Does Low Energy Keep You from Working?
By Peter Lundin
Your stamina and energy level have a lot to do with being able to go to work or to school. If you have low energy, it certainly can determine the type of jobs you can handle. If low energy is a problem, then perhaps you should look at the reasons for this and try to make changes. From the perspective of both a nephrologist and an individual with ESRD, here is a partial list of things to look for.
- Do you get adequate dialysis?
- As a nephrologist, I recommend a Kt/V greater than 1.4.*
- I recommend a URR (urea reduction ratio) greater than 70%.*
- Do you have good hematocrit (Hct)?
- Hct should be at least 33%.
- Hemoglobin (Hgb) should be at least 11 g/dL.
- Are you free of cancer or diseases of the heart, lungs, muscles, nerves, brain, or liver?
- Do you take medications that can cause you to feel weak, such as medicine for high blood pressure or depression, antihistamines, or certain nonprescription medicines (herbs, for example)?
- Are you depressed but not being treated for it?
- Do you have trouble sleeping?
- Are you eating enough protein and do you get enough calories?
- Do you take vitamins?
- Are you out of shape, inactive, a “couch potato”? Lack of physical activity saps strength.
All of the above, except number 3, can be changed to improve your stamina and energy. It’s important to review these points with your healthcare team and get their advice. Just saying that you’re a dialysis patient is not enough reason to “throw in the towel.”
Editor’s Note: According to the Clinical Practice Guidelines of The National Kidney Foundation-Dialysis Outcomes Quality Initiative (NKF-DOQI™), the minimum delivered dose for URR should be at least 65%; Kt/V should be at least 1.2.
Permission received to post the following information:
Name: Peter Lundin, MD
Cause of renal failure: Unknown
Time on dialysis: More than 27 years
Treatments used: In-center and home hemodialysis, transplant
Work/other activities: Nephrologist; past president of the American Association of Kidney Patients (AAKP); member of the Hemodialysis Adequacy Work Group of the National Kidney Foundation-Dialysis Outcomes Quality Initiative (NKF-DOQI™)
Date: May 1999
- Dr. Lundin passed away March 22, 2001.