Early kidney disease can and should be treated to keep it from getting worse.
Ask your doctor about these three simple tests.
They should be done at least once a year, so if you have early kidney disease, it can be treated right away.
The National Kidney Foundation (NKF) recommends three simple tests to check for kidney disease:
TEST 1: BLOOD PRESSURE
Blood pressure. High blood pressure is the second most common cause of kidney disease. High blood pressure may also happen as a result of kidney disease.A blood pressure of 140/90 or higher is called high blood pressure. If you have diabetes or kidney disease a target less than 130/80 is recommended. Keeping blood pressure under control is important to lower risk of kidney disease, heart and blood vessel disease, and stroke.
TEST 2: URINALYSIS
Urinalysis. A urinalysis is a test that checks a sample of your urine for the amount of protein, blood (red blood cells and white blood cells) and other things.Protein and red and white blood cells are not normally found in the urine, so having too much of any of these may mean kidney disease.Having protein in the urine is one of the earliest signs of kidney disease especially in people with diabetes.Several other tests can be done to check for protein in urine. One of the tests is called the protein to creatinine ratio. It is the most accurate way to measure protein in the urine. A value of 200 mg/gm or less per day is normal.
A value higher than 200 mg/gm is too high.
Another test, called the albumin to creatinine ratio, is good for people at increased risk for kidney disease—people with diabetes, high blood pressure, or family history of diabetes, high blood pressure or kidney disease.
A value of less than 30 mg/gm per day is normal for the albumin to creatinine ratio; a value of 30 mg/gm per day or higher is high and may be a sign of early kidney disease.
With either of these tests, you don’t need to collect a 24-hour urine sample, which may be hard to collect.
TEST 3: GFR
Glomerular filtration rate (GFR). GFR is estimated from results of a serum (or blood)creatinine test. The GFR tells how well your kidneys are working to remove wastes from your blood. It is the best way to check kidney function.A serum (or blood) creatinine test alone should not be used to check kidney function. GFR is calculated using the serum creatinine and other factors such as age and gender. In the early stages of kidney disease GFR may be normal. A value of 60 or higher is normal (GFR decreases with age).A GFR number of less than 60 is low and may mean you have kidney disease.Check with your doctor about having the GFR test (a GFR calculator can be found at NKF’s web site)If you are at increased risk for kidney disease (have diabetes, high blood pressure, or family history of diabetes, high blood pressure or kidney disease), you should find out if you have kidney disease.
A Nephrologist specializes in kidneys, but most people see a Specialist after kidney disease has progressed. More General Practitioners need to check the health of people’s kidneys, so things can be detected early.
The above 3 tests can give you peace of mind. Also, I’ve blogged a lot about Nutrition. You can search under the word Kidney in this blog to find Kidney friendly foods.
For information on upcoming NKF kidney health screenings in your area, visit the KEEP (Kidney Early Evaluation Program) Web site at:
Diabetic Nephropathy is the #1 cause of kidney failure
Almost a third of people with diabetes develop kidney disease.
People with diabetes often have other chronic conditions, such as high cholesterol, high blood pressure and blood vessels disease, as well as nerve damage to their bladder, bladder infections and nerve damage, which means kidney disease is either already present or likely to be on the horizon.
Diabetes comes in two main types and each one requires different treatment.
There are two types of kidney disease in people with diabetes. In type 2 diabetes, the kidney disease may already exist by the time they’re diagnosed with diabetes.
About 90% of people with diabetes have the Type 2 version. In this case their bodies don’t produce enough insulin naturally or work well. Diet and exercise are critical for them.
Symptoms of Diabetes
Symptoms of diabetes include: always feeling tired and hungry, frequent urination, blurry vision, numbness or tingling in hands or feet, always thirsty, wounds that won’t heal, sudden weight loss, sexual problems, vaginal infections. See your medical provider to get tested if you recognize these symptoms in yourself.
In type 1 diabetes, diabetic nephropathy develops a decade post diabetes diagnosis.
Type 1 sufferers need to regularly inject themselves with insulin or use an insulin pump. It may develop at any age.
