How to avoid starting dialysis sooner than expected

Although Joe Cosgrove has previously mentioned that starting dialysis is not the end of the world—in fact, he addressed the topic from different points of view including one major concern: how can individuals and patients under dialysis get the most out of life once they start the treatment?—. Many people fear that they will have to quit their jobs, or that they will have to dramatically change their lifestyles. The truth is, the onset of dialysis can be delayed to some extent. And although it is very tough to be diagnosed with chronic kidney disease, if patients are diagnosed in the early stages of such condition, there certain steps and measures they can take to get the most out of their kidneys and prolong kidney function.

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Following a physician’s advice, it is possible to still enjoy a healthy life even with kidney disease. Following adequate and good health practices, staying on the job and continuing to enjoy other leisure activities and social events are ways an individual can overcome the apparent lack of control of their condition. Additionally, aside from following a physician’s advice in order to avoid starting dialysis sooner that expected, having a job with a solid health insurance helps provide security and other health benefits.

One thing is still certain: there are a plethora of causes that may cause chronic kidney disease; however, there is also a myriad of recommendations that, if followed properly, can help an individual delay kidney failure—which is what leads to dialysis and kidney transplant.

The two main causes of chronic kidney disease in North America and other western countries are diabetes and high blood pressure. These diseases have always been on the rise in the American country, which has also caused an increase in the number of patients who suffer from certain chronic kidney disease. The first step, of course, to control any type of CKD is by controlling the aforementioned conditions.

Diabetes and how to extend kidney function

People who suffer from diabetes need to mind their blood glucose levels. There is no shortcut. Blood glucose levels must be kept in an adequate range in accordance with physicians recommend. Additionally, hemoglobin A1C should be below 6.5%. And, of course, patients suffering from early stage chronic kidney disease need to have their kidneys tested at least once a year.

Research has shown that certain high blood pressure medicines are able to protect the kidneys of those who also suffer from diabetes, even they also have normal blood pressure levels.

The high blood pressure scenario

Individuals with high blood pressure—also known as hypertension—, should consult with their primary physician in order to get their blood pressure medicine. As recommended by the The National Heart and Blood Institute, it is recommended to have blood pressure under control (at 120/80 or even lower for those who have early stage kidney disease. For those who suffer from diabetes, blood pressure should be around 130/85.

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Other diseases commonly associated with chronic kidney disease

Aside from the previously mentioned diseases, there are several other conditions that can lead to suffering from chronic kidney disease: glomerulonephritis and lupus, for instance. These diseases affect the immune system, causing it to overact, which ends up affecting the kidneys (due to inflammation). In order to slow down the pace at which the kidneys deteriorate under these circumstances, a physician can prescribe certain medicines such as steroids.

Chronic kidney disease is also a direct consequence of certain infections and other medicines that happen to be detrimental to the organs. Infections, for instance, can be wiped out through the controlled used of antibiotics; certain medications, such as painkillers or antibiotics cause a negative impact on the kidneys: patients with these conditions need to be straightforward with their physicians about their CKD prior to initiating other treatments in hopes of avoiding a worse condition and prevent further damage.

Prolonging kidney function

Irrespective of how an individual develops chronic kidney disease, there are certain steps people can take in hopes of prolonging kidney function. Smoking, for example, is known for having a direct impact and correlation with the progression of kidney disease, therefore, and simply put, it is recommended that those with early stage kidney disease stop spending their money on cigarettes and tobacco. Of course, adopting a healthy diet, losing weight and working out are crucial activities that can act in the betterment of kidney condition. People with high blood pressure should also limit sodium in their diets: physicians believe that avoiding a certain amount of phosphorus and protein may also slow down the pace at which kidneys deteriorate; however, research continues on other foods—and even medicines—to see whether they act in the best interest of the health of the patient.

It is also important to remember that every CKD is unique. It is best to first address a physician and work out on a plan to prevent and slow down the disease while getting the most of life. It is perfectly possible.

