Sexuality, fertility, and maintaining a positive body image are important aspects of life. However, these may be affected when you have kidney disease. Positive body image is a huge factor in sustaining a healthy psychological development while undergoing kidney dialysis. To help you on this, feel free to ask your healthcare team about the following:

• What can I do to gain/lose weight?
• What are the exercises that will improve my muscle tone and strength?
• How can I keep my skin looking healthy?
• How can I keep my hair looking as thick and healthy as possible?
• How can I keep my breath smelling fresh?
• How do I make my scars less visible?
• Do I need to let people know that I’m on dialysis?

Sexuality

Accept that no one wins this battle with kidney disease without scars from vascular accesses, peritoneal dialysis catheters, or transplant. Also, it is worthy to take note that some conditions connected to your kidney disease may reduce your interest in performing sexual intercourse. These conditions include the following:

• Anaemia
• Diabetes
• Neuropathy
• Poor blood flow
• Hormone imbalances
• High blood pressure
• Depression

Pregnancy

Having a baby is a big life decision for everyone in general. It is even more complex when kidney disease is added into the picture. Only you and your partner can decide what is best for you, and how much risk the both of you are willing to take.

Pregnancy with Haemodialysis

If you are on haemodialysis, your nephrologist may alter your treatment to adjust with your pregnancy needs.

• Daily or every-other-day dialysis
• Lower levels of bicarbonate in the dialysate
• Less heparin and use of saline flush instead to reduce the risk of bleeding
• A higher erythropoietin dose to treat anaemia
• Higher protein diet

Pregnancy with Peritoneal Dialysis

If you are on peritoneal dialysis, your nephrologist may alter your treatment to adjust with your pregnancy needs.

• Smaller, more frequent exchanges
• Higher protein diet
• Regular checks for catheter problems, leakage, or peritonitis
• Use of a cycler later in pregnancy to allow frequent smaller exchanges
• Adding haemodialysis to get better adequacy
• In some cases, bed rest may be advised

Breastfeeding

Breastfeeding is a big question for women on dialysis. High levels of sodium and kidney wastes in the bloodstream make the milk unsafe for infants. Also, many drugs may appear in breast milk that can be harmful to infants.