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ХБНХРОНИЧНА-БЪБРЕЧНА-НЕДОСТАТЪЧНОСТ-ПРИ-ДЕЦА

CKD (CHRONIC KIDNEY DISEASE) IN CHILDREN

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

БРЕМЕННОСТ И ДИАЛИЗА

PREGNANCY AND DIALYSIS

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.

DR. NIKOLAY TODOROV – REGULAR CONSULTATION

Dear all,

We would like to inform you that Dr. Nikolay Todorov (Medical Manager and Chief Nephrologist at NephroLife Medical Center) will have regular consultations twice a month here on site at our clinic in Burgas. He will dedicate two days every second week to meet with everyone who wishes to do so.

Those wishing to consult with Dr. Todorov need to call +35956555599 or +359 879 084 777, where they will receive information about the exact dates of the visits and the time of consultations.

We at NephroLife Clinic have always been socially engaged and it is important for us to enable more people from Burgas and the region to have the opportunity to consult with a highly qualified nephrologist, such as Dr. Todorov.
Dr. Nikolay Todorov graduated Medical School in Sofia in 1977. He is a leading specialist in the country in the field of catheterizations for hemodialysis – temporary and permanent tunneled catheters (over 800). There are numerous publications in the field of vascular access in hemodialysis patients and reports at scientific conferences. He is a member of the Bulgarian Medical Association, the Scientific Society of Nephrology, the European Renal Association-European Dialysis and Transplantation Association (ERA-EDTA) and the Vascular Access Society (VAS).

Бъбречната поликистоза

POLYCYSTIC KIDNEY

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

 

диабет и бъбреци

WHAT CAUSES DIABETES TO OUR KIDNEYS?

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.

БЪБРЕЦИТЕ И ЖЕЛЯЗОТО

WHAT IS IRON AND WHY WE NEED IT?

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

 

МЕРКИ ЗА ПРЕВЕНЦИЯ

PREVENTION AND PROTECTION

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

Диализен център NEPHROLIFE

NUTRITION FOR OPTIMAL HEALTH

Nutrition for optimal health

Your nephrologist and medical team will work with you to create a nutrition plan. If you are on dialysis and you have developed diabetes, you will need to control your blood sugar and test your levels at least twice a day. If you have high blood pressure you should avoid salt. Your medical team will explain to you how the food and drinks you consume affects your health condition and your treatment. Your nephrologist could will also recommend if needed vitamins and health supplements.

Diabetes
In our country, diabetes is factor number one in 38% of cases of chronic kidney disease (CKD) leading to dialysis. This is also the main cause of kidney failure worldwide. If you are living with diabetes and kidney disease, it is important to keep control of both conditions by eating properly, following the medication prescribed by your doctor.

High blood pressure (hypertension) – High blood pressure is the second factor of chronic kidney disease, responsible for 28% of CKD cases. If you have high blood pressure, it is important to live a healthy lifestyle and take medicines as prescribed by your doctor. High blood pressure weakens the blood vessels, which can lead to kidney disfunction.

Anemia
 – Having CKD reflects your body’s ability to produce red blood cells that transport oxygen to your organs. Condition of having low level of red blood cells is called anemia and makes you feel tired and weak. Taking medication – erythropoietin and iron – will help your body to generates more red blood cells.

High cholesterol
– If the levels of cholesterol in your blood are too high, it can clog your arteries. It becomes a hard plaque that restricts or blocks blood circulation to your heart. Your doctor may recommend dietary changes, exercises, and most probably special medications to help lower your cholesterol levels.

Bone and mineral diseases
– When your kidneys are not working properly, your body is not able to keep the levels of calcium and phosphate at healthy levels – your kidneys cannot filter out the excess amount of phosphorus in your blood and they are not helping your body of retaining Vitamin D. Your kidneys activate (switch on) vitamin D which is important for calcium balance. When these minerals are not in balance that makes your bones weaker and more fragile. Your doctor will probably prescribe you to take phosphorus binders (medicines that bind phosphorus and lower its levels in your blood and are commonly prescribed class of drug for patients on dialysis) and vitamin D.

