On Kidney Disease Symptoms and Protection

The blogger's note:  Two separate emails on the subject of kidneys were forwarded to the blogger by his friends and they are reproduced as follows for the benefit of all readers.  A comment by the blogger's most learned e-buddy Dr. JB Lim is also appended at the end of the post.

12 Symptoms of Kidney Disease You Shouldn’t Ignore

  

Most people are not aware of the fact that kidney diseases can be silent killers.

They may not show any symptoms for a long time till the situation becomes critical.

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It is important to recognize the symptoms of kidney diseases to catch them early.

 
Here is a list of twelve such symptoms you should look out for:

1. Changes in your urinary function: The first symptom of kidney disease is changes in the amount and frequency of your urination.

There may be an increase or decrease in amount and/or its frequency, especially at night.
It may also look more dark colored.

You may feel the urge to urinate but are unable to do so when you get to the restroom.

2. Difficulty or pain during voiding: Sometimes you have difficulty or feel pressure or pain while voiding. Urinary tract infections may cause symptoms such as pain or burning during urination.

When these infections spread to the kidneys they may cause fever and pain in your back. 

3. Blood in the urine: This is a symptom of kidney disease which is a definite cause for concern.

There may be other reasons, but it is advisable to visit your doctor in case you notice it.

4. Swelling: Kidneys remove wastes and extra fluid from the body.

When they are unable to do so, this extra fluid will build up causing swelling in your hands, feet, ankles and/or your face.

5. Extreme fatigue and generalized weakness: Your kidneys produce a hormone called erythropoietin which helps make red blood cells that carry oxygen. In kidney disease lower levels of erythropoietin causes decreased red blood cells in your body resulting in anemia.

  

There is decreased oxygen delivery to cells causing generalized weakness and extreme fatigue.

6. Dizziness & Inability to concentrate: Anemia associated with kidney disease also depletes your brain of oxygen which may cause dizziness, trouble with concentration, etc.

7. Feeling cold all the time: If you have kidney disease you may feel cold even when in a warm surrounding due to anemia.

Pyelonephritis (kidney infection) may cause fever with chills.

8. Skin rashes and itching: Kidney failure causes waste build-up in your blood.

This can causes severe itching and skin rashes. 

9. Ammonia breath and metallic taste: Kidney failure increases level of urea in the blood (uremia).

This urea is broken down to ammonia in the saliva causing urine-like bad breath called ammonia breath.

It is also usually associated with an unpleasant metallic taste (dysgeusia) in the mouth.

10. Nausea and vomiting: The build-up of waste products in your blood in kidney disease can also cause nausea and vomiting.

11. Shortness of breath: Kidney disease causes fluid to build up in the lungs.

And also, anemia, a common side-effect of kidney disease, starves your body of oxygen.
You may have trouble catching your breath due to these factors. 

12. Pain in the back or sides: Some cases of kidney disease may cause pain.

You may feel a severe cramping pain that spreads from the lower back into the groin if there is a kidney stone in the ureter.

Pain may also be related to polycystic kidney disease, an inherited kidney disorder, which
causes many fluid-filled cysts in the kidneys. Interstitial cystitis, a chronic inflammation of the bladder wall, causes chronic pain and discomfort.

  

It is important to identify kidney disease early because in most cases the damage in the kidneys can’t be undone. To reduce your chances of getting severe kidney problems, see your doctor when you observe one or more of the above symptoms.

If caught early, kidney disease can be treated very effectively.  

(Courtesy of forwarded mail from CK Chang)

10 WAYS TO PROTECT YOUR KIDNEYS

 By Dr. Willie T. Ong (Internist and Cardiologist)

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Most people know how to protect the heart, but do you know how to care for your kidneys? The kidneys' job is to help remove various toxins (drugs and food wastes), and expel them through the urine.

As we grow older, our kidneys will also start to age. A problem with kidney disease is that majority of patients have no warning symptoms.

Some time ago, we interviewed Dr. Elizabeth Montemayor, a nephrologist at the Philippine General Hospital.

Here are 10 ways to protect your kidneys: 

1. Limit your salt intake

Too much salt is not only bad for your blood pressure, it's also bad for your kidneys. Many die of kidney disease, which can be partly attributed to a high salt intake and fondness for fish sauce, soy sauce, plain salt and salted fish. Even instant noodles, chips and nuts are teeming with salt. The problem with salt is that it encourages the body to retain water, and can increase your blood pressure (which damages the kidneys).

2. Don't load up on high protein foods such as meat and steaks

A high protein diet makes the kidneys work twice as hard. Pretty soon, your kidneys could get tired and some of the weaker kidney cells can die. A friendly reminder to people on a high-protein Atkin's Diet or South Beach Diet. The time-tested doctor's advice of moderation in everything will serve you well. Eat a balanced diet of rice, vegetables, fish and fruits and you can't go wrong.

3. Keep your blood pressure at 130/80 or lower

If your blood pressure is above 140 over 90, this can cause kidney damage within five years. The kidneys are said to be "happiest" with a blood pressure of 130/80 or lower. To help control your blood pressure, you should limit your salt intake, reduce weight and take medicines for high blood pressure, if needed.

4. Keep your blood sugar below 120 mg/dl

 
Diabetes and high blood pressure are the two leading causes of kidney failure. A person with uncontrolled diabetes for 5-10 years may develop significant kidney damage. Consult your doctor and keep your blood sugar under control with diet, exercise and maintenance medicines.

