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People with kidney disease, diabetes may develop heart disease 28 years earlier

People with kidney disease, diabetes may develop heart disease 28 years earlier

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According to a recent study, individuals who have type 2 diabetes, chronic kidney disease, or both may be at higher risk for cardiovascular disease (CVD) 8–28 years earlier than those who do not have these conditions. Type 2 diabetes and chronic kidney disease are parts of the cardiovascular-kidney-metabolic (CKM) syndrome, which has a major effect on the risk of CVD.

These findings could aid in the early diagnosis of CVD in patients and aid in disease prevention. Chronic kidney disease, type 2 diabetes, or both may increase the risk of cardiovascular disease (CVD) 8 to 28 years earlier than people without these conditions, according to a recent study presented at the American Heart Association’s Scientific Sessions 2024.

To ascertain the relationship between age and risk factors linked to CKM syndrome, researchers employed simulated patient profiles. These findings could guide early detection and intervention strategies in CVD prevention, even though they haven’t been published in a peer-reviewed journal yet. Type 2 diabetes and chronic kidney disease are two of the four components of cardiovascular-kidney-metabolic (CKM) syndrome, which increase this risk.

According to current CVD prevention guidelines, if a person has a 7 5% chance of having a heart attack or stroke within the next ten years, their risk is elevated. CKM syndrome is defined by the American Heart Association as the relationship among metabolic diseases such as type 2 diabetes and obesity, kidney disease, and cardiovascular disease.

Developing cardiovascular risk profiles
To represent men and women aged 30 to 79 with and without type 2 diabetes and/or chronic kidney disease, researchers created risk profiles. They estimated the age at which each profile would probably reach elevated CVD risk using the Predicting Risk of Cardiovascular Disease EVENTs (PREVENT) calculator from the American Heart Association. Data from the 2011–2020 National Health and Nutrition Examination Survey was used to create the risk profiles.

An estimated glomerular filtration rate (eGFR) of 44.5, which denotes stage 3 kidney disease, was used to categorize chronic kidney disease. A “yes” answer to the PREVENT calculator question, Any history of diabetes, indicated type 2 diabetes. According to the American Heart Association, almost half of all U.S One in three adults has at least three risk factors linked to CKM syndrome, and all adults suffer from cardiovascular disease (CVD) in some capacity. Early identification of high-risk individuals can enhance primary prevention initiatives and reduce the likelihood of early death from CVD.

According to our research, a person’s age and other medical conditions have a substantial impact on their risk of cardiovascular disease. In particular, people with diabetes or kidney disease have a significantly increased risk of heart disease, even in their 30s, which can now be determined using the PREVENT equations. According to Krishnan, the Pooled Cohort Equations, which began at age 40 and excluded kidney function, could not previously be used to evaluate this.

A better understanding of cardiovascular disease risk, which includes heart attacks, heart failures, and strokes, should be made possible by the study, she continued. Even in the absence of a formal diagnosis, people with borderline high blood pressure, glucose, or kidney function may be at risk for unidentified health issues.

For people with CKM (Cardiovascular-Kidney-Metabolic) disorders like diabetes or kidney disease, these risks manifest earlier. For instance, elevated cardiovascular risk can manifest decades earlier in individuals with CKM, particularly when combined with other conditions, whereas it begins around age 68 for women and 63 for men without CKM.

References:
https://www.medicalnewstoday.com/articles/chronic-kidney-disease-type-2-diabetes-may-develop-heart-disease-28-years-earlier#Developing-cardiovascular-risk-profiles


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A new method may help forecast chronic renal illness risk.

A new method may help forecast chronic renal illness risk.

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Heart disease is more likely to strike those with chronic kidney disease (CKD). Researchers created a model to predict cardiovascular risk in CKD patients using proteomics, the study of proteins.

The model was proven to be more reliable than the standard techniques for determining risk. Additionally, scientists found several proteins that might be used in future treatments.

People with chronic kidney disease (CKD) die from cardiovascular disease (CVD) more frequently than any other cause.

Stage 1 of CKD, when there is visible evidence of kidney loss but viable kidney tissue is still present, progresses to stage 5, often known as end-stage renal disease, where dialysis or a kidney transplant is required.

A 2021 study found that stage 4 and stage 5 CKD patients suffer CVD in about half of cases.

The techniques available to medical professionals to assess patients with CKD’s cardiac risk are limited. The Pooled Cohort Equation (PCE), designed by the American College of Cardiology and the American Heart Association in 2013, was created to evaluate cardiovascular risk.

The original version did not, however, account for measurements for chronic kidney disease. Researchers have issued a warning that risk prediction techniques made for the general population may not be as reliable for CKD patients.

A new risk model for cardiovascular disease in CKD patients has been established as a result of an initiative coordinated by scientists at the Perelman School of Medicine at the University of Pennsylvania. According to the researchers, it is more accurate than the methods currently used to assess these people’s cardiac risk.

Protein biomarkers were discovered by researchers.

