Category Archives: Risk Factors

Categories Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Lupus and Kidney Disease may be a Deadly Combination

Kidney disease is related to a great many other diseases and conditions, the most common being high blood pressure and heart and stroke problems. But another condition it’s often linked with is lupus. And for those who have both lupus and kidney disease, the prognosis is unfortunately not good.

Systemic lupus erathymatosus, usually just called lupus, causes damage to the skin, joints, brain, and also to the kidneys. In fact, according to an article on the HealthDay website (Kidney Disease Could Be More Deadly for Kids With Lupus, Friday December 17, 2010), about eighty percent of children with lupus also suffer kidney damage. But whether it’s adults or children who have end-stage kidney disease caused by lupus, all have a higher likelihood of death from any cause than those who have the same kidney problems stemming from a different source.

Researchers from both Johns Hopkins University and the Children’s Hospital of Philadelphia studied the cases of 98,000 children, and this conclusion is what the evidence suggested. Children were 2.4 times more likely to die, when suffering from kidney disease caused by lupus, than children whose disease was caused by something else. Adults had a slightly better record, yet they were still almost twice as many times more likely to die.

While many causes seemed to lead to death for people with kidney disease caused by lupus, the most common cause, according to the study, seemed to be cardiovascular disease and cardiac arrest. For this reason, the researchers suggest that patients with the lupus-kidney combination probably need extra monitoring for atherosclerosis, or the thickening of the walls of the arteries. And when kidney patients are also diagnosed with lupus, that should send up a red flag of warning, so doctors can be more alert to the increased risks of death.

The study, entitled Increased risk of death in pediatric and adult patients with ESRD secondary to lupus, is published in the January 2011 issue of the journal, Pediatric Nephrology.

Categories Kidney Disease, Kundan Kidney Care Centre, Risk Factors

E. Coli and Kidney Problems

Sometimes a person’s kidneys are adversely affected not just by their own lifestyle, but by illnesses they have little control over. One example was recently discussed in an article in the online version of the British Medical Journal. Several researchers analyzed information from the Walkerton Health Study. This study followed the  health of citizens of the Canadian town of Walkerton, Ontario, after their municipal water system was infected with E. coli O157:H7 in May of 2000. Almost two thousand people who had contracted gastroenteritis at the time were monitored for several years.

The results indicated a higher likelihood of experiencing high blood pressure, heart problems, and renal impairment for those who had been infected and developed gastroenteritis symptoms than for those who had not. The risk of high blood pressure was 1.3 times higher, the chance of having either a stroke or heart attack was almost twice as high, and the likelihood of kidney problems was about three times higher.

This analysis is not only pertinent in cases like that of Walkerton, in which E. coli contamination hits an entire community. Most warmblooded organisms have forms of E. coli in their systems, and it is also found in many environments. Most strains are not harmful, but those like O157:H7 can be deadly. The presence of E. coli  often indicates fecal contamination, yet it also enters an environment in other ways.

What this means is that people can contract gastroenteritis from E. coli in ways apart from disasters like that which struck Walkerton. So for those who do encounter these bacteria, whether through mass contamination or in less obvious ways, it is important to monitor their health carefully from that point on. As well as being at a higher risk for blood pressure or heart problems, they will need to be on the watch for potential kidney problems as well.

(Further reading: British Medical Journal, reference BMJ 2010; 341:c6020, November 17, 2010; Medical News Today, November 21, 2010)

Categories Health, Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Pain Killers Bad for Kidneys, Worse for CKD

Do you pop pills at the slightest pain? If you are a pill-popper here is something you should know about analgesics also known as pain killers. They may relieve your pain but may be harming a vital organ in your body: your kidneys.  Even worse is those analgesics further reduce blood flow to the kidney when a person suffers from Chronic Kidney Disease (CKD).

How can the use of analgesics hurt the kidneys? The long term use of ibuprofen, naproxen sodium and other higher dose aspirin can cause chronic interstitial nephritis. For this reason, over the counter (OTC) pain relievers should not be used for more than 10 days and fever reducers for more than three days. This is clearly indicated in the warning labels of OTC analgesics. OTC analgesics include aspirin, acetaminophen, ibuprofen, naproxen sodium and ketoprofen.  Prescription analgesics are also available, and are usually stronger than OTC ones.

