Category Archives: Полезные статьи

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

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.

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).

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.