The extensive study of proteins known as proteomics was used by the researchers to create a model to predict cardiovascular risk. A particular protein may function as a biomarker, a marker for a particular illness in the body.

The Chronic Renal Insufficiency Cohort (CRIC), a prospective study of adults with CKD conducted at seven U.S. clinical centers, and a cohort from Atherosclerosis Risk in Communities (ARIC), a prospective epidemiologic study carried out in four U.S. communities, provided the researchers with nearly 5,000 proteins from 2,667 participants with CKD.

According to Bansal, who was not engaged in the study but cited the model’s and study’s usage of numerous people from various areas throughout the county as one of their advantages

32 proteins were chosen by the researchers to be part of their proteomic risk model using machine learning techniques. These proteins were shown to be the ones that most accurately predicted the risk of cardiovascular disease in CKD patients.

They employed a broad-based approach to identify proteins that may reveal novel biological pathways that increase the risk of cardiovascular disease in individuals with renal illness, focusing on biology and disease mechanisms, according to Bansal.

Research of chronic kidney disease

Cryopreserved plasma samples from the participants chosen for this study from the CRIC were available for proteomic evaluation. The chosen participants had CKD and ranged in age from 21 to 74.

Dialysis patients and participants with end-stage renal disease were excluded. People who at the start of the study self-reported having had coronary heart disease, a myocardial infarction, a stroke, or heart failure were excluded. They were also excluded if they had a documented history of those events.

There were 2,182 participants in the last batch.

Participants in the CRIC were slightly younger, more likely to be men and Black than those in the ARIC. In addition, CRIC participants were less likely to be active smokers and more likely to have a history of diabetes and hypertension.

In comparison to CRIC participants, participants in ARIC had higher total cholesterol levels. There were 459 cardiovascular events throughout a 10-year follow-up period in the CRIC cohort and 173 cardiovascular events in the ARIC cohort.

The risk indicator’s precision

Researchers created a proteomic risk model for incident cardiovascular risk in the participants and used 390 ARIC cohort members, all of whom had CKD, to verify the model.

Researchers also determined the participants’ 2013 PCE. Additionally, they noted the history of hypertension in the participants, as well as their diastolic blood pressure, proteinuria, and estimated glomerular filtration rate (eFGR), a score that represents kidney function.

“They were trying to look at how these biological pathways compare with clinical prediction models, in terms of predicting cardiovascular events,” Bansal said.

The proteomic cardiovascular risk model, according to the researchers, was more accurate in predicting a CKD patient’s risk for having a cardiac event than the PCE and a modified PCE that took into account eFGR scores.

Bansal said, “I believe the study does progress the field.” Over ten years, participants with the highest measure of predicted risk experienced a 60% observed incident cardiovascular event rate.

Nancy Mitchell, RN, a registered nurse with more than 37 years of experience treating patients with chronic renal illness and chronic cardiovascular problems, is optimistic that the study could result in “improving the treatment options for heart disease.”

Researchers may look at how the proteins found in bloodwork relate to cardiac disease and how they may use these discoveries to develop more specialised drugs for the condition, she said.

REFERENCES:

For Renal disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=82

More fruits & veggies might reduce death from CKD.

More fruits & veggies might reduce death from CKD.

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According to research, eating more fruits and vegetables reduces the chance of death in persons with chronic renal disease.

Doctors may recommend a low-potassium diet to patients with severe chronic kidney disease (CKD) because their kidneys have trouble processing it, resulting in excessive potassium levels in the blood.

In this study, researchers discovered comparable baseline serum potassium levels stratified by CKD stage in various groups based on how frequently they consumed fruits and vegetables.

According to the researchers, this shows that regularly consuming fruits and vegetables may not be linked to a rise in serum potassium levels.

Chronic kidney disease (CKD) patients have a progressive loss of renal function. The National Institute of Diabetes and Digestive and Kidney Diseases estimates that more than one in seven persons in the United States have CKD.

Since there are sometimes no symptoms in the condition’s early stages, CKD frequently stays undiagnosed until it is severe. Sometimes damaged kidneys cause blood levels of potassium to rise. The word for elevated potassium levels is hyperkalemia.

Researchers from one study discovered that more than half of the individuals, all of whom had severe CKD, had potassium levels above the recommended threshold. Occasionally, doctors advise patients with CKD to keep to low-potassium diets as their renal function declines.

Consuming more fruits and vegetables

Officials in charge of public health frequently extol the virtues of eating plants. Consuming fruits and vegetables has been linked to a lower risk of cancer, heart disease, and all-cause death.

According to the researchers, advanced CKD patients occasionally find themselves eating fewer meals that include vegetables and fruits due to worries about maintaining a diet low in potassium.

The 2019 systematic review of observational studies piqued the researchers’ interest because it revealed that hemodialysis patients had poor fruit and vegetable intake and that increasing consumption was linked to a lower risk of all-cause and non-cardiovascular death.

More specifically, the researchers found that consuming roughly 17 servings of vegetables and fruits each week, as opposed to just two, was related to a 20% decreased risk of all-cause mortality.

