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Sunday, July 29, 2012

Women on Dialysis become Menopausal 3 Years Earlier


The number of women receiving dialysis treatment for kidney failure in the United States continues to increase. By the end of 2004, there were over 210,000 women receiving dialysis in the U.S. and the majority of these women were older than 50 years of age and likely menopausal when they initiated dialysis. The average age of the women on dialysis at the time menopause is 48; three years younger than the average age of when menopause starts for women in the general population. The average age of the women at the time menopause started was 48, three years younger than the average age of when menopause starts for women in the general population. Due to the risk of clotting the dialysis access, women who desire estrogen replacement for treatment of menopausal symptoms should consider transdermal estrogen to avoid the potential side effects of blood clotting.

For women receiving dialysis, starting doses of estrogen should be half the dose which would be used in a woman with normal kidney function. Other treatment options for menopausal symptoms include:

1. Gabapentin (anti-convulsant)
2. Clonidine (an anti-hypertensive medication)
3. Anti-depressants such as fluoxetine and sertraline.

However, these drugs are not as effective for treating severe menopausal symptoms as estrogen itself.


Vaginal atrophy, which may lead to painful sexual intercourse, is best treated with vaginal estrogen. Lubricants are also helpful to assist with vaginal dryness.

Diabetic Foot Ulcer




 The risk of lower extremity amputation is 15 to 46 times higher in diabetics than in persons who do not have diabetes mellitus. Furthermore, foot complications are the most frequent reason for hospitalization in patients with diabetes, accounting for up to 25 percent of all diabetic admissions in the United States and Great Britain.

Risk Factors for Lower Extremity Amputation in the Diabetic Foot:
1. Absence of protective sensation due to peripheral neuropathy
2. Arterial insufficiency
3. Foot deformity and callus formation resulting in focal areas of high pressure
4. Autonomic neuropathy causing decreased sweating and dry, fissured skin
5. Limited joint mobility
6. Obesity
7. Impaired vision
8. Poor glucose control leading to impaired wound healing
9. Poor footwear that causes skin breakdown or inadequately protects the skin from high pressure and shear forces
10. History of foot ulcer or lower extremity amputation




Do you check your foot everyday?

Diabetes: What should I do during a heart attack?

Heart attack results from the interruption of blood supply to a part of the heart, causing heart cells to die. Typical symptoms of acute myocardial infarction include:
1. Sudden chest pain (typically radiating to the left arm or left side of the neck)
2. Shortness of breath
3. Nausea and vomiting
4. Palpitations
5. Sweating and anxiety (often described as a sense of impending doom).

Women may experience fewer typical symptoms than men, most commonly shortness of breath, weakness, a feeling of indigestion, and fatigue.

Important risk factors are previous cardiovascular disease, older age, tobacco smoking, high blood levels of certain lipids (low-density lipoprotein cholesterol, triglycerides) and low levels of high density lipoprotein (HDL) cholesterol, diabetes, high blood pressure, lack of physical activity and obesity, chronic kidney disease, excessive alcohol consumption, the abuse of illicit drugs (such as cocaine and amphetamines), and chronic high stress levels.


Do you have any emergency plan if you have any of the above symptoms?

Aggressive Blood Glucose Control and Chronic Kidney Disease

To test the hypothesis that aggressive glycemic control can prevent renal disease in patients with type 2 diabetes mellitus, first author Steven G. Coca of Yale University and colleagues searched available medical literature and evaluated seven randomized trials involving 28,065 adult patients who were monitored for two to 15 years.

The team found that compared with those who had usual treatment, intensively controlling glucose with higher doses of medication did not definitively reduce the risk of impaired kidney function, the need for dialysis, or death from kidney disease

To Read More

Tuesday, July 24, 2012

Symptoms of High Blood Pressure


Only when blood pressure readings soar to dangerously high levels (systolic of 180 or higher OR diastolic of 110 or higher) may obvious symptoms occur. Blood pressure this high is known as hypertensive crisis, and emergency medical treatment is needed.

