Princess Maha Chakri Sirindhorn, Thammasat University Hospital, a kidney care center that anyone with kidney disease must visit every week. Today, we will get to know this center and its work in depth from an interview with Ms. Sasithon Tasanasat and Ms. Natthika Chantanphan, professional nurses in the kidney and dialysis department, Thammasat University Hospital.
“Even people in their 20s are coming in for dialysis.”
Nowadays, there are facts about kidney disease that many people may not know. 17.6 percent of Thais suffer from kidney disease, which is about 8 million patients, 80,000 of whom have end-stage renal disease. Importantly, the number tends to increase every year. If we look at the number of patients coming in for dialysis, it is usually not full each round, there will always be a vacancy. But now, Monday through Friday, there are always patients coming in for dialysis every round. In addition, kidney disease used to be considered a disease for the elderly with underlying diseases, but now the number of patients with kidney disease is getting younger and younger.
“Our challenge is to make patients listen and believe.”
Most patients can go on with their normal lives without any concerns or strict control. The nurse’s job is to find a way to get patients to come for dialysis as ordered by the doctor. There are cases where patients only come for dialysis twice a week, but the doctor has ordered them to come for dialysis three times a week. Many patients do not want to come for dialysis. Therefore, this is an important and challenging task to talk to so that patients understand, listen, and comply. A common solution is to advise patients about the negative effects of inadequate dialysis, such as lethargy, fatigue, inability to eat, loss of appetite, and vomiting.
“Many people may not be able to accept the fact that they have chronic kidney disease.”
Some people who have just started dialysis still cannot accept it, and it is difficult for them to accept the fact that they have chronic kidney disease. Having to come in for dialysis 2-3 times a week is difficult to understand and follow. It becomes their suffering, so they show resistance and do not follow the way they should. Therefore, we must find a way to talk to them so that they understand that they are now in this stage and should act in a way that prevents complications from the disease, because complications are likely to occur if they do not receive good care.
“Kidney patients understand everything they need to do, but they don’t do it.”
There is also another type of patient who has been receiving dialysis for a while. They will say that they understand, have knowledge, and have learned well from the nurses about what to do and how to act. But in reality, they still cannot do it by themselves. When the nurse asks what medicine they need to take, they can answer but do not actually do what they are told.
Severity of kidney disease
The severity of kidney disease is divided into 5 stages as follows:
- In the initial stage, the doctor may prescribe a diet that is at risk of causing kidney disease, such as very sweet and salty foods, and good control of your underlying diseases.
- Stage 3: The doctor will start talking about getting ready to enter the high-risk group. If it continues like this, dialysis may be required.
- Stage 5 requires dialysis. If stage 5 is reached, dialysis will be done twice a week. Every three months, dialysis will be conducted to assess the adequacy of dialysis. At the point where the patient is receiving dialysis services, are the equipment used, the solution, and the filter sufficient to remove waste? If it is still insufficient, it is necessary to increase the dialysis appointment to three times a week. Each dialysis session will take four hours.
Behaviors that cause kidney disease
Most cases of kidney disease are caused by an inability to control underlying diseases, such as diabetes, high blood pressure, high cholesterol, or heart disease. Whenever the blood supply to the kidneys is poor, the kidneys will naturally deteriorate with age. Therefore, some patients present with symptoms of fatigue, depression, confusion, and swelling. When they come for a checkup, they find out that they have kidney disease.
“Kidney function deteriorates with age.”
First of all, we need to understand that as we age, our kidneys will deteriorate over time. We cannot stop their deterioration. What we can do is slow down their deterioration as much as possible.
If you have a chronic disease, you should control it. For example, diabetes should be controlled by controlling sugar. For high blood pressure, control blood pressure to be in the normal system. For fat, control the amount of food you eat. Or gout, which may seem like a small thing and not a serious disease, but it can also cause kidney failure. Therefore, we should be careful from the beginning.
Another important thing is annual health check-ups. This should be done regularly so that we can monitor our blood test results and be able to eat the right foods according to our blood test results.
How do you observe yourself ?
Most people with kidney disease, the warning signs are diabetes, high blood pressure, high cholesterol. These diseases will be the top warning signs. If patients with these chronic diseases do not take medication and change their behavior correctly, such as eating spicy or salty food, they will immediately become a risk group. Try to observe yourself to see if you feel more tired than usual or if your body is swollen, such as pressing on your shin to see if it is swollen or if you feel itchy all over your body.
Hospital health checkup
The health checkup at Thammasat University Hospital, in the program, will look at kidney function values, waste trends, urine tests to see what comes out with the urine. It will be another level of screening. This type of examination will help us know in advance.
“We don’t know until the symptoms are severe.”
Kidney disease is a disease that shows almost no symptoms. It will start to show symptoms to us when the symptoms are severe. We therefore have to use blood test results to monitor. Therefore, if the patient has an underlying disease, controlling the underlying disease, having a monthly blood test, or an annual blood test as scheduled by the doctor will help screen for kidney disease in this area.
Conclusion
Kidney disease is something that deteriorates over time, just like our bodies that will have more wrinkles as we age. Our bodies are just normal things that have an expiration date. Our lives are just a matter of choosing whether we will preserve our use to extend its lifespan or whether we will use it without caring about whether it will deteriorate one day.
For those who already have kidney disease and are having to deal with dialysis every week, admitting that you have kidney disease is not a bad thing because it will only get worse if you do not accept it and resist its treatment. Dialysis is a treatment that was discovered to be used to allow patients to return to their original life as close to the original as possible. Therefore, if you want to return to being as healthy as before, everything depends on you from the beginning.
“It depends on yourself from the beginning. Everything depends on yourself.”
“Kidney Disease and Artificial Kidneys” Work that requires heart care | Thammasat University Hospital
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