Thursday, September 23, 2010

7.12 Kidney Failure Risk Factor/Preventing Dialysis 4

Physician's Notebooks 7  - - See Homepage

12. Renal Failure: Risk Factor (RF) & Preventive - Update 26 August 2017

Earliest warning sign is albumin protein in urine detected in micro amount; high risk factors are high blood pressure, diabetes mellitus (DM), glomerulonephritis, (poly)cystic kidneys or loss of a kidney.

As many as 40% diabetics end up on dialysis 15 yrs after diagnosis! Diabetics may avoid dialysis by strict blood glucose control using daily self-blood-test and injecting insulin. 
   Note recently an epidemic of type 2 diabetes dialyses and these patients are the most difficult to treat and have worst outcomes because they do not follow good advice. This is ironic because type 2 diabetes is preventable by keeping a normal low body weight (BMI 18-22).
   Hypertension is independent marker for dialysis later. Treat promptly and vigorously with medication under world class supervision.
   Glomerulonephritis or any acute kidney disease is another warning of renal failure. If you get or had it, pay attention to blood test creatinine and urine protein test.
   Modifiable risk factor (RF) is aspirin or other Non Steroid Anti Inflammatory Drugs (NSAID's, like Ibuprofen-Advil). Reduce use of aspirin and stop all NSAID's because they reduce arterial blood circulation in kidney and contribute to other cause of kidney disease hastening need for dialysis. Another Risk Factor is Kanamycin or Streptomycin antibiotic, best not to use, especially with already damaged kidney or if other RF present.

Lifestyle Enhancers of Good Kidneys

Drink much water and avoid salt (sodium Na+) and keep low red meat.   Animal protein and sodium Na+ stress kidney and high blood pressure. High water intake flushes out and dilutes kidney poisons, and preserves good kidney function.
   Keep a healthy BMI (below 25) and gradually lower it but with good nutrition to assure eating food of high quality protein with adequate caloric intake. Lowering unhealthily high BMI also lowers risk for developing diabetes and helps heart and arteries.
   If you are at risk for kidneys failing, do not allow prolonged urinary tract obstruction (ie, in men, prostate obstruction should be quickly treated; renal tract stone causing renal colic should be treated aggressively to remove block). In eating, fish has been shown to be more protective to kidneys because of omega-3 fish oils. Poultry is safer than red meat.
   Work which involves chronic vibration (U.S. Army tank duty) may damage kidneys. Also hot dry climate is damaging to kidneys by dehydration.
END OF CHAPTER. To read next now, click
7.13 Renal Dialysis - the Reality

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