• What Is It And How Did I Get It Early Stage Chronic Kidney Disease Pdf 2017
• What Is It And How Did I Get It Early Stage Chronic Kidney Disease Pdf File

By Gail Rae-GarwoodAccording to the, there are 22 early signs of chronic kidney disease (CKD). I never experienced any of them, not even one. So how did I discover that my kidney function was slowly declining?

I simply changed primary care doctors because the one I was seeing was too difficult to get hold of.My new doctor was extremely thorough, so thorough that she insisted on all kinds of tests for the new patient even though I’d had my records transferred to her. All it took was that initial blood test for her to call a nephrologist for me. What frightened me terribly is that I got an appointment the next day.

We know that doesn’t happen unless something serious is going on.After talking to the nephrologist, I began to realize just how serious this disease was and started to wonder why my previous nurse practitioner had not caught this. When I asked her why, she responded, “It was inconclusive testing.” Sure it was. Because she never ordered a 24 hour urine analysis!I feel there’s no sense crying over spilled milk (or destroyed nephrons, in this case), but I wonder how much more of my kidney function I could have preserved if I’d known about my CKD earlier. My high blood pressure had been controlled for 20 years at that time, but what about my diet?I had no clue there was such a thing as a kidney diet until the nutritionist explained it to me. I’m a miller’s granddaughter and ate anything – and I do mean anything - with grain in it: breads, muffins, cakes, croissants, you name it.

I also liked lots of chicken and fish not the five ounces per day I’m limited to now. Are you kidding? I was in a new food world.I already knew about restricting sodium because I had high blood pressure, but these other things? I had to keep a list of which foods contain them, how much was in each of these foods, and a running list of how much of each I had during the day so I knew when I reached my limit for that day.And exercise! I was a dancer. Wasn’t that enough? Nope, I had to learn about cardio and strength training exercise, too.

It was no longer acceptable to be pleasantly plumb. My kidneys didn’t need the extra work.Native Americans have double the incidence of kidney disease as non-Native Americans. That’s why I’ve contacted kidney educators who are willing to go to the reservations to talk about screening and CKD education. All I have to do now is get permission from the reservations. I was surprised to discover writing my book What Is It and How Did I Get It? Early Stage Kidney Disease, maintaining a, page, and account of the same name is not enough for me for me to spread the word about CKD screening and education. I'm determined to change this since I feel so strongly that NO ONE should have this disease and not be aware of it.Gail Rae-Garwood was shocked when she was diagnosed with kidney disease.

She is determined to spread the word about testing and risk factors, especially within the Native American community. Check out her for more information. The National Kidney Foundation is the leading organization in the U.S. Dedicated to the awareness, prevention and treatment of kidney disease for hundreds of thousands of healthcare professionals, millions of patients and their families, and tens of millions of Americans at risk.The provides the giving public with an easily recognizable symbol which certifies that the National Kidney Foundation meets the comprehensive standards of America's most experienced charity evaluator. © 2019 National Kidney Foundation, Inc., 30 East 33rd Street, New York, NY 10016, 1-800-622-9010.

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Chronic kidney diseaseOther namesChronic renal disease, impaired kidney functionon the head in someone with chronic kidney diseaseSymptomsEarly: NoneLater:, feeling tired, loss of appetite, high blood pressure,DurationLong-termCauses,TreatmentMedications to manage blood pressure, blood sugar, and lower cholesterol,Frequency753 million (2016)Deaths1.2 million (2015)Chronic kidney disease ( CKD) is a type of in which there is gradual loss of over a period of months or years. Early on there are typically no symptoms. Later, feeling tired, loss of appetite, or may develop. Complications may include, or.Causes of chronic kidney disease include,. Risk factors include a family history of the condition. Diagnosis is generally by to measure the and to measure.

Further tests such as an or may be done to determine the underlying cause. A number of different classification systems exist.Screening at-risk people is recommended. Initial treatments may include medications to manage blood pressure, blood sugar, and lower cholesterol. Should be avoided. Other recommended measures include staying active and certain dietary changes.

