Kidney disease and Dialysis - the psychosocial aspects of renal failure

Kidney disease or renal failure

Take a look into the world of an individual with kidney disease (renal failure) and dialysis, the life between the machines. It was three days before Christmas, two years ago, that I became acquainted with this monster. All festivities came to a crashing halt as we heard that a loved one, a young man of eighteen was in the clutches of the disease.

A simple description of Renal failure

Chronic kidney disease and acute renal failure cause the kidneys to lose their ability to filter and remove waste and excess fluid from the body. Hemodialysis or Kidney dialysis is a process that uses a man-made membrane (dialyzer) to do the work of the kidney. The patient is connected to dialyzer or the dialysis machine by tubes attached to their blood vessels. Blood is pumped from the patient’s body into the dialyzer, where toxic waste and excess fluid are filtered out from the blood. The filtered blood is then pumped back into the body giving the patient a little comfort for a few days until the next visit. This process may have to be repeated two to three times a week and takes about 3-4 hours each time.

Stress associated with Kidney disease

Now with the brief description of renal failure and dialysis treatment in place, let me take you into the mind of a person tied to the dialysis machine for life. I met this young man whom I offered to take under my roof and provide care for a month. I met a young ghost to say the least. He was six foot three, a hunk of a man, who in a span of six months looked much shorter, shriveled up and much older than his eighteen years.

This is not the story of one person, over the years I met a few other young people with the same disease. I noticed that the marked change in their physical appearance caused them much anxiety. These changes in appearance brought along with it a certain amount of disturbance in identity and insecurity associated with it.

The problem of identity is compounded by their perception of the disease. Renal failure or Kidney disease is a terminal illness with no cure insight. Their acceptance of the disease and the ability to cope with life after the disease is what determines the quality of their life. The family member’s sympathetic perception of the disease (and their sympathy vs. empathy) quietly erodes their sense of independence. Sometimes the family members with the good intention of helping the individual make them invalids for life. These individuals start to look at themselves as dialysis patients rather than as a young man, a father, a student etc. They are prone to become dependant on their families to perform even their daily chores. Sometimes an individual may be in complete denial of the condition which is also risky.

Kidney failure - Social problems of Individuals 

Boredom Three days at treatment and almost half a day during each visit to the hospital/ dialysis center ensure that the person’s life is locked between the machine and the house. Imagine watching your blood whirl in a tube in front of you three days a week- sounds like a terrible nightmare. Boredom at the dialysis center, just having to lie down and be able to do nothing is enough to frustrate anyone. Depression is the shadow lurking very close.

Physical discomfort such as nausea, vomiting, fatigue, muscle cramps,itching, swelling of the body especially the legs and sleep disturbances all take a toll on the individual’s personal, social and work life. Stress is very real and they are unable to do much about it.

Socializing goes out of the window with all the diet restriction. The sympathy, their presence at social gatherings bring may sometimes result in avoidance of all social contacts. Restriction on time due to treatment schedules is another culprit. Sports and other activities take a back seat as fatigue sets in. The fear of hurting self or dislodging the stent is real. Outdoor games may slowly fade from the list of activities.

Mental health aspect  - Renal failure

Emotional pain is a every day reality. Fear is another constant companion. Fear of the unknown, anxiety about what next… Education stopped midway, jobs have to be resigned to give place to treatment. Hours of boredom facing them, morbid thoughts racing through their minds, all that they lived for, all ambitions seem lost. Fear of death is something that hangs around the corner as they see and hear news of the death of their new friends at the hospital. Hopelessness steps in, as treatment is only maintenance, with no chance of cure in sight. Waiting for a donor or a cadaver transplant and the fear of the body not accepting the new organ is also heart grinding.

Financial burden increases as treatment is expensive. The family’s economic resources are strained to the maximum extent possible. It may cause a lot of stress not only for the individual but also on the family. If the individual is single, with no family support, the individual has to endure a high level of stress.

Kidney failure - Help  improve quality of life 

One needs to be empathetic and not sympathetic.

Being supportive and encouraging them to do as much as they can, realistically, would be beneficial for the person.

Motivating these individuals to socialize with other healthy individuals with an active life style is important.

Helping them to control thought life and take charge of their life would be a great help.

Enabling them to follow their passion (that does not need much exertion) that will help them earn, as well as keep their minds actively and creatively involved, is a great stress buster.

Care to educate them to strictly follow diet restriction and making their diet visually and tastefully enjoyable will benefit their physical well being.

Engaging them in some light physical activity is also beneficial.

Spiritual well being is a part of heath as defined by the WHO, so being actively involved in spiritual activities will be another plus. Studies prove that faith and religious beliefs enable individuals cope better.

