All About Kidney Disease

All About Kidney Disease

What the Kidneys Do

Most human beings have two functioning kidneys. They are bean-shaped and about the size of a fist. They’re situated in the center of your back, on the left and right of your spine, just below your rib cage.

The kidneys help control blood pressure and make hormones that your body must have to stay healthy. When the kidneys are damaged, wastes can build up in the body.

Kidney Function and Aging

Kidney function may be reduced with aging. As the kidneys age, the number of filtering units in the kidney may fall, the total amount of kidney tissue may fall, and the blood vessels that supply the kidney may harden, causing the kidneys to filter blood.

You might be more likely to have complications from specific medicines if your kidneys start to filter nicely as you age. There may be an unsafe buildup of medicines that are taken off your blood by your kidneys. Also, your kidneys may be more sensitive to particular medications. For example, nonsteroidal anti-inflammatory drugs (NSAIDs) and some antibiotics may damage your kidneys in some situations. The next time you pick up a prescription or buy an over-the-counter medicine or supplement, ask your pharmacist how your kidneys may be affected by the product and interact with your other medications.

Kidney Disease Occurs

Kidney disease means the kidneys are damaged and can no longer remove wastes and additional water from the blood as they should. Kidney disease is usually caused by diabetes or high blood pressure. Many are in danger. The main risk factors for developing kidney disease are:

  • diabetes
  • high blood pressure

Each kidney contains about one million tiny filtering units. These filters are called glomeruli. High blood pressure and diabetes damage these blood vessels, so the kidneys aren’t able to filter the blood as good as they used to. Normally this damage occurs slowly, over many years. This is called chronic kidney disease. As more and more filtering components are damaged, the kidneys eventually are unable to maintain well-being.

Early kidney disease generally has no symptoms, which means you will not feel distinct. Urine and blood tests are the only way to check for kidney damage or measure kidney function. You should be tested for kidney disease if you have a family history of kidney failure, high blood pressure, heart disease, or diabetes.

Kidney Failure

Kidney disease can may lead to kidney failure, and can get worse over time. Kidney failure means kidney damage that is quite advanced with less than 15% normal functionality. End stage renal disease (ESRD) is kidney failure treated by dialysis or kidney transplant.

Treatment options for example dialysis or a kidney transplant can help replace kidney function, if the kidneys fail. Some patients choose not to treat kidney failure with dialysis or a transplant. Talk with your physician about choosing a treatment that is best for you if your kidneys fail.

Chronic Kidney Disease

Chronic Kidney Disease

The Role of Your Kidneys

Nephrons are the tiny units in each kidney which give them functionality. We have about 1 million of these in each kidney.

Kidneys do a lot more for your body then you realize. They maintain our fluid balances, balance out some of the hormones in our bodies such as the parathyroid hormone, clean and filter wastes, and play a role in bone health through the processing of calcium. They also filter things like potassium.

When kidneys don’t do their jobs properly, the fluid balances and processing of other wastes become greatly disturbed. This deteriorating process happens over many years in many cases, or, if kidneys are suddenly injured, can suddenly stop working. That is known as acute renal failure.

Common Causes of CKD

Diabetes is the number one cause of CKD. This is because high blood glucose levels disturb the nephrons in the kidney little by little until they are no longer a functional unit. This is why poorly controlled diabetes gradually reduces the kidney function.

Hypertension is another way in which the kidneys become destroyed. Since the heart’s pumping action is working too quickly in hypertension, the blood vessels are taking repeated damage. Eventually, the blood vessels become damaged within the scope of your kidneys, and therefore the kidneys will no longer filter wastes. You will have a fluid buildup that begins, and kidneys are damaged even more.

Urinary Tract and Kidney Infections

Chronic urinary tract infections over time will likely produce damage to the kidneys. Untreated Urinary Tract Infections can easily travel up to the kidney area, and produce a more serious kidney infection. Kidney infections, (pyelonephritis), quickly destroy nephrons, and can even cause acute renal failure.

Stages of CKD

In stage one of CKD, this is only mild damage. A blood creatnine test will show a GFR of 90-100.A GFR is the glomerular filtration rate. This is a determining factor of how well kidneys are functioning.

It is doubtful that you will notice anything at this stage. Kidneys can hold up well not functioning fully.Some people never go on to develop more stages depending on their medical conditions and how well they are controlled.

In stage two of CKD, you would have a GFR of about 60-89. You likely will not have any symptoms at this stage, but sometimes protein of the urine will begin showing. Foamy urine is a good indication of protein.

In stage three of chronic kidney disease, you may notice that you are urinating at night often. It is possible to feel more fatigued, and there may be signs of anemia present. It is also not totally uncommon to be experiencing cramps in the legs or itchy dry skin.Your GFR rate is below 60 at this point.

In stage four, you will need to see a nutritionist for a special diet that works on limiting your phosphorus, potassium, and sodium. You may start to make less urine then normal, retaining fluids, (have edema and swelling in the extremities), and feeling overall unwell. Both you and your doctor will start making future plans for some type of dialysis. Your GFR will likely display results from 15-29, which is a big loss of kidney functioning.

