Asked Questions About Kidney Disease
Why is cholesterol important?
Too much cholesterol can build up in your vessels. This buildup can narrow vessels and lead to blockage, preventing blood from getting to a certain area of your body. When this occurs in your heart vessels, it is called coronary heart disease and can cause a heart attack.
In people with chronic kidney disease (CKD), heart disease is very common. It is suggested that people with CKD have cholesterol labs drawn at least once a year. Your doctor may want to test more frequently if something has changed with your health.
Cholesterol lab values are different for adults and children. The lab ranges stated below are for adults and should not be used for children. People with good LDL cholesterol, high HDL cholesterol and normal triglycerides are less likely to have heart disease.
|
LDL Cholesterol |
HDL Cholesterol |
Total Cholesterol |
Triglycerides |
| Goal |
Optimal < 100 mg/dL |
> 60 mg/dL F
> 55 mg/dL M
|
Desirable < 200 mg/dL |
Normal < 150 mg/dL |
| Near Optimal |
100-129 mg/dL |
|
|
|
| Borderline High |
130-159 mg/dL |
< 40 mg/dL |
200-239 mg/dL |
150-199 mg/dL |
| High |
160-189 mg/dL |
|
> 240 mg/dL |
200-499 mg/dL |
| Very High |
> 190 mg/dL |
|
|
> 500 mg/dL |
What does diabetes do to the kidneys?
With diabetes, the small blood vessels in the body are injured. When the blood vessels in the kidneys are injured, your kidneys cannot clean your blood properly. Your body will retain more water and salt than it should, which can also result in weight gain and ankle swelling. You may have protein in your urine. Also, waste materials will build up in your blood.
Diabetes may also cause damage to nerves in your body. This can cause difficulty in emptying your bladder. The pressure resulting from your full bladder can back up and injure the kidneys. Also, if urine remains in your bladder for a long time, you can develop an infection from the rapid growth of bacteria in urine that has a high sugar level.
What will happen if my kidneys have been damaged from diabetes?
First the doctor needs to find out if your diabetes has caused the injury. Other diseases can cause kidney damage. Your kidneys will work better and last longer if you:
Control your diabetes
Control high blood pressure
Control high cholesterol
Get treatment for any urinary tract infections
Correct any problems in your urinary system
Avoid any medicines that may damage the kidneys (especially over-the-counter pain medications)
If no other problems are found, your doctor will try to keep your kidneys working as long as possible. The use of high blood pressure medicines called angiotensin converting enzyme (ACE) inhibitors has been shown to help slow the loss of kidney function.
How can lupus harm the kidneys?
Kidney damage from lupus can be mild or severe. It can cause damage to the filtering units (glomeruli) of the kidney. Since these filtering units clear your blood of waste, damage to them can cause your kidneys to work poorly or not at all. About 90 percent of lupus patients will have some kidney damage, but only two to three percent actually develop kidney disease severe enough to require treatment.
The kidney disease may be "silent" and not cause any symptoms. However, you may have dark urine, flank pain, high blood pressure, weight gain from extra fluid and swelling around your eyes and in your hands and feet.
What kind of birth control is recommended for kidney patients?
Dialysis patients who have periods or who could become pregnant should use birth control to guard against pregnancy. The doctor can recommend the type of birth control that should be used. Generally, women who have high blood pressure should not use the pill, since it can raise blood pressure. Transplant patients should not use an IUD. These patients are more likely to get an infection from an IUD because the anti-rejection drugs they must take also lower the body's ability to fight infection. The diaphragm, sponge and condom are good means of birth control, especially when used with spermicidal creams, foams or jellies.
Who is at risk for developing PKD?
The adult type of PKD (also called autosomal-dominant PKD or ADPKD) is passed from one parent to child by an autosomal-dominant type of inheritance. This means that only one copy of the abnormal gene is needed to cause the disease. Therefore, if one parent as the disease, each child has a 50-50 chance of getting the disease. The risk is the same for every child, regardless of how many children develop the disease.
The less common form of PKD (also called autosomal recessive PKD or ARPKD) is passed by an autosomal recessive pattern of inheritance. This means that both parents carry the abnormal gene and both must pass the gene to the child in order for the child to get the disease. In this situation, every child has a 25 percent chance of getting the disease in a family that is at risk.
What are the clues that someone has PKD?