5. Drink 8 glasses of water a day

Doctors usually advise people to take in 8 glasses of water a day, but this really depends on your age and condition. If you're sweating a lot and work outdoors, you may need to drink more than 8 glasses a day. However, if you are above 65 years of age, you may do well with just 6 glasses a day. Drinking enough water also prevents the formation of kidney stones. 

6. Watch your intake of pain relievers and other drugs

Taking pain relievers like mefenamic acid, ibuprofen and the coxibs (like celecoxib) for a prolonged period of time may cause kidney damage. Because of this, we should limit taking these medicines to only a week, or just take th! em as needed. For those with chronic arthritis, try to look for other ways to relieve the pain such as using a hot water bag, pain reliever ointments, or the safer paracetamol tablet.

7. Be careful with tests and procedures using contrast dyes  

Some tests, like CT Scans and MRIs, and angiograms, use a contrast dye which helps doctors delineate the organs better. The problem with such dyes is that they can cause kidney damage. To be safe, I would strongly advise you to consult a kidney specialist before undergoing such procedures.

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8. Don't drink too much Vitamin C

Excess vitamin C (ascorbic acid) can lead to the formation of kidney stones in predisposed individuals. If you need to take vitamin C, a dose of 500 mg or less is safer.

9. Don't rely on food supplements to protect your kidneys

The above tips are so far the best tips to care for the kidneys. 

10. Get a kidney check-up

Simple tests, such as a complete blood count, BUN and creatinin, and a urine analysis are the first screening tests for the kidneys. Finding a trace of protein in the urine can alert the doctor of possible kidney disease.

Bottom line is: Kidney diseases are expensive and difficult to treat. Let's take the necessary steps to protect our kidneys today.

(Courtesy of forwarded mail from Yong Yew Khoon)

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Feedback from Dr. JB Lim received at 4.35pm on  04/11/2013:

Correct! absolutely correct

However, among the 10 steps suggested by Dr Willie T Ong, I should think there are only three which are most important and easiest to follow:

1.    Ensure both your systolic and diastolic (blood) pressures are within the normal range, namely 120/80 mm Hg - irrespective of your age. It is incorrect to give age as an excuse to be sick or have an elevated blood. Too high a blood pressure damages the fine filtration tubules and capillaries of the kidneys, while too low compromises the perfusion of blood and oxygen into the kidneys. The minimum effective blood pressure into the bed of the kidneys for them to function adequately with a balanced urine output is 80 mm Hg.

2.  Ensure your intake of protein and salt are kept  as low as possible within your physiological needs, preferably about 10 % below the US Recommended Daily Allowances for Malaysia for your age, gender, physical activity and body weight. 

3.  Ensure adequate fluid intake of at least 2 litres of plain unsweetened water a day. Increase this by another 0.5 - 0.8 liters if you sweat a lot in hot weather. In such an event, add about another teaspoon of salt into the water, but preferably into coconut water which is rich in potassium to keep your blood pressure down, and to maintain electrolyte balance. Excessive sodium may lead to water retention if the kidneys are already impaired. Coconut water which is high in potassium is the best. It is absolutely clean and sterile and with the right composition and the correct isotonicity as the blood and biological fluid.  

The rest suggested by Dr Ong are okay, except I feel the daily requirements of vitamin C for humans should be far less than 500 mg or less than Dr Ong suggested.

Nobody knows exactly how much vitamin C or any vitamin an individual requires each day to maintain not normal health, but optimal health.

A British Government MRC (Medical Research Council) human experiment conducted during the war between 1944 and 1946 on human volunteers clearly showed that young adults could remain healthy for over a year on a daily intake of just 10 mg of vitamin C, and that just 5 mg not only prevent scurvy, but cure scurvy.

  

However the sub-committee on vitamin C of the MRC recommended that an intake three times that amount, namely 30 mg a day as a safety margin to cater for individual needs would be more than suffice. This has served as a guide ever since in dietary planning in events where vitamin C is in short supply.

Suggestions of vitamin intake over and above 6o mg a day serves no useful purpose in the maintenance of good health other than throwing the excess into the urine and into the drain.

Nevertheless, expert committees on nutrition in various countries have come out with yearly or once every 5 years revisions of recommended daily allowances of various nutrients including vitamin C.  Their recommendation for vitamin C could range from 30 to 60 mg. but hardly beyond that depending on these expert committees. 

These higher suggested allowances are to cater for the prevention of other medical conditions rather than for scurvy. 

Mega doses of vitamins are wasteful. There is a maximum load the body can hold and retain, depending on the nutritional status of the individual, beyond which the soluble ones spill into the urine, while the fat soluble ones are stored in the liver and adipose tissues and they may cause hypervitaminosis and toxicity as in vitamin A.

In fact for the soluble ones like vitamin C and the B group, these are used as a basis for “saturation test” (UK) or “loading test” (USA) to assess the vitamin status of individual besides a battery of other diagnostic parameters and assessment such as food intake, age, sex, epidemiological data and clinical findings.

I should think to be more than generous, an intake of not more than 100 mg a day for all individuals should be more than suffice for the most demanding nutritional requirements inclusive of existing medical conditions.

 

Others are less important as these 3 steps are far easier to follow. Compliance to too many rules and steps are very problematic to most people resulting in most people throwing them all away.

Do only the simple things. That is much more effective. 

jb lim 

 

(Footnote:  Dr. JB Lim later requested to add further comments on the intake of Vitamin C to 'enhance the professionalism' of his write-up as shown by the different font size and colour of the text in the above post.  His prudence and seriousness are indeed most salutable.)