Additionally, analgesics and Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) have been known to contribute to gastrointestinal bleeding and stomach ulcers. The use of NSAIDs also increase the risk of heart attack and stroke. NSAIDs are a group of pain relievers that include ibuprofen, naproxen sodium and ketoprofen.

It is strongly recommended that analgesics be used as prescribed by your doctor, or as stated on the label for OTC drugs; they should be taken at the lowest dose; and used for a short period.

Those with reduced kidney functions are not recommended to take higher dose aspirin and NSAIDs. If necessary, kidney patients should take NSAIDs under a doctor’s care. NSAIDs also have contra-indications for people with heart disease, liver disease, high blood pressure and those over 65. These pills increase the risk of kidney failure and cause progressive kidney damage.

Meanwhile, acetaminophen is the recommended analgesic for kidney patients. Aspirin is not recommended because it acts as a “blood thinner” and may cause bleeding complications. Patients on regular acetaminophen use should be supervised by their doctors. Alcohol should be avoided while on this medication.

The good news is kidney disease caused by the use of analgesics is PREVENTABLE! Here are some guidelines on how to use analgesics without harming your kidneys: Remember what was earlier said about prolonged use? Well OTC analgesics should not be used for more than 10 days for pain, and more than 3 days for fever. Drink at least eight glasses of fluids daily when taking analgesics, and avoid drinking alcohol. Analgesics with a mixture of painkillers and caffeine in one pill should be avoided. These can drastically damage the kidneys. Read the warning labels for all OTC analgesics. Those with underlying medical conditions like high blood pressure, kidney or liver diseases should take NSAIDs under the doctor’s care.  Last but not least, your doctor should be aware of all the medications you’re taking.

Categories Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Kidney Disease and St. Patrick’s Day

Four Leaf Clover 068The month of March brings some interesting coincidences for many people with full-blown kidney disease or kidneys that are at risk. March is designated as National Kidney Month in the United States, or Kidney Health Month in Canada. March 10th is also World Kidney Day. And especially in North America, March 17th is celebrated as St. Patrick’s Day. The question is whether that celebration contradicts the message of the rest of the month, about kidney disease.

That depends how you celebrate the day. Although St. Patrick’s Day ostensibly honors the priest who brought Catholicism to Ireland, many people use it as an excuse to overindulge another activity unfairly associated with that country: the excessive drinking of alcohol. Such overindulgence is worrisome even for the health of people with undamaged kidneys. But for those who are already at some stage of kidney disease, excessive alcohol consumption can bring serious harm.

The symptoms of kidney disease often don’t show up until the kidneys are already compromised. So don’t assume that you have no kidney problems, just because you have no symptoms thus far. If you tend to over-drink, you’re already creating risks for kidney disease. For example, more than two drinks a day can raise the blood pressure, and the carbohydrate overload may lead to obesity and diabetes. All are well-known precursors to kidney problems. And the extra urination and interference with blood chemistry can make the kidneys unable to maintain the chemical balances they need.

With all this in mind, it’s undoubtedly best for a kidney patient not to over-drink on St. Patrick’s Day. But does that mean you can’t celebrate at all? You should decide what you really want out of this day. Do you regard it simply as an excuse to get drunk — or does it have other associations you could concentrate on?

Kidney patients already know that if they attend parties, or meet people at a pub or restaurant, they will retain certain dietary restrictions. Good friends and family should always be willing to accommodate a friend whose health is at risk. After all, it’s still possible to have a lot of fun wearing the green, going to a St. Patrick’s Day parade, and attending other activities. And following a kidney-healthy diet, you can still create special meals.

Despite some people’s belief, excessive drinking isn’t the only way to celebrate St. Patrick’s Day. Have fun with your friends on the day, but remember that no celebration should ever require you to risk your health or life.


Categories Kidney Disease, Risk Factors

Decrease in Diabetes-related Dialysis: Good News? Not so Fast.

