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

 Kidney stones  is a disorder of the urinary tract wherein stones form in the kidney. This happens when solid particles in the urine become concentrated; the solid particles mostly being acid and mineral salts. This disorder can affect any part of the urinary tract: from the bladder to the kidneys. The treatment for this disorder is designed depending on the severity of your symptoms.

Symptoms
Once affected by this disorder, pain in the lower abdominal region will be common. The pain may get aggravated when you urinate. You may also exhibit symptoms of vomiting, nausea and a constant urge to urinate. Hematuria (presence of blood in the urine) is another symptom common to this disorder.

Causes
There is no single known cause for kidney stones. These stones occur when certain solid particles such as uric acid and calcium are present in the urine in large amounts. However, certain factors that increase the risk of kidney stones are:

Family history of kidney stones
Lack of sufficient water in the body or dehydration
Eating foods which are loaded with sugar and salts
Obesity
Ayurvedic treatment
Ayurvedic remedies for kidney stones are natural and free from side effects. Apart from relieving the symptoms, they also help in improving your overall well-being. These remedies balance the various doshas in the body and thus, lead to improved functioning of the abdominal organs. The Ayurvedic remedies for kidney stones are

Stay hydrated: Staying hydrated is the basic you can do to either prevent kidney stones or treating the condition. Dehydration is one of the most important causes for the formation of kidney stones.
Avoid certain foods: You need to avoid consumption of certain foods such as apples, tomatoes and cheese which increase the risks of kidney stones.
Exercise on a regular basis: You need to chalk down and stick to an exercise regimen to keep your weight at optimal levels. Remember that obesity is a major contributor to kidney stones.

How Ayurvedic Remedies are Effective in Treating Kidney Stones?

Treatment for Kidney stones varies depending on the size and type of the stone or the symptoms caused by it. In case of small stones, medication and simple changes in lifestyle can be enough to treat it, but surgeries and extensive treatments are required if symptoms are severe. 

Following are treatment options for kidney stones:

Small stones with minimal symptoms 
1. Drinking water
Drinking around 3 liters of water a day will regulate your urinary system and can effectively eliminate small stones. Unless your doctor advices otherwise, drinking ample amount of fluids, usually water, is one of the commonest way to get rid of small kidney stones. 

2. Pain relievers
There might be a considerable amount of pain and discomfort associated with passing the stone through urine. Your doctor may recommend pain killers like Ibuprofen, Naproxen sodium or acetaminophen. 

3. Medical therapy
In order to eliminate the kidney stone, your doctor may administer medical therapy. Medication like alpha blocker helps in passing the kidney stone with least pain and more quickly. It relaxes the muscles in the ureter and makes the process relatively easy. 

Large stones with severe symptoms
 
1. Using sound waves to break up stones 
In this technique, a procedure called Extracorporeal Shock Wave Lithotripsy (ESWL), is employed. ESWL uses the help of sound waves to create vibrations which breaks the stones in smaller pieces. This procedure takes about an hour and can cause mild pain and discomfort. Your doctor may administer sedatives to reduce your sensitivity. ESWL has side effects like blood in urine or bruising in the abdomen. 

2. Surgical removal of kidney stones 
Surgical removal of stones is done with the help of a procedure called nephrolithotomy. It uses small telescopes and other instruments which are inserted in your back through a small incision. It is generally done in case of large stones and when ESWL fails. 

3. Ureteric Calculi (Using a scope to remove stones) 
A thin illuminated tube called ureteroscope is used to remove a comparatively smaller stone in the kidney or ureter. The ureteroscope is equipped with a tiny camera which determines the location of the stone which is then broken into pieces with the help of other instruments. It may require general or regional anesthesia.

Treatments For Kidney Stones

A diseased kidney is one that has lost its ability to carry out the filtration process in a proper manner. This process of filtration usually sends the waste and toxins out of the body in a routine manner. In such cases, a kidney disease manifests which requires a number of treatment measures. Dialysis is something that enters the treatment plan at a later stage as chronic early stage kidney disease can remain in the patient s body for many years. When the kidney function comes down to 15%, then most doctors recommend the start of dialysis which is basically a process that removes the excess waste and fluid from the blood. This can be a process that will leave the patient fatigued and in a mental state that is not exactly stable and positive at all times. It is common to see dialysis patients battling depression due to the chronic nature of the treatment as well as the low chances of recovery.

So, let us find out how dialysis patients can cope with depression.

