Protect Your Kidneys and Control Diabetes

March 14th, 2010 admin Diabetes 1 Comment

World Kidney day was observed on 11 March in more than 100 countries of the world. The slogan of World Kidney Day this year was “Protect your kidneys, control Diabetes”. World Kidney Days aims to raise awareness about the heavy burden of chronic kidney disease (CKD) on human lives.

The mission of World Kidney Day is to raise awareness of the importance of our kidneys to overall health and to reduce the frequency and impact of kidney diseases and its associated health problems worldwide. The objectives of the World Kidney Day 2010 were the followings:

* Raise awareness about our “amazing kidneys”

* Highlight that diabetes and high blood pressure are key risk factors for chronic kidney disease (CKD)

* Encourage systematic screening of all patients with diabetes and hypertension for CKD

* Encourage preventive behaviours

* Educate medical professionals about their key role in detecting and reducing the risk of CKD, particularly in high risk population

* Stress the important role of local and national health authorities in controlling CKD epidemics. Health authorities worldwide will have to deal with high and escalating costs if no action is taken to treat the growing number of people with CKD. On World Kidney Day all governments are encouraged to take action and invest in further kidney screening

* If detected early, CKD can be treated by reducing other complications and dramatically reduced the growing burden of deaths and cardiovascular disease worldwide

Kidney diseases are silent killers which largely affect the quality of life. There are, however, several easy ways to reduce the risk of developing this kidney disease.

Seven golden rules:
i) Keep fit and active
ii) Keep regular control of your blood sugar level
iii) Monitor your blood pressure
iv) Eat healthy and keep your weight in check
v) Do not smoke
vi) Do not take over the counter pills on regular basis
vii) Check your kidney function if you have one or more of the high risk factors

Diagnosis of CKD with Diabetes:
People with diabetes should be screened regularly for kidney diseases. The two key markers of kidney diseases are eGFR and urine albumin. Kidney diseases are present when eGFR is less than 60 ml/min.

The Americal Diabetic Association (ADA) and National Institute of Health (NIH) recommend that eGFR can be calculated from serum creatinine at least once a year in all people with diabetes.

Urine albumin is measured by comparing amount of albumin to the amount of creatinine in a single urine sample. When the kidneys are healthy, the urine will contain large amount of creatinine but almost no albumin. Even small increase in ratio of albumin to creatinine is a sign of kidney diseases. Kidney diseases is present when urine contain more than 30 mg of albumin per gram of creatinine, with or without decrease eGFR. The ADA and NIH recommend annual assessment of urine albumin excretion to assess kidney damage in all people with type 2 diabetes and people who have type 1 diabetes for 5 years or more.

Good care makes a differencePeople with diabetes should:
* Measure their HbA1C level at least twice a year which should be kept less than 7%

* Regular insulin injection, intake of other medicines, meal planning, physical activity and blood sugar monitoring

* Blood pressure should be checked several times a year which should be kept <130/80 mmHg

* Regular intake ACEI or ARB medicine for controlling high blood pressure

* To measure effective eGFR yearly

* To estimate urine albumin atleast once a year to check kidney damage

* To take reduce amount of protein in the died at to seek health from the dietitian regarding meal planning

In conclusion early detection and treatment of kidney diseases are the best way to prevent CKD in order to reduced substantial burden of health budget.

Kidney Stone Is One of The Most Painful Disorders

March 3rd, 2009 admin Health Resources 1 Comment

Kidney stone is one of the most painful disorders that lead a person to expensive and unpleasant emergency visits, hospitalisations and undergo surgical procedures.

Half of all untreated people will form additional stones and some will form stones chronically. Preventing kidney stones is the primary goal and we have peer-reviewed clinical data for last 20 years proving that the treatment guideline can help reducing kidney stone formation rates up to 80 percent.

Kidney stones form when urine has too many crystal-forming chemicals and/or not enough substances that protect against crystal formation. If the crystals do not rapidly pass through the urinary tract, they can accumulate and form stones. When the volume of urine is too low, stone-forming materials become concentrated helping to promote stones.

Kidney stones can be prevented if measures taken properly. During the last 30 years, treatment plans incorporating diet, fluids and medications have been developed to prevent or stall the formation of new stones.

The primary treatment have been proven in controlled clinical trials. Your preventive treatment may consist of fluid, diet, and/or medications. Diet changes are just as essential as any medications your urologist may prescribe.

General kidney stone prevention guidelines
Increase fluid intake: A very common question is how much water should I drink each day? You should be producing at least 2.5 liters of urine a day. How much you need to produce that much urine will vary depending on many things.

1. Activity level (The more active you are the more you perspire and need to replenish your body with fluids)

2. Living/working in a hot/dry environment

3. Frequent flying (Pilots, flight attendants, business travelers etc.) and flying all day can cause dehydration

4. Salt intake (High salt intakes increases water retention)

Increasing your fluid intake keeps urine diluted and helps keep crystals from forming.

Low oxalate diet: Unfortunately, oxalate is found in healthy plant foods. High oxalate containing foods are tea, beans, nuts, peanuts, peanut butter, soybean curd (tofu), sunflower seeds, chocolate milk, pepper, ginger, soy sauce, blackberries, grapes, lemon peel, bread, whole wheat etc.

If you have other medical conditions like heart related problems, diabetes, high blood pressure, etc. you may have been advised by another physician to eat a diet low in fat and sugar but rich in vegetables that may contain high oxalate.

Then your key to diet should be everything in moderation. Cut on the portion size of the high oxalate containing foods and the number of times a day or week you are eating these foods.

Here and there you will indulge and when you do, make sure you flush out the extra oxalate with an added 8 ounce glass of water – before and after your treat.

Low salt diet: Your sodium intake should be between 2300-3300 mg per day.

Sodium is added to many of our foods that we buy in restaurants or at the store. A single restaurant meal can contain anywhere from 1000 to 4000 milligrams of sodium! It is important to read the nutrition labels on all packaged foods and to look at the ingredients listed. As a rule, if salt and several sodium compounds are listed as ingredients, the product contains more salt than is advisable on a low-sodium diet.

Low purine diet: Purine is a compound that is mainly found in animal protein and when metabolised, breaks down into uric acid. When you eat a diet that is high in protein (beef, poultry, pork and chicken), you have higher uric acid levels.

The normal diet contains from 600 to 1000 milligrams of purines daily. A low-purine diet is restricted to approximately 100 to 150 milligrams daily.

Current treatments
The current treatments available for kidney and ureteric stones include conservative management (waiting for spontaneous passage), extracorporeal shockwave lithotripsy (ESWL), endoscopic techniques (rigid and flexible ureteroscopic lithotripsy), and percutaneous treatments.

The American Urologic Association Stone Guidelines Panel has identified ESWL as a potential first-line treatment for both proximal and distal ureteric stones and for Kidney stones smaller than 2 cm.

ESWL is a noninvasive procedure that uses shock waves to break up the kidney stone into small pieces that can more easily travel through the urinary tract and excreted from body. However, complex presentations frequently are treated best endoscopically.

Following its introduction in 1980, ESWL dramatically changed the management of Kidney stone disease. ESWL is a procedure in which kidney and ureteric stones are pulverised into smaller fragments by shock waves. These small fragments then can pass spontaneously in urine.

ESWL can not be performed in patients with acute urinary tract infection, uncorrected bleeding disorders, pregnancy, sepsis, and uncorrected obstruction distal to the stone. Otherwise, this noninvasive approach allows patients to be rendered stone-free without surgical intervention or endoscopic procedures.