Who's at Risk?

Which person is at greatest risk for developing acute renal failure?


1. A teenager who has an appendectomy
2. A pregnant woman who has a fracture
3. A dialysis patient who gets influenzaed femur
4. A client with diabetes who has a heart catheterization

And the answer is...drumroll please...4

People with diabetes are prone to renal insufficiency and renal failure. The contrast used for heart catheterization must be eliminated by the kidneys, which further stresses them and may produce acute renal failure. Are you a diabetic? Find out for sure by inquiring with your physician about an A1c test which will provide a picture of your average blood glucose levels for the past three months.

Oh No! Kidney Stones

Kidney stones (called renal calculi in medical terminology) are rock-like solid crystallized deposits of excess wastes such as uric acid, calcium, and magnesium in the urine that did not dissolve completely. Although the etiology of kidney stones is unknown, there are some risk factors that make some people more susceptible than others. Some of these factors are:

Diet – Eating a diet high in oxalate that include spinach, fat, caffeine
Dehydration- Reduced water intake
Genetic – A family history of kidney stones
Gender – Men are three times more likely than women to get kidney stones
Kidney Disorders- Polycystic Kidney Disease (PKD)

How will you know if you have kidney stones? Well that’s fairly easy because most people who have kidney stones often report the sudden onset of excruciating, cramping pain in their low back and/or side and can be accompanied by nausea and vomiting. The pain usually increases in degree over time even if you have taken analgesics. Sometimes there may be blood present in the urine from the jagged edges of the stone(s) passing along the urinary tract. So you will know. Other symptoms may include the urgency to urinate, difficulty urinating, and fever and chills if an infection is present in the urinary tract with the stones. Clinically a CT scan or Ultrasound may be done to confirm the presence and location of the stones.

In the attempt to prevent kidney stones, drink more water. Try to drink at least 2 1/2 liters of a day. Drinking lots of water helps to flush away the substances that form stones in the kidneys. Limit salt intake and the consumption of caffeine. Cranberries or pure cranberry juice are great fruit for dissolving kidney stones. If you think you may have kidney stones, contact your doctor’s office directly so that they may assess you and determine the right diet and plan of care for you and your specific type of kidney stones.

DIABETES - A LINK TO DIALYSIS

Did You Know
Diabetes is arguably the number one cause of end stage renal disease on earth. According to the American Diabetes Association, nearly 18 million people in the United States have been diagnosed with Type II diabetes. Nearly 6 million more are unaware that they even have the disease.

What's the Problem?
The problem with diabetes is that when uncontrolled it can kill you. Period.

Diabetes can lead to: A) brain dysfunctions and stroke, B) heart dysfunction and cardiac arrest, C) chronic kidney diseases (CKD), D) blindness, E) amputations and more - all leading to morbid catastrophes.

Doctors are Helping
Medical researchers have measurably improved the quality of care for diabetic patients. Clincal trials indicate earlier referral of diabetic-CKD (Chronic Kidney Disease) patients to Nephrologists effect a better retardation of disease progression. Additionally, Primary Care Physicians now routinely measure the glomerular filter rate (GFR) in their treatment regimens.

The National Kidney Foundation and National Institutes of Health are helping too. They regularly present Grand Rounds and Seminars, encouraging Primary Care Physicians to test patient renal function, and refer to Nephrology in very early CKD stages.

How Patients Can Help Themselves More
Compliance is key. Compliance requires discipline and diligence. When the temptation to eat that cake arrives, decide whether you love sweets more than you love life. You decide.

So what we now need is for diabetes patients to: A) Manage weight; watch diet and exercise daily. Do fun exercises like bowling, dancing and tennis. Walk for fun. B) Manage the disease conscientiously by following closely thdoctor's treatment plan, C) Seek a referral for a nephrology or endocrinology check up for supportive management, D) Get educated. Learn the effects of non-compliant behaviors.

The Center of Disease Control offers a comprehensive set of data about diabetes and many statististics.

KIDNEY TRANSPLANT DONOR - PERHAPS?

Gina has been on dialysis for 2 years. Gina dialyzes at an FMC (Fresenius) dialysis center in New Jersey. She profiles as 68 years old, married, extremely active. A devout Christian, she is a member of a pretty popular Gospel singing group.

About a year ago, Tracey, a member of the singing group offered to be a kidney donor to Gina, without solicitation. This was a complete joy to Gina, her family and friends as it gave her a new lease on life. After the routine testing scenarios, Gina turned out to be a match and the transplantation was scheduled at Beth Israel Hospital in West Orange, New Jersey. During Pre-Admission Testing (PAT) physicians discovered a coronary situation that required a stent, so the kidney transplantation was postponed.

The attempt to re-schedule met with problems when Tracey's employer deemed it too costly and inconvenient to find another temporary replacement for her. After a few months, Tracey and Gina retested with excellent results. But the day before surgery Tracey lost her mother to illness. Tracey was so depressed that she postponed indefinitely. Yet, she would frequently reassure Gina that "...no matter what, I've still got your kidney."

Soon Tracey quit coming to singing rehearsals. Now she neither answers telephone calls nor returns messages. Gina wants to continue her friendship with Tracey whether or not she donates her kidney. She wants to support Tracey in her grief; free Tracey of the commitment.

Is this fear or is this grief on Tracey's part? Kidney donors please respond.