Stage 5 is a critical stage of kidney failure. People are symptomatic at this stage to a high degree, having swelling in the extremities, nausea and vomiting, and hardly any urine production, (maybe a teaspoonful), if they are lucky. Kidneys are not filtering anything, and this is where you are placed on dialysis for survival. Your kidney doctor will now have you on some other medications such as potassium binders, and calcium binders in order to keep down toxins in the blood between dialysis treatments.

If you are having hemodialysis you will have choices of learning to do this yourself at home or do this in a center three times a week. A fistula is placed in the arm for access in dialysis to clean the blood.

Peritoneal dialysis uses a catheter that is placed into the abdominal area. This is a common choice for many people as the restrictions are not as many as for those on hemodialysis. You do peritoneal dialysis several times daily at home, and since this is the case, fluids are not as restricted.

Kidney transplants are not always easy to get, but you can always get on the list for a donor or check woth family members to see if they are a compatible donor. It is often a long process.

As you can see from reading here, the care of your kidneys are very very important. This is why it important to work closely with your doctor and have bloodwork done on a regular basis to monitor kidney function, and try to keep kidney function as long as possible.
  

 
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The Hemodialysis Process

The Hemodialysis Process

Chronic kidney disease and acute kidney injury (also known as acute renal failure) cause the kidneys to lose their ability to filter and remove waste and extra fluid from the body. Hemodialysis is a process that uses a man-made membrane (dialyzer) to:

  • Remove wastes, such as urea, from the blood.
  • Restore the proper balance of electrolytes in the blood.
  • Eliminate extra fluid from the body.

process-of-hemodialysisFor hemodialysis, you are connected to a filter (dialyzer) by tubes attached to your blood vessels. Your blood is slowly pumped from your body into the dialyzer, where waste products and extra fluid are removed. The filtered blood is then pumped back into your body.

There are different types of hemodialysis. Talk about these with your doctor to decide which one might be best for you.

  • In-center hemodialysis. You go to a hospital or a dialysis center. Hemodialysis usually is done 3 days a week and takes 3 to 5 hours a day.
  • Home hemodialysis. After you are trained, you do your dialysis treatments at home. Hemodialysis is usually done 3 days a week (or every other day). Discuss with your doctor how long each session needs to be. A session could be as long as 6 hours, which may help you feel better.
  • Daily home hemodialysis. After you are trained, you do your dialysis treatments at home. Hemodialysis is done 5 to 7 days a week. Each session takes about 3 hours.
  • Nocturnal home hemodialysis. After you are trained, you do your dialysis treatments at home. Hemodialysis is done 3 to 7 nights a week. Each session is done overnight (about 6 to 8 hours).

Before treatments can begin, your doctor will need to create a site where the blood can flow in and out of your body during the dialysis sessions. This is called the dialysis access. The type of dialysis access you have will depend in part on how quickly you need to begin hemodialysis.

There are different types of access for hemodialysis:

  • Fistula. A fistula is created by connecting an artery to a vein in your lower arm. A fistula allows repeated access for each dialysis session. It may take several months for the fistula to form. A fistula may not clot as easily as other dialysis access methods. A fistula is the most effective dialysis access and the most durable. Complications include infection at the site of access and clot formation (thrombosis).
  • Graft. A vascular access that uses a synthetic tube implanted under the skin in your arm (graft) may be used if you have very small veins. The tube becomes an artificial vein that can be used repeatedly for needle placement and blood access during hemodialysis. A graft does not need to develop as a fistula does, so a graft can sometimes be used as soon as 1 week after placement. Compared with fistulas, grafts tend to have more problems with clotting or infection and need to be replaced sooner. A polytetrafluoroethylene (PTFE or Gore-Tex) graft is the most common type used for hemodialysis.
  • Venous catheter. A tube, or catheter, may be used temporarily if you have not had time to get a permanent access. The catheter is usually placed in a vein in the neck, chest, or groin. Because it can clog and become infected, this type of catheter is not routinely used for permanent access. But if you need to start hemodialysis right away, a catheter may be used until your permanent access is ready.

Hemodialysis for acute kidney injury may be done daily until kidney function returns.

What To Expect After Treatment

About once a month, you will have blood tests to make sure you are getting the right amount of hemodialysis. These tests are done to help find out how well hemodialysis is working. Your weight before and after each session will be recorded, as will the length of time it takes to complete the dialysis session. If you have hemodialysis at home, you will need to keep records of your weight before and after each session and the length of each session.

Why It Is Done

Hemodialysis is often started after symptoms or complications of kidney failure develop. Symptoms or complications may include:

  • Signs of uremic syndrome, such as nausea, vomiting, loss of appetite, and fatigue.
  • High levels of potassium in the blood (hyperkalemia).
  • Signs of the kidneys’ inability to rid the body of daily excess fluid intake, such as swelling.
  • High levels of acid in the blood (acidosis).
  • Inflammation of the sac that surrounds the heart (pericarditis).