Symptoms of Diabetic Nephropathy
Early onset of diabetic nephropathy has no symptoms. As kidney function worsens, symptoms may include:
Swelling of hands
Swelling of feet
Swelling of face
Itching (a sign of end-stage kidney disease)
Extremely Dry Skin
Drowsiness (a sign of end-stage kidney disease)
Irregular heart rhythm (a sign of increased potassium in blood)
When your kidneys cannot remove the waste from your blood, it builds up in your body and can reach poisonous levels.
It’s a condition known as uremia that’s extremely dangerous as people can become confused and occasionally comatose.
Diagnosing Diabetic Nephropathy
Specific blood tests and urine tests can diagnose kidney damage. It also can be detected early by finding protein in the urine.
If you have diabetes, make sure to have your urine tested annually.
Treatment for Diabetic Nephropathy
Treatments are available that can help slow the progression of kidney failure.
It’s important to maintain blood sugar control to lower blood pressure. Some medicines called angiotensin converting enzyme (ACE) inhibitors can help slow down the progression of kidney damage.
If a person has side effects from taking ACE inhibitors, another class of drugs called angiotensin receptor blockers (ARBs) can often be given instead.
If not treated, kidneys will continue to fail and larger amounts of proteins can be detected in the urine.
Advanced kidney failure requires treatment with dialysis or a kidney transplant from a cadaver donor. The waiting list for a kidney is currently close to 100,000 people. The other option is finding a living donor that is a match–a family member (they’re not always a match), spouse, friend or a stranger willing to give you the gift of life.
A kidney specialist is called a nephrologist and you need to find one as soon as your kidneys begin to fail so they can help you with diet and treatments.
With medical guidance and dietary changes, symptoms can be eased, and progression of the disease can be slowed.
FLOOD SISTERS KIDNEY FOUNDATION is an excellent resource if you’re experiencing kidney failure or are in need of finding a living kidney donor.
Jennifer Flood and her sisters founded the foundation after finding a total stranger to be a living donor for her father ten years ago. It began with her tenacious use of social media (on Craigslist) that caught broadcast media attention nationwide.
The awareness not only saved her dad’s life, but left her and her sisters with an abundant supply of willing living kidney donors, which then sparked the idea to start a foundation to help other people.
“Upon kidney failure, a lot of people end up on dialysis and then enter themselves on the long waiting list without realizing we have resources available to help them understand their best option is to find a living kidney donor.”
“Our foundation helps by actively seeking perfectly healthy strangers who are willing to donate their kidney now.”
–Jennifer Flood, President/CEO, Flood Sisters Kidney Foundation
Flood Sisters Kidney Foundationhas gained the attention and support from celebrities like Jon Bon Jovi, Barbara Corcoran, Dolly Parton, Geraldo and many more who helped a loved one find a non-related living kidney donor through their foundation.
“For us today, it starts with a commitment to provide trusted MDTV compliant education and awareness. Working with MDTV select hospitals to navigate through the clutter and ultimately providing an altruistic living donor for our client in need.”- Jennifer Flood, President/CEO, Flood Sisters Kidney Foundation
But Flood sisters are not stopping there because as Jennifer says:
“Almost one-third of people with diabetes develop kidney disease. Kidney failure is not just for the rich and famous. It’s actually even more pervasive in poor communities.”
Since 1972, poor people who get stuck on dialysis automatically become covered by medicare insurance and the dilemma is they lose all hope or just don’t know about the living kidney donor transplant option.
According to MDTV it costs over $75,000.00 to educate a community and find just one altruistic living kidney donor. It seems such a small price to pay to save a life, especially since the cost of dialysis is $84,000.00 per year (paid for by Medicare).
Paul Argen, CEO and Executive Producer of MDTV says, “Flood Sisters broke the code for people who are stuck on dialysis and want the best option to return to some normalcy. I am so impressed with thegreat work of Flood Sisters Kidney Foundation that we now have formed an exclusive partnership of collaboration to fund this effort with a long-term commitment to penetrate hundreds of these communities nationwide. Our partnership not only will give people renewed hope and save lives, but deliver a unified channel of education for families, hospitals, caregivers, providers, public health and the media to embrace. We are getting ready to move the needle in this disease state –a much-needed Angelic Gift for society. Stay tuned. Coming soon.”
Remember, only people with end stage kidney disease can be listed for deceased donor transplantation. But living donor transplants can be “pre-emptive” taking place before the need for dialysis. This has a lot of health advantages.
