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Web of Care provides information, support and products for people caring for a loved one with kidney disease at home.
Analgesic nephropathy is a kidney disease caused by prolonged use of two or more analgesics (painkillers like aspirin, ibuprofen and acetaminophen). Analgesics are linked to kidney problems because the kidney is the only organ that excretes them (filters them out of the body). Combinations of ibuprofen (Advil) and acetaminophen (Tylenol) with caffeine and/or codeine have been shown to be harmful.
While sporadic use of a single analgesic (for example, aspirin or only Tylenol) is not harmful, daily use of even one type of painkiller may be doing damage to your kidneys. If you are taking painkillers daily you should consult a medical professional.
Analgesic nephropathy can weaken the ability of the kidneys until they can no longer function (see End Stage Renal Disease). At that point, dialysis or transplantation will be necessary to replace kidney function. Four out of 100,000 people have analgesic Symptoms to watch for include:
Nausea; vomiting
Easy bleeding or bruising
High blood pressure
Swelling in the feet, hands or extremities
Urinary tract infection
Tissue (from damaged kidneys) passing in urinenephropathy, with a higher concentration
Preventing and Coping with Kidney Disease
Serious kidney disease – the kind that results in the need for dialysis – is increasing. the rise in incidence “alarmingI believes this increase is a result of physicians and patients not doing enough to treat and avoid high blood pressure and diabetes, the 2 main causes of kidney failure.
Q. How do you know if there is a
concern about kidney function?
Kidney disease is diagnosed by doing an inexpensive routine blood test called creatinine. The test should be done regularly for diabetics and those with high blood pressure, but it can easily be part of a regular check-up. Ask your doctor if they normally order this test. A normal creatinine level is around 100. An extremely high level is over 500 and usually indicates the need for dialysis.
Dialysis is a costly, time-consuming and difficult procedure. Dialysis is a life-long requirement and this can be very depressing. I have several patients on dialysis and it is a tough struggle.
Q. What can be done to reduce
the risk of kidney failure?
Well, first, look at your lifestyle. Smoking and high levels of alcohol ingestion increase the risk. Regular exercise is important to keep blood pressure at normal values. And then there’s diet.
Q. What kind of foods should be avoided?
If you have mild kidney disease, it’s important to be on a low-protein and low-sodium diet. But you can’t compensate with high carbohydrates because that can lead to high blood pressure and other problems. I recommend a balanced diet, high in vegetables, fiber and soy. Small amounts of red meat and chicken are okay, but I suggest increasing the amount of fish. Processed and canned foods often contain high sodium and should also be avoided.
Q. What about starchy foods?
:
A high fiber choice like brown rice is good. Pasta is fine as long as large amounts are not consumed.
Q. Dairy foods are pretty much pure fat and protein – are they okay?
Dairy products are good in moderation, especially for post-menopausal women who require the vitamin D and calcium they provide. And I must add, drinking lots of water is very important as well.
Q. Let’s talk about medications. Are there any that prevent kidney disease?
The main medications in kidney disease are those that control diabetes and high blood pressure. I was recently involved in the HOPE trials, which tested a relatively new ace-inhibitor drug called Altace (rampiril). It was proven to be highly successful in reducing the risk of kidney disease when given to diabetics at a dose of 10 mg daily.
It was a very significant finding; by reducing blood pressure rampiril may prove crucial in reducing the number of diabetics who need dialysis. However it is more than a blood pressure pill; it can actually reduce the number of diabetics who go on to have kidney failure.
Q. Are there any cautions about rampiril?
Yes. If a patient already has decreased kidney function, then rampiril could make the bad kidneys worse. It needs to be prescribed very cautiously. The best candidates are diabetics with very early or no kidney disease.
Q. Where does the caregiver fit in this whole picture?
To reduce kidney failure in a person with mild kidney disease, it is critical to keep blood pressure at the lowest number the patient can tolerate. The caregiver plays a crucial role here – by helping the patient make the right lifestyle choices and reminding about medications. Patients who have an active, positive caregiver generally do much better than those who do not. Caregivers can make a big difference by supporting good healthy choices with solutions such as the right foods.
What is Glomerulonephritis?
This formidable name refers to a serious disorder. The glomerulus is an integral part of the nephron, the blood filtering unit of the kidney. The specific function of the glomerulus is to bring blood (and the waste products it carries) to the nephron. Glomerulonephritis is inflammation or scarring of the glomeruli. When glomeruli are damaged they can no longer filter out wastes and fluid properly. They will also be unable to keep necessary substances like blood and protein in the body. Glomerulonephritis can lead to End Stage Renal Disease. Types of kidney diseases that cause glomerulonephritis include IgA Nephropathy, Lupus Nephropathy and Goodpasture's Syndrome.
pecific treatment for glomerulonephritis will depend on what is causing the inflammation in and around your glomeruli.
Generally, treatment for glomerulonephritis involves diet changes and medication. You should be monitoring intake of fluids, protein, sodium and potassium. Please consult a medical professional to determine a diet plan best for you.