The researchers chose a Japanese hospital to carry out their study of patients with and without CKD because Asian diets are frequently higher in fruits and vegetables.

Kidney disease diet study

More than 2,000 persons 20 years or older who attended one of the hospital’s several outpatient clinics on Sado Island, Japan, between 2008 and 2016 were a part of this study.

Participants had to provide information about their intake of vegetables and fruits, as well as a record of their baseline serum creatinine and urinalysis measurements. At least one follow-up evaluation was also conducted for them.

The participants’ average age was 69. 64% of the subjects had high blood pressure, 64% were men, and 39% had diabetes.

Participants were divided into groups based on their responses to the question of how often they consume fruits and vegetables: “never or rarely,” “sometimes,” or “every day.” 15% of participants said they never ate fruits and vegetables, while about half said they did so daily.

These participants were separated into three groups: hemodialysis patients, CKD patients, and CKD patients who were not reliant on dialysis. Among the participants, 45% of the patients had CKD but weren’t dependent on dialysis, and 7% were receiving hemodialysis.

With regard to non-dialysis-dependent CKD, more than half of the participants said they regularly ate fruits and vegetables. The percentage of hemodialysis patients who reported eating fruits and vegetables every day was only 28%.

There were 561 fatalities recorded over a median follow-up of 5.7 years. Using obituaries, medical data, and reports from family or friends, researchers were able to determine whether or not the study participants had passed away.

Researchers updated the analyses to account for variables like gender and age, demographics (including individuals’ smoking status and BMI), and a variety of co-morbidities.

Survival benefit of high fruit and vegetable consumption

Those who just occasionally ate fruits and vegetables had a 25% higher chance of passing away from any cause than those who regularly consumed these meals.

A 60% increased chance of passing away from any cause existed for people who either never or infrequently ate fruits and vegetables.

According to initial findings, all CKD stage-strategy groups for vegetable and fruit eating frequency had equal serum potassium levels. This shows, according to the researchers’ article, “that frequency of vegetable and fruit intake is not associated with serum potassium levels even in patients with advanced CKD.”

According to the researchers, “the association was similar regardless of CKD status”, with no effect modification by CKD status.

Our findings imply that daily consumption of fruits and vegetables may not be related with elevated serum potassium levels and that it may actually decrease all-cause mortality in CKD patients, including those receiving [hemodialysis], as opposed to increasing it.

The researchers issued a warning in their publication that participants with severe CKD might have eaten fruits and vegetables that were lower in potassium or soaked or boiled items before eating them to eliminate potassium — a common prescription provided to Japanese CKD patients.

To the contrary, they said, “accumulating evidence suggests that dietary potassium levels are not associated with serum potassium levels or hyperkalemia.”

Kidney disease and potassium

Professor and clinical chief of nephrology at the University of California, Los Angeles’ David Geffen School of Medicine, Dr. Anjay Rastogi, told that the study was “thought-provoking” but that it had certain limitations.

He noted that compared to Americans, a large portion of the population in Japan consumes more fruits and vegetables.

Rastogi was concerned that the individuals would have only submitted labs from one date and had only once reported on their consumption of fruits and vegetables. There were many details that were missing, he claimed.

Rastogi asserted that he believes those with advanced CKD should consume a diet low in potassium. “It’s a very important mineral element in our body, but obviously in patients with kidney disease who have hyperkalemia, it can wreak havoc,” said Dr. Rastogi of potassium. “It might result in cardiac arrest.”

In order to minimise their potassium intake and keep consuming fruits and vegetables, Rastogi advised persons with CKD to engage with a trained dietitian.

There are new potassium binders on the market to treat hyperkalemia for those who cannot control their potassium through diet, he added.

Rastogi declared, “I am a very big advocate of diet and lifestyle changes for slowing down the progression of not just kidney disease but also cardiovascular disease.” Cardiovascular disease is the leading cause of death in patients with kidney disease. Both of them are interrelated.

More complex suggestions

Health professionals frequently “advise people with chronic kidney disease in ways that are not very nuanced,” according to Dr. Deidra Crews, a professor of medicine in the division of nephrology at the Johns Hopkins University School of Medicine in Maryland.

Diets heavy in potassium may be problematic for some people who have very severe chronic renal disease, or even kidney failure, she explained. “However, the vast majority of individuals with chronic kidney disease really have less severe forms of the condition.

Therefore, the majority of the more than 37 million Americans with chronic kidney disease have this type of less severe disease, and the dietary practises that will help them avoid cardiovascular disease and live [a long life] will be very similar to what we might suggest to the more general population, which is: eat your fruits and vegetables.

According to Crews, study into whether diets high in fruits and vegetables are genuinely linked to hyperkalemia in persons with severe CKD is sparked by studies like this one out of Japan.

Even though individuals with advanced CKD frequently cannot eliminate potassium from their bodies through the kidneys, they may be able to do it through “pathways that exist in the gut, in the bowels,” the expert noted.

Crews emphasised that because fruits and vegetables frequently have significant fibre content, they might aid in the process.

