Are dialysis patients immunocompromised/ immunosuppressed?

Due to the global Covid pandemic, everyone has been focusing on building and maintaining their immunity. The importance of maintaining a healthy immune system increases even more in patients with kidney disease and those undergoing dialysis.

 As a patient of CKD, you or your loved one may be worried about it too. I get asked about the effect of kidney failure and dialysis on immunity quite often by patients and their families. So, here I will try to explain it in easy terms for better understanding.

Immunity refers to your body’s ability to fight off infections. A healthy body can fight infections more effectively, thus improving overall health.even though it is not well known but immunity is important in preventing cancers also. 

 Dialysis patients are considered immunocompromised and need to take extra care.

Does kidney disease weaken the immune system?

The simple answer is yes! Having a chronic kidney disease makes your immune system weaker. Patients with CKD have a higher incidence of infections, everything ranging from the common cold to pneumonia. 

Such patients are also less likely to respond to vaccines. As you may know, vaccines work by stimulating the production of antibodies, which in turn provide immunity to infections. 

Besides, immunocompromised patients also have a higher risk of developing various types of cancers. The incompetent immune system finds it difficult to fight off cancerous cells.

So, now, the question becomes

Why does renal failure cause immunosuppression?

Renal failure translates to the inability of kidneys to purify blood effectively. Kidneys play a very important role in maintaining the internal environment of our body. When they purify the blood, they remove toxins that can disturb this environment. However, in CKD, this doesn’t happen.

 In turn, toxins keep on accumulating in the body. These toxins start damaging adversely affect the functioning of almost every other system in the body including the immune system.

Common infections in dialysis patients

In dialysis patients, various infections are common. Infections like a common cold, fever, bacterial infections, etc can occur due to compromised immunity.

Chest infections like pneumonia can affect them more easily. It is so because exposure to organisms causing chest infections is easy.

Another common group of infections prevalent in such patients is septic infections. These are infections in the bloodstream itself. Dialysis catheters encourage these type of infections. They are very prevalent in patients undergoing chronic dialysis.

Viral infections like hepatitis are also pretty common occurrences due to similar reasons. They also transmit by blood and since blood removal is an essential step of dialysis, it can affect many patients. Another ailment that can occur, though rarely, is HIV infection.

Symptoms of infection in dialysis patients

Now that we have talked about common infections that dialysis patients may suffer from, let’s discuss in brief how these infections may appear. It is always advised to contact your nearby dialysis center or your nephrologist in case you face any difficulty.

General symptoms of any infection can include fever, nausea, loss of appetite, muscle pain, vomiting, etc. These can be relieved by taking over-the-counter medication.

Other specific symptoms can vary depending on the region affected. A chest infection can present itself as difficulty in breathing or cough or wheezing sound while breathing.

Similarly, in case of any stomach issue, diarrhea or vomiting or stomach ache can be the presenting symptoms. 

Some patients may experience headaches or dizziness or a ringing sensation in their ear. These may result from underlying disease in the nervous system.

If symptoms persist, you are advised to contact your nearby medical facility. 

How to increase immunity in CKD patients?

In patients with CKD, getting regular dialysis is the best way to maintain your immunity. Getting dialysis as recommended will keep your blood toxins away. This will help maintain your internal environment optimally, which reduces the chances of acquiring infections.

Maintaining a healthy hemoglobin level is also crucial as regular dialysis can cause some blood loss. Along with this, blood sugar levels should also be taken care of. These will ensure a good immune system.

Also, avoid the temptation to experiment and try the so-called “immune boosters”  that are becoming very popular these days. They are made to cater to healthy individuals. Most of them contain potassium and other minerals that may not be well tolerated by the kidney of an immunocompromised person. As a result, they can do more harm than good.

Conclusion

CKD patients are immunocompromised. This puts them at risk of acquiring infections more easily than other people. They are more susceptible to the chest and blood-borne infections. As a result, such patients need to take more precautions against infections. 

To sum up, being immunocompromised doesn’t automatically mean that you will suffer from infections easily. By going for dialysis regularly and maintaining your vitals like blood glucose and Hb level, you can improve your immunity.

I hope this article helped answer your queries. All the best! 

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