Marijuana Use by CKD Patients May Hasten Renal Function Decline
|The following article is part of conference coverage from Kidney Week 2018 in San Diego hosted by the American Society of Nephrology. Renal & Urology News staff will be reporting live on medical studies conducted by nephrologists and other specialists who are tops in their field in acute kidney injury, chronic kidney disease, dialysis, transplantation, and more. Check back for the latest news from Kidney Week 2018.|
SAN DIEGO—Patients with chronic kidney disease (CKD) who use marijuana use may experience a more rapid decline in renal function than non-users, according to study findings presented at the American Society of Nephrology’s Kidney Week 2018 meeting. Marijuana use was not associated with renal function decline among individuals without CKD.
The findings are from a post-hoc analysis of data from the ASSESS-AKI (Assessment Serial Evaluation, and Subsequent Sequelae of Acute Kidney Injury) matched cohort study. Investigators defined CKD as an estimated glomerular filtration rate (eGFR) below 60 mL/min/1.73 m 2 . Of the 1599 participants in the study, 113 (7%) used marijuana. Marijuana users were significantly younger than non-users (mean 54 vs 65 years).
Among patients with CKD at baseline, the mean annual rate of decline in eGFR was 3.22 mL/min/1.73 m 2 among marijuana users compared with 1.42 mL/min/1.73 m 2 among non-users, a significant difference between the groups, a team led by Joshua L. Rein, DO, of the Icahn School of Medicine at Mount Sinai in New York, reported.
Among individuals without CKD at baseline, the mean annual rate of decline in eGFR was 1.74 and 1.63 mL/min/1.73 m 2 for marijuana users and non-users, respectively, a non-significant difference. In this group, marijuana use was not associated with development of CKD.
Marijuana use was not associated with changes in albuminuria over time in patients with or without CKD.
The investigators observed a strong but non-significant trend toward CKD progression—defined as a greater than 50% decrease in eGFR from baseline—among marijuana users with CKD at baseline.
“Marijuana is the most commonly used recreational drug and legal recreational and medicinal use is increasing worldwide,” Dr Rein told Renal & Urology News. “With increasing use and availability of marijuana, we felt it was important to understand the impact of marijuana use on the risk of CKD.”
Patients with advanced CKD and end-stage renal disease experience substantial symptom burden that is frequently undertreated due to adverse medication side effects, he stated. “Medical marijuana may be effective at treating chronic pain and nausea, among other symptoms common to this patient population,” Dr Rein said. “However, the effects of smoked marijuana in those with significant kidney disease are unknown.”
Marijuana use is increasing among adults, most rapidly among middle aged and elderly individuals, populations with a substantial CKD burden. “Recreationally, marijuana is most often smoked, and just like for tobacco, patients with CKD should not smoke marijuana,” Dr Rein said. “Medical marijuana is more commonly vaporized or consumed as a capsule or in food, which remove the cardiopulmonary side effects, but the renal effects remain unknown. Renal function in marijuana users with CKD should be closely monitored.”
With growing acceptance of both medical and recreational marijuana use, future research is needed to investigate the renal endocannabinoid system and the impact of marijuana use on kidney disease outcomes, he said.
Dr Rein acknowledged that his team was unable to assess the motivations or reasons for marijuana use and whether participants were using marijuana recreationally or medically.
|Visit Renal & Urology News’ conference section for continuous coverage from Kidney Week 2018.|
- Substance Use Ups Risks for CKD Progression, Mortality
- Recreational Marijuana Now Legal in Canada
- Marijuana Use Not Tied to Kidney Function
- Marijuana’s Cardiovascular Effects Still Unknown
- Report Id’s Medical Benefits, Harms of Cannabis Products
Rein JL, Texter LJ, Wurfel MM, et al. Marijuana use and kidney outcomes in the ASSESS-AKI Cohort. Data presented at the American Society of Nephrology’s 2018 Kidney Week conference in San Diego, Oct. 23-28. Abstract FR-PO233Marijuana users with chronic kidney disease experienced a significantly greater annual decline in estimated glomerular filtration rate than non-users, study finds.