The Centers for Disease Control and Prevention (CDC) has just released a report on the rates of End-Stage Renal Disease (ESRD) in persons diagnosed with diabetes. ESRD is the stage of kidney failure where the only possible treatment is either dialysis or a transplant, and according to this report, the rates of ESRD among diabetics wentdown thirty-five percent between 1996 and 2007. That’s good news — sort of. But unfortunately, there’s more to the story than that apparent decline.

The problem is that the number of people with ESRD actually went up over that period. In 1996, a total of 32,716 began ESRD treatments, while in 2007, that number had risen to 48,712. The only reason the total percentages were lower is that the number of patients diagnosed with diabetes skyrocketed even more over that decade. So while it’s a good thing that a lower percentage of diabetics are ending up with ESRD — at the moment, anyway — there are still more people with drastic kidney failure than there used to be.

This means that nobody should pat themselves on the back. Steps still need to be taken to reduce and ultimately prevent the incidence of diabetes, and there is still a clear connection between diabetes and kidney disease. The writers of the CDC report speculate that the lower percentage of diabetic ESRD sufferers may be due to better treatments for kidney problems, or some extra attention to risk factors.

But the CDC report points out that the primary risk factors still need considerable attention. The report writers provide a disturbing list:

In addition to diabetes and hypertension, risk factors for kidney disease include cardiovascular disease, obesity, elevated cholesterol, increasing age, and a family history of kidney disease.

While it’s good news that a slightly lower percentage of diabetics are ending up with ESRD, the underlying causes are still there, and still need urgent attention.

(Further Reading: Centers for Disease Control and PreventionMedPage Today;Bloomburg Businessweek – HealthDay)

Categories Kidney Disease, Kundan Kidney Care Centre, Risk Factors

What Teenagers with Kidney Diseases Should Know about Lipids

Being a teenager is not easy. Teenagers deal with peer pressure, an increasing need for more independence, changes in the body, relationship issues (with parents, teachers and friends), among others. Teenagers are more worried about what to wear in the school dance than they would be about lipids! However, teenagers with Chronic Kidney Diseases have a higher risk of developing lipid and heart problems and should be aware of them to remain healthy and continue with activities they enjoy. It is important for teenagers to know about lipids!

So what are lipids? They are simply the fats in the bloodstream of your body. The common type is called cholesterol which the body makes and comes from foods like meats, poultry (eggs and chicken), and dairy (milk, cheeses, ice cream). Fruits, vegetables and grains are cholesterol free. Teenagers should keep in mind that there are good and bad cholesterols.

There are three major types of lipids: Low Density Lipoprotein (LDL), High Density Lipoprotein (HDL) and the triglycerides. LDL is considered the bad cholesterol and is most likely to clog blood vessels and prevent the smooth blood flow in the system. HDL, on the other hand, is the good type of cholesterol which transports cholesterol away from the heart and blood and then back to the liver. From there, the cholesterol breaks down and sent to different parts of the body. Meanwhile, triglycerides are the stored fat in the body. High triglycerides do not clog blood vessels but may lead to diabetes or high blood sugar and can cause pancreas disorder.

LDL builds up in the blood results to the formation of plaque (fatty deposits) in the walls of the arteries. Plaque makes the arteries thicker, harder and narrower which decreases blood flow. Hardening of arteries in the heart leads to a heart attack or stroke.

People should always maintain a healthy level of cholesterol to prevent hardening of the arteries, high blood sugar or disorder of the pancreas. For teenagers the healthy levels of lipids are the following: total cholesterol is less than 200, LDL is less than 130, HDL is above 40, triglycerides are less than 150.  Doctors measure blood lipids through tests.  Haemodialysis patients are advised to have the lipid tests before dialysis while peritoneal dialysis patients are advised to
have the test in the morning. Another way to checks for healthy lipids is through the non-HDL test where the doctor subtracts the HDL from the total cholesterol. Lipids should be checked yearly or about 2 -3 months after a change in treatment.

Unhealthy lipids are caused by obesity, history of cholesterol problems or heart disease, diet high in saturated fats and cholesterol, not having enough exercise and excessive alcohol. To improve unhealthy levels just do the opposite of everything that’s causing it! Lose excess weight, follow a low-fat and low cholesterol diet, exercise regularly and minimize alcohol intake.

