Cleveland Clinic (March 9, 2023) – Nephrologist Sevag Demirjian, MD takes you through the history of dialysis and explain discoveries and innovations along the way.
What is dialysis?
Dialysis is a treatment for people whose kidneys are failing. When you have kidney failure, your kidneys don’t filter blood the way they should. As a result, wastes and toxins build up in your bloodstream. Dialysis does the work of your kidneys, removing waste products and excess fluid from the blood.
Who needs dialysis?
People who have kidney failure, or end-stage renal disease (ESRD), may need dialysis. Injuries and conditions like high blood pressure, diabetes and lupus can damage kidneys, leading to kidney disease.
Some people develop kidney problems for no known reason. Kidney failure can be a long-term condition, or it can come on suddenly (acute) after a severe illness or injury. This type of kidney failure may go away as you recover.
There are five stages of kidney disease. In stage 5 kidney disease, healthcare providers consider you to be in end-stage renal disease (ESRD) or kidney failure. At this point, kidneys are carrying out around 10% to 15% of their normal function. You may need dialysis or a kidney transplant to stay alive. Some people undergo dialysis while waiting for a transplant.
Mayo Clinic (March 6, 2023) – About 15% of adults in the U.S. are estimated to have chronic kidney disease — that’s about 37 million people.
What if those people could be treated with medication that could slow the progression of their disease, and help avoid the need for dialysis and kidney transplantation altogether?
Dr. Naim Issa, a Mayo Clinic transplant nephrologist says there is a class of medications to help people with chronic kidney disease that does just that. He says Mayo Clinic has been incorporating these medications to help patients for the last few years.
March 9 is World Kidney Day, a day aimed at raising awareness about the importance of the kidneys.
Blood in your urine can be a startling sight, one that prompts concern over your health. While it doesn’t always mean something serious, several serious things can cause it. https://t.co/1YsZqx9dhs
Blood in your urine can be a startling sight, one that prompts concern over your health. While it doesn’t always mean something serious, several serious things can cause it. And that means you should contact your doctor right away.
It’s also important to understand what’s going on in your body. You may see a range of colors — from pink or slightly dark urine to bright red or cola-colored liquid. You may also see clots, which can come from your prostate, urethra, kidneys or ureters (tubes connecting your kidney to your bladder).
— Nature Reviews Disease Primers (@DiseasePrimers) May 10, 2022
Lupus is a disease that occurs when your body’s immune system attacks your own tissues and organs (autoimmune disease). Inflammation caused by lupus can affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart and lungs.
Chronic kidney disease, also called chronic kidney failure, involves a gradual loss of kidney function. Your kidneys filter wastes and excess fluids from your blood, which are then removed in your urine. Advanced chronic kidney disease can cause dangerous levels of fluid, electrolytes and wastes to build up in your body.
Video timeline: 0:31 What is kidney disease? 1:09 Who gets kidney disease/risk factors? 2:24 Kidney disease symptoms 3:03 How is kidney disease diagnosed? 3:53 Treatment options 5:23 Coping methods/ What now? 6:16 Ending
Swelling of the ankles becomes increasingly common as you get older. This swelling can be caused by thrombophlebitis, or skin infections which have been discussed in previous articles. Otherwise it is usually part of a condition called edema.
Edema is commonly caused by problems in the cardiovascular system, kidneys, or liver. Edema can occur in the face and abdominal cavity or elsewhere, But because of gravity and the fact that we are usually upright-on our feet, it is usually is most prominent in the legs, especially the ankles. Edema can be caused by a normal pregnancy. The developing baby puts quite a strain on the heart and circulatory system.
Chronic accumulation of fluid in the tissues usually occurs because of heart and blood vessel problems, liver disease (albumin lack), diet (excess salt intake), kidney disease (deficient salt excretion), vein problems (valve malfunction), and lymphatic problems (surgical lymph node excision).
Obesity contributes by impacting the heart and liver primarily. Proper sleep, diet and exercise help in most of these areas, and edema is rare in healthy people.
I have always considered sugar(obesity, cardiovascular effects) and salt(hypertension, cardiovascular and kidney load) as poisonous. I discovered the valve incompetence in the veins of my left leg because it became more blue than my right leg. With good exercise, sleep, diet program and compression stockings, edema never occurred.