Chronic Renal Failure
Home / Conditions / Chronic Renal Failure
Updated on May 15, 2020. Medical content reviewed by Dr. Joseph Rosado, MD, M.B.A, Chief Medical Officer
If you’ve just started dialysis due to your chronic renal failure, instead of taking anxiety medications and painkillers to ward off the common and often debilitating side effects, you may want to consider medical marijuana for chronic renal failure.
How/Why Marijuana Can Be an Effective Treatment for Chronic Renal Failure
Medical-grade marijuana helps with managing pain. However, there’s still been debating beliefs as to whether or not cannabis harms or helps the kidneys. But the claims that cannabis does injure your kidneys typically points to the smoking of the herb that’s the damaging factor and not the other methods of consumption like using tinctures or vapors or infusing the herb into your food.
According to a joint study by the University of Alberta and the University of Calgary, small symptom improvement by using CBD and THC — both cannabinoids in marijuana — in patients who have difficult-to-treat symptoms can be meaningful clinically.
Many patients who have chronic illnesses in their advanced stages experience significant symptom burden related not only to the illness in itself, but also the treatment side effects. Some patients who are not responding well to traditional treatments for pain and other symptom management could very well benefit from cannabis.
Cannabinoids act on your body in various ways, and often how they work is not entirely understood. However, in theory, when it comes to problems involving your kidneys, marijuana for chronic renal failure could work well, particularly when high drug loads add even more pressure to your kidneys.
Two primary ways marijuana can be an effective treatment for chronic renal failure are:
- Symptom relief. In chronic renal failure, many patients feel extremely burdened with symptoms like nausea, pain, itch, poor sleep and poor appetite, and this leads to a poor quality of life.
- Alternative to narcotic pain relievers. Pain relievers, as well as other standard pharmacologic approaches to manage these and other symptoms, are, in many cases, tolerated poorly because of drug toxicity and kidney failure.
It’s here medical cannabis for chronic renal failure may help these patients.
Cannabis has many compounds in it, many with positive effects. You have an endocannabinoid system in your body, and activating this system when you’re nauseous or are in pain to relieve symptoms is where marijuana comes into play.
Of course, there’s still much to learn. But in the meantime, a reasonable option for many CRF patients is medical weed.
What Specific Side Effects/Symptoms of Chronic Renal Failure Can Medical Marijuana Treat?
Your kidneys work by cleaning your blood, getting rid of excess minerals, fluid and waste. Your kidneys also make hormones to keep your blood healthy and your bones strong. Chronic kidney disease attacks the nephrons, causing damage. This damage can leave your kidneys in a state where they can’t eliminate waste. Medications, genetic problems, injuries and illness can lead to CRF.
Thankfully, there’s an abundance of new scientific research and understanding of how cannabis and chronic renal failure treatment can be beneficial. Most CRF patients, particularly patients who are on dialysis, are seeking ways to relieve their stress, chronic pain, loss of appetite, nausea, insomnia, anxiety and more.
Best Strains of Marijuana to Use for Chronic Renal Failure Symptoms and Treatment Side Effects
You have a variety of strains of medical cannabis for chronic renal failure to choose from to help ease your symptoms. In fact, you can treat most of the symptoms with cannabis to help improve your quality of life. Below are some helpful strains to treat the symptoms of kidney disease.
Nausea and Vomiting
- Cheese – hybrid
- Chocolope – sativa
- Death Star – indica
Loss of Appetite
- Girl Scout Cookies – hybrid
- OG Kush – hybrid
Fatigue and Weakness
- Blue Dream – hybrid
- Sour Diesel – sativa
- Granddaddy Purple – indica
- Skywalker – indica
Muscle Twitches and Cramps
- Cannatonic – hybrid
- Silver Haze – sativa
Swelling of Feet and Ankles
- Harlequin – sativa
- Critical Mass – indica
Best Methods of Marijuana Treatment to Treat Side Effects and Symptoms of Chronic Renal Failure
There are various ways you can treat your chronic renal failure with medical cannabis. Some methods include:
You can add medical pot to just about anything, particularly if you first infuse it into oil, glycerin or butter. From THC chocolate bars or vegan, gluten-free THC bacon strips to strain-specific caramels to lozenges, you’ll find endless recipes.
