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Monday, November 16, 2015

Home Dialysis Los Angeles

There are 2 kinds of home dialysis modalities:
1. Home hemodialysis
2. Home peritoneal dialysis.

Home dialysis has several benefits when compared to in-center hemodialysis. In both choices of home dialysis, patients receive more frequent dialysis session than in-center hemodialysis. As such, they have better blood pressure control. This may reduce stress on the heart and blood vessels.

Patients on home dialysis and nocturnal dialysis are able to eat more and use fewer medications. In addition, patients can do more of their daily activities and continue working.

If you are on home dialysis and planning to travel, you need to talk to your dialysis nurses. They are usually available 24 hours - 7 days of the week. They will arrange for you for either hemodialysis or continuing peritoneal dialysis at your destination.

Patients who do home dialysis are more involved in their care, and as such, are more proactive in living healthy and getting better. On the other hand, in-center hemodialysis patients have better support group as they meet with nursing staff and case managers on regular basis.

When making a decision about the type of treatment, you should take into consideration that home dialysis is usually a daily process, similar to the working of the kidney and may be more gentle with fluid removal from the body. Both home peritoneal dialysis and home hemodialysis are excellent choices in treatment on end stage renal disease patients. They are both as effective form of dialysis as in-center hemodialysis.

There are some people for whom home dialysis may not be appropriate. Home dialysis requires independent patients with good family and social support that can help the patient in this process. Home dialysis is not for everyone. People must receive training and be able to perform correctly each of the steps of the treatment. A trained helper may also be used.


Ardavan Mashhadian D.O.
Nephrologist
1127 Wilshire Blvd Suite 510
Los Angeles CA 90017
(213) 537-0328

Source: blogger posts
Home Dialysis Los Angeles

Saturday, August 15, 2015

Ig A Nephropathy and Bloody Urine

The most common clinical presentation of Ig A nephropathy is bloody urine provoked by upper respiratory infection. Infectious source with microbial and viral infection is occasionally present. Food particles have also been proposed. Alternatively, Ig A naphropathy may be an autoimmune disease. Ig A Nephropathy is one of the most common causes of kidney disease. In Caucasians, Ig A nephropathy is more common in men with ratio of 3:1 than women. However, in Asians, the ratio approached 1:1. This disease can be transient or progress to chronic kidney disease and possible end stage renal disease requiring dialysis.

Ig A nephropathy is associated with other diseases such as rheumatoid arthritis, celiac disease, alcohol liver disease, cirrhosis, dermatitis herpetiformis, and HIV/AIDS.

The clinical presentation may be suggestive of Ig A nephropathy. However, renal biopsy is required for confirmation. Kidney biospay further helps for predicting the course of the disease. That being said, not all patients require to have kidney biopsy.

Natural Progression
Some patient with mild disease have remission. However, the presence of high blood pressure, protein in the urine, and reduced kidney function as well as some findings on kidney biopsy increase progression and poor outcomes.

Treatment
Treatment of Ig A nephropathy depends to clinal presentation, urine studies and kidney biopsy result. Depending to the presentation, the treatment of Ig A nephropathy varies from blood pressure medications to immunosuppresive medications. Close follow up with a nephrologist is crucial.

Dietary gluten restriction has not been show to preserve kidney function.


Ardavan Mashhadian D.O.
Nephrologist
1127 Wilshire Blvd Suite 510
Los Angeles CA 90017
(213) 537-0328

Saturday, February 21, 2015

High Blood Pressure - Chronic Kidney Disease, Sodium, and Salt Intake

In patients with chronic kidney disease, management of high blood pressure is crucial. Uncontrolled blood pressures can have devastating effects on your health (heart attack, stroke, death). It is important to check blood pressure frequently and review the numbers with your kidney doctor (nephrologist). Low salt diet (2 gram per day) is the first step. There are many different medications to help with elevated blood pressure. But if you do not decrease your salt intake, control of blood pressure can be very difficult.

With high salt (sodium) intake, you will be more thirsty. As such, you will drink more which can lead to swelling and raise your blood pressure. This can damage your kidneys more and make your heart work harder. One of the best things that you can do to stay healthy is to limit how much salt (sodium) you eat.

To limit sodium in your meal plan:
1. Do not add salt to your food when cooking or eating. One of the first steps in becoming healthy is cooking your own food. With cooking your own food, you will become more health conscious and use healthy ingredients.

2. Try cooking with fresh herbs, lemon juice or other salt-free spices. To make the food delicious and tasty, you do not have to add salt. Fresh herb and lemon juice can be good alternatives. Make sure you do NOT use potassium supplements though (see below)

3. Choose fresh or frozen vegetables instead of canned vegetables. If you do use canned vegetables, drain and rinse them to remove extra salt before cooking or eating them.

4. Avoid processed meats like ham, bacon, sausage and lunch meats. These foods have high salt content. It is much healthier to cook fresh meat.

5. Eat fresh fruits and vegetables rather than crackers or other salty snacks. As the old saying goes: an apple a day keep the doctor away. Try to have healthy habits during the day. One such habits is eating vegetables.

6. Avoid canned soups and frozen dinners that are high in sodium. Try to cook your own soup with fresh ingredients. Its more delicious! You can eat more of it and yet not worry about gaining weight.

7. Avoid pickled foods, like olives and pickled. Substitute it with healthy fruits like avocado.

8. Limit high-sodium condiments like soy sauce, BBQ sauce and ketchup.

One important point! Be careful with salt substitutes. Many food with "low salt" advertisements are high in potassium. Too much potassium can be dangerous for someone with kidney disease. Potassium is mainly excreted with kidney. Patient with chronic kidney disease have decreased kidney function and as such have excretion of potassium. Make sure to look at the nutritional facts for the food. Avoid high potassium foods. Work with your kidney doctor (nephrology) or dietitian to find low-sodium foods that are also low in potassium.




Sources:
http://www.healthaliciousness.com/articles/what-foods-high-sodium.php
http://www.cdc.gov/salt/

Ardavan Mashhadian D.O.
Nephrologist
1127 Wilshire Blvd Suite 510
Los Angeles CA 90017
(213) 537-0328