Tuesday, October 13, 2009

Health Care and Kidney Disease

More than 26 million Americans—one in nine adults—have kidney disease. Millions more are at increased risk for getting it, and most don’t know it. Kidney disease can be found and treated early to prevent more serious kidney disease and other complications. Chronic kidney disease includes conditions that damage your kidneys and decrease their ability to keep you healthy by doing the jobs listed, according to the National Kidney Foundation. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage. Also, kidney disease increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long period of time. Chronic kidney disease may be caused by diabetes, high blood pressure and other disorders. Early detection and treatment can often keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.

Chronic kidney disease is a growing health problem in the United States. A report by the Centers for Disease Control (CDC) determined that 16.8% of all adults above the age of 20 years have chronic kidney disease. Thus, according to eMedicineHealth.com, one in six individuals have kidney disease, and over 400,000 patients are on dialysis or have received kidney transplants. About 67,000 people die each year because of kidney failure. The prevalence of chronic kidney disease has increased by 16% from the previous decade. The increasing incidence of diabetes mellitus, hypertension (high blood pressure), obesity, and an aging population have led to this increase in kidney disease. Chronic kidney disease is more prevalent among individuals above 60 years of age (39.4%). Kidney disease is more common among Hispanic, African American, Asian or Pacific Islander, and Native American people. Much info is located on their website about kidney disease: http://www.emedicinehealth.com/chronic_kidney_disease/article_em.htm .

The kidneys, a pair of bean-shaped organs, are located at the bottom of the ribcage in the right and left sides of the back, according to LabTestsOnline.org. Although the body is equipped with two kidneys, you can function with one reasonably healthy kidney if the other is damaged or removed. The kidneys receive blood from the aorta, filter it, and send it back to the heart with the right balance of chemicals and fluid for use throughout the body. The urine created by the kidneys is moved out of the body via the urinary tract.

According to LifeOptions.org, many people who have chronic kidney disease don't know it, because the early signs can be very subtle. It can take many years to go from chronic kidney disease (CKD) to kidney failure. Some people with CKD live out their lives without ever reaching kidney failure. However, for people at any stage of kidney disease, knowledge is power. Knowing the symptoms of kidney disease can help you get the treatment you need to feel your best. If you or someone you know has one or more of the following symptoms of kidney disease, or you are worried about kidney problems, see a doctor for blood and urine tests. Remember, many of the symptoms can be due to reasons other than kidney disease. The only way to know the cause of your symptoms is to see your doctor. Note the following 10 symptoms:
1.) Symptom 1: Changes in Urination. Kidneys make urine, so when the kidneys are failing, the urine may change. How?
--You may have to get up at night to urinate.
--Urine may be foamy or bubbly. You may urinate more often, or in greater amounts than usual, with pale urine.
--You may urinate less often, or in smaller amounts than usual with dark colored urine.
--Your urine may contain blood.
--You may feel pressure or have difficulty urinating.
2.) Symptom 2: Swelling. Failing kidneys don't remove extra fluid, which builds up in your body causing swelling in the legs, ankles, feet, face, and/or hands.
3.) Symptom 3: Fatigue. Healthy kidneys make a hormone called erythropoietin (a-rith'-ro-po'-uh-tin) that tells your body to make oxygen-carrying red blood cells. As the kidneys fail, they make less erythropoietin. With fewer red blood cells to carry oxygen, your muscles and brain become tired very quickly. This condition is called anemia, and it can be treated.
4.) Symptom 4: Skin Rash/Itching. Kidneys remove wastes from the bloodstream. When the kidneys fail, the buildup of wastes in your blood can cause severe itching.
5.) Symptom 5: Metallic Taste in Mouth/Ammonia Breath. A buildup of wastes in the blood (called uremia) can make food taste different and cause bad breath. You may also notice that you stop liking to eat meat, or that you are losing weight because you just don't feel like eating.
6.) Symptom 6: Nausea and Vomiting. A severe buildup of wastes in the blood (uremia) can also cause nausea and vomiting. Loss of appetite can lead to weight loss.
7.) Symptom 7: Shortness of Breath. Trouble catching your breath can be related to the kidneys in two ways. First, extra fluid in the body can build up in the lungs. And second, anemia (a shortage of oxygen-carrying red blood cells) can leave your body oxygen-starved and short of breath.
8.) Symptom 8: Feeling Cold. Anemia can make you feel cold all the time, even in a warm room.
9.) Symptom 9: Dizziness and Trouble Concentrating. Anemia related to kidney failure means that your brain is not getting enough oxygen. This can lead to memory problems, trouble with concentration, and dizziness.
10.) Symptom 10: Leg/Flank Pain. Some people with kidney problems may have pain in the back or side related to the affected kidney. Polycystic kidney disease, which causes large, fluid-filled cysts on the kidneys and sometimes the liver, can cause pain.

