Risk Factors - Kundan Kidney Care Centre

In another instance demonstrating the interconnectivity of people’s bodily systems, a study about eye problems has led to an observation about kidney disease. The Beaver Dam Eye Study, according to their own description, was designed to “collect information on the prevalence and incidence of age-related cataract, macular degeneration and diabetic retinopathy.” But along the way, they also drew some conclusions about how disease of the kidneys, along with high blood pressure, can also affect the eyes.

Retinopathy, or the disease of the retina causing possible loss of vision, has always been associated with diabetes. But the researchers with the study learned that even those without diabetes can be at higher risk of retinopathy, if they have certain other health conditions. One was uncontrolled hypertension (high blood pressure), and the other was chronic kidney disease.

In 4,699 people between ages 43 and 86 (remember that this was an age-related study), the risk of experiencing retinopathy over a 15-year period was 14.2%. And in those study subjects who had either uncontrolled hypertension or chronic kidney disease, the risk of such negative effects on the eyes increased. That applied to subjects who were not diabetic, so the extra risk cannot be blamed on diabetes. In fact, several other things that one might have considered a real risk did not seem to factor in at all. These would include such things as smoking, body mass index (which would rule out obesity), or inflammation.

These interconnections shouldn’t be a surprise. Hypertension and kidney disease often do interact, and diabetes frequently involves extra complications such as high blood pressure and strain on the kidneys. People don’t always experience all three at the same time, but they are clearly related to each other. So it’s probably not a surprise that retinopathy – which is a very high risk for diabetics – can also factor into hypertension and kidney disease as well.

(Sources: Ocular Surgery News Supersite, December 23, 2010; The Beaver Dam Eye Study.)

Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Iron and CKD

KundanKidneyCare August 1, 2015February 7, 2019

Why Iron is Important for people with Chronic Kidney Diseases

As Health Canada revises its food guidelines on introducing iron for babies as young as 6-months-old we take a look at the importance of this mineral on everybody’s health, especially to those with Chronic Kidney Disease (CKD).

Maintaining a healthy iron level is important for everybody because low levels lead to anemia. Iron helps make healthy red blood cells that carry oxygen from your lungs to all parts of the body. Anemia is caused by low red blood cells (RBC) count. A person with this illness would look pale, is usually weaker, have chest pains, faster heart beats, feel light headed, is more tired than usual and is depressed.

The kidneys make erythproprotein (EPO) that gives the signal to the body to make red blood cells. CKD diminishes the capability of the kidney to produce EPO which causes the RBC count to deplete and in turn develop into anemia. Some doctors prescribe erythropoiesis-stimulating agents (ESA) to help the EPO. When this happens (ESA prescription) more iron is needed to help the EPO.

Measuring Iron Levels

To measure the iron level of your body you need to know your hemoglobin level, which is made up of iron and oxygen. For women, the normal hemoglobin level is 12.0 and for men, it is at 13.5. A person’s iron level can also be measured through the transferrin saturation (TSAT) and ferritin tests. Normal TSAT level is at least 20 percent, while normal ferritin level is at 100 ng/ml. Doctors recommend the monthly testing of iron levels until the normal hemoglobin level is reached. When the target hemoglobin level is reached testing every three months is recommended.

Recommended Treatments for Low Iron

Your doctor will make a treatment plan if you have a low iron level. He will more likely recommend increasing your intake of iron-rich foods such as eggs, leafy green vegetables and red meat such as steak and tofu. A dietician can help develop meal plans suitable for your CKD condition. Another option is for your doctor to prescribe iron supplements either in tablet or liquid form, or prescribe a multivitamin and mineral supplement that has folic acid, iron and vitamin B. A third option is for your family physician to inject iron medicine into your vein. Just remember that iron supplements ingested by mouth may affect other medicines you are taking so always consult with your doctor or dietician for any contraindications.

There is continuous research for new medications to help iron deficiency in people with CKD.

Risk Factors

Mammograms and Kidney Disease Detection

KundanKidneyCare June 4, 2015

A familiar method that doctors use to check for possible breast cancer turns out to be another way of checking the effects of kidney disease as well. Researchers have studied women receiving mammograms, and discovered that some of these effects manifest themselves in breast arteries. They show up in other arteries as well, but unless other parts of the body are similarly scanned, they won’t be noticed.

