All posts by В. Пенчев

Uremia is a clinical syndrome characterized by elevated blood urea levels. It is based on metabolic abnormalities, fluid imbalance, electrolytes and hormones associated with the deterioration of renal function.
Uremia is more common in patients with chronic kidney disease (CKD), especially in the later stages of CKD or in acute kidney damage if the loss of kidney function is rapid. Urea itself has both direct and indirect toxic effects on a number of tissues.

Urea is synthesized in the liver and is the end product of protein metabolism. It is transmitted from the liver through the blood to the kidneys, where it is excreted in the urine. However, when kidney function is impaired, waste products and toxins such as creatinine and urea accumulate in the blood and cannot be effectively filtered and removed. If uremia is left untreated, this condition is life-threatening.

Symptoms:

Tingling and numbness of the hands and feet – neuropathy

General fatigue and low energy

Nausea, vomiting and loss of appetite

High blood pressure

Swelling of the ankles

Dry skin and itching

More frequent urination

Chronic kidney disease and factors leading to kidney failure and uremia are:

Congenital anomalies of the kidneys

Polycystic kidneys

Diabetic nephropathy

Congestive heart failure and arrhythmias

Chronic pyelonephritis

Kidney stones, enlarged prostate

Taking certain medications and corticosteroids

The presence of too much water in the blood and the overload of the body with fluids is called hypervolemia.

One of the main functions of our kidneys is to balance fluids in the body. However, for dialysis patients, it is unable to regulate the required ratio of salts and fluids in the body. Hypervolemia is usually the result of a health problem. However, its mild form can occur after consuming foods with too much sodium or during hormonal changes. That is why it is so important to follow a diet plan that limits the amount of sodium (salt) and fluid intake for patients with kidney problems.

The most common symptoms include:

• unexplained and rapid weight gain
• swelling of the arms and legs
• abdominal bloating
• shortness of breath

Treatment

The condition of hypervolemia is managed in several ways. The most commonly used is with diuretics (drugs that increase the amount of urine that the body produces).
It is important to note that the basis of prescribed treatment is according to the specific health problem. For example, for patients with heart failure, beside taking diuretics, additional therapy will be given.

Clinical studies have shown that in patients with severe kidney problems, diuretics do not lead to the desired result so the necessary therapy is renal replacement, such as dialysis. If you are already on dialysis, longer or more frequent dialysis procedures might be needed to remove excess fluid from your body.
People with heart, kidney or liver disease may also need a diet low in salt. This will help keeping the sodium levels within normal limits, which in turn will avoid the condition of hypervolemia.

We have already paid attention to fruits and vegetables in the summer, suitable for people with kidney disease, so with the onset of September, it is the right time to discuss the autumn ones as well.

Undoubtedly, fruits and vegetables are always a healthy choice, as the best option is to consume seasonal products. For dialysis patients it is important to be cautious with the potassium content in the nutrition plan if a diet restricting this mineral is followed. Potassium is found in almost all kind of foods. Our body needs small amounts of it to make muscles work, but its increased values ​​can cause weakness, muscle cramps and irregular heartbeat.

Balance is the key to a diverse nutrition plan. Consuming a great amount of any food can be dangerous, but the careful selection of the appropriate products can give us the necessary freedom for a varied diet.

According to studies, the most suitable autumn fruits and vegetables are:
Apples, beets, broccoli, cauliflower, brussels sprouts, cauliflower, cabbage, carrots, celery, eggplant, green beans, lettuce, leeks, onions, pears, radishes, peppers, raw spinach, turnips.
In the list of vegetables that are good for patients with CKD is cabbage. It is a great source of vitamin B, vitamin C, magnesium and protein, all well known for their anti-inflammatory properties. It also reduces the swelling commonly found in dialysis patients. Cabbage can be served raw in salads, cooked in soups and stews, boiled or as a side dish.
Cauliflower can provide patients with CKD with vitamin C, folic acid and fiber. It is a vegetable with a lower potassium content and can be consumed often by people with kidney problems.

All fruits contain small amounts of potassium. It is good to limit the consumption of oranges and bananas but to increase that of apples.
Apples provide a variety of vitamins and minerals, including vitamin C, vitamin K and manganese. They are a great source of fiber, low in calories and suitable for regulating weight and blood sugar.
A good nutrition plan makes us feel better and keeps us healthy. A well-balanced diet with the right amounts of protein, calories, vitamins and minerals is vital for leading a healthy and fulfilling life.