In addition to extreme readings, a person in hypertensive crisis may experience:


1. Severe headaches
2. Severe anxiety
3. Shortness of breath
4. Nosebleeds


Target Blood Pressure in Diabetes Mellitus and Chronic Kidney Disease


Higher blood pressure levels in patients with diabetes are associated with faster renal function decline in kidney disease. In addition, all vascular complications of diabetes are exacerbated by hypertension. Therefore, blood pressure should be treated aggressively in individuals with diabetes. Sodium restriction, weight loss, smoking cessation, proper diet, and exercise remain cornerstones of therapy.
Long term clinical trials have demonstrated the beneficial impact of lower blood pressure targets in patients with diabetes as compared to those without diabetes. Both the HOT (Hypertension Optimal Treatment) study and United Kingdom Prospective Diabetes Study or UKPDS study demonstrated that diabetics have improved outcomes with lower blood pressure goals. Because of these studies (and others), current national guidelines recommend target blood pressure in patients with diabetes to be <130/80 mm Hg. Similarly, blood pressure goals in patients with CKD is <130/80 mm Hg. In most studies of patients with CKD, multiple agents were required in most patients to achieve target blood pressure control.

What is the range of your blood pressure? When was the last time  you checked your blood pressure?

Chronic Kidney Disease and Osteoporosis

Despite the abnormalities in calcium metabolism, chronic kidney disease (in the absence of vitamin D deficiency or hyperparathyroidism) is not a specific risk factor for osteoporosis.

Chronic Kidney Disease therefore is not an indication for screening for osteoporosis with DXA scans, but the presence of any risk factors for osteoporosis (e.g., secondary hyperparathyroidism) or a fracture should prompt a DXA scan.

When was the last time you were evaluated for bone disease?

Chronic Kidney Disease and Tylenol


Analgesic nephropathy results from the longterm ingestion of two antipyretic analgesics (often with caffeine and codeine included), which slowly leads to renal papillary necrosis and interstitial nephritis, and may result in progressive renal failure. This is the result of long-term (typically > 5 years) ingestion of a combination of acetaminophen and aspirin. Removal of these analgesic combinations has been associated with decreased incidence of analgesic nephropathy.

Onset of analgesic nephropathy is insidious, often beginning as increased urine frequency. Bloody urine and flank pain will develop, which may result in obstruction of bladder.

How long have you been on combination of tylenol with other pain medications?


Chronic Kidney Disease and NSAIDs


NSAIDs may cause acute damage to the kidney, which may be evident within hours. Of the NSAIDs, aspirin may be the most sparing of renal damage.

NSAIDs should be avoided in those with:
1. High Blood Pressure
2. Diuretics / Dehydration
3. Elderly
4. Congestive Heart Failure
5. Liver Failure

Have you ever tried other medications or life style modifications to control your pain?

How Prevalent is Chronic Kidney Disease?

More than 8 million US adults have CKD, the majority of whom have stage 3 CKD. More than 500,000 have end stage renal disease (ESRD). The risk of death, cardiovascular events, and hospitalization, all increase as kidney function declines. The most common cause of kidney failure in the United States is diabetes followed by high blood pressure.

What is the cause of kidney disease for you or your loved ones?

Tuesday, July 17, 2012

Why is Chronic Kidney Disease so Important?


More than 8 million US adults have Chronic Kidney Disease, the majority of whom have stage 3 CKD. More than 500,000 have end stage renal disease (ESRD). The risk of death, cardiovascular events, hospitalization, perioperative complications, and acute kidney injury all increase as kidney function decreases. Chronic Kidney Disease is defined as decrease kidney filtration rate (GFR) below 60 ml/min for over 3 months. The prognosis of patients with chronic kidney disease is guarded as epidemiological data has shown that all cause mortality (the overall death rate) increases as kidney function decreases. The leading cause of death in patients with chronic kidney disease is cardiovascular disease, regardless of whether there is progression to stage 5. 



