Chronic Kidney Disease: By the Numbers

February 28, 2015

According to the Centers for Disease Control and Prevention (CDC), more than 20 million Americans have chronic kidney disease (CKD) at varying levels of severity. More pinpointed,The National Kidney Foundation puts the number at 26 million. While the numbers seem to paint a gloom and doom picture, early and comprehensive renal disease treatment by a kidney doctor, can delay its progression.

Who Is at Higher Risk for Chronic Kidney Disease?

African Amercians have a three times higher likelihood of experiencing CKD than other races. However, hispanics, American indians, Asians, and Pacific islanders are also at increased risk.

The risk of developing chronic renal disease increases with age, particularly after the age of 50, which makes seniors a target for the condition. It is most commonly seen in individuals over the age of 70.

Other risk factors for CKD include have high blood pressure (hypertension) and diabetes. Specifically, about one third of adults who have diabetes have disease of the kidney, and about 20 percent of adults with high blood pressure have it, according to the CDC.

Being obese and/or having lupus, high cholesterol levels, cardiovascular disease also are increased risk factors for CKD, as is having a family history of diseases of the kidney.

Lastly, men who have CKD have a 50 percent increased likelihood of having kidney failure than their women counterparts.

Symptoms of Chronic Kidney Disease

In the early stages of CKD, many people have no symptoms. However, as the disease progresses, the following may be present:

  • puffiness around the eyes, particularly in the morning
  • swollen ankles and feet
  • itchy, dry skin
  • frequent urination, especially at night
  • muscle cramps, particularly at night
  • difficulty sleeping
  • poor appetite
  • lessened energy and feeling fatigued

Prevention and Treatment of CKD

Individuals who are at high risk for CKD should be screened for the disease. For those that have been diagnosed with the disease, seeing a nephrologist (kidney doctor) regularly can not only improve kidney function and replace lost kidney function, but also potentially delay kidney failure.

Treatment for renal disease varies depending on the cause and severity. In some individuals, medications to reduce high blood pressure and high cholesterol, in addition to medications to relieve swelling, combat anemia, and protect the bones can help control the disease. Eating a low protein diet can also help the lessen the workload of the kidneys in removing waste products.

If your kidneys are unable to remove the body’s waste products and fluid, treatment for kidney failure or end-stage renal disease involves dialysis or a kidney transplant.

If you or a loved one are showing symptoms of kidney disease or have risk factors for developing it, contact Dr. Allan Lauer at Associates in Nephrology.

Options for the Treatment of Kidney Failure

February 14, 2015

Your kidneys play an essential role in your body. They filter your blood and remove waste products so they can be excreted as urine. If your kidneys are not working right, you may have a build-up of waste in your body that can make you very sick.

Chronic kidney failure can be a long, gradual process. By the time your kidney doctor diagnoses you with kidney disease and you find out your kidneys are not working properly, you may already need dialysis or other treatment. The following options for the treatment of kidney failure can help keep you from being too sick if you have kidney disease.

Early Treatment Options: Lifestyle Modifications

Kidney disease cannot be cured, but proper treatment for kidney failure can help slow its progression if your kidney doctor finds it early enough. When you first find out about your kidney disease, take a look at your lifestyle. Improve your diet, if possible, by eating more fruits and vegetables, and less sodium. Losing weight may also help.

As your kidneys get closer to failure, you may need to change your diet again. Some patients need to cut back on potassium. You may also consider cutting back on animal protein because its metabolic products can build up in the blood.

Dialysis: Using Alternates for Filtration

If your kidney disease progresses to a point where your kidneys can no longer filter your blood on their own, your kidney doctor may suggest hemodialysis. In this procedure, your blood is filtered by a machine instead of by your kidneys. Most patients get hemodialysis done at a kidney center, although some do daily home dialysis or nocturnal home dialysis.

If you go to a center, your dialysis will probably be three times a week, such as Monday, Wednesday, and Friday, or Tuesday, Thursday, and Saturday. Some patients get overnight dialysis to leave more time during the day for other activities, such as work and spending time with family. Each session takes a few hours.

To prepare for dialysis, the kidney doctor makes a fistula to create access to your bloodstream. An artery is connected to a vein. During treatment, the nurse opens the bloodstread so blood is drawn from your body, filtered through the dialysis machine, and replaced, clean, back into your body.

Peritoneal dialysis is another option for treatment for kidney failure. It uses your stomach lining instead of your kidneys to filter your blood. It can be one of the following types.

  • Continuous Ambulatory Peritoneal Dialysis (CAPD) during the day.
  • Continuous Cycler-assisted Peritoneal Dialysis (CCPD) at night.
  • Combination of CAPD and CCPD to get more dialysis done.

Kidney Transplantation

The ideal end for treatment of kidney failure comes with kidney transplantation. You will be placed on a donor list. If a kidney donor comes up with a blood type, human leukocyte antigens, and cross-matching antigens that are compatible with yours, and you are at the top of the list, you can receive a new kidney.

How to Choose a Kidney Center

February 8, 2015

Choosing a kidney center is a big decision. It is there that you will be receiving treatment that can keep you from being seriously ill. Because it is such an important place and you will be spending so much time there, you want to find a kidney doctor and center you like. These are some tips to help you do so.

Find a kidney doctor you respect and like.

First, look at the kidney doctor’s credentials. Beyond being a medical doctor, your kidney doctor should have specialized training, such as a residency or fellowship, in nephrology or kidney disease. Membership to prestigious organizations such as the American Society of Nephrology is also a good sign.

