What is Chronic Kidney Disease?

Chronic Kidney Disease (also known as Chronic Renal Failure) is the progressive loss of kidney function occurring over a span of several months to several years and is characterised by the replacement of kidney architecture with interstitial fibrosis.

Chronic kidney disease is classified into five stages on the basis or proteinuria (presence of protein in large amounts in the urine) or Glomerular Filtration Rate (GFR) - 1 being the mildest with no distinct symptoms and 5 being end stage renal failure.

Causes and Risk Factors of Chronic Kidney Disease-

The various reasons (called risk factors) that can increase chances of Chronic Kidney Diseases are:

Diabetes mellitus, hyperlipidemia (excess fat proteins in the blood)
Hypertension

Family history heritable renal disease

Older age, smoking

Autoimmune disease

Past episodes of acute renal disease

The direct causes of Chronic Kidney Diseases are-

Diabetic nephropathy (leading cause)

Hypertensive nephropathy

Glomerulonephritis (swelling of the glomerulus in the kidneys)

Reno-vascular disease (ischemic nephropathy)

Polycystic kidney disease

HIV-associated nephropathy

Transplant allograft failure

Exposure to drugs and toxins

Diet that you must maintain in Chronic Kidney Disease-

It is essential to make dietary as well as lifestyle amends once you are diagnosed with CKD. The main purpose of this diet is to maintain the levels of carbohydrates, fluids and minerals. This is done to prevent the buildup of waste products in the body as the kidneys are unable to fulfil its function properly.

It is recommended to refer a dietician who can make you a diet chart that helps you adhere to your diet.

Here is a list of food items that you may avoid or may consume if you are suffering from Chronic Kidney Disease:

Carbohydrates : Carbohydrates are a good source of energy. If the intake of protein has been restricted, then it is recommended to replace that with carbohydrates as a source of energy. Fruits, vegetables, grains and bread can be consumed as they are rich source of fibres, minerals and various types of vitamins. You can indulge in some hard candies or sweets as well.

Fats: Fats can provide a good amount of calories as well. Ensure that you only stick to healthy fats such as the monounsaturated and polyunsaturated fats that are good for your cardiac health. 

Reduce your phosphorus intake: A diet with no more than 800 mg of phosphorus can help reduce the risk of too much phosphorus building up in your blood.  Limit intake of foods with high levels of phosphate or phosphate additives such as organ meats, whole grain breads, processed foods, cola beverages, cheese, dried beans, liver, peanut butter, dairy products and chocolate. Many beverages and processed foods have these additives. Other high-phosphorus foods to limit include: 

Cheese
Chocolate
Ice cream
Legumes
Milk
Nuts
Seeds
Yogurt
Monitor your potassium levels: Usually, potassium is not restricted in stage 3 CKD unless lab tests show potassium is too high. Your doctor may make medication changes or prescribe a low-potassium diet. Reduce an elevated potassium level by limiting some high-potassium foods and potassium chloride (found in salt substitute and many low-sodium processed foods), such as avocado, bananas, cantaloupe, honeydew, legumes, milk, nuts, potatoes, seeds, tomato products and yogurt. Some high-potassium foods to limit or avoid include: 
Avocado
Bananas
Cantaloupe and honeydew melon
Dried fruit
Legumes
Milk
Nuts and seeds
Oranges and orange juice
Potatoes
Pumpkin and winter squash
Tomato products (juices, sauces, paste)
Yogurt
Proteins: Usually, before undergoing dialysis, it is recommended to adhere to a low-protein intake diet. However when you are undergoing dialysis, it is necessary to consume a certain amount of protein. This detailed information can be obtained from your dietician.
Fluids: In the early stages of CKD, your fluid intake is not monitored. But as the disease progresses, you need to check your intake of fluids as too much fluids may accumulate in your body and create pressure on your kidneys.

Sodium Or Salt Intake: Keeping a check on your salt intake reduces the risks of high blood pressure. Also, having food low on salt can reduce your thirst and prevent fluid retention in your body.

