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

Screening for cancer of the colon or large intestine and rectum is a proven way of saving a person from the impacts of colorectal diseases. This is partly because colon cancer is something that can be prevented if detected at an early stage and the polyps which may advance to cancer are removed properly. Thus if you are turning 50 soon, be prepared to present yourself for a screening colonoscopy that will help you ensure good health and well-being. It may sound uncanny, but do you know that 50,000 people across the world die from colorectal cancer every year, and it is ranked second in terms of cancer-centric deaths.

Understanding the importance of having colonoscopy
You may wonder how a painful, invasive, embarrassing, uncomfortable and time-consuming health test may be called a present. There are reasons enough. A screening colonoscopy is able to expose a cancerous tumour that's presently under way and cast light on the chances and risk factors that may precede it. When you choose to intervene early, you have the power to nip those risks at their budding stage, much before those malicious cells become malignant.

Spreading of the colorectal cancer
Your large intestine is really a big and last organ of the gastrointestinal system where the small intestine discontinues. Its primary function is to remove the water out of the leftover solids of digestion and get rid of them in the form of stool. Cancer may start to develop anywhere within the tube that expands 5 feet long and squares the vacant area of the abdomen. The large intestine expands up towards the right side, i.e. the ascending colon and then turns left through the liver, i.e., the transverse colon, bending down right at the spleen on its left, i.e. descending colon and loops to the middle, i.e., the sigmoid colon before it runs across the rectum and ends at the anus.

People who need a colonoscopy
To simplify matters, it can be said that all adults are at a potential risk of the colorectal cancer, including those people who lead a healthy life. But some people are at a higher risk. Those individuals have a specific gene mutation that predisposes them to develop into numerous polyps. The risk is also high with people who are first-degree relatives of a person diagnosed with cancer before the age of 50. People with Ulcerative colitis, various types of inflammatory bowel diseases and Crohn's disease are also at a higher risk.

Colorectal cancer is a serious ailment and screening colonoscopy is a feasible means of detecting any polyps that may be cancerous in the future. Speak with a reputed gastroenterologist today to stay ahead of the disease.

When Should You Start Having Colonoscopies?

The bladder is a muscular sac that is seated just above the pubic bone. The organ stores urine produced by the kidneys allows us the control the frequency of urination by the expansion and contraction of its muscles. Pain in the bladder is usually caused due to one of three reasons:

Interstitial cystitis: This is a chronic condition which affects more women than men. It makes the bladder inflamed and irritated. The bladder walls turn stiff because of this which makes it difficult for the bladder to expand. Interstitial cystitis may be caused by a defect in the lining of the bladder.

Urinary tract infection: Urinary tract infections can affect a person at any age and may develop in the ureter, urethra, bladder or kidneys. However, it is most commonly seen in the bladder. This infection is caused by bacteria that enter the body through the urinary tract.

Bladder cancer: Cancer that develops in the bladder is known as bladder cancer. Transitional cell carcinoma is the most common type of bladder cancer cell. This begins in the innermost layer of the bladder lining. Pain during urination and discomfort in the lower pelvic region are common symptoms of this disease. Once the cause is diagnosed, antibiotic medication can help treat bladder pain. Along with that, there are a few things you could do at home as well.

Drink plenty of fluids: Ideally, we should drink 8-10 glasses of water a day. Water keeps the body hydrated and helps flush toxins from the body. It also helps dilute the urine. This can make urination less painful as concentrated urine may be acidic and difficult to pass. Water also helps prevent the formation of kidney stones and thus helps the kidneys function optimally.
Urinate frequently: Do not try to control your urine. Holding urine in for extended periods of time allows bacteria to multiply within the body. It is also important to urinate after intercourse as sexual activities can push the bacteria present on the skin deeper into your body. This is important for both men and women.
Dress comfortably: Avoid synthetic, tight fitting underwear and clothes. Instead wear, loose, comfortable clothes that are preferably made out of cotton. These clothes will help keep your skin dry and not allow bacteria to breed.
Pain relievers and heating pads: Sometimes, antibiotics can take a day or two before addressing bladder pain. In such cases, pain relievers can help deal with the discomfort and cramps. Heating pads can also help soothe abdominal and lower back pain that results from bladder infections.

Painful Bladder - What Should You Know About It?

People with chronic kidney disease notice that their bones tend to get weaker and more slender. They become painful and are bound to break more easily as a consequence of mineral loss. The most common kind of bone infections happen when:

There is a change in the balance between two essential minerals in your body - calcium and phosphate, which prompts loss of calcium from your bones.
Four small glands (parathyroid organs), which regulate calcium in your body, turn out to be excessively active.
There is a change in the way your body utilizes vitamin D, a mineral that is vital for healthy bones.
Every bone disease affects bones in different ways.

