The mildly-invasive procedure that helps end-stage renal disease patients

As previously described by Joe Cosgrove, there are several stages of renal disease; there are, in fact, different treatments for each patient. However, to all those patients currently undergoing hemodialysis after being diagnosed with end-stage renal disease, unrestrained and free blood circulation is practically the whole world for them.

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The process of hemodialysis, as previously mentioned in this blog is all about having a machine replace an individual’s kidneys. It mimics the human kidney function by pumping blood from an individual’s body all the way through a series of tubes, thusly cleansing it by getting rid of all the accumulated waste so that it can be returned to the body via an additional tube. This machine, also commonly referred to as a hemodialyzer, requires an additional procedure in order to create an easy access into the patient’s blood flow. When a vein or an artery develops a blockage while providing or carrying blood from or to an individual’s dialysis access area—which is usually a leg or an arm—, the process becomes less efficacious and successful, and, in turn, patients are more prone to experience all sorts of difficulties.

Nonetheless, an almost minimally invasive treatment for all those patients who require long-term management of vein access while undergoing dialysis has been developed. The procedure, also known as an angioplasty and stent, poses a very good opportunity for all those individuals who have to undergo the dreary effects of being on dialysis. It is, in short, the perfect opportunity to improve an individual’s quality of life.

In America, there are up to 470,000 people who have any sort or degree of irreversible kidney failure or end-stage renal disease. Most of them need as soon as possible either constant dialysis or, even worse, a transplant in order to survive. The vast majority, all those patients undergoing dialysis, require somewhat of an additional maintenance procedure: either an angioplasty and stent—the process being described in this article—, or a balloon angioplasty. They are required to undergo this additional procedure up to twice a year in order to keep the body with a proper and adequate blood flow to access the entry area.

The main issue relies on a physician’s ability to perform successful percutaneous interventional procedures, or, better said: any catheter-based interventional proceeding. If an individual is to improve their quality of life when undergoing this type of dialysis heavily relies on this. Prior to developing catheter-based procedures, individuals suffering from any degree of end-stage renal disease would come into operating rooms for different procedures such as open procedures that would leave patients weak, thusly making the healing process long and dreary, not to mention that patients would need to stay at the clinics. That was, of course, not the best case scenario for those individuals on dialysis thrice or four times a week. This serves as the most plausible and accurate explanation for such high dropout rates: it was quite easy, not to say understandable, for them to abandon the process.

Additionally, all of these catheter-based proceedings allow physicians to easily and seamlessly access any sort of blockage or narrowing (also known as stenosis) that could be reached through another process or routine operation. In the past, many of these blockages ended up being untreated due to the impossibility for a physician to access them; however, as a result, the scientific community decided to create a much better dialysis access with its own blood flow so that blockages would be left untreated.

This mildly-invasive procedure, in term of time, seems to be a much fitter choice for individuals under the aforementioned conditions. Patients require only a few hours of their time in the clinic. Not to mention that the outcome surpasses in adaptability the old-fashioned way: it is much more adaptable and adequate to an individual’s lifestyle. After several trials in the past, patients seem to be much happier in comparison with the resulting outcome of the old way.

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During the procedure, or, rather, during its course, physicians must accurately determined whether they are facing a blockage or a narrowing. This suggests that the procedure demands a lot of decision-making skills from a nephrologist. They must also determine the degree of the scenario they are facing: how severe it is and, most importantly, which seems to be the best way to open it and, moreover, keep it open. In addition, they also have to ponder what catheter they need or seem to be more adequate for that specific case; however, be that as it may, patients, regardless of complications—everything has got complications and physicians are required to avoid them—, the possibility of improving an individual’s quality of life is compelling enough for them to consider consulting with their primary nephrologist. Dialysis and renal disease are perhaps amongst the least satisfactory scenarios; however, there have been many developments and advancements regarding this topic: today, people have more than just one option to treat their conditions.

* Featured Image courtesy of Pixabay at Pexels.com

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Is homeopathy a good idea to treat kidney disease?