Diet In Chronic Kidney Disease

Urinary incontinence, commonly known as loss of bladder control can really cause embarrassment. The severity of this condition may range from once in a while leaky urine to the sudden and forceful urge to urinate, due to which you end up urinating before reaching the toilet.

Types of urinary incontinence-

Stress incontinence- when you feel the urge to urinate due to sneezing, coughing, laughing or while doing physical exercise
Urge incontinence- when you feel the urge to urinate, suddenly. This may occur during the day and even at night.
Functional incontinence- when you cannot reach the toilet on time because of a physical or mental impairment.
Mixed incontinence- when you involuntarily urinate due to more than one incontinence
Stress incontinence is the most common type in women. The activities which increase your risk, are:

You have had more than one pregnancy and vaginal delivery.
You have pelvic prolapse. This is when your bladder, urethra, or rectum slide into the vagina. Delivering a baby can cause nerve or tissue damage in the pelvic area. This can lead to pelvic prolapse months or years after delivery.
Female urinary stress incontinence is the involuntary release of urine during any physical activity that puts pressure on your bladder. This potentially embarrassing condition differs from general incontinence in that it happens when the body is under immediate physical stress. Activities that can put stress on your bladder include coughing, sneezing, laughing, lifting heavy objects, or bending over. This condition is particular to women, many of whom experience symptoms after muscles have been weakened due to a vaginal childbirth, following menopause, or during pregnancy.

Ensure that you consult a doctor-

If this condition hinders your day to day activities
If the urinary incontinence is the result of a serious underlying problem
Causes of urinary incontinence-

Urinary incontinence may be temporary or permanent. Causes for temporary incontinence are-

Alcohol
Caffeine and caffeinated drinks
Decaffeinated tea or coffee
Spicy and sugary foods
High intake of vitamin b or c
Urinary tract infection (uti)
Constipation
Causes for permanent incontinence are:

Pregnancy
Childbirth
Old age
Menopause
Hysterectomy
Prostate cancer
Enlarged prostate
Neurological disorders
Complications-

Chronic urinary incontinence can lead to certain complications like.

Skin problems- skin rashes and infections can develop around the vaginal area, because of the constant wetness one feels. It may also cause sores.
Urinary tract infections- urinary incontinence can also result in uti
Impact on personal and social life- urinary incontinence can lead to great embarrassment, thus affecting the social and personal life of an individual.
Treatment for female stress urinary incontinence-

There are several types of treatment available. Treatment options include lifestyle changes, medications, nonsurgical treatments, and surgeries.

Lifestyle changes: make regular trips to the restroom to reduce the chance of urine leakage. Drink fewer fluids and avoid activities such as jumping and running.
Medications: medications that reduce bladder contractions.
Nonsurgical treatments: kegel exercises strengthen your pelvic muscles. Done regularly, these exercises can strengthen your muscles, allowing you to control when urine is released from your body.
Surgery:

If other treatments fail, you will have to go for surgical treatment. Types of surgery include:

Injectable therapy, in which collagen is injected into your urethra to reduce incontinence
Tension-free vaginal tape (tvt) surgery, in which mesh is placed around the urethra to give it support
Vaginal sling surgery, in which a sling is placed around the urethra to support it
Anterior or para-vaginal vaginal repair surgery to repair a bladder that is bulging into the vaginal canal
Retropubic suspension surgery to move the bladder and urethra back into their normal positions
Some doctors even try electrical stimulation and medication. When the condition is highly advanced interventional therapies and surgery is recommended.

Some interventional therapies are-

1. Bulking material injections
2. Botulinum toxin type-a
3. Nerve stimulators.

All About Urinary Incontinence

Most people would panic on seeing slightly red urine being passed. A common urologic condition, this happens because blood cells are leaking into the urine. There are multiple reasons which can cause it, and not all of them are major causes for concern.

Read on to know more about some common causes, and how to manage this.