A happy coincidence — if you can properly call it that — is that women reach the age of needing mammograms at about the same time they would be manifesting kidney disease if they’re going to get it. Many of those who show calcification in the arteries will probably already know they have kidney problems. Yet in some cases, what shows on the mammogram may be their first hint.

Mammograms may not be the best diagnostic tools when it comes to kidney disease itself. There are many other more reliable tests for that. But these procedures can certainly help to keep track of some of the effects of the disease.

And more than that, having a fairly early indication of the calcification in the arteries can serve as a warning of a growing risk of cardiovascular disease. With this extra tool, doctors can be alerted and perhaps take steps to try to prevent things from going that far. In yet another example of the interconnectedness of the body’s systems, using a tool designed to detect one ailment may help in detecting or even preventing others.

(For more information, read Proven Method of Cancer Detection Found Effective in Kidney Disease, January 25, 2010)

Risk Factors

What Happens when Calcium and Phosphorus are Out of Balance

KundanKidneyCare June 4, 2015February 7, 2019

It’s been established that when a person has kidney disease, one of the big concerns becomes the balance of their electrolytes – that is, the electrically charged elements that move through the blood to help the body perform vital functions. Keeping the calcium and phosphorus balanced in the body becomes especially important, because these two electrolytes play a major role in building bones and teeth, and also in conveying energy throughout the body. So what happens if they do go out of balance? How does this imbalance manifest itself?

Diseased kidneys can’t get rid of excess phosphorus, nor can they activate Vitamin D, meaning calcium levels drop. The thyroid triggers more calcium both to bring those levels up and to balance the excess phosphorus. This extra calcium is often leeched from the bones, making them weaker. And calcium phosphate deposits, made from all this extra material, begin latching onto soft tissue, including in the arteries, heart, lungs, and joints. Eventually these deposits start to harden, creating health problems related to the lungs and heart.

When this situation gets severe, it isn’t only the cardiovascular system that’s in danger. The leeching of calcium can make bones more bendable, and in the advanced stages of kidney failure, the jaw in particular becomes rubbery. Meanwhile, calcium phosphate deposits in other soft tissue creates inflammation that is hard to treat. And with the extra parathyroid levels, electrical impulses can’t travel properly along the nerves. This can lead to a patient being dazed and unresponsive.

Trying to maintain a low phosphorus diet can help somewhat, but it’s sometimes hard to avoid foods containing milk, whole grains, peas, etc. We can also help you by providing drugs that serve as phosphate binders. So it’s very important for people with even slight kidney problems to consult and keep checking their electrolyte levels.

Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Calcium, Phosphorus, and the Kidneys

KundanKidneyCare May 28, 2015

Electrolytes float through the blood and perform various functions in people’s bodies. Calcium, Sodium, and Potassium, for example, work together to help the muscles of the body contract. And the work of some of these electrically charged substances is controlled or at least affected by the kidneys.

This means that when the kidneys are diseased, the electrolytes may also function in an unhealthy way. Serious problems can arise that might, at first, seem unrelated to the kidneys at all. But to understand how these issues develop, we first need to know how electrolytes function when everything works properly.

Let’s take a look at two electrolytes – calcium and phosphorus – which often work together, each substance relying on the kidneys to keep it in balance with the other. The first function of the two is probably obvious: to help build up bones and teeth. Almost everyone knows that calcium is good for building bones, but few are aware that phosphorus is just as important. In fact, while about ninety-nine percent of the calcium in the body is concentrated in the bones, as much as eighty-five percent of the body’s phosphorus may also be found there.
In addition, phosphorus plays a major role in transferring energy throughout in the body. Calcium and phosphorus together help keep cells in good order, and regulate nerve function. Remember calcium’s role in helping muscles to contract? This would not be possible without phosphorus working right alongside it. The two electrolytes are equal partners.

