Happy New Year and Welcome back Kidney Warriors! I'm sure we all have been busy with the hustle and bustle of the holiday season and I hope you had a wonderful Christmas and New Years Eve. It was a very difficult Christmas for me. The absence of my father was really felt this Christmas morning. One of the hardest things about a loved ones death is how it changes all your traditions. I think it's all part of life and at some point it happens to each of us however that doesn't make it any easier. I think 2013 was the year of the lessons. The biggest lesson for me was that life can be fleeting and tomorrow is never promised. It makes me realize that even though I live with a life threatening illness I should appreciate everyday. I should appreciate the fact that I live in an area where we have a variety of dialysis options. I should appreciate the fact that the Northeast Kidney Foundation gave me the chance to write this blog and share my journey with each of you. I should appreciate the fact that I have a loving and caring care partner/husband who has stood by me through thick and thin.
With the end of 2013, I would like to review some of the important information from over the last six months of blog entries. It was scary when I was first diagnosed with CKD and I went through a variety of tests preformed by my nephrologist to help determine the caused of my kidney disease which included: "The first test involved finding my GFR. Your GFR or Glomerular Filtration Rate is one of the best methods for determining how much kidney function you have. It uses your individual blood creatinice, age, body size and gender. It then calculates a value which determines the stage of CKD your in. At the time I was well into Stage 3. There are 5 Stages to CKD with stage5 being kidney failure and needing dialysis or transplant. Prevention is the best fight against kidney disease so know your numbers especially your GFR if your at risk.. Knowing these numbers can help decrease the damage to your kidneys
Some of the other tests he did were to determine my BUN which measures the amount of nitrogen in the blood that comes from urea. It's another way to see how much kidney function is left. He also did a 24hour urine collection to check how much protein was in the urine. Normally there should be little to none, so any increased amount could be some form of reduced kidney function. The final and most telling test he did was called an VCUG or Voiding cystourethgram this test uses x-rays of the bladder both when its full and then when its emptied to see if there are any abnormalities between the bladder and upper urinary tract. And finally after 2 months of tests he determined that I had Kidney Reflux or Renal Reflux disease. The most common symptom of renal reflux is a urinary tract infection. This occurs because the bacteria that cause the urinary tract infection are able to travel up the urinary tract as a result of the reflux instead of being pushed out during urination. When I was diagnosed I had not had any UTI's and therefore allowed it to go un~diagnosed for so long. By the time the doctor's found it, the damage was already done. The only symptom I had was flank/lower back pain resulting from urine refluxing up to my kidneys. This condition is usually caught in childhood and can be treated and most times cured.
Okay before we go much further let's discuss the functions of the kidneys and how important they are to our overall well being. Our kidneys are 24/7 cleaning machines. These twin shaped organs located below the rib cage work 365 days a year removing waste from the body. Each and every day these organs pump about 200 quarts of blood through about 140 miles of tubes. On top of removing waste products, the kidneys remove extra fluid, produce hormones like Erythropoietin or EPO, and also help maintain the balance of minerals and chemicals to keep us healthy. And we can’t forget to mention one of the most important functions of the kidneys which is to control blood pressure.
High blood pressure affects all the cells in the body including the kidneys which in turn can prevent them from doing their other jobs. This is a major cause of CKD so if you are at risk for high blood pressure it’s very important to get regular checkups and follow your doctor's instructions to keep it under control. I had to make many changes in my diet and lifestyle that included reducing my salt intake. Now I don’t even keep a salt shaker on the table. I have also found it helpful for me to monitor my pressure at home and share these results with my doctor.
Erythropoietin is the hormone which is responsible for directing your bone marrow to make new red blood cells. Without this hormone your red blood cell production declines and you become Anemic. This condition either requires a replacement hormone or a blood transfusion. Many CKD patients, like myself, require injections of a synthetic EPO hormone on a weekly basis. Anemia causes extreme fatigue and overall weakness. Other side effects of anemia include making you feel short of breathe and look pale. For me, anemia has been one of my biggest challenges with CKD. Please see my blog entry "Anemia and Fatigue in CKD" to review information about anemia. Over the last ten years I have needed multiple blood transfusions due to severe anemia.
High blood pressure affects all the cells in the body including the kidneys which in turn can prevent them from doing their other jobs. This is a major cause of CKD so if you are at risk for high blood pressure it’s very important to get regular checkups and follow your doctor's instructions to keep it under control. I had to make many changes in my diet and lifestyle that included reducing my salt intake. Now I don’t even keep a salt shaker on the table. I have also found it helpful for me to monitor my pressure at home and share these results with my doctor.
