What To Do If You’ve Kidney Disease?
Kidney disease is a silent killer as its early sign is very subtle, and it takes years to progress from CKD to kidney failure. Therefore, it’s particularly important for you to take some useful measures if you already have kidney disease.
Limit the Intake of Protein
You shouldn’t eat too much animal protein. That means you should have a low protein diet (almost “vegetarian” diet), with your daily diet includes 3 -4 ounces of animal products of meat/processed meat, milk or cheese.
Too much protein adds to greater workload on your kidneys, causing them to work helplessly to filter blood urea nitrogen (BUN), a by-product of protein metabolism, out of your blood. The frequent increased workload, undoubtedly, can lead to premature breakdown of the glomeruli in your kidneys. But this is not a case in the healthy kidneys. When protein enters your body, it’ll be broken down into amino acids that contain nitrogen. Urea is formed when the nitrogen combines with other molecules after it’s separated from amino acids. Then, your kidneys take a turn to filter it out of your blood before the excretory product is eliminated out of your body in the form of urine or/ and feces.
For healthy kidneys, the intake of protein is half of the body weight (in pounds) in grams per day. That means you can eat up to 50 grams of protein per day, if your weight is 100 pounds. In contrast, if you’ve problems with your kidneys (kidney failure, kidney disease or any kidney related disease), you should limit the intake of the protein as minimal as possible so that a healthy BUN level can be attained. (Note: The healthy level for BUN is between 4 to 17mg/dL, and the normal blood always contains 7 to 20 miligrams of urea per deciliter of blood. Any reading between 18 to 21 mg/dL indicates that you’ve been eaten too much protein, and your kidneys are under stress and exhausted. The BUN level of more than 21 mg/dL indicates that your kidneys may not be working at full strength, and in this case, you need to seriously reduce your protein intake. The elevated BUN level may also cause by heart failure and dehydration.) Low protein diet has shown to benefit people with stage III or stage IV nephropathy, or people with kidney disease of diabetes and high blood pressure. Excessive consumption of protein has been closely linked with harmful effects in people with diabetes, kidney failure, kidney stone, high blood pressure and other kidney related diseases.
Avoid Taking any Over-the-counter Drugs on a Regular Basis
Certain over-the-counter pain medications such as Acetaminophen (Tylenol and Excedrin), aspirin, naproxen (Aleve), and non-steroidal anti-inflammatory drugs (such as Motrin, Indocin, Vioxx, Naprosyn, Advil) have been identified as the main cause of the kidney failure, kidney damage and other kidney related diseases if used on a regular basis. In contrary, these medications seem not to pose significant health hazard to healthy kidneys if they’re used on time of emergency only. The health professionals have confirmed that the frequent use of anti-inflammatory pain drugs poses significant danger to kidney health than the over-the-counter pain killers.
Control your Blood Pressure
In the Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI), it’s recommended that people with renal insufficiency (proteinuria greater than 1gm/24hrs) should maintain their blood pressure at 125/75 or lower, while people with diabetes should keep their blood pressure at 130/85 or lower. I’d recommend you to have your blood pressure checked/ monitored several times in a year to help maintain a healthy blood pressure level. If your blood pressure is high, then you should work out the way with your physician to keep it close to normal levels.
Use Prescribed Drugs to Lower Blood Pressure
Doctor commonly prescribes drugs that have been found to significantly delay the progression of kidney disease. Angiotensin-converting enzyme (ACE) inhibitor or ACE inhibitor (such as captopril) for example, is one of the prescribed drugs that have shown greater benefits in delaying the progression of kidney disease to either stage IV or V, lowering proteinuria, slowing deterioration in people with diabetes who don’t have high blood pressure, and promising result in protecting the kidneys. Captoril has rewarded patient by lowering blood pressure, which may help protect the kidney’s glomeruli. (Note: It’s always recommended to enquire your doctor whether you may benefit from receiving an ACE inhibitor.) Beta-blockers, calcium channel blockers, diuretics, and adrenergic nervous system modulators are some of the excellent drugs that may help enhance blood pressure control, notably in people with diabetes mellitus.
Any medications that help people with diabetes, high blood pressure, kidney failure or kidney disease to obtain a blood pressure level of 125/75, generally bring the utmost rewards. In any case, as in people with persistent microalbuminuria (occurs when trace amounts of a protein called albumin begin to leak through the damaged filtering structures of the kidneys) or mild hypertension should discuss the use of antihypertensive medications with a doctor to help protect kidneys from being harmed or damaged. As in the case of people in stage III and IV of the kidney disease, both combination of low protein diet and the antihypertensive drugs have shown to slow progression of kidney disease when significant nephropathy is present. In other words, reducing the blood pressure has proved to normal slow kidney damage.
Control Your Blood Sugar
The research conducted in England, Ireland, Scotland and Norway showed the improvements in kidney function in people with type 2 diabetes and those who were at the early stage in kidney disease of microalbuminuria by simply controlling their blood sugar and blood pressure. Another studies conducted in Italy and Scandinavia also showed that kidney disease at the early stage could be reversed with intensive blood sugar control. Moreover, the intensive blood glucose or glycemic control has proved to reveal promising result for those in early stage of nephropathy, particularly among individuals with type I and type 2 Diabetes.