The kidney helps keep phosphorus levels balanced by inducing the production of D vitamins, which in turn help the body excrete excess phosphorus. But as kidney disease progresses, the kidney becomes unable to trigger the Vitamin D. And that’s when the happy partnership of calcium and phosphorus becomes a nightmare instead. We’ll examine what happens under these circumstances with our next look at kidneys and the electrolytes.

Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Introduction to Electrolytes: Part 1

KundanKidneyCare May 27, 2015

One topic that frequently comes up in connection with kidney disease is electrolytes. They play an important role in the body, and relate particularly to kidney malfunction. But what are they, and what do they actually do? We will explore this topic in several installments, to try to explain how electrolytes work, and why their levels are important to monitor when you have impaired kidneys.

Electrolytes are substances that are electrically charged, or ionized. Because of this charge, they can carry electrical impulses along the nerves and muscles. These substances are, in fact, what make most parts of the body function at all. And if they aren’t present in proper levels, or certain types are out of balance, the body begins to suffer the consequences.
So for example, you may have some electrolytes carried along in the blood, and they would pass through membranes and cell walls into muscle tissue, to transmit impulses that make the tissue contract. Muscle contraction depends on the presence of three electrolytes in particular: Calcium (Ca²⁺), Sodium (Na⁺), and Potassium (K⁺), with the plus or minus values indicating what sorts of ions they are. Lower the levels of these three too much, or put them out of balance, and muscle function suffers.

So how does this relate to kidney disease? The kidneys play a major role in regulating fluids (which contain electrolytes) in the body. So when the kidneys are impaired or fail, this often throws out the balance, or results in a surfeit of some electrolytes. If this problem isn’t addressed, other parts of the body can be affected in serious ways, some of them potentially fatal.

In the next few installments, we’ll discuss specific types of electrolyte problems that are most closely associated with kidney disease. We’ll look at symptoms, but we’ll also try to discover ways to restore electrolyte levels and return to a safer, more healthy balance.

Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Mammograms and Kidney Disease Detection

KundanKidneyCare May 25, 2015

What some mammograms show is deposits of calcium left in the arteries. This calcification is a typical result of kidney disease, and if it increases, it can lead to cardiovascular disease as well. The progress of the calcium deposits can be studied over the months and years, as doctors assess the possible risks to the heart and lungs.
A happy coincidence — if you can properly call it that — is that women reach the age of needing mammograms at about the same time they would be manifesting kidney disease if they’re going to get it. Many of those who show calcification in the arteries will probably already know they have kidney problems. Yet in some cases, what shows on the mammogram may be their first hint.

(For more information, read Proven Method of Cancer Detection Found Effective in Kidney Disease, January 25, 2010)

Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Even With a Kidney Transplant, it’s Still Not Over

KundanKidneyCare May 15, 2015

There are so many reasons we should maintain our health to prevent kidney disease in the first place, or maintain as much health as possible after contracting the disease. But if kidney failure progresses so far that a transplant occurs, most people would expect that the surgery solves everything. With a lower rate of organ rejection than ever before, almost all transplant recipients should finally rest easy that health problems related to diseased kidneys are over. Right?

Unfortunately, that may not be entirely true.
Over time, more than half of all kidney transplant recipients develop endocrinal, or hormonal, problems. These can lead to later health issues such as diabetes, higher cholesterol levels, and even osteoporosis. Kidney patients may feel that it’s just not fair, to be at risk of something like diabetes because of failing kidneys, and then be at risk for the same thing after that problem was supposedly rectified.

The reasons for these risks stem in part from the procedures connected with the transplant itself. Immunosuppressants are given to transplant patients to help the body not reject the new organ. But these suppressants include drugs that can reduce the body’s ability to make insulin. By some accounts, as many as one-quarter of kidney transplant patients develop diabetes some time after their surgery.

Other complications may involve leptin levels. Leptins help to regulate appetite, but researchers have recognized another correlation in which they are involved. In transplant patients, when leptin levels are high, bone production appears to be reduced, meaning the possible development of osteoporosis.

Transplantation can save lives, but it’s not the ideal solution to kidney disease. The real solution should be for people to be in excellent health before any disease can develop. And if it does occur, they need to try to heal the kidneys and maintain the best health possible in the meantime.