You may also be required to take medications such as ACE (angiotensin-converting enzymes) inhibitors to control high blood pressure. These medications help your heart to work more efficiently. They also dilate the blood vessels to the kidney and increase excretion of urine (a diuretic effect). ACE inhibitors may also be prescribed because they have been found to slow down the development of End Stage Renal Disease.
Since urinary tract infections can occur with glomerulonephritis, you may be required to take antibiotics to treat the infection.
Dialysis and transplantation will be needed if the disease leads to kidney failure.
Glomerulosclerosis is scarring or hardening of the glomeruli. When the glomeruli are damaged they can no longer filter out wastes and fluid properly. They will also be unable to keep necessary substances like blood and protein in the body. Glomerulosclerosis can lead to End Stage Renal Disease in one to ten years. Types of kidney diseases that cause glomerulosclerosis include diabetes. Glomerulosclerosis can also be caused by infection or drug use.
Symptoms of Glomerulosclerosis
Swelling of the body
Loss of appetite
Foamy urine
High blood pressure
Treatments for Glomerulosclerosis
Specific treatments for glomerulosclerosis depend on what is causing the kidney tissues to harden and scar. A biopsy (where a very small sample of your kidney tissue is removed for examination) may be required to determine the exact cause.
Generally, treatment will include diet changes and medication.
What is High Blood Pressure and Kidney Disease?
High blood pressure or hypertension can be both a cause and result of kidney disease. When the kidneys can no longer function properly, wastes and excess fluids build up in the body. The extra fluids in the body cause blood pressure to increase. When blood pressure increases the heart must work harder to pump blood through the body. This extra work can damage blood vessels all over the body, including those in the kidneys. If there is already some kidney damage, high blood pressure will damage them even more, leading to more fluid build up in the body. High levels of sodium and cholesterol will also affect blood pressure. High blood pressure is the second leading cause of End Stage Renal Disease, responsible for more than 15,000 cases of ESRD per year. Typically, high blood pressure is a condition that tends to develop more in white males and male and female African Americans.
Treatments for High Blood Pressure and Kidney Disease
Treating high blood pressure is a key component of treating kidney disease. Most forms of kidney disease cause high blood pressure and high blood pressure in turn damages the kidneys. High blood pressure will likely lead to End Stage Renal Disease. Treatments for high blood pressure include the use of blood-pressure controlling drugs:
ACE (angiotensin converting enzymes) inhibitors
Diuretics
Calcium channel blockers
Treatment also includes a change in diet by limiting:
Sodium
Alcohol
Cholesterol
Proteins
Fluids
Potassium
What is Kidney Disease of Diabetes?
Diabetes (also known as diabetes mellitus) affects about 15 million people in the US. It is a condition resulting from the body's inability to process sugar properly. There are two types of diabetes:
Insulin-Dependent Diabetes Mellitus (IDDM)
Non-Insulin-Dependent Diabetes Mellitus (NIDDM)
Diabetes can be inherited or acquired. Acquired diabetes is usually caused by obesity.
Diabetes can damage many tissues in the body, including the kidneys. Kidney Disease of Diabetes (also known as diabetic nephropathy) is caused by the excess sugar built up from the body's inability to process it properly. Specifically, diabetes causes the filtering units in the kidneys (the glomeruli) to scar and harden (see Glomerulosclerosis). When the filtering units become damaged they are no longer able to filter wastes and excess fluid from the body.
Kidney disease from diabetes usually progresses slowly. This gradual damage to the kidneys can lead to total kidney failure (see End Stage Renal Disease). The progress of a diabetic's kidney damage leading to ESRD occurs in five stages. Progression through these stages includes loss of valuable protein in the urine and increasingly high blood pressure. Progression of the disease from stage 1 to stage 5 (ESRD) can take more than 20 years.
Diabetes is the leading cause of ESRD. Approximately 50,000 people with diabetes have kidney damage that will eventually lead to ESRD.
Treatments for Kidney Disease of Diabetes
Treatment for kidney disease caused by diabetes focuses both on controlling diabetes (levels of blood sugar) and slowing down the progression of End Stage Renal Disease. High blood pressure can be particularly damaging to a diabetic's kidneys, so lowering high blood pressure is critical. Medications used to treat high blood pressure include:
ACE (angiotensin-converting enzyme) inhibitors
Diuretics
Calcium channel blockers
It is not clear why, ACE inhibitors are particularly effective in slowing the rate of kidney damage in diabetics.
A comprehensive dietary program may be required. The treatment known as intensive management (or glycemic control) has been proven to be very effective in helping to maintain the function of the kidneys of diabetics. Intensive management focuses on keeping the blood sugar levels as normal as possible through a structured diet and exercise plan.
Additional diet changes to treat kidney disease will include monitoring levels of protein and sodium. Since kidney disease varies between individuals, a medical professional should be consulted for an individual diet plan.