All posts by В. Пенчев

Cardiovascular problems is much more common in people with kidney disease or kidney failure.

Like all organs, the heart is made of tissue, which requires a supply of oxygen and nutrients. Although his chamber is full of blood, his own supply comes from a network of arteries called coronary arteries.

The name „heart disease “includes a number of health problems that can affect the heart or blood vessels. Doctors call these disorders cardiovascular disease. The heart and blood vessels work together to deliver oxygen to all parts of the body, including the brain, heart, legs and lungs. Damage to the heart or blood vessels can be very serious and can lead to chest pain, heart attack or stroke.

In addition to kidney failure, most people on dialysis have one or more of the following conditions:

• Diabetes
• High blood pressure
• Anemia
• High levels of fats such as cholesterol in the blood
• Poor balance of minerals such as calcium and phosphorus, leading to disease and heart problems

Each of these conditions forces the heart to work harder, and it eventually loses its ability to pump blood well enough.

Can dialysis patients do anything to keep their heart healthy?

Dialysis people have specific health needs.

You can also follow these easy ten steps for a healthier heart.

• Follow an optimal and healthy diet
• Be physically active
• Keep your blood pressure and cholesterol levels under control
• Maintain a balance of calcium and phosphorus
• If you have diabetes, keep your blood sugar under control
• Do not smoke
• Reduce stress
• Maintain a healthy weight

Nutrition in hemodialysis patients is very important to minimize health complications and ensure quality of life in general.

Diets in patients with chronic disease play an important role in planning the treatment process.

The purpose of the diet plan is to examine patients’ appetites to adjust the systemic norm to alleviate or prevent cardiovascular and peripheral diseases. Also, to neutralize electrolyte disorders and uremic diseases such as itching, nausea, recovery, loss of appetite. In addition, adherence to a balanced diet helps reduce high potassium and sodium levels in the diet, prevent pulmonary edema, hypertension and heart failure. Negatives (hyperkalaemia, hyperphosphatemia, peripheral and pulmonary outflow) in fluid and electrolyte balance are monitored in patients who do not observe these changes.

The result of studies that hemodialysis patients are at risk of malnutrition.

Malnutrition depends on several factors in hemodialysis patients. Two types of malnutrition could be differentiated in this particular group of patients. The first type is determined by the uremic syndrome and the decrease in serum albumin levels due to reduced energy and protein intake. The second type results from the use and atherosclerosis, high risk heart disease. The manifested features here are increased oxidative stress, protein catabolism, increased energy expenditure in energy, hypoalbuminemia. In addition, malnutrition due to unbalanced diet of water to chronic volume overload, congestive heart failure and systemic hypertension, uremic bone examination and extraskeletal metastatic calcification due to the development of hyperphosphatemia and other adverse conditions.

There are different ways to find out if a hemodialysis diet works. A factor in this is how you feel before and after dialysis sessions. Following the rules of your diet, the accumulation of waste products and fluids will be minimal and you will not feel bad. During the procedure itself, the amount of fluid you will lose from your body will not be too large, which will prevent the feeling of weakness or dizziness. Also, you may have fewer health causes caused by taking too much phosphorus, sodium and potassium.

Diabetic nephropathy is a progressive kidney disease that can affect people with diabetes. It is a serious complication of type 1 diabetes and type 2 diabetes, also known as diabetic kidney disease.

It is observed in high blood sugar levels, which subsequently impair the proper function of the kidneys. Diabetic nephropathy is a type of chronic kidney disease that is characterized by the maintenance of high glucose levels for many years, leading to changes in the nephrons. Therefore, people with diabetes often release protein in their urine. The most common protein released is albumin.

One of the first signs of diabetic kidney disease is increased urinary albumin. When only small amounts of it are found in the urine, this is called microalbuminuria. Characteristic of this health problem is weight gain and swelling of the ankles.

The natural course of diabetic kidney disease includes glomerular hyperfiltration, progressive albuminuria, decreased GFR, and ultimately end-stage renal disease. Diabetic nephropathy begins as glomerular hyperfiltration. Microalbuminuria then occurs, urinary albumin excretion in the range of 30 to 300 mg albumin / day. Microalbuminuria progresses to macroalbuminuria usually over years. The nephrotic syndrome (proteinuria ≥ 3 g / day) preceding the end stage of kidney disease takes an average of about 5 years, but this time is also highly variable.

