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

Dealing With Anemia From Kidney Disease

India - Haridwar - 010 - vegetables for sale in Bara Bazaar
Ask your doctor if diet can increase your iron levels

If you think the kidneys have little to do with the composition of your blood, think again. There are reasons why anemia (a lack of sufficient red blood cells) is a problem that plagues kidney disease patients. It isn’t just that kidneys filter wastes from the blood and flush them from the body. The fact is that the kidneys themselves are partly responsible for the blood’s very composition.

Kidneys play an active role in maintaining the body, and one way is to produce a hormone called erythropoietin, or EPO. This hormone signals your body to create more red blood cells. But of course, when the kidneys become compromised, they are less able to make the hormone. And virtually inevitably, those with kidney disease will develop anemia as a result.

How severe the anemia will be, and how early it becomes noticeable, depends on several other factors:

  • whether the person is female;
  • whether the person is of African descent;
  • whether they have diabetes;
  • which of the five stages of kidney disease they are currently in.

As soon as someone shows slight signs of kidney problems, it’s a good idea to have blood tests as well, to find out if there’s already an issue with anemia. In fact, regular blood tests are a good idea anyway, because sometimes anemia is someone’s first sign that they even have kidney disease in the first place. But whether the kidney problems were diagnosed first, or the anemia, this problem can’t just be left untreated. A lower supply of red blood cells makes the heart work harder, and this can lead to heart disease. And that’s the last thing someone needs when they’re already dealing with kidney disease.

Treatment for anemia needs to happen in conjunction with treatments for the kidney disease. Usually the doctor will prescribe drugs called erythropoiesis-stimulating agents, or ESAs. These injections made under the skin help the body create more red blood cells. And since iron is also needed for making the cells, the patient will need iron pills, and might also want to eat more iron-rich foods.

Nobody should have to fight through the lethargy and weakness of anemia while engaged in a primary fight against kidney disease. And nobody should add heart disease to that battle either, by ignoring the anemia. These three conditions are closely intertwined, so if the anemia can be dealt with, it can only help both the heart and the kidneys as well.

 

Categories Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Fathers and Their Children With Kidney Disease

Father’s Day isn’t just a time when  fathers are acknowledged and appreciated for their paternal roles. As a dad, you can use this special day not just to evaluate your accomplishments but to reflect on your responsibilities. And if your child has been diagnosed with kidney disease, you know you’ll have a few more of those than some other fathers might. But it’s part of being a dad, to help your son or daughter face the disease as well as possible.

One thing you’ll learn quickly is that most things go better when you treat your child with respect, and let them understand and participate in their own care as much as you can. Give them matter-of-fact explanations about the disease, the instruments used in the hospital and doctor’s office, and about what the treatments actually do. This helps remove fear of the unknown. They may still not like the discomforts of the treatments, but their fear will be considerably diminished.

You should naturally learn as much as possible about your child’s disease and condition, and participate in the care as knowledgeably as you can. But there are ways to allow the child to participate too. For example, encourage them to ask any questions that occur to them, and answer clearly, with as much information as they can handle and understand. Give them a chance to ask the doctor about foods they can and can’t eat, or about the best ways to take their medicine. The more in control they feel, the more able they’ll be to deal head-on with their illness and treatments.

Developing a regular routine and sticking to it as much as possible is another way you can help your child deal with kidney disease and its treatments. Even unpleasant moments, like taking medicine, can seem less fearsome if the child knows it will happen at this time of day, matter-of-factly, and then they’ll move on.

You yourself will need to project confidence, so your child has a rock to stand on. If you are constantly worried or project fear, the child will sense it, and their own fear will be magnified. That’s probably your biggest responsibility: to let your son or daughter sense that they can feel safe even when dealing with illness. If you can help your child face kidney disease directly and confidently, you won’t merely deserve one special day of acknowledgement a year, as a father. You’ll deserve a medal of honor.

 

Categories Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Retina Problems and Chronic Kidney Disease

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.)

Categories Kidney Diet, Kidney Disease, Kundan Kidney Care Centre

Potassium and Sodium, Another Key Electrolyte Pair

salt shaker
Sodium is everywhere!

Potassium and Sodium form another electrolyte pair that relate to each other and face connected problems when affected by kidney disease. First of all, these two chemicals form a specific balance of fluids inside and outside of the cells of the body. Potassium is highly concentrated inside cells, while sodium is more highly concentrated outside.

While sodium regulates fluid levels throughout the body itself, the sodium-potassium inside-outside chemical balance of the cells is very important. This balance creates an electrically charged potential at the cell membrane. And it’s this electrical potential that is crucial to such things as heart function, muscle contraction, and the transmission of nerve impulses. If these chemicals are thrown out of balance, it’s clear that people could suffer anything from heart problems to weak muscles or even nerve problems.