REFERENCES:

For Chronic Kidney Disease disease medications that have been suggested by doctors worldwide are available here https://mygenericpharmacy.com/index.php?therapy=82

Treating hypertension with help of the ultrasonic device.

Treating hypertension with help of the ultrasonic device.

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Introduction

The findings of a recent meta-analysis of prior studies looking into a novel method of blood pressure control seem promising. It explains a treatment that “mutes” overactive kidney nerves, a sign of hypertension frequently observed in middle-aged adults.

Participants’ blood pressure was dramatically reduced after the procedure, dropping by an average of 8.5 millimeters of mercury (mmHg). Follow-ups two months later and three years later supported the effectiveness of this advantage.

One of the primary causes of death on a global scale is hypertension or high blood pressure. In addition to heart, brain, and renal disorders, it can cause strokes. Since an estimated 46% of people with hypertension are unaware that they have it, it is frequently referred to as the “silent killer”.

Many hypertension medications, may be helpful in addition to a healthy lifestyle and dietary adjustments in managing the illness. Many folks find this to be adequate. Nonetheless, some people’s blood pressure continues to be consistently high.

Reports

According to a recent meta-analysis, the 506 hypertensive participants in three randomized clinical trials had considerably lower blood pressure when therapeutic ultrasonography was used to reduce kidney-nerve hyperactivity.

The exact etiology of hypertension is unknown. Scientists speculate that it may be a result of a mix of genetics, lifestyle, aging, and other processes.

Middle-aged hypertension is typically accompanied by hyperactive renal nerves, which can raise blood pressure in several different ways. It could cause salt and water retention as well as the production of hormones that raise blood pressure.

Even though there are many different medications for treating hypertension, none explicitly target this renal overactivity. So, the “renal denervation” ultrasound approach investigated in the present study provides clinicians with an extra instrument. Thi was made to support patients in maintaining their health.

Researchers from the Université de Paris in France and Columbia University in New York City carried out the study. You can find it in JAMA Cardiology.

How blood pressure is measured?

Millimeters of mercury, or mmHg, is used to measure blood pressure. This is because early precise blood pressure gauges and some contemporary systems rely on mercury.

Two blood pressure readings are usually displayed, one above the other or to the left of the other. Systolic blood pressure, or the pressure the heart puts off when pumping blood, is the first value. The pressure in arteries between heartbeats is shown by the second value, called the diastolic value.

The American Heart Association defines good blood pressure as having a systolic reading of less than 120 mmHg over a diastolic reading of less than 80 mmHG. A value of 130–139/80–89 mmHG indicates stage 1 hypertension. Higher results indicate hypertension in stage 2.

The current study discovered that renal denervation dramatically decreased participants’ blood pressure, by 5 to 10 mmHG, with an average decrease of 8.5 mmHg.

kidney nerves and high blood pressure

It is believed that overactive renal nerves induce water and sodium retention and produce hormones that can elevate blood pressure. They are a contributing factor in the development of hypertension in middle age. As blood arteries stiffen in older adults, hypertension frequently develops.

Antihypertensive medications lower blood pressure in a variety of methods, such as by dilation of blood vessels, removal of extra fluid, or blockage of hormones that elevate blood pressure. Yet, none of these drugs specifically target the renal nerves.

By calming hyperactive nerves in the renal artery, ultrasound treatment blocks the signals that cause hypertension. A thin catheter that is placed into a vein in the wrist or leg and sent to the kidney delivers the therapy to the nerves.

Renal denervation

A tiny catheter that is placed into a vein in the leg or wrist and threaded into the kidney makes up the renal denervation device addressed in the study. During the operation, ultra-high-frequency sound waves are used to treat the kidney’s nerves. This causes minute amounts of scar tissue to form, which reduces the nerve activity. “Ablation” is the name of this procedure.

Lead author Dr. Ajay J. Kirtaine predicted that the surgery would be performed as an outpatient, similar to cardiac catheterization.

“Ultrasound-renal denervation’s ablation portion is less than one minute, and the whole procedure is less than an hour, with conscious sedation/local anesthetic,” he said.

In the research, participants were divided into two groups: the ultrasound denervation group and the control group, which had a sham operation with no therapeutic benefit.

The number of participants in the study arm who received the therapy to lower blood pressure to 135/85 was twice as high. This outcome was the same in all three investigations, which included a population of different racial backgrounds, indicating the technique is probably valuable to many people.

The investigations indicated that the reduction in blood pressure persisted for at least 2 months following the operation and that participants’ blood pressure was improved. The result of the surgery “appears to be durable with follow-up out to 3 years,” according to Dr. Kirtaine.

Not yet, at least not for everyone.

The device is experimental so far, having not acquired permission for usage in the United States. The study’s authors plan to apply it to people whose blood pressure is still uncontrolled despite modifying their lifestyles and taking medication.

Dr. Jayne Morgan, a cardiologist who was not involved in the study, concurred and viewed the procedure as perhaps a secondary treatment rather than a first-choice therapy. But she noted, “I envision that this might certainly be reversed in the future with continued trials and information/data.