Much has been said against homeopathy. Most of its critics say that this system for treating diseases is only a pseudoscience in which the naive fervently believe and that its benefits may be more related to the placebo effect than to real causes. In this post, I do not intend to give a concrete answer to this question but to leave on the table the different arguments of both positions on the subject.

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One of the main arguments of homeopathy’s contradictors, in addition to the fact that in the great majority of cases reviewed by medical specialists from different disciplines, there is a lack of scientific rigor in the studies that defend this system (and, therefore, it does not allow a large part of the medical community to rely on it by the most basic methods to determine objectivity,) there is, as mentioned, the presence of the placebo effect in patients. Of course, this raises other questions, especially from the side that defends homeopathy: If the effect of placebo is indeed positive, and in many cases, there is no evidence of side effects, what is wrong if people want to spend money on sugar pills? However, there are cases that prove that things are not so simple. Unfortunately, homeopathy may have surprising and dangerous side effects. Having nothing directly to do with some homeopathic medicine, in particular, there are indirect results when homeopaths replace doctors as a source of medical advice. For example, many homeopaths have a negative attitude towards vaccination, so parents who are in regular contact with a homeopath may be less likely to vaccinate their children. Homeopaths often tell anecdotes to prove that their system is effective, and yet there are cases that prove otherwise all the time.

According to an article by the Scientific American published earlier this year, there are hundreds of cases regarding children and babies who have suffered terrible effects because their parents have provided homeopathic medicines to solve simple problems as mitigating pain during dentition. In some cases, toddlers have stopped breathing, and it has been necessary to go to emergencies to hospitalize them. Sometimes, the article says, babies, end up dead. In the case of dialysis and renal disease, there have also been fatal cases that demonstrate that, in addition to preventive methods like a proper eating, sleep, and exercise habits, the best way to control kidney disease is traditional medicine ways, including dialysis.

Read also: The Best Eating Habits For Living In Dialysis, by Joe Cosgrove

On the other hand, the Russian Academy of Sciences has also performed studies to determine that homeopathy is a pseudoscience that does not offer evidence of its medical benefits, and that, on the contrary, has led even adult patients to death.

The problem is that, apparently, there are evidence sources that support both sides and confirm their arguments. The proponents of homeopathy, particularly in the case of kidney disease, have an interesting perspective. Homeopathy, according to them, can be supplied at the same time as a conventional medication since there are no incompatibilities in both fields. A renal patient is also a high-risk cardiovascular patient. Taking homeopathic medications may assure that there will be no interaction between both ills. Patients on dialysis can also benefit from homeopathy, always under the control of the specialist, though. Of course, there are some cases that support this view.

If this were true, this would mean that the use of homeopathy is actually effective in chronic renal pathologies, urinary tract infections, and recurrent nephritic colic, as well as for chronic renal patients. This would imply, among other things, that homeopathy would be right for all those people who, because of their deteriorated renal function, do not have good leaks and cannot take anti-inflammatory drugs or certain analgesics. In that case, we would be in the presence of a great step in medical terms, but both sides can never agree to operate in a complementary way.

It is not easy to take sides here. One might think of the benefits of taking natural medicines and think about the possibility of treating some diseases in the least invasive way possible. Nevertheless, things are not so elementary when it comes to homeopathy. The companies that produce this type of medicinal substances do not have to go through the strict filters by which companies that produce drugs do have to pass, which, in turn, have already approved a series of successful experiments that can be scientifically corroborated and verified through statistics. Homeopathic medicines seem harmless and the industry that produces them seems so aware of the environment and the good health of the population, but old-school doctors cannot trust it.

Indeed, it would be wonderful if homeopathy could solve many of the problems that traditional medicine cannot solve on a daily basis. Allergies, the side effects of several medications, the high costs of many treatments, as well as the anomalous behavior of certain diseases in some patients, makes it necessary to constantly think about technological improvements and more effective methods. And that is the question.

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