Creatinine is a natural waste product that is formed in the processes of muscle metabolism. Creatinine is derived from creatine, which plays an important role in producing the energy needed for muscles.
Every day, 2% of creatine (an amino acid) in the body is converted to creatinine. The kidneys remove it from the body, as a result of which it is presented in the blood and urine.
Creatinine can build up in the blood if a person has a kidney problem, but it can also due to high protein intake, intense exercise or the usage of certain medications or supplements.
Monitoring of creatinine levels is often used as a guide for kidney function. High levels of creatinine in the blood or urine could mean that the kidneys are not filtering the blood effectively or for a serious health problem, such as chronic kidney disease.

Causes of high creatinine levels

A routine blood test can measure creatinine levels, as factors that might affect its levels are:

• certain medicines, including some antibiotics and non-steroidal anti-inflammatory creatine supplements
• dietary factors, such as high protein intake
• intensive exercises
• impaired renal function
• low blood flow
• dehydration

Other factors such as shock, different infections and diseases(for example cancer)can also cause elevated creatinine levels due to kidney damage.

High levels of creatinine in the body might be a sign that the kidneys are not working properly. Glomerulus – the part of the kidneys that filters waste products – does not function properly, may cause high levels of creatinine in the blood but low in the urine. This indicates that the kidneys are not functioning optimally.

Diseases that can affect kidney function and increase creatinine levels include:

• diabetes
• tumors
• some infections, such as hepatitis B and C, HIV and syphilis
• systemic lupus erythematosus, called SLE

Blood and urine tests are done to assess the current function of the kidneys. Тo check if an existing disease is progressing, and to monitor kidney function in people who are taking strong medications.

Keeping our kidneys healthy and functioning properly is essential for detoxification and the removal of waste products from our body. Unfortunately, there are some food products that can damage our kidneys and prevent them from functioning at optimal levels. We have already paid attention to the fruits, vegetables and food products appropriate for our kidney diet, so it is time to list some of those which are desirable to avoid.

We definitely give the first place to SALT.
Sodium overload leads to high blood pressure, which increases the pressure on your kidneys. The large amount of sodium chloride makes the kidneys to retain water in order to dilute the salt accumulated in the blood, which in turn impairs and burdens their function.

MEAT AND DAIRY PRODUCTS

According to studies conducted at the Mayo Clinic, a high-protein diet can cause or exacerbate existing kidney problems, as protein metabolism puts a heavy strain on the kidneys, making it difficult to eliminate waste products.
Consumption of dairy products increases the excretion of calcium in the urine, which is associated with a higher risk of developing kidney stones. Studies show that reducing dairy products can have a beneficial effect on people with kidney failure and kidney disease, making it easier to filter their blood when going on dialysis.

CAFFEINE

Caffeine is a stimulant that can cause increased blood flow and high blood pressure. Excessive caffeine intake is also associated with kidney stones. It also has a diuretic effect that reduces the ability of the kidneys to absorb water. In addition to caffeine, energy and carbonated beverages have a negative effect on kidney function.

GMO products

A large percentage of the processed foods we consume contain genetically modified organisms (GMOs). Although there is no solid evidence for the effects of GMO foods on the human body, animal experiments have shown serious adverse health effects, which include changes in major organs such as the kidneys.

One of the important functions of our kidneys is the synthesis of hormones, some of which are: erythropoietin, calcitriol (the active form of vitamin D3) and renin.

They also synthesize prostaglandins, which affect a number of processes related to physiological functions in the human body.

In addition to synthesis, kidneys are also involved in the breakdown of certain hormones – such as insulin or parathyroid hormone.

Erythropoietin

Erythropoietin is a peptide hormone that regulates erythropoiesis, consist of 165 amino acids.
In adults, approximately 90% of erythropoietin is synthesized in the kidneys and the remaining 10% is synthesized by hepatocytes and interstitial Ito cells of the liver (important during fetal and perinatal periods).
Erythropoietin secretion is controlled by the level of oxygen saturation in the blood. Under conditions of hypoxia (insufficient oxygen supply to cells and tissues), plasma erythropoietin increases. Hypoxia might be due to anemia, decreased oxygen capacity, decreased oxygen saturation of hemoglobin molecules, etc.

Calcitriol

Vitamin D taken with food or formed in the skin is hydroxylated in the liver and then in the kidneys to 1,25-dihydroxycholecalciferol, which is the biologically active form of vitamin D called calcitriol. Vit. D facilitates and maintains the intestinal absorption of calcium and those of phosphorus. It supports normal bone mineralization and its deficiency leads to osteoporosis in adults and rachitis in children.

Renin
Renin is a hormone produced by the kidneys which has leading role in controlling blood pressure and other important physiological functions.

