Hi,
This is more of a kidney question than a multiple myeloma question, but I am hoping someone might know about this.
My 78-year-old dad is currently in the hospital after his kidneys basically shut down. He also has a compression fracture in his spine. He had the bone marrow biopsy today, but it is pretty clear he has multiple myeloma due to these and other factors.
He has had dialysis three days in a row, and it looks like he will remain on dialysis for whatever time he has left.
He has always been extremely bright and funny. He's a voracious reader, former lawyer, very involved in current events, etc. What bothers me the most right now is that he is not here anymore. His personality is gone. He is very confused and agitated. We were told the dialysis would help his mental confusion A LOT. It hasn't. We are seeing small signs of improvement (for example, he brushed his teeth today; didn't know how to do that yesterday), but he is nowhere near his usual self.
Has anyone "come back" from this extreme confusion due to kidney failure? I've been doing a lot of research about a lot of things, but can't find information on this one piece. And it's the one thing I really care about.
Thank you!
Forums
6 posts
• Page 1 of 1
-
jcd123 - Who do you know with myeloma?: Father
- When were you/they diagnosed?: June 2016
- Age at diagnosis: 78
Re: Mental confusion from kidney failure: is it reversible?
Jcd,
Sorry to hear your father is going through this. How long has he been confused like this? When did it start? Was the onset gradual or sudden?
Generally speaking, under times of stress, elderly people are at risk of something called delirium. A hospital stay, a new illness like myeloma, dialysis, etc... These are all stressor that increase the risk of delirium. Delirium is basically brain dysfunction. Just like the lungs or kidneys can take a hit when a person is under tremendous physical stress, so can too the brain.
Delirium characteristically onsets suddenly, waxes and wanes quite rapidly, with periods of sleepiness or difficulty rousing.
Does this sound like your Dad?
So if you want to do some research, that's the term to use - delirium.
Fortunately, delirium is quite malleable. He may always be at increased risk of it happening or worsening, but generally speaking once the stressors calm down, his mental status should improve. Delirium can also be improved by environmental modifications - try to regulate the sleep schedule, keep things predictable and as normal as possible.
Good luck!
Tracy
Sorry to hear your father is going through this. How long has he been confused like this? When did it start? Was the onset gradual or sudden?
Generally speaking, under times of stress, elderly people are at risk of something called delirium. A hospital stay, a new illness like myeloma, dialysis, etc... These are all stressor that increase the risk of delirium. Delirium is basically brain dysfunction. Just like the lungs or kidneys can take a hit when a person is under tremendous physical stress, so can too the brain.
Delirium characteristically onsets suddenly, waxes and wanes quite rapidly, with periods of sleepiness or difficulty rousing.
Does this sound like your Dad?
So if you want to do some research, that's the term to use - delirium.
Fortunately, delirium is quite malleable. He may always be at increased risk of it happening or worsening, but generally speaking once the stressors calm down, his mental status should improve. Delirium can also be improved by environmental modifications - try to regulate the sleep schedule, keep things predictable and as normal as possible.
Good luck!
Tracy
-
Tracy J - Name: Tracy Jalbuena
- Who do you know with myeloma?: Me
- When were you/they diagnosed?: 2014
- Age at diagnosis: 42
Re: Mental confusion from kidney failure: is it reversible?
Hi JCD,
As always, Tracy's advise is very helpful. I would just add that, if your father is having kidney issues, he probably is experiencing imbalances in his electrolyte levels, which can cause the sort of symptoms you've described. Those symptoms should reduce, or go away, once electrolyte levels are normalized.
Another thing that could be behind what your father has experienced is very high protein levels in his blood, which can cause "thick blood" ("hyperviscosity"). That's something that can lead to the sort of confusion you've mentioned.
Also, a number of people in this forum have mentioned that confusion can accompany urinary tract infections. I don't know exactly why this is the case. I guess it's possible that such infections somehow directly causes confusion. I think it's more likely, however, that the infections, or antibiotics used to treat them, cause electrolyte imbalances, which then cause confusion.
In any case, I think your father's confusion / delirium is very likely to go away once his other health issues are taken care of.
Good luck!
As always, Tracy's advise is very helpful. I would just add that, if your father is having kidney issues, he probably is experiencing imbalances in his electrolyte levels, which can cause the sort of symptoms you've described. Those symptoms should reduce, or go away, once electrolyte levels are normalized.