The swelling and stretched shiny skin in the ankles that I see in many of my overweight friends makes a tempting target for germs of all kinds. and small skin sores often follow.
If you developed swelling in your ankles or other areas, it’s best to check with your doctor to get an explanation.
Our Kidneys and Liver have a lot in common. They are not dramatic, take-care-of-me-now organs like our Hearts and Brain, but usually do their job quietly until they lose almost all of their function. They have lots of reserve; you can donate one of your kidneys or a piece of your liver and notice no change. They are both vital organs, and you will die without them.
Since they both help clear wastes and toxins from the bloodstream and produce hormones, they SHARE SYMPTOMS such as nausea, vomiting, fatigue, and mental changes.Their performance can be checked by blood tests. Healthy habits will protect their -and your- survival.
Certain Drugs impair their operation. They are both composed of many identical functional units, the nephron in the kidney, and the hepatic lobule in the liver.
The GLOMERULUS of the Nephron is a tuft or ball of capillaries and associated kidney cells that allow the fluid and dissolved molecules of the blood to come through, while restraining the larger proteins and cells of the blood, keeping them in the vascular system. The smaller molecules of sodium, potassium, urea and other waste products leak through the glomerulus.
This filtered liquid travels through the long, folded kidney tubules, where the RIGHT AMOUNT of salt and water are REABSORBED. This keeps the vascular fluids, the internal environment, the MILIEU INTERIOR, perfectly well adjusted for proper cell function. It is when the chemical environment of the body falls out of adjustment, when the kidneys FAIL to do their job, that the cells of the body cannot function properly, and Symptoms-fatigue, lethargy etc. – develop.
BLOOD PRESSURE is intimately involved with the KIDNEYS, which has an Endocrine function. The Renin( Renal=kidneys) Angiotensin system is a major regulator of blood pressure.
You may have heard of the ACE-2 receptor as the binding site of th COVID Virus. This Angiotensin Converting Enzyme receptor is on the surface of cells all over the body and normally functions to control blood pressure.
DIABETES is the most common cause of end stage renal disease (ESRD), bringing our healthy triad of SLEEP DIET and EXERCISE to our attention once again.
POLYCYSTIC KIDNEY DISEASE is an inherited condition where many nephrons fail to hook up to the urine collecting system, and the fluid builds up into cysts, which then eventually replace the rest of the kidney. Pressure from urine blockage by an enlarged prostate, or even lack of ureteral valves can also back up into the kidneys and eventually cause ESRD.
Infections and autoimmune diseases can result in ESRD. Treatment of ESRD is usually a Kidney transplant or Dialysis. There is a waiting list for the former and the latter is life-altering. You can’t beat a healthy lifestyle.
Comprehensive care in patients with diabetes and CKD
Management of CKD in diabetes can be challenging and complex, and a multidisciplinary team should be involved (doctors, nurses, dietitians, educators, etc). Patient participation is important for self-management and to participate in shared decision-making regarding the management plan. (Practice point).
We recommend that treatment with an angiotensin-converting enzyme inhibitor (ACEi) or an angiotensin II receptor blocker (ARB) be initiated in patients with diabetes, hypertension, and albuminuria, and that these medications be titrated to the highest approved dose that is tolerated (1B).
Lifestyle interventions in patients with diabetes and CKD
We suggest maintaining a protein intake of 0.8 g protein/kg)/d for those with diabetes and CKD not treated with dialysis (2C).
On the amount of proteins recommended in these guidelines, they suggest (‘recommend’ becomes a ‘suggest’ at this level of evidence) a very precise intake of 0.8g/kg/d in patients with diabetes and CKD. Lower dietary protein intake has been hypothesized but never proven to reduce glomerular hyperfiltration and slow progression of CKD, however in patients with diabetes, limiting protein intake below 0.8g/kg/d can be translated into a decreased caloric content, significant weight loss and quality of life. Malnutrition from protein and calorie deficit is possible.
Physical activity
We recommend that patients with diabetes and CKD be advised to undertake moderate-intensity physical activity for a cumulative duration of at least 150 minutes per week, or to a level compatible with their cardiovascular and physical tolerance (1D).
Doctors Without Waiting Rooms 