Severe disease may require, or a. Treatments for anemia and bone disease may also be required.Chronic kidney disease affected 753 million people globally in 2016, including 417 million females and 336 million males. In 2015 it resulted in 1.2 million deaths, up from 409,000 in 1990. The causes that contribute to the greatest number of deaths are high blood pressure at 550,000, followed by diabetes at 418,000, and glomerulonephritis at 238,000.

Contents.Signs and symptoms CKD is initially without specific symptoms and is generally only detected as an increase in or protein in the urine. As the kidney function decreases:. is increased due to fluid overload and production of vasoactive hormones created by the kidney via the, increasing one's risk of developing and/or suffering from.

accumulates, leading to and ultimately (symptoms ranging from to and ). Due to its high systemic circulation, urea is excreted in eccrine sweat at high concentrations and crystallizes on skin as the sweat evaporates ('). accumulates in the blood ( with a range of symptoms including and potentially fatal ). Hyperkalemia usually does not develop until the falls to less than 20–25 ml/min/1.73 m 2, at which point the kidneys have decreased ability to excrete potassium. Hyperkalemia in CKD can be exacerbated by (which leads to extracellular shift of potassium) and from lack of.

synthesis is decreased causing. symptoms may range from mild to life-threatening., due to reduced phosphate excretion, follows the decrease in glomerular filtration. Hyperphosphatemia is associated with increased cardiovascular risk, being a direct stimulus to vascular calcification. Moreover, circulating concentrations of (FGF-23) increase progressively as the renal capacity for phosphate excretion declines, but this adaptative response may also contribute to left ventricular hypertrophy and increased mortality in CKD patients., due to deficiency (caused by stimulation of and reduction of renal mass), and resistance to the calcemic action of parathyroid hormone.

Osteocytes are responsible for the increased production of, which is a potent inhibitor of the enzyme (responsible for the conversion of into ). Later, this progresses to, and vascular calcification that further impairs cardiac function. An extreme consequence is the occurrence of the rare condition named. The concept of currently describes a broader clinical syndrome that develops as a systemic disorder of mineral and bone metabolism due to CKD manifested by either one or a combination of: 1) abnormalities of, , or metabolism; 2) abnormalities in, volume, linear growth, or strength ; and 3) vascular or other soft-tissue calcification. Has been associated with poor outcomes. (due to accumulation of sulfates, phosphates, uric acid etc.) may cause altered enzyme activity by excess acid acting on enzymes; and also increased excitability of cardiac and neuronal membranes by the promotion of hyperkalemia due to excess acid (acidemia). Acidosis is also due to decreased capacity to generate enough from the cells of the proximal tubule., which increases in prevalence as kidney function decreases, is especially prevalent in those requiring haemodialysis.

It is multifactoral in cause, but includes increased inflammation, reduction in, and hyperuricemia leading to bone marrow suppression.People with CKD suffer from accelerated and are more likely to develop than the general population. Patients afflicted with CKD and cardiovascular disease tend to have significantly worse prognoses than those suffering only from the latter.is very common in both men and women with CKD. A majority of men have a reduced, and reaching orgasm, and the problems get worse with age. A majority of women have trouble with sexual arousal, and and problems with performing and enjoying sex are common. Causes The most common cause of CKD as of 2015 is followed. Other causes of CKD include idiopathic (i.e. Unknown cause, often associated with small kidneys on renal ultrasound).

A 12-lead ECG of a person with CKD and a severe electrolyte imbalance: (7.4 mmol/l) with (1.6 mmol/l). The are peaked and the.Diagnosis of CKD is largely based on, and combined with the measurement of the serum level (see above). It is important to differentiate CKD from (AKI) because AKI can be reversible.

One diagnostic clue that helps differentiate CKD from AKI is a gradual rise in serum creatinine (over several months or years) as opposed to a sudden increase in the serum creatinine (several days to weeks). In many CKD patients, previous kidney disease or other underlying diseases are already known. A significant number present with CKD of unknown cause.Toxins In CKD numerous uremic toxins accumulate in the blood. Even when ESKD (largely synonymous with CKD5) is treated with dialysis, the toxin levels do not go back to normal as dialysis is not that efficient. Similarly, after a kidney transplant, the levels may not go back to normal as the transplanted kidney may not work 100%. If it does, the creatinine level is often normal.