According to Dr. Morgan, the surgery may be especially beneficial for Black people and other minorities who have high rates of hypertension and heart disease.

This is a terrific reason why Black volunteers should be recruited, she said, since it may offer a more long-lasting option for blood pressure control in the future. 17% of participants in the meta-analysis were Black Americans.

Dr. Devin Kehl, who was not involved in the research, issued a warning: “The trials have been quite limiting in their inclusion and exclusion criteria,” despite the fact that the technique has an outstanding long-term safety profile and is probably safe.

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Important guide on causes and prevention of kidney stones.

Important guide on causes and prevention of kidney stones.

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When dissolved minerals accumulate inside the kidneys, kidney stones begin to form. Low fluid intake, dietary elements, and a person’s medical background could all play a role in their development.

Some kidney stones can develop to the size of a golf ball, however most kidney stones are small and pass through the urinary canal undetected. Significant discomfort may be experienced as larger stones exit the body.

Kidney damage, infections, and urinary issues can result from kidney stones if they are not treated. In the United States, kidney stones are a prevalent issue, and the prevalence seems to be increasing. According to one study, dietary habits and climate change may be responsible for this increase.

Types of kidney stones

The crystals that make up kidney stones differ from stone to stone. Kidney stones come in several varieties, including:

Calcium Stones

The majority of stones are calcium stones. They can be manufactured of calcium phosphate or maleate, although they are frequently made of calcium oxalate.

Your risk of getting this kind of stone can be decreased by consuming less meals high in oxalate. Foods high in oxalate include:

  • fried potatoes
  • peanuts
  • chocolate
  • spinach

Getting adequate calcium in your diet can stop stones from forming, even though some kidney stones are comprised of calcium.

Uric acid stones

The second most typical kidney stone is this kind. People with gout, diabetes, obesity, and other forms of metabolic syndrome are susceptible to them.

When urine is too acidic, this type of stone can form. A diet high in purines can raise the acidity of urine. Animal proteins like fish, shellfish, and meats contain a colourless chemical called purine.

Struvite stone

UTI sufferers are more likely to get this sort of stone (UTIs). Large stones of this nature can clog the urinary tract.

Stones called struvite are brought on by kidney illness. Strucvite stones can be avoided by treating an underlying infection.

Cystine Stones

Cysteine kidney stones occur in about 1 in 7,000 individuals worldwide. The hereditary condition cystinuria causes them in both men and women.

An acid that exists naturally in the body, cystine, seeps from the kidneys into the urine when this sort of stone forms.

Symptoms of kidney stones

Kidney stones can be excruciatingly painful. It’s possible that kidney stones don’t show any symptoms until they start to pass through the ureters. Renal colic is the name for this excruciating discomfort. One side of your back or abdomen may be painful.

Pain may spread to a man’s groyne area. Renal colic can cause severe discomfort that comes and goes. Renal colic patients frequently exhibit restlessness.

Kidney stone symptoms frequently include:

  • either side of the abdomen, the groyne, or both
  • urine with blood in it
  • nausea and diarrhoea
  • an infection of the urinary tract (UTI)
  • If there is an infection, there will be fever and chills
  • a greater urge to urinate

A kidney infection might happen if kidney stones prevent urine from passing. The signs consist of:

  • a temperature and chills
  • tiredness and fragility
  • diarrhoea
  • hazy, repulsive urine

One should seek immediate medical attention if they experience any of these symptoms.

Causes of Kidney disease

People between the ages of 20 and 50 have the highest risk of developing kidney stones. Your likelihood of getting a stone might be increased by a variety of reasons. White Americans have a higher kidney stone prevalence than Black Americans in the US.

Sex also has an impact. According to the National Institute of Diabetes and Digestive and Kidney Diseases, more men than women experience kidney stones (NIDDK).

Kidney stones in the past could put you at danger. A history of kidney stones in the family also helps. Other danger signs consist of:

  • dehydration
  • obesity
  • consuming a lot of protein, salt, or sugar
  • state of hyperparathyroidism
  • having a gastric bypass
  • gastrointestinal conditions that enhance calcium absorption
  • taking prescription pharmaceuticals including calcium-based antacids, triamterene diuretics, and seizure meds

Risk factors for kidney stone

In addition to dehydration, the following factors raise the risk of kidney stones:

  • a personal or family history of kidney stones
  • being at least 40 years old, while they occasionally impact kids
  • sex, as they are more prevalent in men than in women.
  • a diet heavy in salt and protein
  • a sedentary way of life
  • obesity
  • diabetes
  • blood pressure is high.
  • pregnancy
  • recent digestive system surgery
  • Health disorders like persistent diarrhoea and inflammatory bowel illness that interfere with the body’s ability to absorb calcium

A number of drugs, including topiramate (Topamax) and allopurinol (Zyloprim), can also raise the risk. If patients have questions regarding any medications they are taking, they should consult their doctor.