Once this damage is present, the remaining kidney filters must work extra to compensate for deficiencies in the proper functioning of the system. Once the kidneys start working at less than 15% of their capacity, kidney failure is diagnosed and the patient usually goes on dialysis.

There is no specific treatment for diabetic nephropathy, but the progression of the disease can be slowed by controlling blood pressure, optimizing blood sugar levels and changing the diet. Once kidney disease is present, the most important thing to pay attention to is controlling blood pressure.

The diet is extremely important for the proper and balanced functioning of the body. Proper selection of the food we consume can help control the accumulation of waste products and fluids in the blood and reduce the burden on the kidneys. Undoubtedly the most important factor for the health and proper function of the kidneys is the intake of sufficient water which ensures that the level of minerals in the urine is not excessively concentrated and helps prevent the formation of kidney stones.

Here are some of the foods that are recommended for the prevention of kidney disease.

Apples

Apples are a rich source of pectin and soluble fiber, which maintain healthy cholesterol and blood sugar levels. According to research, pectin also increases the content of important antioxidants in the kidneys and are extremely suitable for their detoxification. Daily consumption of apples reduces the risk of developing urinary tract infections and prevents the formation of kidney stones.

Blueberries

They have powerful antioxidant and anti-inflammatory properties that can benefit kidney health. Increase renal blood flow and improve the ability of the kidneys to filter waste.

Red cranberries

Extremely suitable for urinary tract infections. Prevent bacteria from sticking to the lining of the bladder and kidneys.

Cabbage

A source of vitamin C and vitamin K, as well as many B vitamins. Sauerkraut or cabbage soup enhances the activity of key enzymes involved in the prevention of kidney cancer.

Eggs

Eggs are a great source of protein, leucine, lutein, zeaxanthin and vitamin D. In people with chronic kidney failure (CKD), it is advisable to consume only protein, as the yolk is rich in phosphorus, a mineral that interferes with kidney function.

Oily fish

Oily fish such as mackerel, salmon, tuna, sardines or anchovies are rich in omega-3 fatty acids. These healthy fats have powerful anti-inflammatory properties and support kidney function. Omega-3s can also help lower blood pressure, which is a risk factor for kidney disease.

Olive oil

In addition to being extremely beneficial, olive oil helps reduce inflammation throughout the body, including the kidneys.

Sweet potato

Sweet potatoes contain vitamins and minerals that balance sodium levels. However, because sweet potatoes are high in potassium, they should be consumed moderately by people with CKD.

Beets

With its detoxifying and diuretic properties, beets are recommended for strengthening and cleansing the kidneys, liver and gallbladder.

https://nephrolife.bg/en/2020/03/06/the-right-diet-can-help-fight-kidney-disease/

Poly-cystic kidney disease (PCKD) is a genetically heterogeneous disease that affects the kidneys and other organs. It can exist in both autosomal dominant and recessive forms. Accumulations of fluid-filled sacs called cysts develop in the kidneys, which interfere their ability to filter waste products from the blood. The growth of these cysts leads to enlargement of the kidneys and can also lead to kidney failure.

Autosomal dominant poly-cystic kidney disease is a genetic disease that affects 1 in 1,000 people worldwide and is associated with an increased risk of intracranial aneurysms.

How serious is poly-cystic kidney disease?

The disease can cause serious complications, including high blood pressure and kidney failure. It varies considerably in severity, with some complications preventable. Lifestyle and treatment changes can help reduce the degree of disability.

What causes poly-cystic kidney disease?

The cause of poly-cystic kidney disease is a gene mutation or defect. In most cases, if a child carries such a mutation, it is inherited from a parent. In very rare cases, it develops primarily without either parent carrying the mutated gene. Symptoms include acute low back pain or hematuria due to hemorrhage in the cyst, abdominal discomfort due to increased kidney size or symptoms of uremia.

• High blood pressure
• Back or side pain
• Blood in your urine
• Feeling of fullness in the abdomen
• Increased belly size due to enlarged kidneys
• Headache
• Kidney stones
• Kidney failure
• Urinary tract or kidney infections

In laboratory tests, urine is low in relative weight, proteinuria and hematuria are observed. Peripheral blood count is normal.