Credentials only go so far. You need to be able to feel comfortable talking to the kidney doctor, asking about options for treatment for kidney failure, and following instructions for treating kidney disease. Follow your intuition when it comes to evaluating the doctor’s personality and whether he or she is a good match for you.

Check out the atmosphere.

Chances are, you’re going to be spending a lot of time at the kidney center. If you are going in for hemodialysis treatment, you may be visiting three times a week, for several hours at a time or overnight. Even if you are opting for at-home hemodialysis or peritoneal dialysis, you will likely be making several trips a month to the kidney center to monitor your kidney disease.

As you evaluate the environment, think about whether it is friendly and is clean-looking. Do you feel comfortable there? Also consider convenience. Is it too far from your home, or is it easy to get to? You’ll need to drive there often.

Find out about nutritional support.

Proper diet at this time really helps. Keeping your sodium low limits the buildup of fluid and waste in your blood, making dialysis easier. Good nutrition is also important during this time to keep you strong and prevent too much weight loss. A dietitian should be available to talk about foods and meal planning.

To make matters worse, your nutritional requirements and dietary recommendations may change during the course of treatment for kidney failure. Your potassium may be limited, for example. You need to have ready access to nutritional counseling

Talk to other patients about their nurses.

The nurses at the kidney center can make a big impact on your life. They are the ones who provide your treatment. They may be gaining access to your bloodstream on a regular basis, and skillful, gentle hands can make the process more comfortable. Friendliness while you are spending hours on dialysis can also help. Ask other patients about their impressions of the nurses at the center.

FAQs on Dialysis Treatment

January 14, 2015

Your kidneys filter waste from your blood and let it be excreted as urine. You may begin to develop chronic kidney disease over a period of years if your blood pressure is too high or you have other risk factors. If your kidney doctor tells you you need dialysis, you may have a lot of questions. These are some frequently asked questions that can help you understand the dialysis treatment for kidney failure and what to expect.

Why didn’t I realize I needed dialysis before?

Chronic kidney disease takes a long time to develop, but you may not realize you have it until it is far progressed. One reason is that you do not need full kidney function to be able to eliminate waste from your bloodstream. By the time you have symptoms and your kidney doctor diagnoses you with kidney disease, your kidney function may only be about 20 percent what it used to be.

Why do I need dialysis?

You need dialysis if your kidneys are not filtering enough waste from your blood. If they are not working properly, waste can build up in your body and become toxic. Dialysis machines or other alternatives take the place of your kidneys when you go in for treatment for kidney failure. Otherwise, you can get dangerous buildup of fluids or toxins in your body.

What are my options for dialysis?

Hemodialysis is an option that uses a machine instead of your kidneys to filter your blood. This is most common at a kidney center, likely three days a week or overnight. Peritoneal dialysis uses the lining of your abdominal cavity as the filter. You can do this at home, likely every day or night, or both.

How will my lifestyle change with dialysis?

You will need to set aside several hours, multiple times a week, for dialysis. This is for the treatment as well as for traveling to the kidney center, having appointments with the kidney doctor. You may also need to change your diet. A low-sodium diet is common. Your doctor may also have you restrict potassium and protein to reduce waste and fluid build-up in your blood.

Does my health insurance cover dialysis?

Dialysis is very expensive however the cost of dialysis is typically covered by health insurance.  Medicare, Medicaid, and/or private insurance will cover the cost of the dialysis treatments. 

The Basics of Kidney Health and Nephrology

January 8, 2015

Your kidneys perform the essential function of filtering waste from your blood. This wastes is the natural byproduct of metabolism, but it is toxic if it builds up in your blood. The kidneys allow it to be excreted from your body as urine. When your kidneys are not working right, you may need to see a nephrologist, or kidney doctor.

The word “nephrology” come from the Greek words meaning “study of kidneys.” Nephrology is the branch of medicine dealing with the kidneys. The field includes how to keep kidneys healthy, as well as treatment of kidney failure, kidney disease and related conditions. This is what you should know about nephrology.

Nephrologists are medical specialists. Nephrologists are kidney doctors. They have their medical degrees from medical schools, and then undergo specialized training in nephrology in situations such as residencies and fellowships at clinics and hospitals. Nephrologists may belong to professional organizations such as the American Board of Internal Medicine with a specialty in nephrology.

A nephrologist treats diseases related to the kidneys. These can include chronic and acute renal failure, kidney stones, blood or protein in the urine, high blood pressure, and electrolyte imbalances.

Common chronic conditions can lead to kidney disease.

Chronic kidney disease develops over the course of several years, and it often occurs with other diseases or conditions. For example, hypertension, or high blood pressure, puts a lot of stress on the kidneys. Over time, uncontrolled hypertension can lead to kidney disease.

Diabetes mellitus or high blood sugar can cause kidney disease.  Elevated blood sugar over many years can cause scarring of the kidneys and ultimately kidney failure.

A healthy lifestyle can help keep your kidneys healthy.

Kidney disease is often the result of a poor lifestyle, and it can sometimes be prevented. Eating healthy is one way to lower your risk. Limit sodium intake from foods such as salt, salty condiments, soups, processed foods, and pickles. Maintain a high potassium intake from foods such as fruits, vegetables, beans, and fish. You can also help your kidneys by keeping your weight within a normal range or losing a few pounds if you are overweight or obese.

Nephrology aims to slow and treat kidney disease.

Chronic kidney disease is progressive, but you can slow it down with a healthy diet and lifestyle. If you experience kidney failure, you may need dialysis. A kidney doctor can recommend hemodialysis, which uses machines to filter your blood, or peritoneal dialysis, which uses your stomach’s lining to filter it.

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