Diagnosis of kidney Stone

A kidney stone’s presence can be determined by a number of tests.

  • Physical testing may reveal that the kidneys are the cause of the pain.
  • A urine test can detect infections or blood in the pee.
  • Complications can be found using blood tests.
  • Any structural alterations will be visible through imaging tests like a CT scan or ultrasound.

Imaging tests can assist physicians in determining:

  • whether there is a stone
  • any stones’ size and placement
  • if there are any obstructions
  • the state of the urinary system
  • whether or not the problems have impacted other organs

The absence of radiation makes an ultrasound during pregnancy preferable to a CT scan.

How are kidney stones treated?

Your healthcare professional will first decide if you even require therapy after a diagnosis. When you urinate, some tiny kidney stones might pass from your body. This may cause severe agony. Your treatment choices, if determined by your doctor to be necessary, include both medication and surgery.

  • Medications. Drugs could be recommended for:
    • lessen the pain. An over-the-counter drug like ibuprofen or, if you’re in the emergency room, an IV narcotic may be suggested by your healthcare professional.
    • Control nausea and vomiting.
    • To help the stones pass, relax your ureter. Tamsulosin (Flomax®) and nifedipine (Adamant® or Procardia®) are two drugs that are frequently recommended.

Ibuprofen should only be taken after consulting a healthcare professional. When used during an acute kidney stone attack, this medication can raise the risk of kidney failure, especially in people with a history of renal disease and related conditions such diabetes, hypertension, and obesity.

Surgery. To treat kidney stones, four different surgical procedures are available. The first three are minimally invasive, which means the doctor enters your body by a small incision or a natural entrance (like your urethra).

  • Ureteroscopy
  • Shockwave lithotripsy:
  • Percutaneous nephrolithotomy
  • Open stone surgery

How to prevent kidney stones?

A crucial preventive action is proper hydration. It is advised to consume enough liquid to produce at least 2.5 litres of pee every day. It helps to cleanse the kidneys when you pass more urine.

To assist you consume more fluids, you can substitute fruit juice, ginger ale, and lemon-lime soda for water. Citrate juices may aid in the prevention of stones if the cause of the stones is low citrate levels.

You can lessen your risk of kidney stones by limiting your intake of salt and animal proteins as well as oxalate-rich meals.

To aid in preventing the production of calcium and uric acid stones, your doctor may prescribe medicines. Consult your doctor to learn the best ways to prevent kidney stones if you’ve already had one or are at risk of getting one.

REFERENCES:

  • https://www.healthline.com/health/kidney-stones
  • https://www.medicalnewstoday.com/articles/154193
  • https://www.mayoclinic.org/diseases-conditions/kidney-stones/symptoms-causes/syc-20355755
  • https://my.clevelandclinic.org/health/diseases/15604-kidney-stones
  • https://www.kidneyfund.org/all-about-kidneys/other-kidney-problems/kidney-stones

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Quick Guide on diabetic nephropathy you need to know.

Quick Guide on diabetic nephropathy you need to know.

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Diabetes patients may develop diabetic nephropathy, a chronic kidney condition. It happens when a person’s kidneys suffer damage from excessive blood glucose levels.

Chronic kidney disease of this kind is known as diabetic nephropathy (CKD). The body’s fluid and salt balance is maintained by the kidneys, which is essential for lowering blood pressure and safeguarding cardiovascular health.

Diabetes, whether type 1, type 2, or gestational diabetes, occurs when the body is unable to use or make insulin as it should. Pregnancy-related gestational diabetes raises the possibility of developing type 2 diabetes in later life.

High blood sugar levels are a side effect of diabetes. These elevated glucose levels have the potential to harm the kidneys and the cardiovascular system over time. Diabetic nephropathy is the term used to describe the resulting kidney damage.

One of the main causes of chronic kidney disease and end-stage renal disease is diabetic nephropathy (ESRD). The kidneys can no longer function adequately to meet daily requirements in ESRD. Kidney failure brought on by ESRD has the potential to be fatal.

What is diabetic nephropathy?

Patients with diabetes may develop diabetic nephropathy, a progressive kidney disease of this nature. Both type 1 and type 2 diabetics are at risk, and the likelihood of developing it rises with time as well as due to additional risk factors such high blood pressure and a family history of renal disease.

Diabetes is thought to be the primary cause of almost 40% of kidney failure cases, and it is estimated that 180,000 people have kidney failure brought on by diabetic complications. End-stage renal disease is also most frequently brought on by diabetes (ESRD). The fifth and last stage of diabetic nephropathy is called ESRD.

Slow progress is made in diabetic nephropathy. You can reduce or even halt the disease’s progression with early treatment. Not everyone who develops diabetic nephropathy will progress to kidney failure or end-stage renal disease (ESRD), and having diabetes does not guarantee that you will do so.

Stages of diabetic nephropathy

Depending on the GFR, which also measures the proportion of functional kidney function, a clinician may classify the stages of renal disease.

