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Kidney Disease
                                                                          — A Guide for Patients

        C. DIFFICLE (CLOSTRIDIUM DIFFICILE)                   conditions requiring prolonged use of antibiotics
        What is Clostridium Difficle (C. Diff)?               and the elderly are at risk of infection. They can
           C. Diff. is a bacteria that causes diarrhoea and   become infected if they touch items that are
        may cause intestinal conditions such as colitis. It is  contaminated and then touch their mouth.
        a common infection in hospitals and long-term
        facilities.                                           Does C. Diff make a person more ill?
           The use of antibiotics alters the normal bacterial    In most patients, the symptoms are mild and
        content of the bowel and, thereby, increases the      discontinuing treatment with antibiotics and fluid
        risk of developing C. Diff. diarrhoea.                replacement results in rapid improvement.
                                                              Sometimes, it is necessary to give a specific
        Where is C. Diff found?                               antibiotic, by mouth, for the condition.
           C. Diff is found in the bowel of some people and   Unfortunately, 20-30% of patients relapse and
        can also survive for a long time on surfaces.         need further courses of antibiotics.
                                                                 Patients need to be nursed in a single room
        How do people get C. Diff?                            (isolation) or, in a room with other patients
           Healthy people are not at risk from getting        with C. Diff (cohorted), until bowel movement has
        C. Diff. People who have other illnesses or           returned to normal.

                  As prevention is always better than cure, the Department of Heath and Children
                advise that certain vaccinations be given to people with kidney disease. Your kidney
                   doctor or GP will advise you when you need to start getting vaccinated, but, in
                 general, once a diagnosis of chronic kidney disease is confirmed, the vaccinations
                                              listed below should be given:

        ● Pneumococcus - This bacterium can cause                injection (boost) or a repeat course to develop
           serious infection in the lungs (pneumonia), the       immunity. In addition, people on haemodialysis
           blood (bacteraemia) and covering of the brain         or peritoneal dialysis have a blood test, yearly,
           (meningitis). Vaccination consists of a single        and, depending on the result, may need a boost.
           injection, followed by a once-off booster dose     ● Varicella (chicken pox) - Vaccine for patients not
           5 years later.                                        immune and planning to receive a transplant.
        ● Influenza (flu) - An annual flu vaccine is             People should not get the vaccines if they ever
           advised, as infection can be complicated by        had a life-threatening allergic reaction to yeast
           pneumonia, which is dangerous for people with      (Hepatitis B), eggs (flu) and/or to a previous dose
           chronic illness.                                   (all vaccines). Pregnant women should discuss
        ● Hepatitis B - Hepatitis B is a serious illness and  vaccination, with their doctor, and people who are
           as haemodialysis is a recognised risk for          ill should defer vaccination until feeling better.
           acquiring Hepatitis B vaccination is advised. The     While a vaccine, like all medicines, is capable of
           vaccination course varies, depending on the        causing a serious problem, such as severe allergic
           product used, but it is usually 3 or more          reaction, the risk of vaccinations causing serious
           injections, over a 6-month period, with a          harm, or death is extremely small.  Getting
           follow-up blood test to check if immunity has      vaccinations is much safer than getting the
           developed. Some people need an additional          disease.

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