The kidneys serve a vital function in keeping these electrolytes balanced, excreting excess amounts so the body stays regulated. But what happens if there is more of a particular chemical in the body than the kidney can possibly eliminate? We see this question coming more and more to the forefront as the North American diet, in particular, is increasingly swamped with sodium. Excess sodium can lead to fluid retention, high blood pressure, and kidneys that become so overworked that they start to falter or even fail.

At the same time, if the kidneys aren’t able to function at full strength, and can no longer eliminate potassium in the way they are supposed to, people can begin to experience a condition known as hyperkalemia. This promotes further buildup of fluid in the body, but its worst effects have to do with the heart. It may result in a weak or irregular heartbeat, and a difficulty controlling the muscles. At its worst, it can lead to problems with breathing, weakness, or cardiac arrest. But like so many conditions related to kidney function, it often shows no symptoms at all until the kidneys are already severely compromised.

Doctors need to be careful in trying to rebalance sodium and potassium. When patients receive diuretics that promote urination, to remove excess sodium, they sometimes experience depleted potassium, which creates further nerve, heart, and muscle problems. Yet a lack of balance can damage the kidneys – and damaged kidneys can throw the balance even further out. It’s far better to eat a healthy diet and promote kidney health to begin with, than scramble to try to fix these electrolyte imbalances after they arise.

 

Categories Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Calcium, Phosphorus, and the Kidneys

Skeletons in Buffalo Museum of Science - IMG 3795
Calcium & Phosphorus together help build the bones
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.

 

Categories Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Introduction to Electrolytes: Part 1

Cell electrolytes
Electrolytes passing through cells (click to enlarge)
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.

Categories Kidney Disease, Kundan Kidney Care Centre

Raising Kidney Patient Hemoglobin Levels Can be Risky

It’s well-known that Chronic Kidney Disease (CKD) reduces the ability of the kidneys to help make red blood cells. As a result, people with diseased kidneys can often become anemic. And since red blood cells carry oxygen through the body, this may then lead to oxygen starvation, causing all sorts of symptoms from shortness of breath to cardiovascular problems.

For this reason, doctors have always been encouraged to use stimulating agents to help raise the hemoglobin levels of kidney patients. But the latest guideline offered by Great Britain’s National Institute for Health and Clinical Excellence (NICE) adds a cautionary note about the levels of hemoglobin doctors should aim for. The reason, they say, is that in this case, there can actually be too much of a good thing.

Anemic kidney patients obviously receive considerable benefit from having their hemoglobin levels brought back up. But according to NICE researchers, there is a specified upper limit above which these levels should not go. If hemoglobin rises above them, rather than experiencing even greater health benefits, these patients could face certain new risks. Such risks might include strokes or blood clots.

The new guidelines released by NICE on February 9, 2011, address many issues about managing anemia in kidney patients. For example, doctors need to take into account how active the patients might be in their daily work. They might also accept slightly higher than recommended levels of hemoglobin if no other factors suggest a risk of cardiovascular problems.

But on the whole, the NICE guidelines recommend that physicians stay pretty much within the suggested upper and lower hemoglobin levels. Doctors need to take  into account the conditions their patients have already developed and risks they know already exist; Keeping these in mind, they must then should monitor their hemoglobin treatments to ensure new health risks are not introduced into the lives of the patients.

(National Institute for Health and Clinical Excellence, on the new Guidelines, February 9, 2011)

Categories Kidney Disease, Kundan Kidney Care Centre, Risk Factors

Mammograms and Kidney Disease Detection

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.

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.

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)

Categories Kidney Disease, Kundan Kidney Care Centre

Tips for Getting That Recommended Exercise

So you are a kidney patient and your doctor advises you to get some exercise, to keep as fit as possible and help your condition as much as you can. You’re planning on bike rides, three or four times a week. Naturally you know that you can’t overdo it, but what sorts of things should you keep in mind as you get started?

If you are on dialysis, you may work at a lower level than otherwise, but there is still much you can do. All kidney patients should begin with gradual stretching to warm up. Dialysis in particular can create possible thigh problems, so ease slowly into your exercise session. After you’ve increased your pace for a while, slow down again and ease out of the session just as carefully.
Exercise every other day, three times a week, in the morning if possible, though evening will also do. The main thing is to avoid the hottest part of the day. Be sure not to exercise just before bedtime, or you might not sleep that well. Give yourself at least an hour to wind down afterwards. And if you don’t feel completely normal an hour after exercising — whenever you do it — then you’re working yourself too hard.

Those in the know suggest that if you are exercising so hard that you’re unable to talk with someone while you do it, you’re overdoing things. Always monitor your own condition during the exercising, and after it’s over. Walking, swimming, and cycling are good exercises, and you can even lift weights, if you start small and slowly work up to higher levels.

Having kidney disease does not mean you must stop everything. In fact, that will only lessen your body’s strength and make it less able to cope with the disease. If you exercise in a way that doesn’t push too hard, your general health will only benefit.

Categories Kidney Disease, Kundan Kidney Care Centre, Risk Factors

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

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)