All posts by В. Пенчев

Vitamin D is one of the main nutrients that support human health.

Researches have shown that vitamin D deficiency is closely linked to common chronic diseases, such as bone metabolic disorders, tumors, cardiovascular disease, diabetes, neuropsychiatric disorders and autoimmune diseases.
In healthy people, the active form of vitamin D is produced by the kidneys, but in renal failure, the production of active vitamin D is reduced, which can lead to low levels of calcium and high levels of parathyroid hormone in the blood. Even in the early stages of chronic kidney disease the level of active vitamin D. is reduced. Its deficiency affects a number of processes in the human body and causes a significant number of pathological conditions. Vitamin D should be given according to serum calcium, phosphorus and parathyroid hormone levels. Due to improper metabolism and losses caused by dialysis, supplements of aqueous solutions of vitamins are recommended. In patients with chronic kidney disease, especially in advanced stages, vitamin D medications (vitamin D3 and vitamin D2) are not recommended, because the reduced kidney tissue may not be able to process them in sufficient quantity as it is supposed to be.
On the other hand, the correct dosage of vitamin D helps to treat a number of diseases and improve overall health. It protects against cardiovascular disease, successfully fights depression, has antiviral function, suppresses the development of autoimmune diseases such as diabetes, rheumatoid arthritis, multiple sclerosis, psoriasis, and helps destroy cancer cells in the body.

Some of the main causes of CKD in adults are diabetes and high blood pressure, which are not the main reasons for developing the disease in children. However, there is a tendency to increase the number of children suffering from diabetes and high blood pressure, mainly due to the problem of obesity. In addition to those already listed, being overweight significantly increases the risk of developing other serious health problems, one of which is CKD.

Chronic renal failure is defined as a clinical and laboratory syndrome that results from the irreversible loss of basic renal function.

The main reasons for the development of CKD in children are:

Congenital anomalies of the urinary system, most often up to 5 years of age
Acquired glomerulopathies – Conditions that damage the filtering units of the kidneys (glomeruli)
Urinary tract problems that block the normal flow of urine
Inherited diseases such as polycystic kidney disease (PKD)

Common symptoms of CKD in children:

Swelling around the eyes, feet and ankles
Frequent headache caused by high blood pressure
Frequent urination
Growth retardation

Loss of appetite and chronic nausea
Fatigue
Anemia and pale skin

The the most accurate method for confirming pregnancy for women with confirmed renal failure is ultrasound, because of the fact that β-hCG levels can increase during this period, which in turn can lead to false positive results from pregnancy tests. The incidence of pregnancy in women on dialysis is extremely low, but the rate of successful pregnancies in this context has increased over the years

Going on dialysis before getting pregnant results in a higher live birth rate and a lower likelihood of preterm birth than conception after initiation of dialysis. Cohort data show that dialysis intensity influences outcomes for more successful births, longer gestational age and higher birth weight of the newborn. During pregnancy, women on dialysis should be monitored for low levels of potassium, phosphate and folate, as well as for high glucose, especially for patients going on peritoneal dialysis. It is also important to be monitored for anemia, to maintain a healthy diet and observe the magnesium levels. A strategy in the study of the importan of dialysis during pregnancy is the evaluation of recorded data to determine the impact of early or late initiation of dialysis in pregnancy and to observe the results focused on live birth, pregnancy survival, gestational age and weight of the newborn.

Therefore, all pregnant women on dialysis are facing a number of extremely stressful challenges. The difficulty in conceiving, maintaining a healthy pregnancy and the following care of a baby by a person struggling on his own to survive, requires enormous support from family and the loved ones.

Polycystic kidney disease in adults is an inherited disease that is characterized by the formation and growth of multiple cysts in both kidneys and leads to the development of chronic renal failure. There are areas between the cysts with preserved renal tissue although the mechanism of disease development is still unclear. It is assumed that even in embryonic development, many of the glomerular tubules are formed defectively, the accumulated primary urine dilates them and cysts appear. The genetic frequency relative to the general population is 1 per 1000. It is assumed that various DNA mutations are the basis for the formation of polycystic kidney disease.
There are several types of the disease according to the specific gene defect. However, the most common is autosomal dominant renal polycystosis. It is one of the most common inherited kidney injuries, with approximately 10% of all patients reaching chronohemodialysis as a result.

Symptoms:

The disease is initially asymptomatic. The symptoms begin to appear most often in the 30s and 40s of the patient’s life. The most common symptoms are:
• Pain and heaviness in the lumbar region;
• Presence of blood in the urine (haematuria);
• Kidney formation, which in some cases can reach significant sizes;
• Hypertension;
• Frequent and nocturnal urination
• In more severe conditions, fever, fatigue, loss of appetite, dizziness may occur

What Causes Diabetes to our Kidneys?

