KIDNEY CITIZEN Issue 11

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Identifying SepsisRisk and SymptomsBy Marijke Vroomen Durning, RNPeople who live with kidney diseaseare more susceptible to contractinginfections than the general public.A weakened immune system, frequenthospital or clinical visits/stays, andpossible points of entry for infection(catheters, ports, etc.) all contribute tothis increased risk. Unfortunately, someof these infections can lead to sepsis,which can be life altering, even fatal forthousands of people.14Sepsis is your body’s inflammatoryresponse to an infection. It can be anytype of infection—viral, as with influenza;bacterial, as with a urinary tract infection(UTI); even fungal or parasitic. No oneknows why two people may get the sameinfection, but one may develop sepsis
while the other does not. Sepsis can, anddoes, occur in people of all ages whoare usually very healthy and fit, as wellas those who have underlying healthproblems, like kidney disease.When you have an infection, your immunesystem tries to fight it off, alone orwith medications. Most of the time it’ssuccessful, but sometimes, your immunesystem overreacts and instead of attackingthe infection, it starts to attack your body.This is sepsis. Untreated sepsis can leadto organ dysfunction, a drop in bloodpressure and septic shock.Currently, the only way to prevent sepsisis to prevent or quickly identify and treatinfections. This means that everyoneshould know what sepsis is, what to watchfor in terms of infections and sepsis, andwhen to seek help. If you have a lovedone living with kidney disease or kidneydysfunction, you can help reduce the riskof serious illness from sepsis by watchingfor the signs and symptoms and by gettingmedical help as quickly as possible.The Importance of TimeOnce sepsis develops, quick identificationand treatment is key to protect thebody from permanent damage—likeamputations or death. Your chances ofdying from sepsis increase by up to eightpercent for every hour it is not effectivelytreated. Just like there is a golden hourfor saving people from a heart attack orstroke, there is a golden hour for sepsis.Sepsis Alliance developed the mnemonic,TIME to help people remember the mostbasic of symptoms:T: Temperature is higher or lower thannormal.I: There is an infection present, or there isreason to suspect an infection.M: Change in mental status, such asexcess drowsiness or confusion.E: Extreme pain or feeling like you mightdie.Other signs and symptoms of sepsis mayinclude:• Drop in blood pressure• Rapid heartbeat• Rapid respirations (breathing)• Chills (shivering)• Little or no urine output• Skin rash or change of skin colorIt’s not unusual for people with sepsisto think that they just need to sleep itoff. They may think they have the flu orsome bug that is going around. But manysurvivors say that they were saved becausea loved one refused to allow them to “gosleep it off,” and insisted that they go toan emergency room or call 911.Older PeopleAs people age, their immune system canbecome weaker or they may have chronicillnesses, such as diabetes, that can lowertheir ability to fight infections. Older peoplemay also take more medications, somethat could affect their immune system.If kidney disease is thrown into the mix,their risk for getting an infection rises. Butwhat makes detecting an infection in olderpeople more difficult is they often don’tshow common symptoms. For example,older people with UTIs may not complainof pain or burning when urinating, or theymay not notice that they are urinating moreoften. For many, the first sign of infectioncould be a change in their mental status.Someone who is usually very sharp mayshow signs of confusion. Someone whois already confused may exhibit a suddendeterioration.If your loved one appears to be changingquickly, even without obvious signs ofinfection, it is worth contacting yourdoctor or going to an urgent care clinic torule out an infection.ChildrenChildren are vulnerable to infectionsbecause they get viruses and otherinfections from each other at school,daycare or while playing together.Children also may not be consistent withgood hand washing, or they may get a cutor scrape that their parents don’t noticeuntil an infection sets in.If your child starts to act out of character,think about who he or she has been incontact with or if he or she may havegotten hurt. Check for scrapes, bug bitesor cuts that could be infected. Signs andsymptoms of sepsis include those foradults, but children can have other ways ofshowing sepsis, including:• Reduced sucking (for infants)• Poor or no appetite• Slower movements• Seizures• Change in skin color (bluish or ashencolor)If someone, child or adult, starts to showsigns of infection or sepsis but thereis nothing obvious—like exposure tosomeone who had the flu—think back tothe past few weeks. Did he or she haveany type of invasive treatment (an IV,new fistula, urinary catheter, surgicaltreatment, etc.)? Was there an injury, askin tear, a scrape, anything that mayhave gotten infected? While there maynot be an obvious infection, any invasivetreatment or injury that opens the skinor exposes the body to external bacteriaputs you at risk for developing aninfection.Marijke Vroomen Durning is the Director ofContent Sepsis Alliance.15
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KIDNEY CITIZEN Issue 11

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