Skin changes People with kidney disease, particularly those on dialysis, often have skin problems. The most common is itchiness, which can be annoying, and is often difficult to treat. There are many reasons for itchy skin in people with kidney failure: • High levels of phosphate • High levels of urea, which means poor kidney function or not enough dialysis • Dry skin • Infections (like scabies) • Other possible reasons that doctors and researchers do not yet understand The most effective way to avoid skin problems is to prevent them from occurring in the first place. Dry skin, especially during cold winter months, is a common problem. People on dialysis are prone to dry skin, which can cause itching. A number of strategies can be used, or in combination, to treat itching. A first step is to control the phosphate in your diet, take phosphate-binding medications if needed, and get the right amount of dialysis. If these don’t work, your doctor may prescribe special creams, medications or ultraviolet light treatments. For temporary relief from itching, try using a cold compress. Soak a face cloth in cool water and press it against the itchy area for five to ten minutes. Repeat as often as necessary. Afterwards, apply a fragrance-free, oil-based cream for dry skin.
family members to do advance care planning for themselves so that you would know what they would want if you had to make decisions on their behalf. Talking with family, friends and your healthcare team Talking with your family, friends and your healthcare team about your wishes and concerns is a very important part of the advance care planning process. Sometimes it can be difficult and painful to discuss these matters. It’s often better to have these discussions while you’re in good health rather when the end of life is near. You then have the time and peace of mind to think about and discuss your future care and get more information if you need it. Here are some suggestions to help start the conversations with your family, friends, and healthcare team: With your family, you start by saying that you have been reading about advance care planning and you feel it is something you would like to do. You can then say that you would like to talk to them about your advance care plan once you’ve finished it. While you’re working on your plan, it’s sometimes helpful to discuss your questions with your doctor to make sure you’re working with accurate information about possible treatments, etc. And most people will talk to their spouse, partner or a close family member while they’re thinking about and writing down their plan. You don’t have to do your plan alone, but you can make all your own decisions. Once you’ve finished your plan, you might start by sharing it first with your spouse, partner or other close family member. You may then wish to your plan with other family members and friends, either a few people at a time or in a group setting. Try to organize things so
What can I do for myself? There are lots of things you can do to change how you feel about yourself. Taking extra care with personal grooming is one. A different hairstyle or some new clothes may improve the way you view yourself. When you feel good about how you look, you feel better overall. Thinking of sexual intercourse as the only real sex act may cause you unnecessary distress if you have limited desire or energy. Sexuality doesn’t have to include intercourse. There are many forms of sexual expression that don’t require as much energy and are enjoyable. Simply hugging, kissing and caressing can make you feel better and improve your outlook. If you’re a little shy, books can be a good source of self-help information. Bookstores and libraries often have whole sections covering every imaginable aspect of sexuality. Browse through them – you may find a book that will help you with your concerns. Most importantly, don’t ignore the problem. If you’re not satisfied with your sexuality, try to talk it. A positive attitude is important to physical health. Frequently asked questions Here are answers to some frequently asked questions about chronic kidney disease as it relates to sexuality, childbearing and birth control. Can I have a child while on dialysis? Women with end-stage kidney disease often stop having their monthly periods. However, once a regular pattern of dialysis is established, a normal menstrual cycle might return. Although it is rare, some women on dialysis can become pregnant. Pregnancy on dialysis is difficult and you should talk to your doctor about any plans to become pregnant. Being pregnant while on dialysis is considered a “high risk” pregnancy and you will need regular involvement with an obstetrician who is used to dealing with high-risk pregnancies.
Cruises and resorts A few companies cruises especially for people on hemodialysis. They have fully-equipped hemodialysis units on board, staffed with qualified medical and nursing personnel. Even though these cruises are usually expensive, they offer a unique chance to travel. The point of departure is usually an American city, although many Alaskan cruises leave from Vancouver. Cruises are also available in the Mediterranean, Baltic Sea, Southeast Asia and other areas. There are also resorts around the world for people on dialysis. They have complete hemodialysis units, are staffed with qualified medical and nursing personnel, and can cater to your special dietary needs. When signing up for cruises or resorts, always indicate any special needs you have. Unexpected events and emergencies You know what unexpected events may occur during your travels, so it’s always best to be prepared. There may be unplanned travel problems such as plane delays that cause a major disruption to your schedule, local weather problems that make ground travel difficult, blackouts or other emergencies. You should try to arrange a back-up plan that you can rely on if you need to. Be sure to carry along your latest dialysis and medical information, plus a current letter from your doctor outlining your medical condition, dialysis information, medications and contact telephone numbers. In the case of an emergency when you have to return home immediately, explain the situation to the airline. They can usually get you a seat on the next flight, even if it’s full. It’s always a good idea to have a major credit card so you can buy a direct flight home if you have to. Travel insurance It is wise to obtain travel insurance in case of an accident or illness. However, are a lot of variations in the policies provided by different travel insurance companies. There are often limitations and exclusions relating to pre-existing medical conditions, age, and travel inside and outside Canada. It is