Demystifying Kidney Disease for the Average Joe!

BACKGROUND It is estimated that more than 20 million Americans may have chronic kidney disease (CKD). That means roughly 1 in 15 Americans. Subjectively speaking, and for some reason, the rate seems to be even higher where I practice (Bradenton / Sarasota, Florida), but that could be related to the older aged population here. Whether you could "cure" CKD would depend on the cause of kidney disease . Quite often, the cause happens to be a chronic disease that can only be "controlled" (like diabetes or hypertension), but not technically cured. And so is the case with CKD. That is, you can usually not cure and get rid of CKD, but you should be able to control the worsening of your CKD and prevent the fall in your GFR.  I have discussed in my previous posts about how physicians measure your kidneys' function and the concept of GFR. You may want to take a look at the picture of the " GFR meter " again wherein I had mentioned that the needl...

Most of us, even the fitness freaks, feel good about consuming diet soda...that harmless, calorie-free, sugar-free indulgence. What could ever be wrong about a can of zero calorie, carbonated, flavored water?! Possibly a lot, it seems. The potential for harm stems from the various ingredients that go in to conjuring your favorite diet soft drink. Lets break down a typical artificially sweetened beverage (diet soda) in to its bare ingredients that are pertinent for this discussion : artificial sweeteners, caffeine, caramel color, and phosphoric acid.

I often see patients in my office who refuse dialysis (should it become necessary) for their advancing kidney disease. I divide these patients in to two categories. The more common category is patients who refuse it because of the "fear of dialysis". They could have trouble understanding dialysis and what potential benefits they could derive from it. They would often make good dialysis candidates who have more to lose than gain by refusing dialysis therapies. The other category is the patient who rightfully refuses dialysis because she or he would not make a good candidate for such treatment. There could be multiple reasons for that. It could be advanced age and frailty, presence of other severe disease conditions like heart failure or metastatic cancer, etc. In such cases, it is hard to always predict if dialysis would add anything to the quality/quantity of life. And often, patients are simply looking at the "big picture". So the questions that come up in ...

I had covered why excess protein in the urine needs to be treated in my earlier post.  Lets talk briefly about how we go about achieving that.

I set off to try and answer this question after one of my patients brought along an article that claimed that " nettle leaf lowers creatinine level in the blood ". This by extension would mean that it could perhaps cure CKD? I was quick to admit that not once during my typical "western medicine" training had I heard of that claim. To me, CKD had always been this inexorable malady that can be, at best, controlled or slowed down from progressing further. "Cure" is not a word that gets thrown around a lot when you talk about CKD. As I had discussed earlier , once kidney function declines chronically, it can typically not be regained.    But I do try to have an open mind, the good old scientific temper and all that. So rather than dousing disdain over my patient's excitement, I tried to look for evidence to see if the article's claim was indeed true.

Pain, both acute and chronic, is commonly prevalent in patients with chronic kidney disease (CKD) . This is due to the myriad diseases that often coexist in kidney disease patients (like arthritis, diabetes, obesity, etc). I had earlier written a post on how certain painkillers adversely affect the function of the kidneys. So we know that many pain medications are bad for your kidneys. We also know that even if some pain medications are not directly toxic to your kidneys, they can still accumulate in your body and affect other organs in patients who have kidney disease. It saddens me when patients with pain come to my office after being told that they can't take a particular pain medication because "their kidney numbers have worsened". Granted that could certainly happen; but not coming up with an alternative and leaving patients "marooned" is also a disservice to them. What then could be some viable options for patients with kidney disease to deal with thei...