QWhat is a nephrologist?
ANephrologists are physicians that trained in internal medicine, internists, and then pursued additional training in kidney disease. Nephrologists help take care of patients with weak or failed kidneys. They are the only physicians trained to provide dialysis for kidney failure. Nephrologists also are part of the kidney transplant team though they don’t operate.
QWhat is GFR?
AGFR stands for Glomerular Filtration Rate. It gives an estimate of the degree of kidney function. GFR is a very important value for all patients with CKD (Chronic Kidney Disease). Change in GFR is very crucial in the management of patients with CKD and therefore all patients should know their baseline GFR and stage of kidney disease.
QIs there a special diet that is good for the kidneys?
ADoctors often recommend a diet low in protein to help preserve kidney function, or a low-sodium diet to help lower blood pressure. If you have weak kidneys talk to your doctor before starting any diet.
QWhat are the kidneys and what do they do?
AThe kidneys are essential organs that filter the blood in order to remove waste and regulate the various chemicals in the blood. In addition, the kidneys secrete hormones that regulate blood pressure, prevent anemia, and promote bone strength.
QWhat diseases affect the kidneys?
AThe most common causes of kidney disease are hypertension and diabetes. These two diseases can affect every organ in the body. If not well controlled, either of these conditions can result in kidney failure and dialysis. Other diseases that attack multiple organs including the kidney are lupus, HIV and viral hepatitis.
QWhat are the symptoms of kidney disease?
ASymptoms can include blood in the urine or urine that is foamy, fatigue, high blood pressure, weight loss, ankle swelling from retained fluid, anemia, nausea or vomiting. Kidney disease is often silent until late in the course and after severe damage has occurred.
QMy doctor told me I have weak kidneys, how do they know that?
AKidney function is most commonly determined by measuring the level of creatinine in the blood. The kidneys clean the blood and creatinine is a waste product made by muscles. As kidney function decreases the level of creatinine rises. One way to look at it is to think about your house and garbage collection. If you live in a city with daily garbage collection, very little trash will accumulate in your house. If the city cuts garbage collection to once a week, the amount of garbage that accumulates in your house will rise. If they cut back to once a month the level will rise even further. Kidney function is like the frequency of garbage collection and the blood level of creatinine is the amount of trash that accumulates prior to garbage day. The higher the creatinine is, the weaker the lower the kidney function.
QWhat can I do to protect my kidneys?
AStop smoking, maintain a healthy weight, and exercise. Talk to your doctor about ways to adjust your diet. Other important aspects of kidney therapy are careful regulation of blood pressure if you have hypertension, and tight control of your blood sugar if you are diabetic.
QWhat is the difference between urologists and nephrologists?
ANephrologists are internists and use medicines to treat patients, whereas urologists are surgeons that have specialized in the kidney, bladder and prostate. While urologists do use medicines to provide therapy they are uniquely trained to operate on the kidneys to correct various problems.
QWhat is the best blood pressure for someone with kidney disease?
AThe Joint National Commission (JNC7) report on hypertension recommends patients target a blood pressure less than 130/80. Another panel of experts who specialize in kidney disease agree with the JNC recommendations except in patients with a lot of protein in their urine. They recommend more aggressive blood pressure reduction to 125/75.
QIs drinking a lot of water good for the kidneys?
ADespite widespread belief, there is no evidence that drinking 8 glasses of water is good for your kidneys. The one exception is patients who have recurrent kidney stones. In this population drinking water is among the most effective therapies to prevent the recurrence of kidney stones.
QWhat type of tests does the nephrologist use to learn about my kidneys?
AThe most common tests are on the blood. Other blood tests are used to determine the cause of kidney damage or to look for problems resulting from the kidney failure. Nephrologists also use ultrasound to look at the size and shape of the kidneys. Ultrasound is the same technology used to look at fetuses in the womb. It is safe, painless and quick.
QWhat are the risks of a kidney biopsy?
AThe most common side effect is some pain. Rarely patients can get an infection. The most serious side effect is bleeding. If the bleeding doesn’t stop on its own surgery will be required to stop the bleeding.
QWhat should I do to get ready for my kidney biopsy?
APatients are allowed to eat prior to a kidney biopsy but since patients must lie on their bellies and often are nervous, we recommend eating only a very light meal. Since many medications increase the risk of bleeding make sure you give your nephrologists a complete and up-to-date list of your medications including over-the-counter medications such as aspirin or ibuprofin (Motrin™, Advil™). Aspirin, even a baby aspirin, can increase the risk of bleeding. All aspirin products must be stopped for one week before and three days after the biopsy. Patients on coumadin or Warfarin need special treatment to get a biopsy. If you take this medication make sure you tell your nephrologists prior to your biopsy.
QWhat happens if my kidneys completely fail?
APatients whose kidneys have completely shut down can live productive lives for years using a renal replacement therapy. The kidney is the only organ that modern medicine has been able to successfully replace with long-term success. There are three types of renal replacement therapy: hemodialysis, peritoneal dialysis and kidney transplantation.
QWhat is polycystic kidney disease (PKD)?
APolycystic kidney disease is a genetic condition that causes s large number of cysts to form in the kidneys. These cysts are filled with fluid and profoundly enlarge the kidneys. This change to the kidneys' structure causes reduced kidney function and eventually leads to kidney failure.