  • 1st Stage: Kidney damage is present, but kidney function is normal, and the GFR is 90% or higher.
  • 2nd Stage: GFR between 60 and 89% and kidney injury with partial loss of function.
  • 3rd Stage: A GFR of 30-59%, mild to severe loss of function.
  • 4th Stage: GFR of 15 to 29% and severe loss of function in stage 4.
  • 5th Stage: GFR less than 15% and kidney failure in stage 5.

Symptoms of diabetic nephropathy

A person might not have any symptoms in the early stages. They may feel ill and exhibit the following symptoms in stage 4 or 5:

  • water retention-related swelling of the hands, foot, lower legs, or ankles
  • blood in the pee causes darker urine.
  • breathing difficulty
  • tiredness brought on by a blood oxygen shortage
  • dizziness or vomiting
  • a mouthfeel that is metallic
  • Cardiovascular illness is one of the side effects of advanced renal disease.

A person with diabetes can better manage their blood sugar levels, lower their risk of kidney complications, and determine whether they need to take any action by adhering to their treatment plan and getting frequent health checkups.

What causes diabetic nephropathy?

Kidney damage stresses these important organs and stops them from functioning normally.

When this takes place:

  • Protein begins to leave the body through the urine.
  • The kidneys are unable to eliminate waste from the circulation.
  • The kidneys cannot keep the body’s fluid balance in a healthy state.

The onset of diabetic nephropathy is gradual. One study found that 15 years after a diabetes diagnosis, a third of patients had high levels of albumin in their urine. Less than half of these individuals will experience complete nephropathy, though.

According to statistics, kidney disease is less likely among patients with diabetes who have had the disease for less than ten years. A person also has a minimal likelihood of developing kidney damage if they don’t exhibit any clinical indications of nephropathy 20–25 years after developing diabetes.

If a person with diabetes efficiently controls their glucose levels, diabetic nephropathy is less likely to occur. Due to the harm done to blood vessels by high blood glucose levels, high blood pressure is more likely to occur. Hypertension, or high blood pressure, may be a factor in kidney disease.

Risk elements of diabetic nephropathy

If you have diabetes, the following things can make you more likely to develop diabetic nephropathy:

Complications of diabetic nephropathy

Diabetic nephropathy complications can appear gradually over months or years. They may consist of:

  • Fluid retention, which can cause edoema in the arms and legs, hypertension, or fluid in the lungs (pulmonary edema)
  • an increase in blood potassium levels (hyperkalemia)
  • Stroke risk is increased by heart and blood vessel disease (cardiovascular disease).
  • damage to the blood vessels in the rear of the eye’s light-sensitive tissue (diabetic retinopathy)
  • fewer red blood cells are needed to carry oxygen (anemia)
  • diarrhoea, foot ulcers, erectile dysfunction, and other issues because of damaged blood vessels and nerves
  • bone and mineral problems brought on by the kidneys’ inability to keep the blood’s calcium and phosphorus levels in the proper range
  • Complications of pregnancy that put the mother’s health and the unborn child at danger
  • End-stage renal disease causes irreversible kidney failure, necessitating dialysis or a kidney transplant in order to survive.

Treatment of diabetic nephropathy

Diabetic nephropathy can be delayed or prevented with early treatment. Maintaining and controlling blood pressure and blood glucose levels is the major goal of treatment. The usage of drugs could be involved in this.

  • Drug treatment
  • Dietary changes
  • Managing blood sugar levels
  • Late-stage treatment options
    • Dialysis
    • Kidney transplant

Prevention of diabetic nephropathy

To lessen the possibility of getting diabetic nephropathy:

  • Maintain routine appointments for managing diabetes. Maintain annual appointments, or more frequent ones if your medical team so advises, to check on how well you are controlling your diabetes and to screen for problems such diabetic nephropathy.
  • Medicate for diabetes. You can stop or delay diabetic nephropathy with appropriate diabetes management.
  • Control other medical issues, such as excessive blood pressure. Work with your doctor to manage any problems, such as high blood pressure, that put you at risk for renal disease.
  • Take prescription and over-the-counter drugs as directed. Observe the directions on the packaging of over-the-counter painkillers such aspirin and nonsteroidal anti-inflammatory medications like naproxen (Aleve) and ibuprofen (Advil, Motrin IB, others). These kinds of painkillers can harm the kidneys in patients with diabetic nephropathy.
  • Keep a healthy weight. When you reach a healthy weight, make an effort to keep it there by staying active most days of the week. Consult your doctor if you need to reduce weight to learn about weight-loss techniques including upping your daily physical activity and cutting calories.
  • Avoid smoking. Smoking cigarettes can harm your kidneys and exacerbate whatever kidney problems you already have. Ask your doctor for advice on how to stop smoking if you smoke. You can get aid to stop from support groups, counselling, and some drugs.

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Aspects of Kidney infection(Pyelonephritis) and its remedy.

Aspects of Kidney infection(Pyelonephritis) and its remedy.

