Wish the patients with kidney disease a happy Christmas day ahead of time

2013年6月15日星期六

kidney damage caused by severe dehydration


kidney damage caused by severe dehydration
A sudden, serious drop in blood flow to the kidneys. Heavy blood loss, an injury, or a bad infection called sepsis can reduce blood flow to the kidneys. Not enough fluid in the body (dehydration) also can harm the kidneys.

dehydration Symptoms
Symptoms of dehydration include dry mouth, thirst, dizziness and rapid heart rate. You may also experience shortness of breath, confusion and fluid retention in your ankles, legs and feet.

What happens to your kidneys with dehydration?

If your body becomes severely dehydrated, this can lead to a prerenal state. You kidneys do not receive the fluid they need to function properly. The kidneys pump blood throughout the body to enable all of our organs to work properly. When the kidneys become impaired, the condition is called a prerenal state.

A prerenal state is one step away from renal failure where the kidneys are barely working. Temporary dialysis will be necessary. Depending on other factors such as age, conditioning and other syndromes or illnesses a patient has will determine if dialysis will become a part of your life or if after dialysis the patient can continue life with the kidneys back to working order.
How to prevent dehydration

Always check with your physician but for the elderly and for children, monitor their fluid intake and how many times they go the bathroom. If you have a loved one in the hospital or in a rehabilitation/nursing home, do not let up on the supervision. Unless they have intravenous fluid going in, do not think that they are taking in enough fluids. There is no more ice water container given to patients unless they ask, so there is no extra fluid during the day other than at meals. Push the fluid for adults and add Pediasure for children. The Pediasure helps to hydrate and also has vitamins that a child would need.

2013年6月14日星期五

effects of metformin on kidneys


Metformin, or Glucophage, is a drug commonly used to treat type 2 diabetes mellitus. It is available in both short and long-acting forms. RxList reports the most common side effects associated with metformin, occurring in more than 5 percent of patients using the drug, are diarrhea, nausea, vomiting, flatulence, diffuse lack of strength, headache, indigestion and abdominal discomfort. Metformin-induced renal side effects are rare but can be lethal.

Metformin reduces the overproduction of glucose by the liver, which is what frequently causes high morning blood glucose. In fact, metformin is often first prescribed because of high morning blood glucose, and research bears out its effectiveness at alleviating this common problem. Long-term research studies (those lasting five years or longer) have also shown metformin to reduce damage to the small blood vessels, a common consequence of chronic high blood glucose. Conditions that can result from this damage include neuropathy, retinopathy, and nephropathy.

Effects of metformin on kidneys

Metformin carries a low risk of lactic acidosis, a very serious side effect. Lactic acid is a chemical made by muscle cells; the kidneys must get rid of lactic acid, otherwise it builds up in the blood. When too much lactic acid accumulates in the blood, a person develops lactic acidosis. The symptoms are not very specific: abnormal breathing, nausea and vomiting, abdominal pain, and confusion are all common. The condition is very treatable if it is detected early but may lead to organ damage or even death if not corrected. Metformin increases lactic acid production. If the kidneys are working properly, this isn't a problem. However, in people who have kidney disease, usually with an elevated creatinine level, metformin increases the risk of lactic acidosis, so the drug should not be used.

In other situations where the kidney function may be reduced, such as in people who have heart failure or are on diuretics, a doctor may recommend against using metformin. The intravenous dye given for CT scans and certain other X-ray tests may damage the kidneys, so the usual recommendation is to stop metformin for about twenty-four to forty-eight hours around the time of the test, until it's clear that the kidneys weren't harmed. Some doctors are hesitant to use metformin in older people -- usually those over 80 -- because they often have some underlying kidney dysfunction and are prone to dehydration; both are conditions that can make kidney function even worse if they become ill.

Metformin is contraindicated in any condition that may increase the risk of lactic acidosis, including heart failure, kidney disorders (creatinine levels over 150 μmol/l,although this is an arbitrary limit), lung disease and liver disease. It is recommended that metformin be temporarily discontinued before any radiographic procedure involving iodinated contrast (such as a CT scan or angiogram) as contrast may temporarily impair kidney function and indirectly lead to lactic acidosis.

2013年6月13日星期四

Creatinine high 520, ATN/Cortical Necrosis,where can we go for this treatment?



6 year old with ATN/Cortical Necrosis following traumatic premature birth +/- bilateral hypodysplasia. creatinine currently 205 and heading towards transplant.is Micro-Chinese Medicine Osmotherapy an option? where can we go for this treatment. At birth his creatinine reached a dangerously high 520. Within 4 months it fell to 90. Over the 1st 5 years of life it rose to 170.Today however, it has reached 223.



His doctor is right and kidney transplant will be the final choice if his creatinine keeps increasing. But, sincerely speaking, he is only 6 years old and we all feel worried about whether his body can burden this big operation. Anyway, this is much too big operation for a 6 year-old boy.At birth his creatinine reached a dangerously high 520. Within 4 months it fell to 90. Over the 1st 5 years of life it rose to 170.