You may buy or fill tincture dropper bottles with infused glycerin, alcohol or vegetable oil with high CBD content and drop it under your tongue.
Vaporizing the flower lets you use more cannabinoids and get a better taste of the terpenes without having to burn the plant. It also creates leftover vaped material you can use for cooking.
Applying Topical Solution
If you live in a state allowing medical cannabis dispensaries, you could buy a topical marijuana solution. Or you may even want to mix up your cannabis oil with some light coconut oil or almond oil, aloe vera or beeswax.
Becoming a Medical Marijuana Patient for Chronic Renal Failure
You may be able to get a nephrologist’s recommendation for a medical marijuana card if you’re on dialysis and are suffering from some or all of the mentioned symptoms above. Search for a medical marijuana dispensary or cannabis doctor today on our website.
What Is Chronic Renal Failure?
Chronic renal failure (CRF) or chronic kidney disease (CKD) occurs when you gradually lose function of your kidney. Your kidneys are responsible for filtering excess fluids and waste from your blood, which then excretes into your urine. When you reach an advanced stage of chronic renal failure, dangerous levels of electrolytes, fluid and waste may build up in your body.
When you’re in the earlier stages of kidney disease, you may only have a few symptoms since the condition often doesn’t become apparent until the functioning of your kidneys is significantly impaired.
Chronic renal failure treatment works by slowing kidney damage progression, typically by keeping the underlying cause under control. Chronic kidney disease may, however, progress to end-stage kidney failure, which, if you don’t have a kidney transplant or dialysis, can be fatal.
Types of Chronic Renal Failure
Classification of chronic renal failure depends on its primary damage location.
The three main types of chronic renal failure are:
- Pre-renal CRF
- Renal CRF
- Post-renal CRF, or obstructive uropathy
Your type of chronic renal disease can be acute or chronic. Acute may occur due to direct kidney trauma, from an accident or injury for example. Chronic kidney disease occurs over extended period and involves long-term damage.
History of Chronic Renal Failure
The first patient began chronic renal failure treatment through repetitive hemodialysis (HD) in March 1960 at the University of Washington Hospital in Seattle. Over 30 years have elapsed since legislation was passed by the U.S. Congress to create the Medicare End-Stage Renal Disease Program.
Today, many nephrologists aren’t familiar with the history of these political and clinical developments that led to the dialysis treatment we know today.
Symptoms of Chronic Renal Failure
Symptoms and signs of CRF develop gradually if your kidney damage has a slow progression.
Kidney disease symptoms may include:
- Loss of appetite
- Nausea and vomiting
- Sleep problems
- Weakness and fatigue
- Persistent itching
- Urination changes
- Swelling of your ankles and feet
- Decreased mental sharpness
- Hypertension, or high blood pressure
- Chest pain with fluid buildup in your heart’s lining
- Muscle cramps and twitching
- Shortness of breath when you have a buildup of fluid around your lungs
CRF symptoms are many times nonspecific, which means other illnesses can cause them. Since your kidneys can compensate for lost function and are highly adaptable, your symptoms might not show up until there is irreversible damage.
Effects of Chronic Renal Failure
There are both physical and mental effects of chronic renal failure.
CRF may affect any area of your body. Some possible complications could include:
- Fluid retention leading to leg and arm swelling, fluid in your lungs and high blood pressure
- Hyperkalemia — sudden potassium blood level rise — may impair how your heart functions and could be life-threatening
- Weak bones and an increase in your risk of bone fractures
- Blood vessel and heart disease
- Central nervous system damage involving personality changes, difficulty concentrating or seizures
- Erectile dysfunction, decreased sex drive or reduced fertility
- Decrease in immune response, making you more susceptible to infection
- Complications of pregnancy carrying risks for both the developing fetus and the mother
- Pericarditis, or swelling and irritation of the membrane around the heart
- Irreversible kidney damage, or end-stage kidney disease, where you’ll require a kidney transplant or dialysis to survive
Patients often go through a continuous psychological process with CRF to adjust to the new hemodialysis condition and accept their new quality of life.