Hemodialysis is sometimes used when acute kidney injury develops. Dialysis is always used with extra caution in people who have acute kidney injury, dialysisbecause dialysis can sometimes cause low blood pressure, irregular heart rhythms (arrhythmias), and other problems that can make acute kidney injury worse.

How Well It Works

Hemodialysis may improve your quality of life and increase your life expectancy. But hemodialysis provides only about 10% of normal kidney function. It does not reverse chronic kidney disease or kidney failure.

Dialysis has not been shown to reverse or shorten the course of acute kidney injury. But it may be used when fluid and electrolyte problems are causing severe symptoms or other problems. Some people who develop acute kidney injury stay dependent on hemodialysis and will go on to develop kidney failure.

A Look At Potassium

A Look At Potassium

Range:

The normal range is 3.5-5.0 mEq/L or that is the normal range for 95% of the population, so you may fall outside of that range and be totally normal. If you are below that level, we call it hypokalemia, and if you are above that level, we call it hyperkalemia. These word come from hypo (meaning under) or hyper (meaning over), kalium (meaning potassium), and emia (meaning a condition of the blood).

What Are They Looking For:

Hypokalemia especially below 3.0 mEq/L is the most worrying and tends to result in muscle weakness, muscle cramps, constipation, and even flaccid paralysis.

Hyperkalemia is most concerning above 5.5 mEq/L though symptoms are more nonspecific including malaise, palpitations, muscle weakness, and potentially cardiac arrhythmia and sudden cardiac death.

Both conditions are equally worrying if symptomatic and not treated. Hyperkalemia increases mortality from cardiovascular events whereas hypokalemia increases mortality from end-stage renal disease.

Organs Involved:

For such a little particle, potassium incorporates a number of organs. The heart, kidney, muscles, gastrointestinal tract, and adrenal gland just to name a few. All of these systems work together to keep everything level, so when there is extreme deviation it could be a sign of something problematic. These changes normally result from chronic diseases that have other symptoms associated with them though knowing the potassium level can help better elucidate the cause.

Treatment:

All of the treatments looks to bring the potassium level back in normal range to alleviate symptoms and then treat the underlying condition. In the setting of hypokalemia, potassium supplements are given either in an oral or intravenous form. Hyperkalemia on the other hand is a little more challenging because the body may no longer be able to excrete excess potassium on its own resulting in a need for diuretics or even hemodialysis.

Hypokalemia can result from various medical conditions, such as diabetic ketoacidosis, Cushing’s syndrome, and Bartter Syndrome, but is much more likely to be caused by poor diet, diarrhea, and certain diuretics.

Hyperkalemia on the other hand can result from congenital adrenal hyperplasia, Addison’s disease, and tumor lysis syndrome; but is more likely to be the result of medication and some degree of renal insufficiency.

Take Home Point:

If your potassium levels are a little outside of the normal range and you feel fine, your doctor is unlikely to pursue that further. Being on the low end means you probably could increase you intake some and being on the high end means you might want to take a look at your current medications.

 

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The Delicate Diet of a Renal Patient

The Delicate Diet of a Renal Patient

Our kidneys, like the lungs are paired organs that work equally to eliminate wastes in the body while removing excess water from the blood. Surprisingly, a human body could survive with one kidney alone and is able to live a normal life. No organ in the body could replace the function of the kidneys. There are certain instances that render the functions of both kidneys, making our bodies unable to process waste materials like urine. Kidney illnesses are characterized from mild to life-threatening problems. More often, people that suffer from kidney failures undergo treatment called hemodialysis were the blood is being filtered via a machine, removing wastes materials that is poisonous to the body and getting rid of excess fluids in the blood. Some only uses dialysis in short period of time until their kidneys are able to function, while others with complete kidney failure, the procedure are a lifetime process. People that undergo dialysis are required to follow a strict diet. Sad to say there are a lot restrictions regarding the diet of a renal patient.

Low sodium foods

A person who undergoes dialysis is not allowed to eat high sodium foods. Sodium attracts water like a magnet, since the function of the kidneys of a renal patient is low to none, excess fluids inside the body is very deadly. Medical experts and doctors are very strict regarding the diet of a renal patient; they know that one wrong move could be fatal.

Low potassium foods

Potassium like sodium also attracts fluid in our body. Although they could cancel each other out excess quantities to both fluids would be unhealthy to renal patient. Potassium rich foods are very abundant to the market. We all know that fruits are very beneficial to our health, however, there are certain types of fruits that is not appropriate to a renal patient. Mangos, avocados, watermelons and papaya are some of the potassium rich fruits, while apple and pineapple are allowed in the diet of a renal patient. Carrots, celery, cucumber, red pepper, and green pepper are low potassium vegetables are included to the diet of the dialysis patient.

Restrict fluids

A renal patient is required to monitor his or her fluid intake, excess fluids could cause damage to remaining healthy organs in the body. Soups and Oatmeal should be taken at a minimal manner.

The diet of a renal patient is very fragile. We must familiarize ourselves of the allowed and not allowed foods, if not their conditions could worsen. The key to any diet is balance; if we could attain that, our heath would be secured.

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