Teenagers will find it helpful to discuss what they have learned about lipids with their parents, and keep the communication line open especially with CKD issues. It is never easy living with a disease, and it complicates matters when hormones are changing. But awareness is key to remain healthy and continue with activities you enjoy as a teenager.*

Categories Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Detecting Kidney Disease – Stage Five

Tacky Lab Equipment
Get those tests done — early!

Why is it so important to detect kidney disease in its early stages, even if it’s rather hard to diagnose? Because when you reach Stage 4, you are likely past the point of living without serious medical intervention or even a transplant. And by the time you arrive at Stage 5, you have virtually no other option. There is nothing else to do but plan for a transplant.

In Stage 5, the kidneys have only about 15% of function left – or less. At this point, if left on their own, they would be completely unable to keep the patient alive. Dialysis now becomes very important to filter the blood of impurities the kidneys can’t remove.

Most symptoms are the same as for Stage 4 or earlier, but multiplied considerably. The person experiences the same tendency to hypertension (high blood pressure) because of the inability to expel fluids. And because the heart is working that much harder as a result, the person may suffer pericarditis, which is an inflammation of the lining around that organ. There would now be very high levels of creatinine and urea, which the kidneys can’t filter out. And susceptibility to infections would also increase.

The inability to absorb calcium or for the kidneys to produce the chemical that stimulates production of red blood cells worsens. And therefore the reduction in bone density and the tendency toward anemia would continue to be a problem. Added to these symptoms would come others that might seem comparatively “minor,” but which could be aggravating. These include difficulty sleeping, shortness of breath, increased itching, or frequent vomiting.

Certain treatments can attempt to bring down blood pressure or reduce anemia, while dietary adjustments may allow more absorption of calcium. But now with such reduced filtering capacity, dialysis is usually the only way to cleanse the bloodstream of impurities. Some patients can survive for a long time with dialysis treatments, though the most common form of dialysis takes several hours, three days a week, and therefore restricts their lifestyle. But for others, dialysis may lose its effectiveness relatively quickly. And the best hope in both cases is for a kidney transplant.

There are usually signs of kidney disease well before things reach Stage 5. To maintain good health and never allow themselves to arrive at this stage, the wisest course for everyone is to have yearly, thorough checkups with detailed blood work, and to investigate even the most nebulous symptoms that might indicate kidney disease.


Categories Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Detecting Kidney Disease – Stage Four

In previous entries, we’ve examined symptoms and effects of Stages One and Two of kidney disease, and then Stage Three, where things finally become noticeable and serious. In Stage Four of kidney disease, the symptoms start to be debilitating, and kidney function is severely impaired. In fact, at this stage, there is only 15-29% kidney function. The body may have disguised its condition for quite a while, but now the disease becomes drastically apparent.

The symptoms magnify things that had begun appearing in Stage Three: fatigue increases considerably, the appetite keeps declining, and an earlier phenomenon of itching might become much worse. High blood pressure continues to be problematic, because of course the kidneys have lost much of their capacity to excrete unneeded fluid, so it is retained in the body, making the heart and blood vessels work harder. And the kidneys may have trouble producing erythopoietin, which stimulates blood cell production, so anemia is another problem.

At Stage Four, a cascade of effects may produce other effects, all of which contribute to an increasing weakness and a worsening of symptoms. As the kidneys become less able to filter phosphate, the levels of that electrolyte increase. In turn, this makes it more difficult for the body to absorb calcium. And since it’s the proper interaction of phosphorous and calcium that strengthens bones, bone density itself may gradually decrease. This may produce aching in the bones, but it also leaves the person more prone to fractures, which take longer than usual to heal.

Treatments at this stage are many. Blood pressure is often treated with diuretics, though some of these can play havoc with potassium levels. Anemia can usually be successfully counteracted with drugs resembling erythopoietin. Medications may prevent bone disease, and much of the phosphorous/calcium imbalance can be reduced with diet.

But these are generally stop-gap measures. This is the stage where the patient begins heading in the direction of dialysis, and starts receiving consideration for a possible transplant. While the effects of Stage Four can be mitigated to some extent, the fact remains that the kidneys are so seriously diseased that the body can’t go on forever like this.