When you reach the point of requiring dialysis, your quality of life is significantly affected since you’ll have significant changes in your lifestyle and daily habits. Also, your functional status, physical health, economic and social status and personal relationships are also greatly affected.
Common stressors of chronic renal failure and having to undergo routine dialysis are:
- Changes in marital and social relationships
- Financial difficulties
- Inability to take vacations
- Regular hospital admission
- Fear of disability
- Restriction of leisure time
- Fear of death
- Uncertainness about the future
- Problems sleeping
- Increased dependence
- Physical fatigue
- Artificial kidney machine
Another common psychological complication with CRF is depression and its severe impact on the hemodialysis patient’s quality of life. Depression also negatively affects your economic, social and psychological well-being.
Medical marijuana can help with some of the physical effects of chronic renal failure, such as nausea and vomiting, and mental effects of anxiety, major depression and chronic fatigue.
Chronic Renal Failure Statistics
Statistics from the Centers for Disease Control and Prevention (CDC) show:
- Around 15 percent of, or 30 million, adults in the U.S. are estimated to have CRF.
- Ninety-six percent of individuals who have mildly reduced kidney function or kidney damage aren’t aware of having CRF.
- Approximately 48 percent of individuals with severely reduced kidney function who aren’t going through dialysis aren’t aware of having CRF.
Current Treatments Available for Chronic Renal Failure and Their Side Effects
Treatments for end-stage renal disease are a kidney transplant or dialysis — ideally only until a kidney transplant is available. In certain situations, medications and lifestyle changes can help.
Surgery for a kidney transplant involves the surgeon removing your damaged kidneys and inserting a donated, functional kidney. All you need is one healthy kidney — therefore, donors are typically alive, though in some cases, you can obtain a viable kidney from a recently deceased person. They’re able to continue functioning normally after donating one of their kidneys.
You can live a healthy life with one kidney but will need to take immunosuppressive drugs most likely for the remainder of your life to prevent rejection.
Risks of substantial complications with a kidney transplant include:
- Blood clots
- Blockage of or leaking from the ureter, or tube connecting your kidney to your bladder
- Rejection of your new donated kidney
- Failure of a donated kidney
- Heart attack, stroke or death
- Cancer or an infection transmitted by a new donated kidney
You have a couple of options available to you when you’re undergoing dialysis.
This option processes your blood with a machine. This machine uses a solution to filter out waste. The machine then adds new, clean blood back into your body. Hemodialysis is typically used several times a week and takes around three to four hours each session.
2. Peritoneal Dialysis
This option involves the doctor adding a solution into your abdomen. They then remove it later through the use of a catheter. You can conduct peritoneal dialysis at your home with sufficient training. You can have this treatment while you’re sleeping overnight.
Side Effects of Dialysis May Include:
- Sepsis, or blood poisoning
- Low blood pressure
- Itchy skin
- Muscle cramps
- Weight gain
- Other side effects
Dialysis also a time-consuming process and requires you to visit a hospital or dialysis clinic multiple times a week.
If you have hypertension or diabetes, you’ll need to control either of these conditions to lower your risk of end-stage renal disease. Drug therapy is beneficial for both of these conditions using ACE inhibitors (angiotensin-converting enzyme inhibitors) or ARBs (angiotensin receptor blockers).
Your doctor can give you specific vaccines to help to prevent severe end-stage kidney disease (ESRD) complications. The pneumococcal polysaccharide (PPSV23) and hepatitis B vaccines may lead to a positive prognosis, according to the CDC — particularly before and during your dialysis treatment.
Side Effects of ACE Inhibitors May Include:
- Dry cough
- Loss of taste
- Hyperkalemia, or increased blood-potassium
You may experience rapid weight changes with fluid retention. Therefore, you’ll need to monitor your weight. You’ll also want to decrease your protein consumption and increase your caloric intake. Consume a diet low in potassium, sodium and other electrolytes, along with fluid restriction.
To avoid too much potassium and sodium consumption, limit these foods:
- Peanut butter and nuts
Take a vitamin supplement of vitamins C and D, calcium and iron to absorb essential nutrients and help your kidney function.See how medical marijuana could help relieve your chronic renal failure symptoms. Find patient reviews on local doctors and information on treatment options. ]]>