Smoking

– If you smoke you should consider giving it up. When you have CKD, tobacco increases the stress on your heart and other organs, which is extremely dangerous. Some versions of smokeless tobacco also contain molasses, which has high levels of potassium and should be avoided.

 

БЪБРЕЧНАТА ДИСФУНКЦИЯ

THE RIGHT DIET CAN HELP FIGHT KIDNEY DISEASE

KIDNEY DISEASE

When living with chronic kidney disease, managing what you eat and drink can be a challenge.

Some of the waste in your blood comes from foods you consume, so following a proper diet can help avoid a buildup. This can reduce stress on your kidneys, which can slow the progress of kidney disease.

There is a group of products that is recommended to be included in our diet plan.

Skim milk, cantaloupe and brown rice may be the keys to prevent kidney disfunction. According to research, junk food, smoking and obesity can cause kidney disease in otherwise healthy people.

A group of scientists led by Alexander Chang, MD of Loyola University Medical Center found that people with normal kidney function and no hypertension or diabetes whose diet was high in red meat, sugar-sweetened beverages and low in fruit and whole grains were 97% more likely to develop kidney disease. Additionally, obese people or those with BMI over 30 were nearly three times more likely to develop kidney disfunction. Those who smoked were 53% more likely to develop it.

Researchers also pointed a connection between sugary sweet beverages and the development of chronic kidney disease. Those who drink more than 4 sugary sweet beverages each week had a 150% increased chance of developing kidney disease. “Consumption of these beverages has recently been linked to the presence of protein in the urine, one of the earliest signs of kidney disease, ” said Dr. Chang. “It’s possible that the fructose in these drinks is uniquely metabolized, promoting production of uric acid which has been shown to cause hypertension and reduced blood flow to the kidney in rat models.”

ДИАЛИЗА

AVOIDING INFECTION WHILE ON DIALYSIS

When you’re on dialysis, it’s important to avoid infections of any kind. Infections occur when bacteria, viruses or fungi enter the body by touch or inhalation through the nose or mouth. Some people on dialysis may be likely to get an infection due to the vulnerability of their access site or other health conditions like diabetes. People living with kidney disease are also at greater risk for complications related to illnesses like the flu and pneumonia

It’s important to be your own advocate. Remember that you are the person who can have the most direct impact on looking after your health. Staying healthy and avoiding infection can help keep you out of the hospital.

How can I avoid infection?

There are simple steps you can take to help you stay your healthiest:

Practice good hygiene—washing your hands often or using an alcohol based hand sanitizer can help prevent infection.

Care for your access properly—it’s important to follow your nurse’s exact instructions on how to care for your hemodialysis access site or care for your peritoneal access site.

Check for infection—learn the signs and symptoms of access site infection elsewhere in your body. Alert your nurse immediately if you think you may have an infection, so you can receive proper treatment.

If you’re on peritoneal dialysis (PD): infection can cause peritonitis, a serious infection of your peritoneum. Treating peritontis early with antibiotics is important. Tell your nurse immediately if you think you have contaminated yourself during PD treatment or if you suspect you may have an infection.

Talk to your nurse or doctor about infection

If you suspect you have an access infection or any other infection in your body, alert your care team immediately. A severe access infection can prevent you from getting dialysis, so it’s important to treat any infection as early as possible. Inspect your access site regularly and look out for redness, draining, tenderness or swelling. Also tell your doctor right away if you have a fever—a sign your body is fighting infection.

Take all antibiotics exactly as directed

Your doctor or nurse practitioner will prescribe the exact dose and duration of antibiotics for your particular infection. It’s important to take your medication exactly as prescribed to clear the infection completely and help prevent recurrence.

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