Another thing that could be behind what your father has experienced is very high protein levels in his blood, which can cause "thick blood" ("hyperviscosity"). That's something that can lead to the sort of confusion you've mentioned.
Also, a number of people in this forum have mentioned that confusion can accompany urinary tract infections. I don't know exactly why this is the case. I guess it's possible that such infections somehow directly causes confusion. I think it's more likely, however, that the infections, or antibiotics used to treat them, cause electrolyte imbalances, which then cause confusion.
In any case, I think your father's confusion / delirium is very likely to go away once his other health issues are taken care of.
Good luck!
Re: Mental confusion from kidney failure: is it reversible?
Hi jcd123.
Uremia, (renal failure), can certainly cause altered mental status as can hypercalcemia (if he has that in the setting of myeloma, renal failure and a compression fracture). If he is on some medications cleared by the kidney, this effect can be magnified. If he has anemia, this may be worse as well.
As Tracy J mentions, add stress to this and you can have delirium. There is also the possibility of an acute stress reaction due to the diagnosis or hospitalization.
Correction takes time for some people; it's not an on/off switch. If his BUN / creatinine and calcium have returned to more normal levels, you may want his doctors to look for other causes, but there's no reason to assume this is his or your new normal yet.
Here's hoping those small signs are built upon tomorrow. Wishing you both the best.
Uremia, (renal failure), can certainly cause altered mental status as can hypercalcemia (if he has that in the setting of myeloma, renal failure and a compression fracture). If he is on some medications cleared by the kidney, this effect can be magnified. If he has anemia, this may be worse as well.
As Tracy J mentions, add stress to this and you can have delirium. There is also the possibility of an acute stress reaction due to the diagnosis or hospitalization.
Correction takes time for some people; it's not an on/off switch. If his BUN / creatinine and calcium have returned to more normal levels, you may want his doctors to look for other causes, but there's no reason to assume this is his or your new normal yet.
Here's hoping those small signs are built upon tomorrow. Wishing you both the best.
-
rick - Name: rick
- Who do you know with myeloma?: husband
- When were you/they diagnosed?: nov 2015
- Age at diagnosis: 50
Re: Mental confusion from kidney failure: is it reversible?
Hello JCD,
From personal experience, not related to multiple myeloma, for both my wife's father and my father (on multiple occasions), they had electrolyte (in one case, I specifically recall potassium level) and other issues (dehydration due to pneumonia), they had their kidneys shut down, and experienced what I would call severe "lucidity" issues. I am not sure of the exact word, it was not exactly a coma.
In any case, as the other posters had mentioned, once rehydration occurred and the numbers came back, the condition ended completely. In both their cases, I recall it was surprisingly quickly.
Good luck to you.
From personal experience, not related to multiple myeloma, for both my wife's father and my father (on multiple occasions), they had electrolyte (in one case, I specifically recall potassium level) and other issues (dehydration due to pneumonia), they had their kidneys shut down, and experienced what I would call severe "lucidity" issues. I am not sure of the exact word, it was not exactly a coma.
In any case, as the other posters had mentioned, once rehydration occurred and the numbers came back, the condition ended completely. In both their cases, I recall it was surprisingly quickly.
Good luck to you.
-
JPC - Name: JPC
Re: Mental confusion from kidney failure: is it reversible?
Thank you all very much for the information and encouragement.
To answer Tracy's question, I don't really know how quickly the delirium set in. We spent about three weeks thinking that all of my dad's health problems were due to his bad back. He was taking a lot of pain meds during that time, including morphine, so I assumed his altered mental state was related to the medications. I don't think that is / was the case, though.
He has several more days in the hospital, then a rehab facility. I am hopeful that once we get him home and back to his normal environment that he will truly bounce back mentally.
Thank you, again. So grateful I found this site.
To answer Tracy's question, I don't really know how quickly the delirium set in. We spent about three weeks thinking that all of my dad's health problems were due to his bad back. He was taking a lot of pain meds during that time, including morphine, so I assumed his altered mental state was related to the medications. I don't think that is / was the case, though.
He has several more days in the hospital, then a rehab facility. I am hopeful that once we get him home and back to his normal environment that he will truly bounce back mentally.
Thank you, again. So grateful I found this site.
-
jcd123 - Who do you know with myeloma?: Father
- When were you/they diagnosed?: June 2016
- Age at diagnosis: 78
6 posts
• Page 1 of 1