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                       What is Chronic Kidney disease

What kidneys do?

Kidneys are one of the most important vital organs in the body as they help us to:

  1. Remove toxic waste products.
  2. Remove excess water and salts.
  3. Play an important role in controlling your blood pressure.
  4. Produce a hormone called erythropoietin (EPOfor short) which stimulates red cell production from the bone marrow – you become anaemic due to lack of this hormone.
  5. Help to keep calcium and phosphate in balance for healthy bones.
  6. Maintain the blood in a neutral (non-acid) state to make you feel well.

What is chronic kidney disease (CKD)?

Chronic kidney disease (also called chronic renal failure) is a condition in which the kidneys lose some of their ability to remove waste and excess water from the bloodstream over a period of time. As waste and fluids accumulate, other body systems are affected, potentially leading to complications.

What are the symptoms of CKD?

In the early stages of Chronic Kidney Disease, there are no symptoms. People develop symptoms only when they loss 90% function of their kidneys.

As your kidney function deteriorates to 10% or low, you will develop any of the following symptoms: poor appetite, vomiting, tiredness, swollen ankles, shortness of breath and itch. The diagnosis of chronic kidney disease can be delayed as there can be other explanations for most of these symptoms.

Even when kidney failure is advanced, most people still make a normal or near-normal amount of urine; this is sometimes confusing. Urine is being formed, but it does not contain sufficient amounts of the body’s waste products.

Why it is important to diagnose this silent disease (CKD)?

People with kidney disease are at greatly increased risk of heart attacks, stroke and problems with the circulation. This risk increases as the kidney disease advances. In simple words, you could reduce the risk of having a heart attack, stroke and circulation problems by early diagnosis of kidney disease. It is particularly important that kidney disease is diagnosed early so appropriate steps are taken to minimise this risk.

How is chronic renal disease diagnosed (CKD)?

It can be easily diagnosed with a blood test called GFR (Glomerular filtration rate). GFR estimates at what percentage your kidneys are currently working. At Pace Hospitals, we routinely measure GFR as part of kidney function.

Depending on your GFR, CKD is classified into stages:

 

Stage

 

GFR

 

Description

 

1

90+ Normal kidney function but abnormal urine or renal scan point to kidney disease
 

2

60-89 Mildly reduced kidney function in presence of urine or kidney scan abnormalities
 

3

30-59 Moderately reduced kidney function
 

4

15-29 Severely reduced kidney function
 

5

14 or less Very severe kidney failure

Who should be tested for chronic renal failure (CKD)?

You should be tested if you have one of the following risk factors:

  • Diabetes
  • High blood pressure
  • Overweight
  • Smoking
  • Older than 50 years
  • If you have suffered from heart attack or stoke
  • Family history of kidney disease
  • Having abnormal urine test such as presence blood or protein
  • If you have used long term pain killers such as Diclofenac or any medications that can affect your kidney function.

What is the aim of treatment?

The main goal of treatment is to prevent progression of CKD to complete kidney failure. The best way to do this is to diagnose chronic kidney disease early, control the underlying cause and treat kidney disease early.

Dr Satyanarayana Reddy

DNB, MRCP(UK), MMedSci Research(UK), CCST General Nephrology(UK), CCST Nephrology(UK)

Sr Consultant Nephrologist

 

 

     All you need to know about Low uric acid diet

Uric acid is a waste end product generated within our body when a type of protein called purine found in certain food breaks down to uric acid. Increased levels of uric acid in your blood may occur if you have kidney problems. However, there are other causes for a raised uric acid levels in blood.

Can high uric acid levels effect my heath?

High uric acid levels can cause joint pain (Gout), kidney stones, kidney failure (CKD), hypertension and heart diseases.

Life style changes

Uric acid levels can be reduced simply by losing weight. However, it is important to avoid any type of crash dieting and rapid loss of weight can increase uric acid levels. A combination of balanced healthy eating and regular physical activity is the best way to lose weight safely.

Which foods should be avoided?

It is advisable to reduce foods that contain high purines.

High purine foods include: (avoid)

  • Meat products – liver, kidneys, heart and Red meat
  • Oily fish
  • Seafood – Mussels, crab, shellfish
  • Alcohol – Beer
  • Sweetbreads

Moderate purine foods include: (eat in moderation)

  • Meat – beef, lamb and pork
  • Poultry – chicken and duck
  • Beans and legumes – baked beans, kidney beans, soya beans and peas
  • Mushrooms
  • Some vegetables – asparagus, cauliflower and spinach
  • Wholegrains – bran, oat and wholemeal bread

 Low purine foods include: (eat normally)

  • Dairy – milk, cheese, yoghurt, butter
  • Eggs
  • Bread and cereals – (except wholegrain)
  • Pasta and noodles
  • Fruit and vegetables (see moderate purine list)

Can certain fruits reduce uric acid levels with food?

Taking additional vitamin C as a dietary supplement (500 to 1500mg/day) can reduce blood uric acid levels. This is achieved by helping to remove uric acid from the body via the kidneys. You can get natural Vitamin C from citrus fruits like lime, lemon and orange. Certain type of cherries or cherry juice can reduce blood uric acid levels.

Can I drink alcohol?

Alcohol can raise the level of uric acid in the blood in a number of ways and so trigger a gout attack. Many beers contain large quantities of purines from the fermenting process and alcohol stimulates the production of uric acid by the liver. More importantly, alcohol is converted in the body to lactic acid which interferes with the removal of uric acid from the body by the kidneys.

Dr Satyanarayana Reddy

DNB, MRCP(UK), MMedSci Research(UK), CCST General Nephrology(UK), CCST Nephrology(UK)

Sr Consultant Nephrologist