Phosphate is found in many food items you eat. Your kidneys normally eject whatever is not required in the body. At the point when your kidneys have stopped functioning properly, phosphate may develop in your blood. Excess phosphate in your blood prompts loss of calcium from your bones, which has a tendency to weaken them. Eating food items that are low in phosphate can keep phosphate from building up in your blood.
Since phosphate stays in your body when your kidneys are no more ready to remove it, four small glands in your neck (parathyroid organs) turn out to be excessively active. When this happens, calcium is expelled from your bones over a long period of time, making them weak.
Vitamin D is a vital vitamin, which affects the balance in the calcium content of your body. Typically, vitamin D is processed into a more soluble state by the kidneys and can be utilized by the body. In case your kidneys have deteriorated, they can no more do this critical job. Luckily, the dynamic type of vitamin D is accessible in the form of medications that can be prescribed by your specialist, if necessary. In case you have a kidney disease, it is vital to find a way to prevent bone illness. Some of the solutions are as follows:
Limit the amount of phosphorus you take in every day. Ask your specialist or dietitian to let you know how much phosphorus you need to have. You can likewise request a list of high-phosphorus food items.
Take a phosphate folio. This is a medicine that you bring with dinners to keep your body from taking in the phosphorus that originates from your food and beverages. This can keep phosphorus from winding up in your blood.
Take a calcitriol supplement. Your kidneys make calcitriol with the help of vitamin D that you get from food and the sun. When your kidneys are not working, they can't make calcitriol. A man-made type of calcitriol can help your body utilize the calcium and phosphorus it needs.
Exercise can make your bones more strong and keep them from breaking.
Try not to smoke or use tobacco. It can aggravate bone disease.
Take your medications the way your specialist instructs you to and do not skip dialysis medicines.
Even after changing your diet and taking medicines, if you still have an excess of phosphorus in your blood, your specialist may propose that you undergo further dialysis.

Kidney Disease - How It Affects Your Bones?

One of the most common issues with old age in men is the enlarged prostate. Any difficulty with urination (no constant stream, difficulty initiating, or incomplete emptying of the bladder for instance), and the first suspect is an enlarged prostate. These symptoms are followed by a digital rectal exam to check for an enlarged prostate. Once confirmed, the next step is to check for levels of prostate-specific antigen (PSA). If both the exam and the PSA are positive, it could mean prostate cancer. As with any cancer, it is believed that sooner it is diagnosed and the treatment is started, the better.

Historically, the best way to rule out the prostate cancer had been to do a prostate biopsy. This is a minor invasive procedure, wherein biopsies are taken from various regions of the prostate which are known to develop cancer (about 12). A disadvantage of this procedure includes missing out on the front part of the prostate which can also develop cancer. Secondly, it is not a very pleasant experience and given a chance, most men would not want to have it done.

There is good news for these men who would like to avoid prostate biopsies. The first is the multiparametric MRI which uses no x-rays and is considered very safe with extremely accurate results. This MRI exam requires about an hour, and once the images are obtained, the doctor will analyse these images and check for several parameters to assess for prostate cancer. The absence of cancer can be confirmed with up to 90% accuracy, which is far greater than with usual biopsies. If there is a possibility of cancer, then a biopsy can be done to confirm it. 

Also, these images indicate the exact region where cancer likely is, and this guides the doctor to biopsy only where absolutely essential. The chances of false positive and false negative results are reduced drastically. The one disadvantage here is that MRI detected biopsies usually tend to be of a higher grade which requires immediate treatment.

Another way to reduce chances of the biopsy by 30% to 50% is by the 4K test. It helps detect a variety of prostate issues including cancer. It can be used once higher levels of PSA is identified and before going for a biopsy. It combined 4 prostate-specific biomarkers with clinical information to accurately provide men with a risk of developing prostate cancer. It can be used even after negative biopsies to confirm the diagnosis of prostate cancer.

These two measures can drastically reduce the incidence of prostate biopsies, which is neither pleasant for the patient nor very effective for the doctor.

Prostate Biopsies - Ways You Can Avoid It!

There can be no better way to maintain a healthy lifestyle other than a regular exercise and fitness routine. Sometimes even after surgeries, doctors recommend exercise to the patients for a speedy recovery. A kidney transplant is one such surgery that requires you to follow a strict fitness regime after the operation process.

Importance of Exercise after a Kidney Transplant:

Exercise, as recommended by the doctor, should be an integral part of the lives of kidney transplant patients. The variations of exercise may differ depending on the age and general physical health of the patient. The need for exercise after a transplant is as follows  

  Helps to increase energy levels
  Increases overall physical strength and immunity
  Helps maintain a standard weight as an obese body is very harmful for patients suffering from kidney ailments
  Reduces stress, anxiety and depression
  Prevents after effects of kidney transplant like high blood pressure and cholesterol level
  Helps to strengthen bones
  Helps tone muscles and increases balance and joint flexibility
  Strengthens the heart and overall cardiovascular system
  Helps the patient to sleep better
  Boosts self-image and increases confidence

Types of Exercises that can be done:

  Stretching   Consistent stretching before any exercise helps increase muscle strength. It also prevents muscle strain and injury.
  Aerobic   Aerobic or cardiovascular exercises are generally recommended for younger patients. It includes moderately heavy exercises involving a greater number of muscles. This kind of exercise strengthens the heart and lungs and improves breathing. Aerobic exercises include walking, jogging, jumping rope, bicycling, skating, rowing and water aerobics. However, for most patients, brisk walking or jogging is recommended.
Ideally one should exercise for a minimum period of 20 minutes at least four times a week.

Things to Remember:

  It has been medically proved that patients who exercise regularly following a kidney transplant procedure are more likely to survive healthily for the upcoming 5 years compared to patients who lead a sedentary life.
  However one should not resort to heavy and strenuous exercises immediately after the surgery. It is advisable to start with mild forms of exercise like walking and increase the levels gradually depending on one s age.
  One should not eat a heavy meal just before exercising.
  It is important to stop for breaks in between exercise. The patient should not over exert himself.
  It is advisable to avoid lifting heavy weights like dumbbells.
  Stop exercising immediately if you experience chest pain, lightheadedness or pressure in chest, neck or arm.
  Consult the doctor for the kinds of exercises you can do depending on your condition.

With a healthy diet and regular exercise, there are fewer chances of reoccurrence of kidney ailments.

Fitness/Exercise/Games After Kidney Transplant!

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