Rehabilitating Patients with Renal Failure

Patients often suffer from fatigue, lethargy, and weakness. In addition, they may complain of nausea, vomiting, nocturia, shortness of breath, bone pain, acute arthritis, uraemic pericarditis, uremic pleuritis, and peripheral edema. Neurologic signs bath withal be present; these may include irritability, inability to concentrate, confusion, musculus twitching, muscle cramping, and coma. Finally, nephritic failure may cause hormonal abnormalities. These can alter reproductive system functioning, and may be credi devilrthy for amenorrhea, loss of libido, and impotence (Cattran, 1983, p. 229).

For the most part, renal patient sustentation involves many different choices. The primary treatment modalities include transplantation, hemodialysis, and peritoneal dialysis. These different options offer various prognoses (Kutner, 1994, p. 321). Investigators claim observed that the pick rates for hemodialysis and peritoneal dialysis are similar. In addition, researchers have compared the outcomes for hemodialysis and transplantation. One recent study found that the relational risk for mortality was initially greater for transplant patients. However, more or less 325 days after surgery, transplant recipient mortality fall relative to that for hemodialysis patients.

Each therapeutic modality also consists of specific technical and interpersonal components. In transplantation, for example, numerous factors await to be associated with graft survival. Hence, transplant mor

With regard to psychological treatment modalities, patients may receive round combination of pharmacologic treatment and psychotherapy. There are two rules in ESRD pharmacology: (1) medicines administered cannot be excreted by the kidney; and (2) pharmacologic agents cannot be dialyzable. The first of these rules must be enforced to avoid deadly drug levels; the second rule precludes sub-therapeutic levels. The requirements eliminate the use of boor tranquilizers and lithium carbonate as ESRD psychopharmacologic treatment modalities. However, the phenothiazines (i.e.

, major tranquilizers such(prenominal) as chlorpromazine) may be applied against anxiety, and the tricyclic antidepressants--imipramine (Tofranil) and amitriptyline hydrochloride (Elavil)--may be prescribed for slump (Levy, 1978, pp. 99-106). As a group, ESRD patients carry to resist psychotherapy. However, "talking" therapies may help patients to overcome their depression (NIMH, b., pp. 1-9). Patients' attention should be directed away from their dialysis and towards some reflection of their life involving improvement. All patients need hope for the future (Tuttle Jr., 1985, pp. 15-18).

Painter, P. (1994, July). The sizeableness of exercise training in rehabilitation of patients with end-stage renal disease. American Journal of Kidney Disease, 24 (Suppl 1), S2-S9.

Anderson, J., & Levine, J. L. (1983). Identification and prevention of psychosocial problems in the renal patient. In D. Z. Levine (ed), Care of the renal patient (pp. 27-33). Philadelphia, PA: W. B. Saunders Company.

Halstead, L. S. (1978). versed attitude reassessment programs, rehabilitation, professionals and the physically disabled. In A. Comfort, & M. B. George (eds), Sexual consequences of impairment (pp. 255-258). F. Stickley Company.

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