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What is Chronic Kidney Disease?

Chronic kidney disease occurs when the kidneys are losing their ability to function properly over time. The main function of the kidneys is to remove wastes and excess water and minerals from the body. Chronic kidney disease has five (5) stages (stages) and each defines a greater decrease in kidney function. Why does chronic kidney disease occur? The main causes of chronic kidney disease are diabetes and high blood pressure. However, there are other factors that can affect the proper functioning of the kidneys. These are:
  • Autoimmune diseases (such as lupus, scleroderma, HIV)
  • Congenital problems (polycystic kidneys)
  • Infections of the kidneys (Glomerulonephritis)
  • Recurrent urinary tract infections
  • Injury or trauma to the kidney
  • Kidney stones (stones in the kidneys)
  • Problems in the arteries that carry the blood flow to the kidneys
  • Abuse of analgesics for pain
  • Use of contrasts for certain medical studies.
Chronic kidney disease worsens over time. However, early stages (stages 1-3) of kidney disease usually do not produce any symptoms. The function of the kidneys may decrease over a period of months or years. In many cases the loss of kidney function is so slow that the condition is not detected until the person is already in more advanced stages of the disease and begins to feel some symptoms. The last stage (stage 5) is known as Permanent Renal Failure or Terminal Renal Disease. At this stage, the kidneys have already lost the ability to remove enough waste or fluid from the body so that the patient can live properly. At this time, it will be necessary to resort to a treatment that is known as dialysis or to a kidney transplant. What symptoms can someone with chronic kidney disease have? Because chronic kidney disease usually does not produce symptoms during the first stages, any symptom that the patient feels may be mistaken for a symptom of another condition. This is why in many cases, the diagnosis of chronic kidney disease is made in more advanced stages. Some of the symptoms you may notice are:
  • Lack of appetite
  • Feeling of general weakness and malaise
  • Headaches
  • Itching and dry skin
  • Sickness
  • Unintentional weight loss (unwanted)
Some other symptoms you may notice, especially in more advanced stages (such as 4 or 5) are:
  • Darkening or lightening of the skin
  • Bone pain
  • Changes in the nervous system and brain:
  • Much sleep and confusion
  • Difficulty concentrating and thinking
  • Numbness of the hands or feet
  • Cramps
  • Bad breath
  • Excessive thirst
  • Decreased sexual interest or impotence
  • Decrease or stoppage in menstrual periods (amenorrhea)
  • Difficulty sleeping (insomnia) or restless legs syndrome
  • Swelling of feet and hands (from accumulation of fluids)
  • Vomiting, usually in the morning
What tests can I take to find out if I have chronic kidney disease? A simple urine test called urinalysis can detect if there is a protein in the urine. This can begin to detect from 6 months to 10 years before kidney disease begins to produce symptoms. Some blood tests help to check how kidney function works. These are:
  • Creatinine levels
  • Nitrogenated Blood Urea (BUN)
Other laboratories may also be affected by chronic kidney disease. For this reason it is important that the patient perform regular laboratory tests to continue monitoring kidney function.
  • Albumin – a blood protein
  • Calcium
  • Cholesterol
  • Hemoglobin / Hematocrits
  • Magnesium
  • Match
  • Potassium
  • Sodium
  • Acidity of blood (CO2)
  • Vitamin D
For more information, you can visit our clinics or call 787-710-2532. We are here to help!
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My doctor has told me I have Chronic Kidney Disease. What treatments should I follow?

It is very important to control blood pressure. This will decrease kidney damage and may delay the progression of your kidney disease. For that we must consider:
  • Use of medications to control blood pressure
  • The goal is to maintain blood pressure at 130/80 mm Hg or less
There are other recommendations to improve control of chronic kidney disease and avoid heart problems. They are between them:
  • No Smoking
  • Follow a diet low in fat and cholesterol
  • Exercise regularly (with prior medical authorization)
  • Use the medicines as prescribed by your doctor
  • Maintain good control of your blood sugar levels
  • Use your diabetes medications as ordered
  • Avoid foods high in sugars
  • Doing physical activity regularly
  • Monitor your glucose levels at home.
  • Decrease your intake of foods high in sodium
Notify your health care team (primary care nurse, dietitian, social worker, or nephrologist) before you start using any vitamin or natural supplement or medication. Also, let the other doctors know that you visit that you have chronic kidney disease. Sometimes it may be necessary to use other treatments such as:
  • Special medications called phosphorus traps to help keep phosphorus levels in the blood from rising too much.
  • To improve your anemia – iron supplements in pills or by vein and sometimes special injections of a drug that will help improve your hemoglobin levels and avoid blood transfusions.
  • Calcium and extra vitamin D (in amounts prescribed by your doctor.Never use supplements without first talking to your nephrologist)
In addition to using medications, part of your treatment includes making changes in your eating habits. These include:
  • Decrease your sodium intake
  • Control your fluid intake
  • You may need to decrease the amount of protein you eat
  • Reduce the amount of foods high in potassium and phosphorus
  • Consume the calories needed to stay at a healthy weight for you.
At CKD clinics we can help you manage your chronic kidney disease as we have expert renal health professionals.
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Simple diagnosis of incipient chronic kidney disease in diabetes patients