Monday, July 16, 2012

Adult College Student Donates his Kidney to his 18-month-old Cousin Born with Kidney Failure

The college student hardly knew what a kidney was up until this spring when he found at he was the perfect match for Jackson, his 18-month-old cousin born with chronic kidney failure, already in stage five. For more information on organ donation visit the Donate Life website

Sunday, July 15, 2012

Traveling with Kidney Disease

As a person with kidney failure, you are dealing with many daily stresses. A trip with your spouse, family or friend allows you to leave behind many of your responsibilities. Many dialysis centers, especially in popular tourist areas such as Hawaii, California, Arizona and Florida, need at least three months notice. If you plan to travel during holiday times such as Christmas or to popular seasonal destinations (the beach or mountains in the summer, "snowbird" areas during the winter), contact centers six months in advance. The Patient Travel Service, sponsored by Fresenius Medical Care North America, is a free service that continually updates its information on all dialysis centers in the U.S. and abroad. Although the service does not publish a list, it can provide the most current information on all the centers near where you are going. Call  (800) 634-6254 between 9 a.m. and 5 p.m. Eastern Time, Monday through Friday to speak with a representative. 


For more information: visit: http://www.aakp.org/aakp-library/traveling/
Where is the next destination in your bucket-list?

Caregiver's Wish List. What does your caregiver wish his/her loved one on dialysis could do for them?

Being on dialysis is difficult. Nearly 80 percent of adults who need long-term care depend on a family member to provide them with that help. Love is why caregivers risk their own health and wellbeing. Unfortunately, the lack of attention to their own health has lead many to become sicker than the person for whom they are caring. Support groups can offer both you and your caregiver an opportunity to be with others who share similar experiences. It’s a great place to hear how others have learned to cope and it is empowering to know you are not alone. To find a group near you, visit www.aakp.org/outreach

What can you do to improve your caregiver quality of life?

Thursday, July 12, 2012

8 Problems to Watch During Dialysis

Hemodialysis involves fluid removal, because most patients with renal failure pass little or no urine. Call your nurse or dialysis technician if you have any of these 8 symptoms during or after treatment:
1. Chest pain
2. Fever or chills 
3. Nausea or vomiting 
4. Shortness of breath 
5. Headache or lightheadedness
6.Muscle cramps
7. Itching 
8. Bleeding from the needle site 






What abnormal sensation do you have during your hemodialysis?

Tuesday, July 10, 2012

Is Peritoneal Dialysis Right for You?


Peritoneal dialysis (PD) is a way to cleanse the blood. Some patients may prefer this method due to poor hemodialysis access routes and heart instability. Others prefer it due to more flexible diet and fluids intake. Peritoneal dialysis uses a natural membrane inside your body and a special solution (dialysate). The solution needs to be changed several times a day. This can be done as part of your home or work routine. Or it can be done at night by a machine. During peritoneal dialysis, you will hook up your belly tube to the dialysis tubing. You will pipe clean fluid into your belly. The fluid will stay there for a certain amount of time. When the fluid is in your belly, it’s called a “dwell.” During a dwell, your belly might feel full or bloated, but it shouldn’t hurt. It takes about 10 minutes for the dialysate to fill your belly. the dialysate must stay in your belly for two hours or more, depending on your body size and how much waste has to be removed. Because your dialysis fluid contains sugar, you may have a tendency to gain weight. Your dietitian can help you plan your diet to get the right amount of calories and keep the right weight for you. If you have diabetes, your dosage of insulin or other medications may need to change.


For more informations click on the following link --> Peritoneal Dialysis


Sunday, July 8, 2012

Mobilysis

Mobilysis is a thoughtful and innovative system that aims to ease the lifestyle of patients by making it possible to cleanse the blood while going about their daily routine rather than spend several hours at the hospital each week. The device attaches to the waist and is compact enough that clothes can fit over it. Controls are at the user’s fingertips through a smartphone app and hard buttons located on the device itself.


2012 Kidney Walk Video - Friends forever


2012 Kidney Walk Video


Kidney Kitchen

As a patient with chronic kidney disease, your recommended diet
may change over time, depending on how much kidney function
you have. 

Here is Healthy Nutritious Diet for Patients with Kidney Disease



Friday, July 6, 2012

Printing Human Kidney


Surgeon Anthony Atala demonstrates an early-stage experiment that could someday solve the organ-donor problem: a 3D printer that uses living cells to output a transplantable kidney. Using similar technology, Dr. Atala's young patient Luke Massella received an engineered bladder 10 years ago; we meet him onstage.

Anthony Atala asks, "Can we grow organs instead of transplanting them?" His lab at the Wake Forest Institute for Regenerative Medicine is doing just that -- engineering over 30 tissues and whole organs