Nephrology and Your Health: What’s the Link?

March 16, 2015

You may not hear much about nephrology, but it is an important branch of medicine that may save your life. Nephrologists, or kidney doctors, help promote kidney health and slow progression of chronic kidney disease, or CKD. To prevent kidney problems or stop yours from getting worse, you might want to learn a bit about nephrology.

GFR: Basic Measure of Kidney Function

When discussing kidney health and function, one measurement keeps coming to the surface. The glomerular filtration rate is an indicator of how well your kidneys are filtering blood. It is based on the amount of a metabolic product called creatinine in your blood, and it can be calculated with a blood test of creatinine and your body weight. Your GFR decreases as chronic kidney disease, or GFR, progresses.

The maximum GFR is 100, and you will not have symptoms of kidney disease if it is over 90. A GFR between 60 and 89 is Stage 2 CKD, while GFR 30 to 59 is Stage 3. At this point you may have symptoms. Your doctor will watch for nutritional deficiencies and ask you to make decisions about your future care if you reach Stage 4, or GFR 15 to 29. Once it dips below 15, your GFR shows you have renal failure and need dialysis, a kidney transplant, or palliative care.

Nephrology and Hypertension: Key Relationship

You may think about stroke as the main consequence for high blood pressure or hypertension, but kidney failure is another risk. If you have high blood pressure, your kidneys are under more stress because they are filtering greater volumes of blood. Over time, the strain can damage the kidneys and lower your GFR.

Take high blood pressure seriously. Monitor it if you have pre-hypertension, and follow your doctor’s recommendations for lowering it if it is high. Between diet, exercise, medications, and stress-reduction techniques, you may be able to control your blood pressure and protect your kidneys.

Dialysis when Kidneys Fail

The main treatment for kidney failure is dialysis, which uses a filter instead of your kidneys to filter your blood. Hemodialysis uses an external filtration machine that takes your blood, filters it, and returns it to your body. In peritoneal dialysis, filtration takes place in your abdominal cavity through a membrane.

Lifestyle for Healthier Kidney

The goal when discussing any medical field is to prevent the need for medical treatment in it. Your lifestyle can greatly affect your kidney health. Throughout your lifetime, think about maintaining a healthy weight, staying active, and eating right to prevent kidney troubles.

If you develop high blood pressure or diabetes, get these conditions under control with a healthy lifestyle and/or by using the medications your doctor prescribes. If you have CKD that progresses to renal failure, your kidney doctor will likely have you restrict certain foods, such as high-protein, high-sodium, or high-potassium choices.

Treatment Options for Kidney Failure

March 7, 2015

Kidney Failure

Kidney failure means you need to sit down with your doctor and discuss treatment options. Without functioning kidneys, toxins build in your system and the excess fluid pushes your blood pressure up. Treatments replace what you lose when your kidneys fail to work properly. The staff at dialysis clinics help you find the best treatment option based on your health and medical needs.

What is Hemodialysis?

Hemodialysis is blood filtering that removes toxins from your body. That is the short answer. The hemodialysis process is actually much more complex. During this procedure, blood passes through a machine with a special filter called a dialyzer, explains the National Kidney and Urologic Diseases Information Clearinghouse. The filter sits in a canister next to the hemodialysis machine – the device used to remove and replace your blood.

How often you need dialysis depends on a number of factors. Some people require daily dialysis while others get it three times a week. Some individuals need hemodialysis only a few times to remove a specific toxin, a complication of a drug overdose, for example.

What is Peritoneal Dialysis?

Hemodialysis is done via a vein, while peritoneal dialysis is processed in the abdomen. The kidney doctor inserts a catheter directly into the belly to deliver a solution. After a few hours, the solution drains out through a tube taking waste products with it. This is a process done over and over to keep the blood free of toxins.

There are three types of peritoneal dialysis. One requires a machine to cycle the fluid in and out of the stomach, usually overnight while the patient sleeps. Ambulatory dialysis allows you to stay mobile during the procedure, stopping only to fill and drain the bags.

Transplantation

Dialysis is not a cure for kidney failure. Over time, the body will develop complications and a kidney transplant is the next stage of the process. During transplant surgery, a new kidney replaces the two that are not longer working effectively. The surgeon may or may not remove your natural kidneys. If they are not causing any medical problem, they may opt to leave them in place and add the transplanted organ under them.

Transplantation is the only option for many kidney patients, but it comes with risks. Prior to the surgery, the doctor will sit down with you and discuss the possibility of rejection and what you can do to reduce the risk.

Kidneys are essential organs, meaning you can’t live without them. If yours fail, there are treatment options that can extend your life long enough for a transplant or allow you to live with less than perfect kidneys.

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.

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