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Physical activity for dialysis patients

Joe Cosgrove has previously covered renal compensation and dialysis thoroughly from different angles; however, one common thing dialysis patients wonder is whether they can perform physical activities during and after the treatment. The truth is, the vast majority of dialysis patients firmly believe they cannot execute any physical activity or exercise; nonetheless, research has shown that actually, they can. Many out of those patients have previously described their first physical activities as something that helped them feel normal again shortly after starting their dialysis treatment. As asserted by various physicians, the act of motion and exercise, regardless of length and intensity, helps those individuals with chronic kidney disease feel much better and stronger, and subsequently more in control of their bodies and their health.

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Many out of those patients have previously described their first physical activities as something that helped them feel normal again shortly after starting their dialysis treatment. As asserted by various physicians, the act of motion and exercise, regardless of length and intensity, helps those individuals with chronic kidney disease feel much better and stronger, and subsequently more in control of their bodies and their health.

The medical community, especially those who specialize in working with renal rehabilitation have found that exercising on a regular basis, carefully, of course, not only improves an individual’s potential for future and more intense physical activity but also does wonders regarding the overall quality of life for those undergoing the dreary process. It is well known that exercise may also come in handy for gaining back the ability to carry out activities that were part of people’s routines prior to starting the treatment. Of course, this also has a huge impact on an emotional level: whether it is returning to the office or taking over domestic chores, patients basically agree upon the fact that exercise has given them back a part of themselves that was somewhat lost.

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Thus, with that being said, for all those individuals who are currently undergoing dialysis, any kind of controlled and supervised physical activity is highly recommended; however, before recklessly jumping into action, it is advisable to consider the following aspects:

Consult your physician

When it comes to delicate medical conditions, addressing the primary physician is key. Doctors are the first source of information about what kind of physical activity can be done depending on the patient’s current stage of the treatment. In fact, physicians often feel happy for those patients who show eagerness to work out and improve their overall health. Measures often include several recommendations such as consulting a physical therapist as well in order to avoid falling victim of any possible injury. Meal plans and controlled diets are always advisable.

Alongside their primary physician and their physical therapist, patients undergoing dialysis can make their current stage more fun and enjoyable—which ends up providing a tremendous positive effect on the patient’s body and mind.

Choose the physical activity and exercise you like the most

Most patients are used to taking long walks. Walking, in fact, is perhaps one of the least demanding and strenuous exercises people can do; yet it is also one of the healthiest ways of keeping a good physical condition. Taking a walk provides several benefits and helps various corporal functions at the same time: it improves the patient’s digestion, increases their energy levels, reduces their bad cholesterol levels, controls their blood pressure, lowers the risk of having a cardiovascular condition, helps them sleep much better and, most importantly, helps fade away those high-stress levels.

Start!

It is undeniable that undergoing dialysis takes a toll on every patient: the vast majority of those individuals who are currently on dialysis oftentimes agree upon the fact that they always feel exhausted and too tired to exercise, and, subsequently, they firmly believe that adding extra activity to their already demanding routines will leave them even more tired. The truth is, even a little-controlled amount of physical activity, let us say 20 to 25 minutes a day, has proven to help patients feel less exhausted. Doing otherwise—not exercising—actually makes people fall victim of those unwanted low energy levels: the longer they postpone any kind of physical activity, the weaker they will feel.

One of the most renowned side effects of suffering from kidney failure is muscle loss. This simply means that those individuals who are currently undergoing dialysis are more likely to lose muscle mass. Exercise, however, helps keep the muscle from shrinking. In fact, there is the chance to bring it back!

Always stretch

As mentioned above, the common denominator of those undergoing dialysis is a constant weakness. People are simply too tired to do basically anything; however, stretching prior to any kind of physical activity has proven to do wonders; besides, it is practically something all dialysis patients can do: it is the perfect way to get blood to those stiff body parts. Stretch both lower and upper body prior and after exercising, as it reduces the chances of suffering from cramps and other unwanted and unsolicited pains. Of course, the key here is to mind the pace, meaning: start slowly. There is no need to become the ultimate athlete to have a good and effective workout. Exercise at a controlled pace and improve over time. It will definitely pay off!