People who choose pre-emptive transplantation have a lower risk of death and loss of kidney transplant function, compared to those who spent time on dialysis beforehand.
The good news is according to 26 studies involving almost 500 kidney donors, 95% of kidney donors in the United States, rate their experience as good to excellent.
We support the work of Flood Sisters Kidney Foundation as the best resource for matching people with living kidney donors and raising awareness about it.
You’re not a celebrity, non-celebrity or number to them. You’re family.
Other complications of diabetes include:
dental and gum diseases
eye problems and sight loss
foot problems, including numbness, leading to ulcers and untreated injuries
Fatal complications include heart disease, stroke and kidney disease.
In the case of kidney disease, this complication can lead to kidney failure, water retentionwhen the body does not dispose of water correctly, and a person experiencing difficulties with bladder control.
Regularly monitoring blood glucose levels and moderating glucose intake can help people prevent the more damaging complications of type 2 diabetes.
For those with types 1 diabetes, taking insulin is the only way to moderate and control the effects of the condition.
Meantime, everyone in the world can benefit from paying attention to their nutrition and how it affects them.
Here Are Nutritional Tips for People With Diabetes and Kidney Disease
Sodium can build up when kidneys start to fail, causing fluid to accumulate in tissues. It’s called edema, and will show up as swelling in hands, face and lower extremities.
Most organizations recommend limiting sodium to 1,500-2,300mg/daily. Besides table salt itself, other high sodium foods you want to avoid are: bacon, ham, canned or instant soups, canned vegetables, cheese, crackers, salted nuts, olives, potato chips, processed foods, soy sauce, barbecue sauces, bottled sauces, pickles, bouillon cubes, dehydrated soups.
Read sodium content on all labels.
Reduce or eliminate processed foods.
When kidneys can’t filter out potassium, too much can circulate in your blood.
An excess of potassium can be very dangerous because it can cause irregular heart rhythm, which could become severe enough to cause your heart to stop working.
Restricting high potassium foods can help prevent this from happening.
Regular blood tests to monitor your potassium levels can alert your doctor to potential problems. If you must restrict your potassium levels, most people need to limit their intake to ~2000mg/daily.
If you are someone who has diabetes and often experiences low blood sugar, you’ll want to avoid treating with orange juice and will want to use glucose tablets instead.
High-potassium foods include bananas, broccoli, raisins, tomatoes, apricots, baked beans, beets, cantaloupe, collard and other greens, molasses, mushrooms, nuts, oranges, peanut butter, potatoes, dried fruit, salt substitute, and chocolate.
Hyperphosphatemia (high phosphorus levels in the blood) does not typically become evident until stage 4 chronic kidney disease.
When kidneys start to fail, phosphorus can start to build up in your body. This causes an imbalance with calcium, which forces the body to use calcium from the bones.
It’s important to keep phosphorus levels close to normal to prevent weakening bones.
Reducing high phosphorus foods you eat is one way to keep phosphorus levels down. If you must, most people benefit from restricting phosphorus to 800-1000mg/daily.
Reducing phosphate additives includes eliminating foods that contain ingredients such as, sodium acid pyrophosphate or monocalcium phosphate.
Other foods rich in phosphorus to avoid include beer, bran cereals, peanut butter, caramel, cheese;, cocoa, cola, dried beans, ice cream, liver, milk and milk products, nuts, and sardines.
If you have diabetes and kidney disease you still want to include carbohydrate sources, but from vegetables, fruit, and whole grains.
You want to avoid beverages and sugars with sucrose and high fructose corn syrup. .
If you are someone with advanced kidney disease you may have to discuss reducing intake of high potassium and high phosphorus sources of carbohydrate with your dietitian.
Too much protein can be bad for your kidneys if you’re living with kidney disease.
When choosing proteins, aim to include lean sources of protein, such as white meat chicken, fish, turkey, and lean beef.
Focus on incorporating healthy fats into the diet such as oils, and fatty fish and avoid saturated fats and trans fats – processed meats, full-fat cheese, and desserts.
It seems like there’s almost nothing left to eat after you see this list. Fear not.
Raising Awareness: Kidney disease is a “hidden epidemic” affecting more than 850 million people worldwide, renal experts say.
That’s twice the number of diabetics (422 million) and more than 20 times the number of people with cancer (42 million) or HIV/AIDS (36.7 million).