Financial help is always welcome for such an individual.

Helping others individuals with similar problems and focusing on unfortunate others is a sure fire way of keeping the mind actively away from morbid thoughts; it may help regain one’s sense of self worth.

More by this Author

Comments 15 comments

Jewels profile image

Jewels 6 years ago from Australia

All hale empathy over sympathy. To be honest I can't imagine what a life tied to a machine would be like. I know that through reading peoples experiences, I value my liver and kidneys and heart and brain much more than before. I've taken steps recently to delete processed foods from my diet in order to honor my body more. At least it's being conscious of something precious - quality of life.

sofs profile image

sofs 6 years ago Author

Wow!What a wise decision. You are a Jewel indeed, I really wish we would honor this life we have with all our being. It pays to change our lifestyle and care of our health, better safe than sorry! Though kidney disease may sometime have no relation to lifestyle at all.

Thank you for taking the time to write this. God bless!

Jewels profile image

Jewels 6 years ago from Australia

Yes, I was aware when making this comment that some people get a bum draw with their kidneys and it has nothing to do with food or lifestyle. Unfortunately so many people take what they have for granted. Take care sofs.

days leaper profile image

days leaper 6 years ago from england

Very accurate account, it brings it all back! -those early days. Having done some blogs on and around this subject already. I intend to maybe do another on coping with dialysis: A thought you inspired, Thanks!

eg. ..though TV's are often presented -analogue. So invest in something like a DS or other hand held device. I'm quite thoughtful, and like writing and took a notepad and pens, but found some of even the staff to be quite nosey, or thinking I was writing about them -in one unit. ...

Thanks again.

sofs profile image

sofs 6 years ago Author

Days leaper, I know what you are talking about, those fears are so real and dark that most people don't even want to talk about them anymore. I am happy to be an inspiration, I am sure your hub on coping will provide a clear account of what goes on in the mind of a person under going dialysis. Thank you for sharing your thoughts with me. My best wishes to you. God bless!!!

Lita C. Malicdem profile image

Lita C. Malicdem 6 years ago from Philippines

My elder brother was on dialysis 3X a week. In less than a year, he shows signs of disorientation, and heaviness of chest cavity. He succumbed to heart failure last February, 2010. I'm an insulin-dependent diabetic like he was. I'm taking all precautions so I won't go that level of renal failure. Thanks for reminding me, that I need to be more careful. Dialysis is expensive and yet it doesn't guarantee a cure.

sofs profile image

sofs 6 years ago Author

Lita, often we need reminders to live better. Though we know the hard facts of life, reminders shake us up a little bit from our complacency. Lita I hope that you will really take care, we have just one life and we need to live it well. Best wishes and God bless!

days leaper profile image

days leaper 6 years ago from england

What if there was a cure? We just haven't found it? As you say it is expensive, so are the medics motivated to find one? If there is a common ground -a would be causal factor -every-one in there that I've ever met 'likes a drink' ..or ten!- As renal is linked to not passing water, and the drinking that these people like cannot really be called "water", maybe it's something in the water. Having said that I've weaned myself off the stuff and I'm no better, my illness is still progressing! So who knows?

Sorry to hear about your cousin. And Thanks. You're a real sweatheart.

sofs profile image

sofs 6 years ago Author

I can understand how you feel, I wish too that the medical world got their finger on to something..I am real glad to see you back, hope you are felling better... Be positive.. never give up...

Thank you, please do keep in touch, God bless!

Ariel 6 years ago

Socializing is a big problem for dialysis patients, I had a friend who had a kidney disease and had to go for dialysis, it was bad.

sofs profile image

sofs 6 years ago Author

Ariel, thank you for the visiting the page, and for your insightful comment. Yes, socializing is a huge problem indeed, the very fact that one is uncomfortable with self and that people are not sure what to say, may makes things worse, apart from all that has been discussed.

Your concern for your friend shows, my best wishes to your friend.

Diana Park 6 years ago

Thank you for sharing this it has a very informative content.. I hope more of this comes..

If you have time you can visit this site:

Kidney Dialysis

God bless and more power..

sofs profile image

sofs 6 years ago Author

Thanks Diana ..I will visit your site. God bless!

profile image

MP50 5 years ago

I can relate to this Hub, thanks for sharing well written and accurate information.

sofs profile image

sofs 5 years ago Author

MP50, Thank you so much for visiting this hub. Your endorsement means a lot to me. Have a lovely day. God Bless!

    Sign in or sign up and post using a HubPages Network account.

    0 of 8192 characters used
    Post Comment

    No HTML is allowed in comments, but URLs will be hyperlinked. Comments are not for promoting your articles or other sites.

    Click to Rate This Article