Tag Archives: ckd

Categories Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Iron and CKD

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.

Categories Kidney Disease

Taking Your Blood Pressure Meds Can Improve Kidney Disease Outcomes

You’d think it would be completely straightforward. Since one of the things that sometimes results from kidney disease is higher blood pressure, a kidney disease sufferer with hypertension problems would naturally take their medication. But a recent report has suggested that one-third of these patients actually don’t maintain their blood pressure treatments.

Researchers from the University of Cincinnati and the Cincinnati Veterans Affairs (VA) Medical Center have just published a report that describes this problem. They took two years’ worth of data from 7,227 patients at the VA who had chronic kidney disease (CKD), and who also suffered from hypertension. And this was when they uncovered the astonishing fact that about thirty-three percent of these patients either didn’t take their blood pressure medications, or had what was described as “poor medication adherence.”

The consequence appears to be a twenty-three percent higher likelihood of a worse outcome for those CKD patients themselves, when it comes to the progression of the disease. Doctor Charuhas Thakar, associate professor at the university and chief of the renal division at the VA, points out that high blood pressure is “probably the most important modifiable risk factor in chronic kidney disease.” This means that if patients are able to regulate their blood pressure and reduce the strain on the kidneys, they can do much better at improving their kidney health and, incidentally, lowering medical costs.

The report has just been published in the November 2nd online edition of the American Journal of Nephrology. Doctor Thakar points out that the results of this analysis need further confirmation, since all of this data came only from one place. But certainly this news suggests that people with CKD should not neglect their blood pressure medication if they suffer from hypertension.

(Further reading: UC Academic Health Center News Release, November 3, 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

More Detailed Blood Test may one day predict Kidney Disease

An American medical study spanning several generations may have inadvertently discovered significant blood markers that will one day help predict whether a person will experience Chronic Kidney Disease (CKD). The Framington Heart Study has been conducted since 1948 by the National Heart, Lung, and Blood Institute in Framington, Massachusetts. And some unexpected results that relate to CKD were published in theJournal of the American Society of Nephrology on October 21, 2010.

A new blood test for kidney disease?

The main test currently used to detect CKD is a test for creatinine in the blood. Unfortunately, though, creatinine only noticeably accumulates after the kidneys have already lost much of their function. If the new study’s results can be reproduced and further validated, they will provide ways of detecting CKD much earlier, meaning treatment can also begin earlier, thereby possibly saving the kidneys and preventing further damage.

The 2,300 study participants gave blood samples between 1995 and 1998, with normal kidney function. The odd thing was that since the study was mainly concerned with the heart, the focus was not at first on kidney disease at all. Yet when 9.5 percent of participants had developed CKD within a decade, with another eight percent having reduced kidney function, researchers examined six blood markers from the original samples to check for correlations. Two of these – homocysteine, which builds proteins, and aldosterone, dealing with how kidneys handle salt, had elevated levels, as did B-type natriuretic peptide, which also can indicate heart damage.

This doesn’t mean doctors can now simply test for these markers and immediately predict CKD. For one thing, the study must be replicated, widening beyond the largely European-descended group originally tested. But if these results hold true in future clinical studies, they may provide a way both of testing early for CKD, and taking steps to prevent and treat it.

(Further reading: Times of India, October 22, 2010; Medscape Today, October 21, 2010; My Health News Daily, October 21, 2010)

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