But most people don’t realize that kidney disease is a major health issue.
“It is high time to put the global spread of kidney diseases into focus,” says David Harris and Adeera Levin of the International Society of Nephrology.
Harris is the group’s president and Levin is past president. They note kidney diseases often cause no early symptoms.
And many people aren’t aware of their increased risk for heart problems, infections, hospitalization and kidney failure.
Chronic kidney diseases (ones lasting more than three months) affect 10 percent of men and nearly 12 percent of women around the world.
Up to 10.5 million people need dialysis or a kidney transplant, but many don’t receive these lifesaving treatments due to cost or lack of resources.
In addition, more than 13 million people suffer acute kidney injury. Some will go on to develop chronic kidney disease or kidney failure.
Levin says, “Using all these sources of data, and existing estimates of acute and chronic kidney diseases, we estimate approximately 850 million kidney patients — a number which surely signifies an ‘epidemic’ worldwide.”
Kidneys remove waste products and help balance the volume of fluids and minerals in the body. They also produce a hormone that tells the body to make red blood cells, the researchers explained.
“Even if many patients with damaged kidney function don’t feel ill, they’re at high risk for other health problems,” says Carmine Zoccali, president of the European Renal Association — European Dialysis and Transplant Association.
Heart disease deaths due to chronic kidney disease are high — 1.2 million cardiovascular deaths were attributed to kidney disease in 2013.
“The number of people with kidney diseases is alarmingly high, but the public is not aware of this reality. These patients have outcomes and kidney diseases impose a heavy financial burden on health care budgets,” says Mark Okusa, president of the American Society of Nephrology.
The annual per-patient cost of dialysis is $88,195 in the United States.
Even though you can have no symptoms, here are 10 to look out for, according to the National Kidney Foundation.
While the only way to know for sure if you have kidney disease is to get tested, Dr. Vassalotti shares 10 possible signs you may have kidney disease.
If you’re at risk for kidney disease due to high blood pressure, diabetes, a family history of kidney failure or if you’re older than age 60, it’s important to get tested annually for kidney disease.
Be sure to mention any symptoms you’re experiencing to your healthcare practitioner.
You’re more tired, have less energy or are having trouble concentrating. A severe decrease in kidney function can lead to a buildup of toxins and impurities in the blood. This can cause people to feel tired, weak and can make it hard to concentrate. Another complication of kidney disease is anemia, which can cause weakness and fatigue.
You’re having trouble sleeping. When the kidneys aren’t filtering properly, toxins stay in the blood rather than leaving the body through the urine. This can make it difficult to sleep. There is also a link between obesity and chronic kidney disease, and sleep apnea is more common in those with chronic kidney disease, compared with the general population.
You have dry and itchy skin. Healthy kidneys do many important jobs. They remove wastes and extra fluid from your body, help make red blood cells, help keep bones strong and work to maintain the right amount of minerals in your blood. Dry and itchy skin can be a sign of the mineral and bone disease that often accompanies advanced kidney disease, when the kidneys are no longer able to keep the right balance of minerals and nutrients in your blood.
You feel the need to urinate more often. If you feel the need to urinate more often, especially at night, this can be a sign of kidney disease. When the kidneys filters are damaged, it can cause an increase in the urge to urinate. Sometimes this can also be a sign of a urinary infection or enlarged prostate in men.
You see blood in your urine. Healthy kidneys typically keep the blood cells in the body when filtering wastes from the blood to create urine, but when the kidney’s filters have been damaged, these blood cells can start to “leak” out into the urine. In addition to signaling kidney disease, blood in the urine can be indicative of tumors, kidney stones or an infection.
6. Your urine is foamy. Excessive bubbles in the urine – especially those that require you to flush several times before they go away—indicate protein in the urine. This foam may look like the foam you see when scrambling eggs, as the common protein found in urine, albumin, is the same protein that is found in eggs.
7. You’re experiencing persistent puffiness around your eyes. Protein in the urine is an early sign that the kidneys’ filters have been damaged, allowing protein to leak into the urine. This puffiness around your eyes can be due to the fact that your kidneys are leaking a large amount of protein in the urine, rather than keeping it in the body.
