Are all the medications safe for a kidney patient?
Are all the medications safe for a kidney patient?
:The medications
that prescribed by your physician can be divided into three main divisions
i.
Safe
drugs: this group of medications are completely safe that means they can be
used with the same dose given to a normal person without any change.
ii.
Unsafe
drugs: this type of medications is completely contraindicated for a kidney
patient that means their use will result in complete destruction of by these
agents to the kidney tissues. The best example of these are the group analgesic
medications certain antibiotics. The harm of this group could be either:
1)
Direct
toxicity to the kidney tissues or,
2)
Indirect
toxicity through retention of the drug due to failure of its removal from blood
by the kidney purification system.
iii.
Intermediate
group: that can be used partially through dose reduction. The latter maneuver
depends on how much the kidney is failing i.e., Spacing and reduction of dose
timing and magnitude will depend on the degree of renal failure severity, the
much more sever the kidney failure the more space between drug dosage
consumption will be and the smaller the amount of a given drug.
-
However,
this piece of information will result in several recommendations:
1) You need to evaluate your kidney function serially through
laboratory checkup of your renal profile to determine which stage you are in
and recognize the best maneuver you should follow.
2) Avoid intake of unnecessary medications.
3) Avoid intake of any medication without your physician consultation.
4) Revise your nephrologist after any visit to other specialty.
5) Consult your nephrologist before any medical/surgical intervention
or surgical or radiological technique.
6) Avoid radiological examination with dye contrast.
7) If mandatory, certain precautions should be followed before and
after these maneuvers with enough time.
8) Repeat your renal profile on a daily basis immediately after these
intervention to make sure that no harm or progress in your kidney function has
been developed and to take the proper action in the meantime.
9) Finally, adherence to your physician, compliance with you
medications and serial evaluation of your kidney function are the only
guarantee to keep yourself away from dialysis as much as possible.
I am a nephrology consultant with M.D. degree in nephrology and renal
transplantation. I am interested in clarification the vital points in
nephrology practice in regard to kidney patient care, follow up and prevention
of renal failure as well as improving quality of life. There are may options
for kidney patients i.e. conservative treatment, kidney dialysis and kidney
transplant. Helping the patients to choose the best therapeutic option and clarification of the best therapeutic
guidelines are my main targets in this blogger. Many questions about
complications of kidney failure, medication use, types of nutrition and patient
survival are currently running in patient’s mind. The magnitude of psychological
stress that exerted on kidney patients once he knew that his kidney in danger
lead me to proceed in declaring the nature of kidney disease and the best
maneuvers to manage its complications. Many unnoticed ordinary habits like
analgesic abuse can cause serious depression of kidney function. As there are
several options to manage kidney failure, we need to determine the best
therapeutic option to control the rate of kidney function deterioration. I am
ready to answer any question related to my specialty. The responsibility of
preservation of kidney- one of the most vital organs- is not confined to the
medical staff. Nevertheless, patients education is a fundamental step in renal
disease management. Patient adherence to his clinician is mandatory in this
regard. Strict compliance to his medications, laboratory profiles testing and
physician orders is the cornerstone in
stabilization of kidney function. Efforts still going to introduce a novel
solution for a failing kidney. Kidney transplant using a new regimens of
immunosuppression and stem-cell transplantation are the best examples. I will
be happy expand your data base in regard to early detection of your kidney
dysfunction and offer the best available instructions to keep your kidney safe and healthy.
What are the most dangerous risk factors that can harm my kidney?
The kidney is
one of the most vital organs in the human body. We discussed its main vital
functions before. However, to keep this organ in its best state and to prevent
its malfunction, we have to be aware to the most dangerous risk factors that
can interfere with the normal physiology of the kidney. Some of these factors
are very simple and easy to correct. However, other diseases that are called
co-morbid disease need to be clarified and to recognize the mode by which they
can harm the kidney. Unfortunately, gathering of more than one risk factor will
augment the burden on this organ, so that the progress of renal failure will be
rapidly developed. Consequently, a full detailed history from the patient
should be performed to declare any unnoticed harmful agent (s).
Now, let us
revise the most important risk factors that make your kidney in danger and more
liable for kidney failure:
1)
Dehydration: the human body cannot do without
enough water to enable the all the vital organ functioning properly. Rate of
water loss is also very essential in kidney failure development. Workers in the
hot sunny weather with prolonged exposure to sun rays may result in excessive
sweating and loss of body fluids. Perfusion of the kidney at that time will be
shut down and urine output will be decreased that is called oliguria up to
complete loss of urine output that is called anuria. Treatment at that time is
very simple i.e., to replace the lost fluids and rehydration of the kidney
tissues. However, if there is delay in kidney tissue repletion, an irreversible
damage to the kidney will ensue. Timely diagnosis and prompt interference are
crucial in the management of this simple risk factor.
2)
Analgesic abuse: One of the
common risk factors for kidney dysfunction is the common use of analgesic drugs
for any type of pain. This behavior can be seen frequently in developed
countries. Actually, very few types of analgesics can be considered safe e.g.,
paracetamol, otherwise could be harmful. The harmful effect of analgesics
currently take time, up to years, however, certain agents can induce acute
renal failure. The latter can be treated conservatively but if prolonged,
dialysis may be the sole therapy. In the developing countries, it is commonly
for the public to call the pharmacy for any medicine without doctor prescription
or consultation. This cultural behavior can be seen also in low social standard
communities. So, a thorough history, particularly in regard to his medication
list is mandatory. Also, public education in regard to the danger of
medications abuse and over consumption with collaboration of the medical
authorities is warranted. It is
noteworthy to mention that every nephrologist has been supplied by extended
lists of the medications of particular interest in regard to mild, moderate and
sever impact on kidney function.
3)
Diabetes mellitus (DM): This is
the most common of kidney failure in Europe, USA and other developed countries
as mentioned before. Five years- at least- should be elapsed before development
of DM-associated renal disease that is called “diabetic nephropathy”. Not all
patients with diabetes can develop kidney dysfunction. Many factors can
facilitate the development of this disease, e.g., 1. Poor control of blood
sugar level. 2. Prolonged period with diabetes mellitus. 3. Associated
co-morbid diseases like hypertension and gout. 4. Use of nephrotoxic drugs like
the angiotensin-converting enzyme inhibitors (ACEI) and angiotensin- receptors
antagonists drugs (ARB).
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