Diabetes mellitus ( DM) is the most common diagnosis of patients on dialysis in Puerto Rico. Avoid or reduce the possibility that DM patients are candidates for dialysis is one of the most urgent priorities in Puerto Rican medicine. So why do so many people living with diabetes in Puerto Rico? There are several factors to consider. First, is the hereditary factor . Many Puerto Rican families, both father and mother, suffered or suffering from DM . The possibility of developing DM is high in the members of these families. The harmful lifestyles of patients with DM is alarming. The high incidence of obesity and comes from a high -calorie, salt, lack of exercise more inadequate diet. Another important factor is that , although there is evidence of simple laboratories that detect changes in renal function in patients with DM, they are referred late to the nephrologist. The diagnosis of incipient chronic kidney disease in patients with DM is simple. Only two laboratory tests are needed to make an early diagnosis. The two tests used to assess kidney function are serum creatinine, which measures kidney function, and albumin in the urine. This way, you can know if your kidneys are functioning mild, moderate or severe or if you need dialysis. Also, it is important to ask the patient if urination DM observes a lot of foam in the urine. This may be an important signal because it can be associated with amounts of protein / albumin in urine increased. The presence of protein / albumin in the urine is a sign of kidney or heart disease in patients with DM. However, at present, there are scientific knowledge for early detection of kidney disease in patients with DM and establish a systematic treatment to prevent or slow the progression of kidney disease in this.
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Advice for good kidney health

The kidneys are two organs in the body whose proper functioning is vital for human life. In each kidney there are thousands of small microfilters (glomeruli) that are responsible for maintaining the proper balance of water, minerals, acids, bases, toxic substances and nutrients necessary for a good functioning of our body. In addition, the kidneys produce hormones that help in the production of red blood cells and maintain hemoglobin (Hgb) and other substances that strengthen our bones to acceptable levels. These microfilters act as “strainers” where, depending on the holes or pores of each, normal or excessive amounts of albumin or red blood cells in the urine are retained or leaked. The presence of small amounts of albumin in the urine (microalbuminuria) may be indicative of an initial kidney disease. Among the diseases that can affect these microfilters are diabetes mellitus type 1 and type 2, and hypertension. These conditions can affect the performance of microfilters and, depending on the damage they cause to these structures, the filters or pores are enlarged, allowing large amounts of albumin and red blood cells to pass into the urine. Progressively, the microfilters and their pores are clogged, and can not perform the functions of the kidneys to normal levels. According to the loss of the microfilters, toxic substances can be retained that can do damage in our body. In addition, anemia (under Hgb) and possible weakening of the bones can occur. The overall functioning of microfilters is well known, such as renal function. There are clinical laboratory tests that can, in a simple way, detect whether your microfilters are working properly. The two tests used to evaluate kidney function are serum creatinine, which measures the function of the kidney and albumin in the urine. If we know the value of these tests, we can detect the overall functioning of microfilters or, in other words, the total renal function of both kidneys. This way, you can know if your kidneys are functioning normally, mild, moderate or severe and if you need dialysis. It is vital that you know the functioning of your kidneys. Ask your doctor to tell you which stage of function your kidneys are in. In short, early detection of problems in the functioning of your kidneys can help you avoid, in many cases, the progressive deterioration of your kidney function and the possibility that you need dialysis. Prevention now or pay later: that is the slogan. To protect the functioning of your kidneys, the following is recommended:
  • Controlled blood pressure.
  • Decreased microalbumin, if detected.
  • Normalization of blood sugars.
  • Maintain the ideal weight for your height.
  • Decreased consumption of salt.
Suitable cholesterol levels, especially bad cholesterol, known as LDL. Acceptable protein intake (levels acceptable for a healthy adult are: 1 gram for each kilogram of weight). Avoid using medications to control pain (such as naproxen-related medications). Proper use of natural medicines, as some of these can cause damage to the kidneys. The author is chief medical director of P.R. RENAL HEALTH & amp; RESEARCH, in Carolina, Guaynabo, Ponce and Toa Baja. For information, call 787-710-CKDC (2532).
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Diabetes

Diabetes is a common life-long health condition. There are 3.2 million people diagnosed with diabetes in the UK and an estimated 630,000 people who have the condition, but don’t know it.
Diabetes is a condition where the amount of glucose in your blood is too high because the body cannot use it properly.
This is because your pancreas doesn’t produce any insulin, or not enough insulin, to help glucose enter your body’s cells – or the insulin that is produced does not work properly (known as insulin resistance).
  • Insulin is the hormone produced by the pancreas that allows glucose to enter the body’s cells, where it is used as fuel for energy so we can work, play and generally live our lives. It is vital for life.
  • Glucose comes from digesting carbohydrate and is also produced by the liver.
  • If you have diabetes, your body cannot make proper use of this glucose so it builds up in the blood and can’t be used as fuel.
  • There are two main types of diabetes: Type 1 diabetes and Type 2 diabetes.
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