8. Your ankles and feet are swollen. Decreased kidney function can lead to sodium retention, causing swelling in your feet and ankles. Swelling in the lower extremities can also be a sign of heart disease, liver disease and chronic leg vein problems.
9. You have a poor appetite. This is a very general symptom, but a buildup of toxins resulting from reduced kidney function can be one of the causes.
10. Your muscles are cramping. Electrolyte imbalances can result from impaired kidney function. For example, low calcium levels and poorly controlled phosphorus may contribute to muscle cramping.
HOW IS KIDNEY DISEASE DETECTED?
Early detection and treatment of chronic kidney disease are the keys to keeping kidney disease from progressing to kidney failure. Some simple tests can be done to detect early kidney disease. They are:
A test for protein in the urine. Albumin to Creatinine Ratio (ACR), estimates the amount of a albumin that is in your urine. An excess amount of protein in your urine may mean your kidney’s filtering units have been damaged by disease. One positive result could be due to fever or heavy exercise, so your doctor will want to confirm your test over several weeks.
A test for blood creatinine. Your doctor should use your results, along with your age, race, gender and other factors, to calculate your glomerular filtration rate (GFR). Your GFR tells how much kidney function you have.
It is especially important that people who have an increased risk for chronic kidney disease have these tests. You may have an increased risk for kidney disease if you:
have high blood pressure
have a family member who has chronic kidney disease
are an African American, Hispanic American, Asians and Pacific Islander or American Indian.
If you are in one of these groups or think you may have an increased risk for kidney disease, ask your doctor about getting tested.
Flood Sisters Kidney Foundation https://floodsisterskidneyfnd.org
Established by 3 sisters determined to get their Dad off kidney death waiting list. They saved him, and now help other patients connect with donors.
Kidney Research Foundation http://www.kidneyresearchfoundation.org
Established by Jim Plante to explore policy options to find a solution to immediately increase number of kidneys available for transplant, educate public on problem and quantify public support for various policy approaches.
Type 2 diabetes is a lifelong metabolic disorder characterized by high levels of glucose or sugar in the blood.
Type 1 diabetes is when the body does not generate sufficient insulin.
Type 2 diabetes is when the cells do not respond to insulin.
Diabetes type 2 is the most common type of diabetes and affects 90-95% of diabetics. It is characterized by insulin resistance or a defective response by the cells to insulin. In some cases, production of insulin by the pancreas may be reduced.
Glucose or blood sugar provides fuel for the cells in the body. Insulin is responsible for transporting glucose from the bloodstream into the cells. When insulin cannot move the glucose into the cells, glucose accumulates in the blood and can cause diabetes complications such as damage to the nerves, kidneys, cardiovascular system and vision.
What Causes Type 2 Diabetes?
Type 2 diabetes is primarily caused by lifestyle factors and genetics. A sedentary lifestyle, obesity, and a diet high in carbohydrates and sweets are the most common causes of diabetes 2.
The usual symptoms of diabetes are increased frequency of urination, increased thirst, and increased hunger. People who have diabetes may also lose weight for no apparent reason.
When left untreated, diabetes can result in vision damage. Prolonged high levels of glucose in the blood can cause glucose absorption in the lens of the eye, resulting in changes in its shape leading to blurred vision.
Other symptom of diabetes are skin rashes and wounds that heal very slowly.
Treatment of Type 2 Diabetes
Type 2 diabetes is a chronic disease with no known cure. As such, “treatment” may be a misnomer. A better term might be “management” of the disease. Management focuses on keeping blood glucose levels as close as possible to normal. If you are diagnosed with diabetes type 2, your doctor may prescribe some form of medication. Diet and exercise are also important in controlling type 2 diabetes.
Recent studies show that type 2 diabetes can be successfully managed without the need for medications. A healthy diet that is low in carbohydrates and high in fiber, protein, wholegrain cereals, dairy products, fruits and vegetables can keep blood sugar at normal or near-normal levels. The right diet and exercise help diabetics manage their blood sugar levels and prevent or reduce complications of diabetes such as blindness, kidney damage, nerve damage, and heart disease.
Type 2 diabetes is the more prevalent form of the disease, accounting for about 90 percent of cases. Often tied to obesity, type 2 diabetes involves a gradual decline in how insulin responds to changes in blood sugar (glucose).