Erythropoietin is the hormone which is responsible for directing your bone marrow to make new red blood cells. Without this hormone your red blood cell production declines and you become Anemic. This condition either requires a replacement hormone or a blood transfusion. Many CKD patients, like myself, require injections of a synthetic EPO hormone on a weekly basis. Anemia causes extreme fatigue and overall weakness. Other side effects of anemia include making you feel short of breathe and look pale. For me, anemia has been one of my biggest challenges with CKD. Please see my blog entry "Anemia and Fatigue in CKD" to review information about anemia. Over the last ten years I have needed multiple blood transfusions due to severe anemia.
Symptoms of Anemia include:
1. Looking pale
2. Shortness of breath
3. Trouble sleeping
4. Feeling dizzy and having headaches
I later learned that one of the functions of your kidneys is to make a hormone called EPO. Hormones are secretions that your body makes to help your body work properly and keep you healthy. EPO tells your body to make new red blood cells. When you have kidney disease, your kidneys cannot make enough and this causes your red blood cell count to drop and that’s when you develop anemia.
Most people with kidney disease will develop anemia. Anemia can happen early in the course of kidney disease and grows worse as the kidneys lose their ability to work well and make EPO. Anemia is especially common if you:
1. Have diabetes
2. In stages 3,4, or 5 of kidney disease
3. Are female
But because not everyone with anemia gets symptoms you should have regular blood tests to measure your hemoglobin levels.
Hemoglobin is the part of the red blood cell that carriers oxygen throughout the body. Your doctor can tell if you have anemia by measuring your hemoglobin levels. If your hemoglobin levels are below normal which is 12.0 for women and 13.5 for men. Your doctor will start a treatment plan to raise your hemoglobin. This usually includes drugs that work as an EPO stimulate. These agents are called ESA’s and helps your body to make new red blood cells that your kidneys cannot. It is usually given as an injection under the skin and most CKD patients learn to do this at home as self injections.
The other treatment part of anemia is controlling your iron stores. Your body needs iron to make red blood cells especially when you are receiving an ESA treatment. Without enough iron, your treatments will not work as well. Iron can be given either in pill form or through IV. Your iron stores should be at least 20% and should be checked along with your hemoglobin levels.
Your doctor will check your hemoglobin levels on a monthly basis to bi~monthly basis. This tells your doctor how well your doing and your dose of the ESA will may need to be changed, depending on how well you respond. If untreated, anemia can make your health conditions worse and cause your heart to work harder.
1. Looking pale
2. Shortness of breath
3. Trouble sleeping
4. Feeling dizzy and having headaches
I later learned that one of the functions of your kidneys is to make a hormone called EPO. Hormones are secretions that your body makes to help your body work properly and keep you healthy. EPO tells your body to make new red blood cells. When you have kidney disease, your kidneys cannot make enough and this causes your red blood cell count to drop and that’s when you develop anemia.
Most people with kidney disease will develop anemia. Anemia can happen early in the course of kidney disease and grows worse as the kidneys lose their ability to work well and make EPO. Anemia is especially common if you:
1. Have diabetes
2. In stages 3,4, or 5 of kidney disease
3. Are female
But because not everyone with anemia gets symptoms you should have regular blood tests to measure your hemoglobin levels.
Hemoglobin is the part of the red blood cell that carriers oxygen throughout the body. Your doctor can tell if you have anemia by measuring your hemoglobin levels. If your hemoglobin levels are below normal which is 12.0 for women and 13.5 for men. Your doctor will start a treatment plan to raise your hemoglobin. This usually includes drugs that work as an EPO stimulate. These agents are called ESA’s and helps your body to make new red blood cells that your kidneys cannot. It is usually given as an injection under the skin and most CKD patients learn to do this at home as self injections.
The other treatment part of anemia is controlling your iron stores. Your body needs iron to make red blood cells especially when you are receiving an ESA treatment. Without enough iron, your treatments will not work as well. Iron can be given either in pill form or through IV. Your iron stores should be at least 20% and should be checked along with your hemoglobin levels.
Your doctor will check your hemoglobin levels on a monthly basis to bi~monthly basis. This tells your doctor how well your doing and your dose of the ESA will may need to be changed, depending on how well you respond. If untreated, anemia can make your health conditions worse and cause your heart to work harder.