It is an enzyme involved in the renin-angiotensin system (RAS), which regulates blood plasma, lymph and intestinal fluid through arterial vasoconstriction. Performing that function the blood pressure in the human body is regulated.

Prostaglandins

Prostaglandins are a group of lipids that have a great influence on the basic physiological processes in the body. Prostaglandins are hormones that are not synthesized by the glands, but are created during a chemical reaction at the site of injury or inflammation. Prostaglandins, which are produced by platelets, are actively involved in the blood clotting process and in the blood thinning process.

Definitely, for all patients on dialysis, life have changed completely. The whole process of understanding the disease and this particular way of living is stressful and requires strong-mindedness and toughness of spirit. However, dialysis should not prevent you from enjoying the life and keeping you isolated by the hospital bed. As difficult as it may sound from time to time – Be positive and look to the future!

Be positive and focus your energy on activities that are enjoyable for you.

Travel – Take time to plan things. Do not stop dreaming of visiting new places – there are doctors and clinics everywhere that can meet your needs.

Eat Healthy – The more toxins you put into your body, the more waste you will produce. Following a healthy diet will ensure that you improve your health and help you prevent some common side effects of dialysis.

Meet friends – They will support you as you go through these changes of life and you will feel a lot of positive feedback and energy around you.

Take an active part in your life – Do not look at your life as a bystander. Take an active part in your treatment plan. Inform yourself about everything that interests you.

Love yourself – Accept yourself as the person you are. Take small steps – one day, one moment, believing that everything will be fine regardless of the circumstances.

Look at life positively – Focus your positive energy on finding a suitable hobby for you, take a pet or just spend more time with your loved ones. Enjoy each and every new day and do not feel sorry for yourself.

Summer is the perfect time of the year when fresh fruits and vegetables are easily accessible. However, patients with chronic kidney disease and those on dialysis observe certain restrictions before eating their favorite fruits and vegetables. The reason for this is the high levels of potassium in various summer products. However, we will now present a list of suitable fruits and vegetables that meet the dialysis diet and are easily available in the summer.

Fruits

Blackberries – Blackberries are very good antioxidant. According to long-term research by the US Department of Agriculture (USDA), blackberries rank second on the scale – “Oxygen Radical Absorption Capacity”

Blueberries – Blueberries reduce DNA damage which helps the protection against aging and cancer

Cherries – Cherries are rich in flavonoids – such as the important anthocyanins for immunity. They also contain quercetin – a strong anti-inflammatory substance that relieves joint pain and protects against eye diseases.

Grapes – Grapes are rich in vitamins – C, B and provitamin A, which strengthen the nervous system, blood vessels, bones, nails and have a beneficial effect on vision. Grapes are also rich in potassium which supports the heart muscle and exudes the excess fluid, so grapes and its juice are recommended for high blood pressure, heart attacks, atherosclerosis, arthritis, gout, kidney stones or gallstones.

Peaches – Helps to remove toxins from the body in patients with kidney disease, rheumatism, heart disease and improves the function of the bile, liver and intestines.

Plums – For the liver, kidneys and heart, plum juice is a great helper for discomfort. Prunes are also recommended when suffering from multiple sclerosis. Just a quarter cup of prunes is enough to provide approximately 16.9% of the required daily dose of beta-carotene.

Strawberries – Their healing properties successfully fight the symptoms of melancholy, against seizures, fever, inflammation, blood poisoning and kidney stones.

Vegetables

Carrots – The main merits of carrots are vitamins: carotene (provitamin A), vitamins B1, B2, PP, C. They also contain many enzymes, essential oils, minerals – potassium, sodium, calcium, magnesium, phosphorus, iodine, iron and trace elements manganese and copper.

Cauliflower – Cauliflower is rich in provitamin A, pantothenic and nicotinic acid, folic acid and vitamin K.

Cucumber – Regular consumption of cucumbers can prevent the formation of kidney stones.

Eggplant – a tasty and nutrient-rich vegetable

Lettuce – Lettuce is a green leafy vegetable that contains a lot of vitamin C, folic acid and is also rich in fiber and water.

Peppers – Peppers are an indispensable supplier of vitamin B and folic acid. They balance homocysteine, the high level of which can lead to heart attack and stroke.

Peas – Peas are low in fat and thus help maintain a healthy weight. In the amount of one cup can be found less than 100 calories, but at the same time a lot of protein, fiber and micronutrients.

Radishes – contain vitamin B, as well as certain amounts of vitamin C, which makes them a weapon against colds, viruses and flu.

VITAMIN D AND CHRONIC KIDNEY FAILURE