QWhat is creatinine?
ACreatinine is a waste product made by muscles that kidneys remove from our blood. The level of creatinine rises as kidney function decreases. Thus, kidney function is most commonly determined by measuring the level of creatinine in the blood.
QWhat is peritoneal dialysis?
AIn peritoneal dialysis, special fluid is introduced into the abdomen through a plastic catheter in the abdomen. The fluid remains in the abdomen and draws excess fluid and waste products from the blood. After a prescribed period, the fluid (with the waste products) is drained and discarded. Patients repeat this process 3-6 times a day. Peritoneal dialysis is done by the patient or family member at home and requires some training.
QHow does high blood pressure affect the kidney?
AHigh blood pressure (also called hypertension) damages the kidney's blood-filtering units so the blood doesn't get cleaned. Eventually, this type of damage can cause irreversible shutdown of the kidneys
QWhat is Phosphorus?
APhosphorus is a mineral found in many foods. You absorb phosphorus into your bloodstream every time you eat. Phosphorous is used by muscles for energy and combines with calcium to form bones. Any excess phosphorous is removed from the blood stream by the kidneys and excreted in the urine.
QWhat happens when blood phosphorus is too high?
AOver time, a high PTH and high phosphorus can cause bone and blood vessel disease. This can cause bone pain, muscle weakness and broken bones. The blood vessels can harden and this may contribute to high blood pressure, strokes and heart attacks.
QWhat are phosphate binders?
APhosphate binders are prescribed to patients that need additional help controlling phosphorus. Taken with every meal, these medications prevent the body from absorbing the phosphorus in food.
QI was told that I need a kidney biopsy. What is that?
AA kidney biopsy is done by nephrologists to determine what is damaging your kidneys. 95% of kidney biopsies reveal the cause of the kidney disorder.
A biopsy is a diagnostic test that involves collecting small pieces of tissue, usually through a needle, for examination under a microscope. The patient lies on her belly for the entire procedure, sometimes a pillow is placed under the belly to arch the back and put the kidneys in a more accessible position. An ultrasound machine is then used to locate the kidneys. Local anesthetic (lidocaine) is used to numb the skin and the surface of the kidneys. Then a needle is inserted into the kidneys and removes a tiny sample, called a core. Usually doctors need three of these cores to fully evaluate your kidney disease. The whole procedure usually takes less than an hour and most of that time is spent locating the kidneys and preparing the biopsy site to prevent pain and infections.
Following the procedure patients are monitored either for a number of hours or overnight. During that time the nephrology team looks for signs of bleeding or other complications. The final results are usually done by a week after the procedure.
QWhy are African Americans at increased risk for chronic kidney disease?
ADiabetes (the leading cause of chronic kidney disease) and high blood pressure (the second leading cause) occur more often in African Americans than other ethnic groups. Many experts believe these groups may have an inherited tendency to develop these diseases. Thus, staying at a normal weight and getting enough exercise is very important for African American patients to help prevent diabetes and high blood pressure.
QTell me about hemodialysis.
AIn hemodialysis, the patient's blood is pumped from the body, through an artificial kidney and then returned to the body. The artificial kidney works by pumping the patient's blood through thousands of tiny tubes that are bathed in a special solution, called the dialysate. Waste products in the blood float across the tubes into the dialysate, purifying the blood. In order for hemodialysis to work patients need a way to get blood out of the body into the artificial kidney and back in to the body. This pathway is called a "vascular access," or simply an "access." Patients must have a vascular access surgically placed prior to starting hemodialysis. Hemodialysis is generally done three times a week, and takes between three and four hours per session at a dialysis center.
QWhat "habits" damage the kidney?
ASmoking worsens kidney disease. If you have kidney disease quitting smoking will help you preserve your kidneys and lengthen your life.
People are aware that high cholesterol can cause heart attacks. High cholesterol can cause kidney damage as well. People with high cholesterol need to make changes in the food they eat and the amount of exercise they get in order to lower their cholesterol. Medication is often prescribed to lower the cholesterol. These pills should be taken as directed.
Drinking 1-2 alcoholic beverages a day decreases blood pressure and lowering blood pressure is a primary strategy to preserve kidney function. Drinking more than two drinks a day increases blood pressure so it is harmful to the kidneys. Cocaine and amphetamines both increase blood pressure. Heroin is not directly toxic to the kidney but injecting drugs can cause infections (staph, hepatitis, and HIV) which can cause kidney failure.
Over the counter and prescription pain medications can damage the kidney. If you take a lot of these pills tell your doctor and nephrologist. Also make sure that any doctor who prescribes you pain medications knows about your kidney disease.
QWhat are the risks of kidney transplant surgery?
ATransplant surgery contraindications (factors that serves as a reason to withhold a treatment) include irreversible heart disease, cancer and severe lung disease. Obesity and smoking put transplant patients at higher risk for surgical complications, so all patients are encouraged to abstain from smoking and to approach ideal body weight.
QHow long must I wait to receive a donor kidney?
AAverage wait time to receive a kidney varies across the United States. In some states the wait time is less than 2 years whereas in other states it can approach 8 or 9 years!