People who have inherited ADPKD often do not notice anything unusual until they are 30-40 years old. The first noticeable symptoms include:
High blood pressure
Back or side pain
An increase in the size of the abdomen
Blood in the urine
Frequent bladder of kidney infections
High blood pressure is the most important treatable risk factor in PKD. Occasionally, patients may develop headaches related to high blood pressure or their doctors may detect high blood pressure during a routine physical exam. Finally, about 25 percent of PKD patients have a so-called floppy valve in the heart, and some of these develop a fluttering or pounding in the chest as well as chest pain. These symptoms almost always disappear on their own, but may be the first hint that someone has PKD.
Can analgesics hurt kidneys?
Generally, when used according to directions, over-the-counter analgesics are safe. However, heavy or long-term use of these medicines, especially those that contain a mixture of painkilling ingredients—such as aspirin, acetaminophen and caffeine—in one pill, have been linked to chronic kidney disease in European studies. The warning labels on over-the-counter analgesics tell you not to use these medicines more than 10 days for pain and more than three days for fever. If you have pain and/or fever for a longer time, you should see your doctor. The doctor can check for possible medical problems and advise you about what medications you should take.
My doctor recommended that I take an aspirin every day to prevent heart attacks. Will this hurt my kidneys?
No. There is no risk to the regular use of aspirin in small doses recommended for prevention of heart attacks.
What analgesics are safe for people who have kidney disease?
Acetaminophen remains the drug of choice for occasional use in patients with kidney disease because of bleeding complications that may occur when these patients use aspirin. However, kidney patients who need to use acetaminophen habitually should be supervised by their doctors.
What are NSAIDs? Are they safe to take?
Nonsteroidal anti-inflammatory drugs (NSAIDs) are a specific group of pain relievers. Some NSAIDs are available over the counter. This includes different brands of ibuprofen, naproxen sodium and ketoprofen.
NSAIDs are safe for occasional use when taken as directed. However, these medications should only be used under a doctor's care by patients with kidney disease, heart disease, high blood pressure, or liver disease or by people who are over 65 or who take diuretic medications. In these people, NSAIDs may cause an increased risk of sudden kidney failure and even progressive kidney damage.
What happens if your kidneys fail? When is treatment needed?
Your kidneys normally remove wastes and excess fluid from your blood. When your kidneys are not working well, as a result of disease or in jury, wastes and excess fluid can build up in your blood and make you sick. You may have the following symptoms:
Nausea (feeling sick to your stomach)
Trouble sleeping
Poor appetite
Fatigue
Hiccups
Dry, itchy skin
Weight loss
Cramping at night
Abnormal bleeding
Swelling
Anemia (low blood count)
Trouble breathing
What treatments are available for end-stage kidney disease? How do I know which is best for me?
The treatments for kidney failure are dialysis and kidney transplantation. Two different kinds of dialysis can be done—hemodialysis and peritoneal dialysis. Each type of treatment has pros and cons. You will need to speak to your doctor and your family about which treatment is best for you. The decision will be based on a number of factors including:
Your medical condition
Your lifestyle
Your comfort
No matter what treatment you choose, you need to make a commitment to follow your treatment plan. This includes:
Following your treatment schedule
Following your special diet
Taking all the medications prescribed for you
What is hemodialysis?
Hemodialysis is a treatment that cleanses your blood of the wastes and excess fluid that have built up. During hemodialysis, your blood travels through soft tubes to a dialysis machine where it goes through a special filter called a dialyzer, or an artificial kidney. As your blood is cleansed, it is returned to your bloodstream. Only a small amount of blood is out of your body at any time. In order to be connected to the dialysis machine, you need to have an access, or entrance, to your bloodstream.
Hemodialysis treatments are usually done at a dialysis center, which may be located in a hospital or may be in a separate facility. Treatments are done three times a week, and each one lasts about three to five hours. Dialysis can also be done at home. With home hemodialysis, you and an assistant are trained to do all the steps of the procedure and you can schedule your three weekly treatments to fit your own schedule.
What is peritoneal dialysis?
In peritoneal dialysis, your blood does not travel to a machine, but is cleansed inside your body. The lining of your abdomen (the peritoneum) acts as a natural filter. You pass a cleansing solution, called dialysate, into your abdomen (your belly) through a soft tube called a catheter. The catheter is placed during minor surgery. Wastes and excess fluid pass from your blood into the cleansing solution. After several hours, you drain the used solution from your abdomen and refill with fresh cleansing solution to begin the process again. Removing the used solution and adding fresh solution takes about a half hour and is called an "Exchange." Peritoneal dialysis can be done at home, at work, at school or even during travel. Many people choose peritoneal dialysis because they feel it allows them greater flexibility.