Again, it is extremely important to take good, thorough stock of one’s complete health every few months. The symptoms of kidney disease are easy to miss, in the stages when a person might do something about it.


Categories Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Detecting Kidney Disease – Stage Three

Blood pressure measurement
High blood pressure and kidney disease make each other worse
We’ve discussed Stages One and Two of kidney disease, and what to look for, to get one’s condition diagnosed as quickly as possible. But as many people learn to their distress, the first two stages of this disease are not easily detected unless one looks and watches very carefully. The first clearly noticeable symptoms finally reveal themselves as the disease reaches Stage Three, when already the person has less than 60% kidney function remaining, and may have as little as 30%. Yet even then, the symptoms can often be mistaken for something else.


People can go on for a long time with such reduced kidney function, because some of the initial symptoms — tiredness and changes of appetite —  are so vague that they could be caused by many other things. But when they are combined with other symptoms like itching, water retention, and anemia, this is when the pieces slowly fall into place. As the kidneys become less able to filter fluids and remove them from the body, more fluids are retained, and the person may experience swelling and puffiness. Even their urine may become more clear, because fewer impurities are being excreted.
Naturally this contributes to higher blood pressure. But the blood itself becomes more anemic, because it’s when the kidney releases the hormone erythropoietin (EPO) that red blood cells can be created. When the kidney can’t release as much EPO as it’s supposed to, the blood cell count goes lower and the patient becomes more anemic. In turn, the blood carries less oxygen and the body has to work harder in order to function. As a result, the person experiences greater and greater fatigue.

At this stage, the patient absolutely must take steps to reduce sodium in the diet and bring the blood pressure down. The higher the pressure, the more damage to vein walls, and the more damage to veins in the kidneys, the worse kidney function becomes. Adjustments must also be made to other elements of diet: protein will need to be reduced, though the patient can’t live completely without it. Patients may also need to take a phosphorus binder and vitamins that help boost kidney function. Working on these things with a knowledgeable dietitian is essential.

Even if earlier stages have been missed and the person has advanced well into Stage Three, it’s vital to get diagnosed as early as possible, to preserve what kidney function is left and prevent the disease from progressing any further.


Categories Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Detecting Kidney Disease – Stages One and Two

SEM blood cells
Checking the blood content levels to detect kidney disease
Chronic Kidney Disease appears in five stages, ranging from an early stage with little obvious effect to a final stage where the patient is on life-saving dialysis or awaiting a transplant. Each stage has certain characteristics and means of detection. The more that people know the various signs and effects of being in each stage, the sooner they may get a proper diagnosis from their doctor. Early detection is the best key to effective treatment.

Stage One leaves the patient with 90% kidney function. The person can survive at this level, but it’s still necessary to detect the problem so causes and treatments can be addressed. If they don’t take steps at this point, the disease is very likely to progress to the next level. Stage Two leaves only 60-89% kidney function, as the damage to these organs has increased.

The difficulty is that there are no obvious symptoms of kidney dysfunction at either stage. This may lead to a lack of detection at a crucial time when the disease could have been nipped in the bud, or curtailed before it got much worse. So it’s essential that the person have their regular yearly physical checkups, including urine tests and extensive blood work. Even with no other physical symptoms, these tests can detect:

  1. elevated creatinine levels (which indicate how well the kidneys are filtering out wastes)
  2. elevated protein levels (another indication of inefficiency in filtering wastes)
  3. elevated blood urea nitrogen levels (kidneys take urea from the blood and expel it in the urine, but if the blood levels are high, this is another hint of failing kidneys)

In addition to the potential for early detection with blood and urine tests, high blood pressure is a well known hint of problems with kidney function. The most often mentioned symptom is high blood pressure, which can either cause kidney disease, or be caused by it. So if a person’s blood pressure rises, this can be a spur to doing the urine and blood tests, either to detect kidney disease or rule it out. And all steps (medication, exercise, alterations in diet) must be taken to bring the blood pressure down.

If blood and urine tests indicate a possible problem, doctors can go further and take a kidney biopsy, do a CT scan, or perform an MRI. So even at these early stages, while it’s more difficult, it’s still possible to detect incipient kidney disease. What it takes is vigilance, and thorough, regular checkups.


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