The new drug, called TAK-875, is a pill designed to enhance the secretion of insulin in response to such changes, which means that it has no effect on insulin secretion when blood sugar levels are normal — potentially reducing the risk for hypoglycemia.
The trial, led by Dr. Charles Burant of the University of Michigan Medical School, included 426 patients with type 2 diabetes who were not getting adequate blood sugar control through diet, exercise or treatment with the first-line diabetes drug metformin.
The patients were randomly assigned to receive either TAK-875 (303 patients), placebo (61 patients), or another diabetes drug called glimepiride (brand named Amaryl).
The study was funded by Takeda Pharmaceutical (which is developing the drug), and appears online Feb. 26 in The Lancet.
After 12 weeks, all the patients taking the different doses of TAK-875 had significant drops in their blood sugar levels, the researchers said. A similar reduction occurred in patients taking glimepiride.
However, the incidence of episodes of hypoglycemia was much lower among patients taking TAK-875 (2 percent) than among those taking glimepiride (19 percent) and the same as those taking the placebo (2 percent).
The incidence of treatment-related side effects was 49 percent among patients taking TAK-875, 48 percent among those in the placebo group, and 61 percent among those in the glimepiride group, according to the researchers. They write that they are “excited about the potential of TAK-875 and are eager to conduct larger trials to find out how well this drug works, how safe it is and what its place is in the treatment of diabetes.”
In a journal commentary, Clifford Bailey of Aston University in Birmingham, England, cautioned that, “on the journey to approval of a new class of treatment for type 2 diabetes, many questions will be asked of [drugs such as TAK-875],” including questions of how long they might remain effective, as well as safety issues.
Other diabetes experts had mixed views on the new findings.
Dr. Loren Wissner Greene is clinical associate professor of endocrinology at NYU Langone Medical Center in New York City. She noted that glitazones — a separate class of newer drugs such as Rezulin, Avandia and Actos that also target insulin resistance — have all shown initial promise in clinical trials before worrisome side effects began to surface in users (Avandia was recently withdrawn from the U.S. market due to heart risks).
As for TAK-875, it targets a separate mechanism “but again, until more is known about short-term and long-term cardiovascular effects, we need to proceed with moderated enthusiasm for each new drug and drug mechanism,” Wissner Greene said.
Dr. Minisha Sood, endocrinologist at Lenox Hill Hospital in New York City stressed that, “given the rising global incidence of type 2 diabetes, the medical community is eagerly awaiting the development of novel agents to add to our existing armamentarium of anti-diabetic agents.”
She said that, “though this study includes a small sample size followed for a short period of time, the results are promising in that TAK-875 appears to be effective for glycemic [blood sugar] control without significant risk for hypoglycemia or weight gain. However, like Wissner-Greene, Sood said that “further investigation is warranted, especially including [heart disease] patients.”
Jan. 27, 2012 — The FDA has given its nod to Bydureon, making it the first weekly treatment for type 2 diabetes, according to drug’s manufacturer.
Given as a shot, Bydureon (pronounced by-DUR-ee-on) is the long-acting form of Byetta, a twice-daily injection. It works by stimulating pancreas cells to produce insulin when blood sugar is too high. It is used along with diet and exercise to improve blood sugar control among people with type 2 diabetes, the form of the disease most commonly linked to obesity.
The approval marks the third time the FDA has considered Bydureon, which is manufactured by Alkermes PLC and Amylin Pharmaceuticals Inc. Previously the FDA had expressed concerns that it may increase the risk of heart problems. As part of the new approval, Bydureon manufacturers must now conduct a study to determine whether the drug does increase these risks.
The approval is based on results from a 24-week study that showed people who used the new drug had greater improvements in their blood sugar with just one dose per week, compared with people treated with Byetta injection. The most common side effects were nausea, diarrhea, headache, vomiting, constipation, itching at the injection site, a small bump at the injection site, and indigestion.
“With Bydureon, U.S. physicians and patients can now choose a therapy that offers continuous blood sugar control in just one dose per week,” says John Buse, MD, PhD, professor of medicine, director of the Diabetes Care Center, and chief of the division of endocrinology at the University of North Carolina School of Medicine in Chapel Hill, in a news release. “New treatment options are essential for the millions of adults with type 2 diabetes who continue to struggle to achieve optimal blood sugar control.”