In your message, you asked us about the micro-Chinese medicine osmotherapy. To be honest, I am a doctor and I have the responsibility to tell you the truth. This therapy is good to protect his present kidney function, but it can not recover his kidney to normal size. His kidney is 5 cm as mentioned in your last email, which means the severity of fibrosis or scarring in his kidney. We should know that once kidney is damaged, there are three kinds of cells, health cells, damaged cells and sclerosed cells. We can only protect health cells and repair the damaged cells, but this therapy, micro-Chinese medicine osmotherapy, can not make the sclerosed cells work again.
Now, what we can do is to keep his present condition stable, so that he can maintain his present health condition for a relative longer time. In this way, even doctor decide to offer kidney transplant finally, his body condition is better than now, which can get a relative high success rate of kidney transplant and also a better prognosis. If you talk with his doctor, I think he will also tell you clearly that the success rate as well as prognosis of kidney transplant is not so good for such a little boy. So, now the best results is to keep his condition stable and protect present kidney function, so as to keep him live a better life.
If you have any questions or difficulties about the treatment, please let me know directly and we can work together to solve the problems.

medullary sponge kidney disease



Medullary sponge kidney (MSK) is a birth defect of the tubules-tiny tubes inside the kidneys. In a normal kidney, urine flows through these tubules as it is being formed. In MSK, tiny sacs called cysts form in the medulla-the inner part of the kidney-creating a sponge-like appearance. The cysts keep urine from flowing freely through the tubules.
The name medullary sponge kidney is misleading because the affected kidney does not resemble a sponge. The names tubular ectasia and cystic dilatation of the collecting ducts have been suggested as alternatives; however, medullary sponge kidney is the most commonly used name for this disorder.
Complications associated with medullary sponge kidney include the following (see Presentation, Workup, Treatmen t, and Medication):
Renal stones
Urinary tract infection (UTI)
Hematuria
Distal renal tubular acidosis (RTA; type 1 RTA)
Renal insufficiency (rarely)
Causes
MSK is a birth defect featured with dilation of a collection duct. The dilation is caused by occlusion by uric acid during fetal life or results from tubular obstruction due to calcium oxalate calculi secondary to infantile hypercalciuria.
Prognosis
MSK is usually associated with a good prognosis. However, Renal Insufficiency can account for 10% cases among people with the disorder.
Renal Failure rarely occurs. But in rare cases, it may occur due to repeated pyelonephritis and or urinary tract infection. Therefore, controlling infection is very important to prevent kidney damage.

47 yrs.old .my sister have kidney problem.her kidney is already shrunk,dialysis 3 times a week.


47 yrs.old .my sister have kidney problem.her kidney is already shrunk,dialysis 3times a week.

As mentioned, there is already kidney shrinkage with her case. I am not sure whether she has adopted dialysis, if so, how long she experienced dialysis? Kidney disease is a progression of kidney cells becoming damaged and necrotic. I will explain you more here.
Given your present condition, and if analyzed from cytology, there are three types of cells in the kidneys. There are healthy functional cells, damaged cells and necrotic cells. Healthy cells are working excessively, and if checked by Biopsy, we can find these cells are enlarged. Long term overloaded station makes them fragile to any external influence like infection. And this is the reason why some patient with stable condition may experience sharp kidney function decline after an infection like serious cold. As to these damaged cells, they are still working but partial incapability, and they are on the road of becoming necrotic. As to these necrotic cells, frankly speaking, there is no method to restore their function. So, treatments should focus on protecting these healthy cells, restoring these damaged cells and replenishing more functional cells through stem cell transplant to replace these died kidney cells.
For most patients, if treated well, their kidney function will have some room for improvement. As to your sister's condition, please reply me with more details on her medical history and present condition. Recent medical reports will be much more helpful for analyzing her condition.

Kidney Cyst 24 * 25 mm, right kidney cyst 101 * 47 mm , 118 * 56 mm,


Kidney Cyst 24 * 25 mm, right kidney cyst 101 * 47 mm , 118 * 56 mm,
The cysts are not so big and your kidney is also not seriously enlarged, so i doubt that your kidney function should also be in a relative good condition. But, how about your blood pressure?
Seriously speaking, for your condition, it is the best treatment time because you can still live normally if we control the disease at present condition and you will not need to worry about the disease in the future.
To be honest, we had patient from India and as far as we know, Ayurveda is good at maintain body health, but not so good at treating the cysts. If the cysts can not be treated, they will become bigger and bigger, causing more pressure to surrounding kidney. Then finally, kidney function decline. You also said five family members died from this disease, so I believe that you also know clear about the severity of the disease and its terrible prognosis if no treatment is taken.
Now, we have treatment for Polycystic kidney disease. After the treatment, the cysts can be controlled and kidney function is improved. Some of our PKD patients also stop dialysis after a period of dialysis.


On one hand, we need to increase the permeability of renal tubule epithelial cells in order to increase the absorption of the inner fluid, and then the fluid can discharge out of body with urine. After some period treatment in hospital, the most direct effect is increasing foam in urine. Why foam occurs? The cyst fluid has high tension than urine, so when cyst fluid is discharged with urine, it will form more foam, but if patient have urine test, no protein is found. At the same time, cyst inner pressure also decreases. At the same time, the pressure from cyst to renal parenchyma decreases. At this moment, kidney function can also get some improvement to some degree.
On the other hand, we need to inhibit the activity of renal tubule epithelial cells so as to stop it secreting more cyst fluid. This can stop further cyst enlargement and further progression of the disease. Besides, damaged kidney function can be repaired by activating blood circulation, removing stasis as well as repairment. By the way, we can get a relative satisfied and prospective treatment effect.
From the above, we can see that the treatment is to treat the disease from the cysts, which is more fundamental and effective than only medicine for blood pressure or even dialysis. Once the cysts are controlled at early stage, the further progression of the disease can also be stopped so you will not need to worry about dialysis in the future. At the same time, different with the surgery which is only working on larger cyst, the treatment is working on all the kidney or each renal tubule, so all the cysts can be controlled. But honestly speaking, I can not give you 100% promise that we can remove all the cysts completely because it is kind of genetic disease. What i can promise is that we will do our best to control the disease at this stage so that you can live a normal range. This is already a very good result for PKD patients.

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