The toxins show various cytotoxic activities in the serum and have different molecular weights, and some of them are bound to other proteins, primarily to albumin. Uremic toxins are classified into three groups as small water-soluble solutes, middle molecular-weight solutes, and protein-bound solutes. Hemodialysis with high-flux dialysis membrane, long or frequent treatment, and increased blood/dialysate flow has improved removal of water-soluble small molecular weight uremic toxins. Middle molecular weight molecules are removed more effectively with hemodialysis using a high-flux membrane, hemodiafiltration and hemofiltration. However, conventional dialysis treatment is limited in its ability to remove protein-bound uremic toxins. Screening Screening those who have neither symptoms nor risk factors for CKD is not recommended. Those who should be screened include: those with hypertension or history of cardiovascular disease, those with diabetes or marked obesity, those aged 60 years, subjects with African American ancestry, those with a history of kidney disease in the past, and subjects who have relatives who had kidney disease requiring dialysis.

Screening should include calculation of estimated GFR from the serum creatinine level, and measurement of urine albumin-to-creatinine ratio (ACR) in a first-morning urine specimen (this reflects the amount of a protein called albumin in the urine), as well as a urine dipstick screen for hematuria. The GFR (glomerular filtration rate) is derived from the serum creatinine and is proportional to 1/creatinine, i.e.

It is a reciprocal relationship (the higher the creatinine, the lower the GFR). It reflects one aspect of kidney function: how efficiently the glomeruli (filtering units) work. But as they make up. End-stage chronic kidney disease with increased echogenicity, homogenous architecture without visible differentiation between parenchyma and renal sinus and reduced kidney size. Measurement of kidney length on the US image is illustrated by '+' and a dashed line.Treatment Apart from controlling other risk factors, the goal of therapy is to slow down or halt the progression of CKD. Control of and treatment of the original disease are the broad principles of management.Blood pressure Generally, (ACEIs) or (ARBs) are used, as they have been found to slow the progression. They have also been found to reduce the risk of major cardiovascular events such as, and death from cardiovascular disease when compared to placebo in individuals with CKD.

Furthermore, ACEIs may be superior to ARBs for protection against progression to kidney failure and death from any cause in those with CKD. Aggressive blood pressure lowering decreases peoples risk of death.Although the use of ACE inhibitors and ARBs represents the current standard of care for people with CKD, people progressively lose kidney function while on these medications, as seen in the IDNT and RENAL studies, which reported a decrease over time in estimated GFR (an accurate measure of CKD progression, as detailed in the K/DOQI guidelines ) in people treated by these conventional methods.Other Aggressive treatment of high blood lipids is warranted. Low-protein, low-salt diet may result in slower progression of CKD and reduction in proteinuria as well as controlling symptoms of advanced CKD to delay dialysis start. Replacement of erythropoietin and, two hormones processed by the kidney, is often necessary in people with advanced disease.

Guidelines recommend treatment with prior to treatment with erythropoietin. A target hemoglobin level of 9–12 g/dL is recommended. The normalization of hemoglobin has not been found to be of benefit. It is unclear if help with anemia.

Are also used to control the serum levels, which are usually elevated in advanced chronic kidney disease. Although the evidence for them is limited, and show potential for helping men with sexual dysfunction.At stage 5 CKD, is usually required, in the form of either or a.Prognosis CKD increases the risk of cardiovascular disease, and people with CKD often have other risk factors for heart disease, such as.

The most common cause of death in people with CKD is cardiovascular disease rather than kidney failure.Chronic kidney disease results in worse all-cause (the overall death rate) which increases as kidney function decreases. The leading cause of death in chronic kidney disease is cardiovascular disease, regardless of whether there is progression to stage 5.While renal replacement therapies can maintain people indefinitely and prolong life, the is negatively affected. Kidney transplantation increases the survival of people with stage 5 CKD when compared to other options; however, it is associated with an increased short-term mortality due to complications of the surgery. Transplantation aside, high-intensity appears to be associated with improved survival and a greater quality of life, when compared to the conventional three-times-a-week hemodialysis.