Urinary tract infections: There could be an infection of the entire urinary tract including the kidneys, the ureters, the bladder, and the urethra. In addition to blood in the urine, there could also be an urge to urinate, pain with urination, fever, and flank pain.
Enlarged or infected prostate: The prostate naturally enlarges with age and can obstruct the urethra, causing pain and blood in the urine. There is a constant urge to urinate and difficulty initiating the stream. Infection of the prostate also produces similar symptoms along with fever and pain.
Kidney diseases: In addition to infections, other kidney diseases including glomerulonephritis, which can also lead to hematuria. Kidney stones, which are quite common, are also another reason, and this will be characterised by the sudden sharp pain around the flank which is very diagnostic of kidney stones. Injury to the kidneys from trauma or sports is another reason for hematuria.
Cancers/tumours: Cancers in the kidney, bladder, or prostate can cause blood to appear in the urine, but this would happen once cancer has reached some advanced stage, not very early in the process.
Listed below are some risk factors for hematuria.

Age: Men older than 50 are more prone to hematuria
Sex: While men are more likely to have stones or prostate infections, UTIs are quite common in women below 50s.
Family history: though not hereditary, if kidney stones or cancers or infections are in the family, chances of developing hematuria also goes up.
Medications: Aspirin, blood thinners, NSAIDs, and some antibiotics increase the chances of hematuria.
Exercise: Long distance runners are shown to be more prone to developing hematuria.
Diagnosis: In addition to a physical exam, blood tests, imaging (CT scans and/or MRI) and cystoscopy might be required to confirm the diagnosis. Identifying the cause is extremely important as treatment would depend completely on the causative agent. Though hematuria is just one of the symptom, the underlying cause could have severe adverse effects on the whole body system.

Treatment: Whether it is an infection or enlarged prostate or kidney stone or tumour, once the cause is identified treatment is customised accordingly. Antibiotics for the infections, laser treatment for the stones, etc. are recommended.

If you see your urine turning slightly pink in colour, talk to your doctor immediately. Identifying the underlying cause and treating it will help solve the problem of hematuria.

In case you have a concern or query you can always consult an expert & get answers to your questions!


Blood In Urine - Is It Actually Serious?

When your kidney function falls below a certain point, it is referred to as a kidney failure or renal failure. Fortunately, you can still continue to lead a normal life with the right treatment for renal failure. Here are the three best treatments that you can choose depending on your condition and lifestyle:

1. Dialysis: Dialysis is the process that takes over the function of your kidneys to filter out the waste from your blood and maintain the proper balance of chemicals in the blood. You may use dialysis for many years or as a short-term treatment while waiting for a kidney transplant. Dialysis is not a cure for kidney disease, rather it helps you deal with renal failure. It is life-saving and without it, the kidneys will no longer function.

There are two types of dialysis treatments that you can choose from:

Hemodialysis   This type uses a machine to remove waste from the blood and sends it back to your body. It can be done at home or at a dialysis center.
Peritoneal Dialysis   This type uses the lining of your belly called the Peritoneum to do the work of your kidneys. A catheter and dialysis solution is used to carry out the function.
There are benefits and complications for each type of dialysis. The treatment decision will largely depend on the patient s illness and their past medical history. Discuss with your doctor to decide the best option for you.

2. Kidney Transplant: Kidney transplants can provide a better quality of life than dialysis and can be seen as a potential cure for kidney failure. A healthy kidney from a live donor or deceased donor is surgically placed in your body as a replacement to the failed kidneys. Although this may be a better option for you, it has certain shortcomings. There is an element of rejection and you may have to wait for a long time to get a donor. Extensive testing and anti-rejection medications are prescribed with this treatment.

3. Palliative Care: Rather than cure, it is the care that people with serious illness need. With so much to deal with, the patients have an array of tough questions and challenges to deal with. Patients need to take into account all medical options and care options based on their condition and severity of the renal failure.

Making the right treatment choice is difficult and that too when you are ill. It is normal to be fearful and worried about the risks involved. Get support from your family and doctor to help you make the right treatment choice. It may also be helpful to visit a dialysis or transplant center to talks to others who have been through these treatments.

3 Best Treatments for Renal Failure!

At a point when our bodies process the protein we eat, the procedure creates waste products. In kidneys, millions of tiny blood vessels act as filters since they have even tinier holes in them. As blood flows through these vessels, little molecules such as waste items may press through the gaps. These waste items turn out to be a part of the urine. Helpful substances, such as protein and red blood cells are too enormous to go through the gaps in the filter and stay in the blood.