(Further reading: The Times of India, January 6, 2011; RxPG News, December 27, 2010)

Risk Factors

Kidney Disease and Painkiller Safety

KundanKidneyCare May 13, 2015

If a person’s kidneys become compromised, one of the first steps often taken is to alter their diet. Good exercise and a healthy lifestyle are also vital. But as they plan how to eat and exercise, many people forget another important element in trying to keep their kidneys healthy: common, everyday painkillers.

The labels on these painkillers, with suggested dosages and durations for use, are on the containers for a reason. In general, no painkiller should be taken for more than three days for a fever, or for longer than ten days for pain. This is why doctors recommend that even if a person’s kidney function is normal, they should take as low a dose of painkillers as possible, and should take them for the shortest possible time.

Yet some people have conditions for which painkillers are actually recommended: for example, a heart condition for which they take aspirin. Are these patients now doomed to choose between heart problems and kidney problems? Fortunately, that doesn’t seem to be the case. The aspirin dose is usually low enough that it doesn’t affect kidney function.

Aspirin, in fact, seems to be the painkiller that does the least harm, at least when taken in moderate amounts. Yet the characteristic that makes them most useful with heart problems (blood thinning) can cause other health issues. So the user still must be careful about potential stomach bleeding or ulcers, and if their liver is compromised, even aspirin could be off the table as a painkiller.

Some painkillers, the NSAIDs (non-steroidal anti-inflammatory drugs), can actually cause a form of kidney disease called chronic interstitial nephritis, if taken for too long. Ibuprofen and naproxen are the main culprits for this. They should be avoided by anyone who knows their kidneys have impaired function, and should be used with a doctor’s guidance if the patient has other issues like liver disease or high blood pressure.

Acetominophen seems to be the only relatively safe painkiller if the patient can’t tolerate aspirin. Doctors warn against drinking alcohol while taking this drug, but kidney patients should be treating alcohol moderately anyway. And even this medicine should be taken under a physician’s guidance.

People inevitably need painkillers from time to time. But the more they know about how these medicines affect the kidneys, the less casually they may take them. Convenient and effective as they are, these drugs can still have devastating side effects, especially when it comes to kidney health.

Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Physical Fitness Improves Kidney Disease Outcomes

KundanKidneyCare May 13, 2015

It may seem a little unfair to talk to patients with kidney disease, especially those on dialysis, about how physically fit they are, when they’ve already got so much to deal with. It may be tempting for them to feel that they need to keep quiet and relaxed so they don’t strain anything. But keeping as fit as possible can actually help their condition.

We already know that interconnections in the body mean that if you have one physical problem, like diabetes, you have a higher likelihood of developing others such as hypertension or kidney failure. In the same way, strengthening the body to deal with or prevent one problem can ease a related problem. So a person may find that by getting some exercise they will lower their blood pressure and perhaps lose some weight. This, in turn, will ease the strain on the kidneys. And having good muscle tone and a well functioning cardiovascular system will always be of benefit.

The National Kidney Foundation recommends exercise for kidney patients, but also recognizes that they shouldn’t overdo things. It’s probably not a wise move, for example, to plan a climbing excursion to Mount Everest. But after consultation with a doctor, these patients can engage in certain recommended activities. Heavy lifting is probably out, but there are other things that can be done, some of them fairly strenuous.

For example, a type of workout that exercises a large array of muscle groups at once, and goes on continuously, can be very beneficial. This would include things like swimming, walking, cycling, or even skiing. Exercise sessions should go perhaps 30-45 minutes, every second day, three days a week.

Kidney patients may be uneasy about the extra work they might make their bodies do by exercising. But under a doctor’s supervision, getting themselves in as good a shape as possible will only do them good.

(Further reading: National Kidney Foundation)

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Category Archives: Risk Factors

Retina Problems and Chronic Kidney Disease

Iron and CKD

Mammograms and Kidney Disease Detection

What Happens when Calcium and Phosphorus are Out of Balance

Calcium, Phosphorus, and the Kidneys

Introduction to Electrolytes: Part 1

Mammograms and Kidney Disease Detection

Even With a Kidney Transplant, it’s Still Not Over

Kidney Disease and Painkiller Safety

Physical Fitness Improves Kidney Disease Outcomes