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An unexpected and serious kidney infection is known as acute pyelonephritis. The swelling it produces to the kidneys could result in long-term harm. Pyelonephritis poses a serious risk to life. The illness is referred to as chronic pyelonephritis when attacks happen frequently or persistently. Although the chronic form is uncommon, it tends to affect kids or persons who have urinary blockages more frequently.

The lower urinary system, particularly the bladder (cystitis), the prostate (prostatitis), or the upper tract and kidney can all be infected (pyelonephritis). Typically, it is a bacterial illness. In the United States, three to seven people out of every 10,000 are affected by the condition. About 2 percent of pregnant women experience it. If caught early, it is easily curable.

Ninety percent of kidney infections are brought on by a bacteria known as Escherichia coli (E Coli). The germs move up the tubes (ureters) that connect the bladder to the kidneys from the genital area through the urethra, which is the tube that drains urine from the body. Some bacteria can enter the kidneys through the bloodstream, such as staphylococcus infections.

Symptoms of Pyelonephritis

In most cases, symptoms start to show two days after infection. Typical signs include:

  • a temperature of 102°F (38.9°C) or higher
  • abdominal, back, side, or groyne pain
  • scorching or uncomfortable urinating
  • murky urine
  • pee with pus or blood in it
  • frequent or hurried urinating
  • urine that smells fishy

Additional signs can include:

Children and older individuals may experience distinct symptoms than other people do. For instance, mental confusion is a frequent symptom in older persons and is frequently the only one. People who have chronic pyelonephritis may only have minor symptoms or possibly no discernible symptoms at all.

Causes of kidney infections

Normally, the passage of urine flushes out bacteria. A kidney infection can, however, be made more likely by a number of issues. These issues could involve:

  • obstruction of urine flow due to structural anomalies (strictures, stents, stones, surgery).
  • a urethra that is being compressed by a benign prostatic hyperplasia, or enlarged prostate.
  • Urine recirculation (reflux) from the bladder to the kidneys.
  • if you experience immune system issues (low white blood cell count, use of certain medications, HIV, cancer, an organ transplant).
  • pregnancy, when the growing uterus might constrict the ureters and lessen urine flow, enabling the germs to go to the kidneys.
  • uncontrolled type 2 diabetes.

Risk factors for kidney infection

Pyelonephritis acute

Acute pyelonephritis is more likely to occur when there is an issue that prevents urine from flowing normally. For instance, acute pyelonephritis is more likely to result from a urinary tract that is unusually large or shaped.

Additionally, because women have shorter urethras than males do, bacteria can enter their bodies more easily. Because of this, women are more likely to contract kidney infections and develop acute pyelonephritis.

Other individuals at higher risk include:

  • anyone who has recurring kidney stones or other renal or bladder issues, especially older people
  • those with immune systems that are weakened, such as those who have cancer, diabetes, or HIV/AIDS
  • Individuals who have vesicoureteral reflux(a condition in which a tiny volume of urine backs up from the bladder into the kidney and ureters)
  • individuals with enlarged prostate

Additional elements that may increase your susceptibility to infection include:

  • using a catheter
  • cystoscopic analysis
  • urological surgery
  • certain medicines
  • spinal cord or nerve injury

Persistent pyelonephritis

People with urinary blockages are more likely to develop chronic versions of the illness. These can be brought on by anatomical malformations, vesicoureteral reflux, or UTIs. Children are affected by chronic pyelonephritis more frequently than adults.

Kidney Infection Diagnosis

Following a discussion of your symptoms, your doctor may order tests such as:

  • Urine testing to look for bacteria, pus, and blood in your poop
  • to determine the type of bacteria in your urine

Additionally, your doctor might carry out the following tests:

  • CT or ultrasound. These check for obstructions in the urinary tract. If treatment doesn’t work after three days, your doctor may prescribe these.
  • Cystourethrogram voiding (VCUG). This kind of X-ray is used to check for urethral and bladder issues. These are frequently prescribed by doctors to kids with VUR.
  • Digital rectal examination (for men). To check for a large prostate, your doctor inserts a finger that has been greased into your anus.
  • DMSA scintigraphy uses dimercaptosuccinic acid. This shows kidney infection using radioactive material.

Kidney Infection Treatment

You may require antibiotics for a week or two, which your doctor will likely prescribe. Within a few days, your symptoms ought to become better, but be sure to take the entire prescribed dosage. If you have a serious illness, you will require hospitalisation and intravenous (IV) antibiotic treatment.

If you have recurrent kidney infections, there may be a problem with the design of your urinary system. Your physician might refer you to a specialist, like a urologist. Many times, surgery is required for these problems.

Kidney Infection Prevention

Bladder infections are not fully preventable. However, you might have a lower chance if you:

  • Avoid using deodorant douches or sprays to your genitalia.
  • Condoms and diaphragms shouldn’t be used with spermicide since they can encourage bacterial growth.
  • Use condoms with lubricant. Other varieties can irritate the urethra, increasing the risk of infection.
  • Get plenty of water.
  • As soon as you have an urge, use the restroom.
  • Pee after sexual activity.
  • After using the restroom, wipe the door to the back.

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