Cold weather and seasonal bugs can aggravate existing health problems, making people with long-term conditions, such as kidney disease, more vulnerable to illnesses. Even if people are managing their long-term condition well, and leading otherwise healthy lives, it’s important that they continue to protect themselves. Kidney Care UK advise on the information which patients should be equipped with in order to keep well throughout winter.
Chronic kidney disease (CKD) affects around three million people in the UK. Most of these people will not go on to develop stage five CKD, requiring renal replacement therapy with dialysis or a transplant. However, people at all stages of CKD need the support of their local pharmacist to make sure that they are able to live well with their kidney disease.
Kidney Care UK are the UK’s leading kidney patient support charity. They have put together five top tips to pass on to kidney patients this winter:
Patients are advised to seek early advice to avoid exacerbations of coughs and colds. So, their local pharmacist is likely to be one of their first ports-of-call, especially if they have to wait for a GP appointment.
Kidney patients need to maintain their stocks of medication, especially over the Christmas holiday or when bad weather is forecast when pharmacies or GP surgeries are likely to be closed or difficult to access.
Get the Flu Jab
Dialysis and transplant patients of all ages are at-risk groups eligible for flu vaccination from their pharmacist or GP. Since both the trivalent and quadrivalent vaccines are inactivated, they can safely be given to kidney patients, including immunosuppressed transplant recipients. Specialist advice should be sought before administering the live attenuated flu vaccine to children with kidney disease.
Look After Yourself
To reduce the risk of colds, kidney patients are advised to rest, avoid dehydration, and optimise nutrition. Some over-the-counter cold remedies that may affect kidney function (e.g. those containing a non-steroidal anti-inflammatory drug) are contraindicated in CKD.
People with kidney disease often feel the cold and are advised to heat their home to at least 18c in winter.
People with CKD are at higher risk of acute kidney injury. This rapid deterioration in kidney function is linked to infection and dehydration, and any patient reporting frequent episodes of vomiting and diarrhoea is at risk. As a general rule, if a patient has had a fever, has not been able to keep fluids down for 24-to-28 hours, and has not been passing as much urine as usual, they need an urgent blood test to check their kidney function.
While some kidney patients can be managed in the community by their GP (in consultation where applicable with the specialist renal team), others will need hospital admission for rehydration and monitoring of kidney function. It’s also important to ensure that any prescribed medications, which may have been stopped under ‘sick day rules’, are restarted when kidney function has returned to baseline.
Eating well is important for people with kidney disease. However, dialysis patients have to cope with a side range of dietary restrictions (e.g. avoiding foods high in potassium or phosphorus). Kidney Care UK want to help bring enjoyment back into food, and pharmacists can now signpost patients to the Kidney Kitchen – a website featuring recipes and video demonstrations to help highlight all the foods patients can eat, rather than focusing on all those they can’t.
Eating healthy, nutritious food, keeping well, and keeping warm are all important for people with kidney failure, and are all things that they can do for themselves at home. But that’s not the only thing that happens at home. Of the 60,000 people in the UK with kidney failure, more than 1,000 dialyse at home. They therefore rely on their access to both electricity and water supply, which is why Kidney Care UK have been working with Thames Water and UK Power Networks to encourage kidney patients to register with the Priority Services Register.
By being on the register patients are prioritised and given extra help in an unplanned power cut, and they will be given advance notice of disruption should there be any planned works in their area. It is hoped that this pilot will pave the way towards the ultimate aim of addressing the need for a single central Priority Services Register used by all customers and utility providers.
For more information about Kidney Care UK, visit www.kidneycareuk.org. The Kidney Kitchen can be found at www.kidneykitchen.org.
NICE guidance on acute kidney injury is at www.nice.org.uk/guidance/cg169/chapter/1-Recommendations#managing-acute-kidney-injury.
For information on the Priority Services Register, visit www.kidneycareuk.org/get-support/priority-services-register-psr.