According to eMedicineHealth.com, although chronic kidney disease sometimes results from primary diseases of the kidneys themselves, the major causes are diabetes and high blood pressure. Note the following medical issues that can cause kidney disease:
--Type 1 and type 2 diabetes mellitus cause a condition called diabetic nephropathy, which is the leading cause of kidney disease in the United States.
--High blood pressure (hypertension), if not controlled, can damage the kidneys over time.
--Glomerulonephritis is the inflammation and damage of the filtration system of the kidneys and can cause kidney failure. Postinfectious conditions and lupus are among the many causes of glomerulonephritis.
--Polycystic kidney disease is an example of a hereditary cause of chronic kidney disease wherein both kidneys have multiple cysts.
--Use of analgesics such as acetaminophen (Tylenol) and ibuprofen (Motrin, Advil) regularly over long durations of time can cause analgesic nephropathy, another cause of kidney disease.
--Certain other medications can also damage the kidneys.
--Clogging and hardening of the arteries (atherosclerosis) leading to the kidneys causes a condition called ischemic nephropathy, which is another cause of progressive kidney damage.
--Obstruction of the flow of urine by stones, an enlarged prostate, strictures (narrowings), or cancers may also cause kidney disease.
--Other causes of chronic kidney disease include HIV infection, sickle cell disease, heroin abuse, amyloidosis, kidney stones, chronic kidney infections, and certain cancers.

If you have any of the following conditions, you are at higher-than-normal risk of developing chronic renal disease, according to eMedicineHealth. Your kidney functions may need to be monitored regularly if you have any of the following medical issues:
--Diabetes mellitus type 1 or 2.
--High blood pressure.
--High cholesterol.
--Heart disease.
--Liver disease.
--Kidney disease.
--Sickle cell disease.
--Systemic Lupus erythematosus.
--Vascular diseases such as arteritis, vasculitis, or fibromuscular dysplasia.
--Vesicoureteral reflux (a urinary tract problem in which urine travels the wrong way).
--Problems of the joints or muscles that require regular use of anti-inflammatory medications.
--If you have a family history of kidney disease.

Important treatments for kidney disease are tight control of blood glucose and blood pressure. Blood pressure has a dramatic effect on the rate at which the disease progresses. Even a mild rise in blood pressure can quickly make kidney disease worsen. Four ways to lower your blood pressure are losing weight, eating less salt, avoiding alcohol and tobacco, and getting regular exercise. Not everyone with diabetes develops kidney disease. Factors that can influence kidney disease development include genetics, blood sugar control, and blood pressure. The better a person keeps diabetes and blood pressure under control, the lower the chance of getting kidney disease. According to the American Diabetes Association, once kidneys fail, dialysis is necessary. The person must choose whether to continue with dialysis or to get a kidney transplant. This choice should be made as a team effort. The team should include the doctor and diabetes educator, a nephrologist (kidney doctor), a kidney transplant surgeon, a social worker, and a psychologist.

Kidneys are remarkable organs, according to the American Diabetes Association. Inside them are millions of tiny blood vessels that act as filters. Their job is to remove waste products from the blood. Sometimes this filtering system breaks down. When our bodies digest the protein we eat, the process creates waste products. In the kidneys, millions of tiny blood vessels (capillaries) with even tinier holes in them act as filters. As blood flows through the blood vessels, small molecules such as waste products squeeze through the holes. These waste products become part of the urine. Useful substances, such as protein and red blood cells, are too big to pass through the holes in the filter and stay in the blood. In time, the stress of overwork causes the kidneys to lose their filtering ability. Waste products then start to build up in the blood. Finally, the kidneys fail. This failure, ESRD, is very serious. A person with ESRD needs to have a kidney transplant or to have the blood filtered by machine (dialysis) as previously noted.

Treatment varies depending on the type of kidney or urinary disease present, according to LabTestsOnline.org. In general, the earlier kidney or urinary disease is recognized, the more likely it is to be treatable. Dietary restrictions, drug therapy, and surgical procedures may be appropriate. If the kidneys can no longer effectively remove waste and water from the body, a dialysis machine used several times a week can take over kidney filtration. Also, as previously mentioned, kidney transplant surgery is another option when kidneys fail. If you have diabetes or hypertension, control of your blood pressure and blood sugar is extremely important to prevent or minimize kidney damage.

Until next time. Let me know what you think.

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