Territory Stories

The chronicle



The chronicle

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Chronic Diseases Network of the Northern Territory


The Chronicle newsletters; Chronic Diseases Network newsletters; E-Journals; PublicationNT




Date:2013-03; Made available via the Publications (Legal Deposit) Act 2004 (NT).; This publication contains may contain links to external sites. These external sites may no longer be active.




Chronic diseases -- Northern Territory -- Treatment -- Periodicals; Chronic Diseases Network of the Northern Territory -- Periodicals

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Chronic Diseases Network of the Northern Territory

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v. 25 no. 1

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13March 2013 Continued from Page 12 by correcting of anaemia and the associated increase in plasma testosterone and reduction in elevated prolactin levels diminished sperm counts, impaired sperm motility and testicular atrophy resulting in male subfertility and increased incidence of adenocarcinoma of the prostate in haemodialysis patients. 5 6 The importance of counselling, regular examination and screening for prostate specifi c antigen (PSA), review of medications especially antihypertensive medications and treatment of anaemia are evident. Again, this is not a topic that those affected may initiate or wish to discuss however it is an issue that will impact on relationships, mental health and quality of life. The issue of gender health, especially in relation to sexual dysfunction in ESRF patients, is a complication of renal failure that is often overlooked. This, in part, could be the result of the patients reluctance to talk about such things, the preoccupation of health staff in treating the renal problems as well as cultural inappropriateness. It is, however, an area of life that is so important for the quality of life, relationships and sense of well being of ESRF clients and should be given greater emphasis in patient care planning. Footnotes: 1 ANZDATA registry, 34th Report, Grace B. et al, 2011, New Patients commencing treatment in 2010 http://www.anzdata.org. au/anzdata/AnzdataReport/34thReport/20 11c02_newpatients_v1.5.pdf 2 Daugirdas, J. et al, Handbook of Dialysis, 4th edition, 2007, Chapter 27, Psychological Issues in End stage Renal Disease, Cohen Scot D et al, Lippincott Williams & Wilkins, Philadelphia, USA 3 ANZDATA registry, 34th Report, Mc Donald S. et al, 2011, End stage Kidney disease among Indigenous peoples of Australia and New Zealand, ANZDATA registry, 34th Report, Grace B. et al, 2011, New Patients commencing treatment in 2010 Continued on Page 14 increased bleeding exacerbated by heparinisation during the haemodialysis process increased bleeding associated with the use of intrauterine devices and heparinisation anaemia due to heavy uterine bleeding decrease in libido and ability to achieve orgasm dyspareunia due to oestrogen defi ciency blood in peritoneal dialysis fl uid during menstruation and possible aseptic peritonitis high risk of cervical cancer in women who are receiving immunosuppressive therapy for renal transplant Pregnancy occurs in just 0.5% of women on dialysis, however the occurrence of conception is 2-3 time more frequent in haemodialysis patients compared to Continuous Ambulatory Peritoneal Dialysis (CAPD) and pregnancies are high risk for both mother and foetus with high risk of spontaneous abortion.4 5 To ensure women with ESRD receive holistic care, culturally appropriate communication to discuss these issues and appropriate treatment along with regular well womens checks are important not only for prevention and treatment of medical problems but also for the quality of life of these clients. Some male gender issues associated with ESRF are: impotence, which is believed to occur in roughly 70% of men treated with dialysis whether this be organic or functional in origin. There is no reported difference between those receiving haemodialysis or peritoneal dialysis although extended time dialysis (either short daily or nocturnal dialysis) may make a signifi cant difference the use of erythropoietic stimulating agents has been shown to enhance sexual function G EN D ER H EA LTH

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