Watch Your Diet
It’s also very important to avoid sugar and other simple carbohydrates to keep your blood sugar and insulin stay at healthy level. As mentioned earlier, high protein diet poses greater danger to kidney health, particularly when the protein is cooked. It’s therefore essential to substitute simple carbohydrates packed with moderate amount of healthy protein, non-starchy vegetables and lots of high quality fat. If you’re not sure what to eat, always consult your doctor or a registered dietician to help workout your meal planning.
Have Your Hemoglobin Examined Yearly
If you’ve diabetes, you should have your haemoglobin A-1-c level examined at least twice a year. By doing this examination, you’ll be acknowledged with a weighted average of your blood glucose level for the past 3 months. It’s recommended to keep the level well below 7 percent.
Have Your Urine and Blood Checked Yearly
It’s very important to note that you should have your urine checked for microalbumin and protein once a year, particularly when you’ve diabetes. Meanwhile, you should also prompt your doctor to check your blood for elevated amounts of waste products (such as creatinine).
Creatinine is a waste product created in the blood by the normal breakdown of muscle during activity. Unhealthy kidneys are unable to separate creatinie out of the blood and put it in the urine to leave the body as what the healthy kidneys do. That’s why creatine forms up in the blood. The normal creatinine range is 0.6 to 1.2 mg/dL. Any readings that are slightly above this normal range may tell you that your kidneys are not functioning at full strength. However, the creatinine value is very variable since it can be affected by diet, and thus you’ll have your creatinine examined regularly to confirm whether your renal function is decreasing or not. Bear in mind that when your blood contains too much urea nitrogen, protein or creatinine, it tells you that your kidneys are not fully performing.
Another important test is creatinine clearance test which shows how fast your kidneys separate creatinine from your blood. In this test, you’re required to collect urine for 24 hours. And your doctor will examine your creatinine clearance by observing the amount of creatinine in your blood and the amount of creatinine in your urine. For female, the normal creatinine clearance rate is 88 to 128 ml/min, while for male; the normal rate is 97 to 137 ml/min. If your reading is below the stated normal range, that means your kidneys are not functioning at its full strength.
Go for Other Additional Tests
If your blood and urine tests reveal the possibility of reduced renal function, then you’re advised to go for a renal imaging (taking pictures of the kidneys) test. The test consists of magnetic resonance imaging (MRI), ultrasound and computed tomography (CAT scan). This test is important as it helps the doctor to identify the main cause of the kidney function, while it’s very useful in finding abnormal growths, tumors or blockages that may have blocked the flow of your urine.
In the Proteinuria (protein in the urine which shows a poor kidney functions) test; you’ll be required to collect urine for 24 hours. Then, your doctor will test the presence of the protein from your urine sample using a dipstick, and the color of the lipstick will tell the doctor the presence or absence of proteinuria.
Besides the renal imaging and proteinuria test, renal biopsy is another useful test that doctor performs to identify problems at the cellular level. In this test, the doctor will ask you to lie prone (on your stomach) on a table while receiving local anesthetic to numb the skin. Then, he/she will insert a needle via your skin into the back of your kidney to retrieve about ½ to ¾ of an inch long of a strand of tissue in order to obtain the tissue sample that will be viewed under a microscope.
Dialysis or Kidney Transplantation
When one of your kidneys fails (cannot function anymore), you can still lead a normal life with the remaining renal function. Nevertheless, when both kidneys fail (you’ve lost 85%- 90% of your renal function), you must go for either a kidney transplant or go for regular dialysis for the rest of your life. Both renal replacement therapies will enable you to continue with your daily activity. While undergoing dialysis, you’ll have to be connected to the dialysis machine for several hours, at least 2 or 3 times a week. In dialysis, your blood is drawn from an artery of the body and channelled through a tube into the dialysis machine. In the machine, the tube passes through dialysis fluid which contains dissolved salts and sugar. Small particles such as waste products in the blood diffuse from the blood into the dialysis fluid which will be discarded, while large particles such as blood cells, glucose and amino acids cannot diffuse into the dialysis fluid. The filtered blood is then returned to a vein in your arm.
You may also choose to go for a kidney transplant. In this case, your damaged kidney is replaced with a healthy kidney from a donor. The transplanted kidney must be compatible with you; otherwise it’ll be rejected by your body.
Both renal replacement therapies have seen to prolong the survival of kidney patient. But, in certain cases, people with diabetes who receive either dialysis treatment or a kidney transplant may experience higher risk of morbidity and mortality. This is due to the coexisting complications of the diabetes, with the most notably damage in nerves, eyes and heart.
In conclusion, kidney disease improves with insulin adjustment, meal planning (less salt, less fat, less protein and less oil), blood glucose and blood pressure monitoring, exercise, and frequent consultation with health care professional. By keeping on top of your condition, you actually have a lower risk of kidney related complications or even have fewer lesions developed in your glomeruli.
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