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Chronic Kidney Disease Stage 3: assessment, management, risk factors and tips to prevent it

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Stage 3 CKD is something that has to be taken seriously. In a previous post in this same blog, we talked about the 5 stages of Chronic Kidney Disease. We understood that stage 1 and stage 2 are not that serious and that the illness can be managed with diets and good habits. We also learned that Chronic Kidney disease in these two stages is invisible and that is very hard to detect unless other tests are done. We also learned that stage 3 is divided into two stages and that is here where the thing gets really serious (especially in stage 3B) and that it will be most likely that the patient needs treatment, medications, special diets and future dialysis and specific kidney treatments. Stage 4 and 5 are the last stages where the kidney is already working under 50% and the patient will need a transplant and a serious and well-managed treatment combined with diets and medications and we learned that stage 5 is already terminal and the patient has to be managed very carefully.

Today we are going to take a look at stage 3A within a Chronic Kidney Disease, the way it should be assessed and managed, the risk factors every patient has and some tips to prevent the progression of stage 3 in CKD.

Assessment and management of Stage 3 CKD

Most Stage 3 CKD patients are not at high risk and can be managed with primary care. The objective becomes to identify the patients that are in risk of passing on to stage 3B  and its associated risks.

The most important symptoms or pointers in stage 3A of patients at risk are: When the patient´s proteinuria is ACR>70 or PCR>100; the patient has a declining GFR and he or she is at a young age. After these pointers, doctors have to ask themselves if the patient is functioning well, if the patient has a history of this illness and if there has been any urinary abnormalities or other specific indicators.

The first value that has to be determined is the creatinine levels to see if they are elevated. Then compare them with previous tests and values. If previous tests don’t exist, there has to be a 14-day gap to take another test and compare values and it has to take them to the lab as deteriorating renal function needs rapid assessment.

As for the clinical assessment, the tests focus on heart failure or direct assessment of bladder enlargement. This can be done by imaging which can indicate the level of obstruction that doctor suspect. Here urine tests become ever more important because they can indicate the amount of proteinuria by ACR/PCR that can be seen in the body and this is a reliable indicator of progressive renal disease.

Management of Stage 3 CKD

In this stage, there is always a big cardiovascular risk. The idea is that the person starts having a healthier lifestyle and quit bad habits such as smoking, and starts a discipline in their exercise and eating habits. There should also be a cholesterol lowering therapy or approach if there are already any macrovascular disease symptoms. In this stage of CKD, the patients tend to be over 60 or 70 years old and most of them do not go onto stage 4. However, there should be a close assessment and control over diseases such as heart attacks, strokes, and narrowing of other arteries.

Stage 3 CKD risk factors

When we talk about risk factors we are mainly talking about cardiovascular events. The patient has to be monitored on his or her proteinuria, hematuria, and declining GFR levels and they must be closely managed. This is an accurate indicator that the CKD is progressing. The idea of understanding these risk factors is that doctors can accurately attack the kidney disease either by reducing the risk of having cardiovascular complications or by prescribing treatments that slow down or stop the progression of CKD.

Tips to prevent stage 3 CKD

Basically, there are three ways a person can prevent the body reaching stage 3 CKD: the first one is to have a kidney-friendly diet; the next one is to have a very good discipline when it comes to medications, and the third one is to exercise.

As for a kidney-friendly diet the idea is to eat the correct amount of calories, cut down on  phosphorus-rich foods because it is very hard for the kidney to process this type of food and avoid high-potassium foods (if  there is a possibility of a dietician it is a good idea because people can understand the amount of  potassium they can take.

Medications include drugs to prevent risk factors such as blood sugar levels and blood pressure.

Exercising and non-smoking become very important at this stage just to prevent the progression of CKD and to help the patient live his life as normal as possible.

Be sure to also read this post about The Most Significant Early Symptoms Of Kidney Disease