Inheritance of a gene mutation can be determined by DNA analysis.

CKD is a partial or complete reduction in renal function and is characterized by five stages. The disease progresses slowly and is determined by the extent to which renal function is reduced. An indicator of this is the so-called “Glomerular filtration”.

First stage of CKD – initial and still reversible phase of the disease with glomerular filtration> 90 ml (normal). At this stage, there is a very slight impairment of renal function, which is asymptomatic. At this stage, the kidneys function normally, but a change in urine results is possible – for example presence of protein.

Second stage of CKD – glomerular filtration between 60 and 89 ml. In second-stage of CKD, there is a slight impairment of renal function. The kidneys are still functioning well, which in turn does not cause symptoms.

Third stage of CKD – glomerular filtration between 30 and 59 ml, regardless of whether there are other symptoms suggesting the presence of kidney disease. During this period of the disease there is a moderate impairment of renal function.

This phase is divided into two stages:

– with glomerular filtration between 45 and 59 ml.

– with glomerular filtration between 30- and 44-ml.

Common symptoms are: swelling of the legs and arms, back pain, more or less urination than usual, high blood pressure, anemia.

Fourth stage of CKD – ​​glomerular filtration between 15- and 29-ml

Moderate to severe renal impairment is already observed here. Characteristic of this condition is that it is the last stage before the complete cessation of renal function. At this stage of the disease there are symptoms such as: swelling of the legs and arms, back pain, more or less urination than usual and the consequences of the accumulation of waste products from the metabolism in the blood. Water-electrolyte homeostasis is disturbed. Pathologies in the endocrine function of the kidneys are observed and the synthesis of erythropoietin in the kidneys is reduced.

Fifth stage of CKD – ​​glomerular filtration <15 ml

In grade 5 of CKD, the kidneys have stopped working or are functioning very little. At this stage of the disease there are always symptoms caused by the accumulation of fluids and waste products in the body: itching, muscle cramps, nausea and vomiting, swelling of the legs and arms, back pain, often complete cessation of urination, shortness of breath, insomnia. In laboratory tests are typical high levels of urea and creatinine, an increase in serum phosphate and potassium. High levels of protein, red blood cells, sediments and others can be observed.

After the kidneys have failed to function, the patient must undergo hemodialysis, as well as discuss the possibility of transplantation. Transplantation eliminates the need for hemodialysis, but in turn requires a strict control and medication against immune rejection of the organ.

There are two types of dialysis – hemodialysis and peritoneal dialysis.

HD uses an out-of-body filter called a dialyzer. With the help of the hemodialysis machine, the blood from the body is filtered through an artificial membrane – “dialyzer”, or “artificial kidney” to clear toxins that the kidneys can no longer remove. Peritoneal dialysis is a way to remove waste products from the blood in a different way from the more common blood filtration procedure called hemodialysis.

A peritoneal catheter is required before initiating PD. PD uses the lining of the abdominal cavity, called the peritoneal membrane, which serves as a natural filter to remove fluids and harmful substances from the blood. This is achieved by periodically infusing a special solution into the abdominal cavity. The lining of the abdomen (peritoneum) acts as a filter to remove waste products from the blood. Your doctor can tell you which type of dialysis may be the best option for you.

Factors to consider are:

– Your kidney function – Overall health

– Your personal preferences

– Your way of life

Peritoneal dialysis may be a better option if:

– You want to minimize the interruption of your daily activities

– You want to work or travel easier

– You have some residual kidney function

Peritoneal dialysis may not work if you have:

– Adhesions and mechanical defects of the abdominal wall also complicate the procedure.

– Inflammatory bowel disease or frequent attacks of diverticulitis

– Impossibility to observe strict hygienic measures

Advantages of peritoneal dialysis

– No vascular access with fistula or catheter is required;

– Patient mobility

– The therapy is carried out at home

– Lower risk of transmitting dangerous viral infections.

Disadvantages of peritoneal dialysis:

– Risk of infections

– Risk of obesity

– Impaired fat metabolism

– Cleansing from nitrogenous bodies (urea and creatinine) is not so good

People with kidney disease often undergo a number of medical tests and procedures. They are an indicator of the diagnosis made or are performed to monitor progress during treatment.