For me one of the most complex issues in dealing with CKD was embracing a renal diet. From day one, the way I approached food needed to change. Throughout every stage of CKD there are different requirements and it was important to educate myself during each stage. Calorie intake, limitations of salt, phosphorus, potassium and protein were all concepts that I had to learn. Some of these things I had never even heard of before I was diagnosed and now I realize the importance of controlling them all. I learned that having proper nutrition can help reduce the workload on the kidneys and allow the best environment for optimal kidney function. This is very important in the first stages of CKD when you still have kidney function.I was never in my life a label reader and once I was diagnosed that all changed. Reading labels can help make healthy food choices for your kidneys.
Sodium: is a major mineral found in the fluid surrounding the cells in the body, It helps to regulate blood pressure and fluid volume. It also helps maintain ph balance in the body. Both muscles and the nervous system rely on sodium to function correctly.
Phosphorus: is a mineral that makes up 1% of a person's total body weight, and is present in every cell of the human body. Most phosphorus is found in the teeth and bones. It plays an important role in how the body uses carbohydrates and fats. It is also needed for the production of protein which is necessary for growth, maintenance, and repair of cells and tissue. It also helps in kidney function, muscle contractions, normal heartbeat and nerve signaling.
Potassium; is a dietary mineral necessary for balancing ph and fluids in the body. It's important to maintain normal blood pressure and works in opposition to sodium. It also is needed for normal muscle growth and function of the nervous system and brain functions.
Some foods high in sodium include: Fast foods and processed foods, canned goods, baked goods, cheese, salted snacks and luncheon meats. High sodium increases the risk of stroke, high blood pressure, heart attack and kidney disease. In dialysis patients it also causes increased edema or swelling in the feet or ankles.Which can lead to breathing issues and pulmonary edema. That's why its so important to limit sodium intake.
Some foods high in phosphorus include: dairy products, chocolate, processed meats, beer, cola's and dark soft drinks, nuts/seeds and dried beans and peas. High phosphorus levels causes your body to pull extra calcium from the bones and can weaken them. When you have both high phosphorus and calcium, which usually go hand and hand, it can lead to dangerous amounts of calcium deposits in the lungs, eyes, heart and blood vessels. You want to maintain a phosphorus level of 3.5 to 5.5 mg/dl.
Some foods high in potassium include: raisins, prunes, dates, strawberries, bananas, watermelon, soy and soy foods, turkey and beef. High potassium levels causes irregular heartbeat, nausea and a slow, weak or absent pulse. Low potassium level causes fatigue, muscle pain, cramps, constipation and dizziness. You want to maintain a potassium level of 3.5 to 6.0 mg/dl,
Some foods high in phosphorus include: dairy products, chocolate, processed meats, beer, cola's and dark soft drinks, nuts/seeds and dried beans and peas. High phosphorus levels causes your body to pull extra calcium from the bones and can weaken them. When you have both high phosphorus and calcium, which usually go hand and hand, it can lead to dangerous amounts of calcium deposits in the lungs, eyes, heart and blood vessels. You want to maintain a phosphorus level of 3.5 to 5.5 mg/dl.
Some foods high in potassium include: raisins, prunes, dates, strawberries, bananas, watermelon, soy and soy foods, turkey and beef. High potassium levels causes irregular heartbeat, nausea and a slow, weak or absent pulse. Low potassium level causes fatigue, muscle pain, cramps, constipation and dizziness. You want to maintain a potassium level of 3.5 to 6.0 mg/dl,
One of the most important things we discussed was the need for Organ Donors both living and deceased. Today I am waiting with 99,206 others who all need kidneys. All together there are 121,153 in the United States alone who need organ transplants. This is why we have such a dire need for organ donors. Waiting is the hardest part, never knowing if and when the phone will ring. The way I've dealt with waiting is to not think about it. I just deal with the day to day. I do all I can to keep healthy and stick with my dialysis, renal diet. This is why the National Donor Sabbath means so much to me. It is yet another chance to raise awareness to cause that will one day hopefully save my life. My faith has helped me get through so much in dealing with kidney disease. The National Donor Sabbath is a weekend to celebrate, through faith, the need for organ donation and transplant. I hope each of you will take part this weekend. Even if only inspires you to sign up at Donate Life America to be an organ donor! Do it for me, Do it for the 121,153 waiting.
I want to thank each and every one of you for joining me over the last six months. I look forward to 2014 being a better year and I hope it is for you as well. I look forward to your comments, questions or concerns.
Keep on fighting, you Kidney Warriors!
~Kidney Blogger
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