A long periods of high blood glucose levels can severely damage the structure of the kidney.
Diabetes mellitus can impair the ability of the kidneys to filter blood by damaging millions of small blood vessels in them. When this happens, they cannot cleanse the blood properly. Your body will retain more water and salt than it needs, which can lead to weight gain and swollen ankles. Proteinuria may occur as well as accumulation of waste products in the blood.

Diabetes can also cause damage to the nervous system, leading to difficulty in emptying the bladder. Pressure from the full bladder can disrupt kidney function. Also, if the urine remains in the bladder for a long time, it is possible to develop infections due to the rapid growth of bacteria in the urine when there is a high level of blood sugar.

How Many Patients with Diabetes Will Develop Kidney Disease?

About 30 percent of patients with type 1 diabetes and 10 to 40 percent of those with type 2 diabetes will eventually suffer from kidney failure.

What Are The Early Signs Of Kidney Disease In Patients With Diabetes?

The earliest sign of kidney disease is increased albumin content in the urine. This is long before the usual tests done for kidney disease, so it is important to have this screening every year. Increased blood pressure is also possible.
In the early stages of kidney disease there are medications that can prevent the patient from getting worse. When kidney disease is left untreated or established late, the number of patients who develop kidney failure increases. At this stage of kidney damage, waste products begin to accumulate in the blood and dialysis treatment may be required.
Maintaining control of diabetes can reduce the risk of developing severe kidney disease.

What is Iron and why we need it?

Iron is a mineral that is necessary for the maintenance of healthy red blood cells and for the overall health condition of the body. The required amount can be added through a variety of foods or through various supplements or medications prescribed by your doctor.

Iron helps our body in many ways, one of which is the synthesis of red blood cells. Red blood cells transport  oxygen from the lungs to all parts of the body and supply us with the energy we need for our daily activities. The kidneys make our body  generate red blood cells, and iron in turn helps them stay healthy.

Why  Iron is so important?

If the amount of iron in our body is not enough you can develop anemia. Anemia is generally a lack of red blood cells. As a result, the blood cannot transport enough oxygen throughout  your body.

How much iron do I need?

You need  iron to maintain a healthy hemoglobin level. Hemoglobin is part of your red blood cells. This is the part that carries oxygen through your body. Hemoglobin is composed of oxygen and iron. So, one way to know if your body has enough iron is to measure how much hemoglobin is in your blood. People with kidney disease or kidney failure may have lower levels.

What are the symptoms if my iron level is low?

Common Signs are:

Pale skin

Feel  tired or weak

Depression

Shortness of breath

You have chest pain

You feel dizzy

You may feel numbness or coldness in your arms and legs

Have a faster heart rate

If I have kidney disease, what is the treatment for low iron?

If you have low iron and low hemoglobin, your doctor will develop a treatment plan that is right for you. Some of the following general rules could also be observed:

• A diet rich in iron, which includes red meat, beans and green vegetables. However, consuming foods rich in iron may be hard due to your kidney diet.
• A vitamin and mineral supplement with iron, vitamin B12, and folic acid.

Keep in mind that iron supplements may affect other medicines you are taking. Therefore, it is important to consult your doctor before taking supplemental iron-rich medicines.

THE RIGHT DIET CAN HELP FIGHT KIDNEY DISEASE

News headlines are primarily for the spread of coronavirus-COVID-19. Although, day after day, we learn more about the nature of the virus, there is still much that remains to be discovered. Medical teams all around the world share information and work together to limit the spread of the virus as much as possible.

With the increasing number of confirmed COVID-19 (Coronavirus) cases worldwide and globally, patients with renal failure, who are more susceptible to infection, should follow the personal care tips and to be up-to-date of the dynamically changing situation with COVID-19.

Prevention, protection, screening and isolation measures are essential to limit the epidemic level and must be taken seriously by each of us.
– Wash your hands. This is one of the best ways to prevent the disease and spread of germs. You should do this for at least 20 seconds.
– Cover your nose and mouth when coughing or sneezing. Do not cough in your hands and use tissue if possible.
– Avoid touching your eyes, nose or mouth. It’s easy to say, but difficult to implement
– Avoid touching surfaces in public
– Avoid greeting people with a handshake, a hug, or a kiss
– Stay home. If you are sick, stay home. If you have traveled to another country where the coronavirus is confirmed or have been with someone who has a confirmed coronavirus case, you will need to be quarantined.
– Contact your doctor if you feel unwell. The main symptoms of a coronavirus are: fever, cough and shortness of breath

We are constantly monitoring the situation to ensure that our preventative measures are sufficient for a global pandemic.

We take this very seriously, we carefully monitor the situation and update our information in its dynamic global changes.

Our primary responsibility is to protect the health and well-being of our patients and the medical team, as well as to prevent the spread of the infection in our center.

AVOIDING INFECTION WHILE ON DIALYSIS