All Posts Tagged: renal

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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What is End-Stage Renal Disease?

End-Stage Renal Disease (ESRD) is defined as a stage where tissue is destroyed and the kidneys suffer permanent reduced function. At this stage, toxic substances accumulate in the body because they cannot be eliminated by the sick kidneys. The kidneys, in their normal state, produce a hormone known as erythropoietin which is responsible for stimulating the bone marrow to produce red blood cells.  In ESRD erythropoietin levels are low, resulting in low hemoglobin levels.  

After 30 years of age and as aging progresses, kidney function decreases.  Certain medical conditions such as diabetes mellitus, hypertension and abuse of pain relievers can accelerate the loss of kidney function and can eventually pose the need for receiving dialysisor a kidney transplant.

In Puerto Rico the leading cause of ESRD is diabetes mellitus (67.4%) followed by hypertension (12.8%).  In our country the majority of the people who begin dialysis are between 60 and 80 years old.  It should be clarified that most people who are in this age group will not develop permanent kidney disease and need dialysis.

However, it is important to emphasize that those who are between the ages of 60 and 80 years should be evaluated to determine renal function and whether any albumin or protein is present in urine.  Be aware of foam in urine, since this finding may suggest presence of albumin or protein in the urine, a marker of kidney damage and cardiovascular risk.

If we can detect kidney disease, we can also detect in what stage of the disease each person is.  More importantly, we may determine if the loss of kidney function is due solely to the aging process of the person and the kidneys.  

The greatest challenge is working on early prevention or dealing with the disease later.  Dr. Rafael Burgos Calderón Medical Director of Atlantis and PR Renal Health & Research, Inc

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