Dialysis and kidney care when you are a woman over 40

Patients with chronic kidney disease go through different stages and physical and emotional changes. Both men and women go through different processes, and in this article we will focus on those women who are already past the 40-year mark. What are the renal care they should have to avoid CKD or when they already have it? When should you think about dialysis and what effects could it have on your body? This and other doubts are resolved by the Baxter RCS nephrologist, Dra. Izcay Ronderos .

What you can read in this content:

    • Care that women over 40 years of age should have to avoid CKD

    • Nephroprotection in women over 40 years of age who already have CKD

    • At what stage of CKD should dialysis be considered?

    • Side effects that dialysis can cause in older women

What kidney care should women over 40 have to keep their kidneys healthy and free from kidney-related health problems, such as CKD?

You must, first, maintain healthy habits that allow us to have excellent kidney health. These are: physical activity, adequate hydration (it is recommended to drink between 1 liter and 1.5 liters of water daily), avoid eating foods rich in sodium and/or ultra-processed foods as much as possible, increase the consumption of vegetables and fruits (5 daily servings), not self-medicate, stop smoking and reduce alcohol consumption.

It is important to prevent the appearance of precursor diseases of chronic kidney disease (CKD) such as diabetes, high blood pressure and other pathologies, for which it is recommended to visit the doctor every year to make an assessment and carry out the indicated tests, for example, cytology and mammography, which are used for early detection of cancer.

Hypertension and diabetes are the two main diseases that lead to chronic kidney disease. If a woman who is past the age of 40 already has any of these diseases, what care should she take to avoid developing CKD?

You must receive the treatment and intervention of a multidisciplinary team that allows you to reach your blood pressure and glycemic control goals, in addition to close monitoring of all cardiovascular risk factors, review of your lipid profile, and continue with all your habits. of healthy living and monitor kidney function by taking laboratory tests. This, in addition to avoiding it, will also allow an early diagnosis.

What kidney care should a woman over 40 years of age have when she is already diagnosed with CKD? What should your lifestyle be? What treatment should you follow?

The treatment is the same for any patient with chronic kidney disease regardless of age: it must be under control with an interdisciplinary group that includes follow-up and management by nephrology, nutrition, nursing, social work and more, who will seek to reduce or stop the risk of progression and manage the factors that most influence it, such as control of blood pressure figures, diabetes and diseases that may influence the greater compromise of renal function.
 
There are several factors that influence this issue. Depending on the compromise of kidney function, patients should be prepared to opt for renal replacement therapy in a timely manner and avoid complications. They should also continue to maintain a healthy lifestyle, performing regular physical activity, avoiding cigarettes, reducing alcohol consumption and removing ultra-processed foods from their diets.

At what stage of the disease should dialysis be considered?

When renal functions < 25 ml/Min occur, an educational process should be initiated with a view to preparing the patient to opt for the renal replacement therapy method. This should be in accordance with your clinical condition and with your preferences and needs.

What is dialysis? How is this treatment talking about women who are already over 40 years old?

Dialysis is a treatment that replaces the function of the kidneys when they have a lower level of functioning. It can be done through two modalities: hemodialysis and peritoneal dialysis. The treatment has no preference for the age or gender of the patients, either of the two can be used as long as there is no clinical contraindication and the patient so wishes.

Can a woman's hormonal cycle be affected when she has CKD, but especially when she comes to dialysis? How does the hormonal cycle change when talking about women who are already over 40 years old?

The hormonal cycle can change, and not only for this one, but for all groups of women with chronic kidney disease in advanced stages (4 and 5). In women on dialysis, alterations in the menstrual cycle are more common and range from amenorrhea (absence of menstruation), oligomenorrhea (infrequent cycles with little flow or of short duration), to having early menopause (being without menstruation for a period greater than 12 months). Another factor to consider is ovulation, which can compromise fertility due to hormonal dysfunction.

Can dialysis cause a decrease in sexual desire?

It is a process that can occur in women on dialysis, but not only due to the treatment itself, but also due to a situation of multifactorial origin such as depression, changes in body appearance and hormonal changes that occur in women. chronic kidney disease. Dyspareunia (pain during intercourse), anorgasmia, and decreased arousal may also be seen.

Dialysis can cause conditions such as fatigue, sleep disturbances, and depression. What other effects can it have on a woman over 40?

This is so, especially at the beginning of dialysis therapy, as a consequence of both hormonal changes and the adaptation to dialysis therapy. Changes related to the presence of menopause such as hot flashes, mood swings, etc. may also occur.

Can the decrease in sexual desire and the aforementioned alterations be improved with other treatments or medications?

The issue of decreased sexual desire must be studied first because it can be multifactorial, both physical and emotional, therefore it requires a comprehensive approach to help us determine the cause or causes of this condition.
  
For cases such as early menopause, which is so common in these patients and can cause changes in sexual desire, it is recommended to give hormone replacement until the average age at which menopause usually occurs is completed. This, in order to reduce symptoms and help with sexual desire.

REFERENCES

    1. Ahmed, SB (2017 ) Menopause and Chronic Kidney Disease. Semin Nephrol (37) 404 - 411
    2. Wiles K , Nelson-Piercy , C., and Bramham , K. (2018 ). Reproductive health and pregnancy in women with chronic kidney disease. Nature / Nephrology , (14) 165–187.