    Professional Help: Depression is said to be like a common cold when it comes to mental diseases. The state of a person s body can very well affect the balance in his or her mind and lead to depression. Starting from pressing circumstances to hormonal changes as well as chronic ailments, depression can affect people due to a number of reasons. Dialysis patients who are undergoing depression must consult a professional specialist like a psychiatrist who will help the patient understand and cope with the situation with the use of therapy based counselling.
    Medication: The patient can also be given medication that will prevent the build up of unnecessary stress by blocking the production of those hormones that result in a negative state of mind. This medication must be prescribed after speaking the patient s nephrologist about what kind of medication will suit the patient specifically.
    Psychotherapy: Long term psychotherapy is also known as talk therapy that can help the psychiatrist or clinical psychologist in talking the patient through the problems. Besides giving the patient the scope and platform to air out the problems and reach solutions regarding normal day to day functioning despite the troubles, this kind of therapy also aims at equipping the patient with a better perspective and improved attitude.

While going through this kind of therapy and medication, it is important to keep a team of nephrologists and psychiatrists in the loop so that the patient may reach out at any time in order to avail help in the most trying situations. This will give a blanket of security to the patient as well.

3 Ways a Dialysis Patient can Cope with Depression

An overactive bladder is marked by problems with one s bladder storage system that results in sudden urge to urinate. Involuntary and leakage of urine is also a possibility in such a case.

The problem of an overactive bladder arises when the muscles of the bladder contract involuntarily. The conditions contributing to overactive bladder are:
1. Excessive production of urine due to diabetes, poor kidney function or excessive fluid intake
2. Medications that increase urine production by the bladder
3. Acute infections in the urinary tract
4. Abnormalities in the bladder, for instance, bladder stones or tumors
5. Factors hindering bladder outflow such as constipation, enlarged prostate or earlier treatments for incontinence (loss of bladder control)
6. Excessive intake of alcohol or caffeine
7. Decline in one s cognitive abilities due to factors such as ageing, thus making it hard for the bladder to comprehend the signals it gets from the brain
8. Incomplete emptying of the bladder, leaving only a little storage space for the urine
9. Constipation
10. Neurological disorders

How it can be treated?

Behavioral interventions help to manage overactive bladder effectively and without side-effects. They include-
Exercises to strengthen one s urinary sphincter and pelvic floor muscles
Maintaining a healthy weight
Regulating fluid consumption
Planning a schedule for trips to the toilet
Employing a catheter to empty the bladder entirely
Medications to alleviate the symptoms of incontinence and overactive bladder are-
Fesoterodine
Mirabegron
Darifenacin
Solifenacin
Trospium
Oxybutynin gel
Oxybutynin as a skin patch
Tolterodine
Injecting small doses of Botox (Botulinum toxin), protein-bacteria, directly into the bladder tissues to partially paralyze the bladder muscles, thus delaying urination.
Surgery to magnify bladder capacity
However, it is a must that you seek the guidance of a urologist on immediate basis. 

Overactive Bladder - Can Infection in Urinary Tract Lead To it?

Polycystic Ovary Syndrome (PCOS) is a condition, which is born due to an imbalance of hormones within the female body. When this happens, the female body faces anumber of problems as far as her periods or menstrual cycles goes, besides finding it difficult to conceive naturally and easily. Let us find out more about this condition.

PCOS and hormones
To begin with, let us understand what hormones are. These are chemical impulses that send messages to various parts of the brain and rest of the body to signal the release of other kinds of hormones that may be vital for various functions. In PCOS, it is normally seen that the sex hormones are thrown out of balance, due to which the ovaries start producing a small dose of some male hormones. This creates problems as far as ovulation is concerned and also, it gives rise to the growth of facial hair, acne and changes in the overall appearance of the patient. Insulin resistance is another cause that may also trigger PCOS. It is also an inherited issue in many cases.

Symptoms
From irregular periods to an increase in acne and facial hair, there are many symptoms that may point at the existence of this condition. Fertility problems and issues related to normal ovulation are also often seen in women who are suffering from this condition due to the irregular periods. Additionally, depression may be seen in many patients who are suffering from this condition on a chronic basis. Thinning of hair and excess weight gain with difficulty in losing extra pounds may also be indicative of PCOS.

Diagnosis
The diagnosis of PCOS is usually done with the help of a physical examination as well as a blood test that will primarily help in determining the sugar levels and insulin. The doctor will also conduct other hormone tests so as to understand which hormones are not in balance and which ones may be triggering changes in the body. Apart from all this, the doctor will also study the body mass index (BMI) of the patient to find out if there has been a sudden and drastic change on the weight of the patient. During the lab tests, where the blood and urine are examined, the doctor will also seek to rule out any anomalies in the thyroid gland. An ultrasound of the ovaries will also be conducted.

Treatment
Weight loss programs as well as diet tweaks that remove excess dairy and meat may be recommended by the doctor. Further, the doctor may also put the patient on birth control pills so as to bring better balance of hormones. Moreover, moderate exercise will be required for the patient so that the normal production of hormones may be resumed eventually. 

PCOS - How It Can Be Diagnosed?

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