Diabetes and kidneys: Diabetes can harm the kidneys. Abnormal amounts of glucose make the kidneys filter a lot of blood. After a couple of years, they begin to spill and helpful protein is thereby, lost in urine. Having low protein levels in the urine is called micro albuminuria.

Medication: When kidney disease is analyzed on time, during micro albuminuria, a few medications may keep kidney disease from getting worse. Having elevated levels of protein in the urine is called macro albuminuria. When kidney disease is looked up some other time during macro albuminuria, end-stage renal disease (ESRD) usually follows.

Causes: Strain on the organs may cause the kidneys to lose their filtering capacity. Waste items then begin to develop in the blood. Finally, the kidneys start to fail. This failure, ESRD, is intense. A patient with ESRD needs a kidney transplant or a blood filtration by a machine (dialysis).

Other complications: Individuals with diabetes will probably have other kidney-related issues such as bladder infections and nerve damages in the bladder.

Preventing complications: Not everybody with diabetes goes through a kidney disease. Elements that can impact kidney disease improvement include genetics, blood-sugar control and blood pressure. The more a person keeps diabetes and blood pressure under control, the lower the chances of getting a kidney disease.

Keeping your glucose level high can counteract diabetic kidney problems. Research has demonstrated that blood glucose control diminishes the danger of micro albuminuria by 33%. For individuals who suffer from micro albuminuria have now a reduced danger of advancing to macro albuminuria. Different studies have recommended that blood glucose control can reverse micro albuminuria.

Treatment: Essential treatments for kidney infection include control of blood glucose and blood pressure. Blood pressure dramatically affects the rate at which the condition progresses. Indeed, even a gentle increase in blood pressure can rapidly aggravate a kidney infection. Four approaches to bring down your blood pressure are:

Shedding pounds
Eating less salt
Maintaining a strategic distance from liquor and tobacco
Exercising regularly
A low-protein diet can decrease the amount of lost protein in the urine and increase the protein levels in the blood. Never begin a low-protein diet without talking to your physician or nephrologist.

Diabetes & Kidney Problems - Know The Complications!

No Blood, No needle, No visit to hospital, you can do yourself at home with water. A thin layer of transparent screen like structure hangs in front of the abdominal muscles known as peritoneum. This peritoneum protects the abdominal structures and the muscle. This can also be used for performing dialysis which is carried out when the functioning of kidney gets affected. In peritoneal dialysis a thin and soft catheter is placed in the person s belly one week before performing the procedure.

The catheter has numerous holes in order to facilitate the transformation of fluids. Dialysis solution is prepared in a bag and the tubing is connected to the catheter placed in the abdomen thereby, the fluids absorb the waste materials from the body. The fluid is allowed to stay in your body for a particular period of time which is commonly referred as dwell time and later the fluid is drained out.

There are two types of peritoneal dialysis, continuous ambulatory peritoneal dialysis and automated peritoneal dialysis. This is the simple form of dialysis which anybody can perform after a short training period and this can be done anywhere in clean private place like hotels, home and even in office.

Procedure followed during Peritoneal Dialysis
All you need to perform a peritoneal dialysis is catheter and transfer set, cycler, dialysis solution and safety precautions materials to stay away from getting infections.
Step 1 - Perform a sterile aseptic technique. Wear a glove and surgical mask before connecting the catheters and transfer set. Clamp the tubing and remove the catheter once the dialysis solution enters your abdomen
Step 2 - Allow the solution to remain in your abdomen for a particular period of dwell time
Step 3 - Drain the fluid from the abdominal cavity into the drain bag. You may feel a mild tugging sensation when adequate amount of fluid is drained.
Step 4 - After drain close or clamp the transfer set and later flush a fresh solution directly to drain bag so as to remove the air from the tubing.
Step 5 - Close your drain bag and open your transfer set and refill your belly with fresh solution.

Make sure you perform without giving way for infection and excess fluid and dextrose absorption.

Peritoneal Dialysis - Procedure to be Followed!

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