To determine the state of renal function, tests for creatinine, blood urea and albumin are most often prescribed.

Creatinine – is a waste product of muscle activity. It is usually removed from the blood by the kidneys and passes into the urine. When kidney function is reduced, it remains in the blood. The main reason for the increased levels of creatinine in the blood is the reduced glomerular filtration in the kidneys, which is due to acute disease or chronic diseases.

When the patient is on dialysis, creatinine levels are always high.

The appointment of a creatinine test may be for prophylactic or diagnostic purposes or in case of suspicion of certain diseases.

Urea – Urea is a waste product that is formed in the liver. Blood urea testing provides important information about kidney and liver function, helping to diagnose various kidney diseases.

If the body retains urea, it means that the kidneys are not working properly. Increased urea levels may also occur during strenuous exercise, as well as when taking certain drugs, such as hormones. Generally speaking, urea levels in the blood inform the kidneys’ ability to remove harmful substances from the body.

Albumin – Human albumin is a small globular protein consisting of 585 amino acids. Albumin is synthesized in the liver, after which it is excreted into the bloodstream. It plays an important transport role – for hormones, vitamins, or medications.

An important indicator is the amount of albumin and the ratio of total sweat in various disease processes: chronic liver disease, chronic kidney failure, cancer or in the diagnosis of edema.

The renal nuclear scan is a diagnostic test and can be performed in several different ways using a radioactive indicator. It is used to diagnose suspected kidney problems and to assess their function. It is an extremely effective diagnostic tool because, in addition to showing their anatomy, it reveals how well they are functioning at the moment.

Radioisotope research is done by introducing a small amount of radioactive isotope into the body and monitoring its entry, accumulation and excretion by the kidneys. During the scan, the corresponding indicator is injected into a vein and monitored to and through the kidneys with special detectors. The process is monitored on a computer screen. The resulting images show the delivery of fluid to the kidneys through the bloodstream and the ability to excrete fluid from the kidneys through the ureters and bladder. The ability to analyze kidney function allows doctors to diagnose specific kidney diseases and problems much more accurately than with the possible standard imaging tests.

Reasons for conducting the test

– to assess renal function

– to see abnormalities in the size, shape and structure of the kidneys

– renal artery stenosis

– to monitor renal function after transplantation

– detect damage or obstruction in the ureters

– for diagnosis and evaluation of tumors, cysts or abscesses in the kidneys.

Scanning the kidneys is generally painless, but it is possible to experience mild discomfort. The patient can return to his daily activities immediately after the procedure. Redness and soreness at the injection site are possible side effects. Although radiation exposure is minimal, you should tell your doctor if you are pregnant or breast-feeding before undergoing the procedure.

pH is a scale that measures the alkaline and acidic properties of the aquatic environment and represents the ratio of positively charged hydrogen ions to negatively charged ones in a solution. This is one of the most important indicators of homeostasis in the body. Our body is made up mainly of water, and the environment we need to maintain is slightly alkaline – from 7.35 to 7.45.

The acid-base balance requires the cooperation of three main organs: the liver, kidneys and lungs.

The acidic environment is rich in protons, while the alkaline is rich in electrons. Electrons determine an oxygen-rich environment that provides the required amount of oxygen throughout the body and meets the needs of normal, aerobic cells.

Plasma buffer systems include plasma proteins, phosphate and bicarbonate, and carbon buffers. The kidneys help to control the acid-base balance by releasing hydrogen ions and generating bicarbonate, which helps keep blood plasma pH within normal limits.

With disturbed alkaline-acid balance with low pH values there are problems related to weight, allergies, arthritis, fungal infections, impaired metabolism, chronic fatigue and lack of energy, muscle pain, cramps.

The kidneys and lungs are the main factor in neutralizing the acid accumulation in our body. They help in the process of acid control and support the balance of the blood. Their main task is to neutralize sulfuric or uric acid through urination. As these or other acids increase, the kidneys increase their production of hydrogen ions to balance these processes.

Thanks to their work, our body has a filtering mechanism that removes acids from the bloodstream, eliminated through the urine. Proper kidney function is ensured by alkaline reserves or alkaline substances, which are desirable to be regularly provided to the body through an optimal diet.

Alkaline food intake helps to:

– Proper metabolism

– Digestion

– Energy depots are increasing

– Immunity