Cancer risk Patients with ESKD are at increased overall risk for cancer. This risk is particularly high in younger patients and gradually diminishes with age.

Medical recommend that physicians do not perform routine cancer screening in patients with limited life expectancies due to ESKD because evidence does not show that such tests lead to improved patient outcomes. Epidemiology About one in ten people have chronic kidney disease. African Americans, American Indians, Hispanics, and South Asians, particularly those from Pakistan, Sri Lanka, Bangladesh, and India, are at high risk of developing CKD. African Americans are at greater risk due to a prevalence of hypertension among them. As an example, 37% of ESKD cases in African Americans can be attributed to high blood pressure, compared with 19% among Caucasians.People with high blood pressure and diabetes are also at high risk of suffering from CKD than those people without these underlying conditions. About one of five adults with hypertension and one of three adults with diabetes have CKD. Other health conditions that may lead to CKD are obesity, high cholesterol, a family history of the disease, lupus, and other forms of cardiovascular diseases.Chronic kidney disease was the cause of 956,000 deaths globally in 2013, up from 409,000 deaths in 1990.

What Is It And How Did I Get It Early Stage Chronic Kidney Disease Pdf 2017

In Canada 1.9 to 2.3 million people were estimated to have CKD in 2008. Found that CKD affected an estimated 16.8% of U.S. Adults aged 20 years and older in the period from 1999 to 2004. UK estimates suggested that in 2007 8.8% of the population of Great Britain and Northern Ireland had symptomatic CKD.Treatment efficacy also differs between racial groups. Administration of antihypertensive drugs generally halts disease progression in white populations but has little effect in slowing kidney disease among blacks, and additional treatment such as bicarbonate therapy is often required.

While lower socioeconomic status contributes to the prevalence of CKD, significant differences in CKD prevalence are still evident between African Americans and Whites when controlling for environmental factors.Studies have shown a true association between history of chronic kidney disease in first- or second-degree relatives, and risk of disease. In addition, African Americans may have higher serum levels of human leukocyte antigens (HLA). High HLA concentrations can contribute to increased systemic inflammation, which indirectly may lead to heightened susceptibility for developing kidney disease. Lack of nocturnal reduction in blood pressure among groups of African Americans is also offered as an explanation, which lends further credence to a genetic cause of CKD racial disparities.A high and so-far unexplained incidence of CKD, referred to as the, has been noted among male workers in Central America, mainly in sugar cane fields in the lowlands of. Heat stress from long hours of piece-rate work at high average temperatures of about 36 °C (96 °F) is suspected, as are agricultural chemicals and other factors.

What Is It And How Did I Get It Early Stage Chronic Kidney Disease Pdf File

In, another epidemic of CKD of unknown cause has become a serious concern. Society and culture In the US, the is a national organization representing patients and professionals who treat kidney diseases. The is a national nonprofit organization providing treatment-related financial assistance to one of every five dialysis patients each year. The is a nonprofit, patient-focused, patient-run organization that provides nonmedical services to those affected by CKD. The is a nonprofit, patient-centric group focused on improving the health and well-being of CKD and patients. The is an association representing professionals.In the United Kingdom, the and British Kidney Patient Association (BKPA) represents patients, and the represents renal physicians and works closely with the for kidney disease.

Serves that country.The is an international body representing specialists in kidney diseases.Other animals The total rate of CKD in dogs was 16 cases per 10,000 years. The mortality rate of CKD was 10 deaths per 10,000. The breeds with the highest rates were the Bernese mountain dog, miniature schnauzer and boxer. The Swedish elkhound, Siberian husky and Finnish spitz were the breeds with the lowest rates. Research Currently, several compounds are in development for the treatment of CKD. These include the angiotensin receptor blocker (ARB) and, a mixture of low molecular weight heparin and dermatan sulfate.

References.