Chronic Kidney Disease (CKD) is the gradual decline of kidney function over time. Once we hit our 40s, our kidney function naturally begins to decline, even without us having done something to cause it. This decline can be accelerated by other chronic conditions such as diabetes, hypertension, and heart conditions. It is important to understand how CKD is assessed, what the different stages are, and what they mean.
How it is Measured There are two important numbers to consider when looking at kidney function: creatinine and eGFR. Creatinine is a measurement of the amount of toxins in the blood or urine. eGFR is a calculation of the kidney function. We will be focusing on eGFR for this post. The Stages of Chronic Kidney Disease Stage 1: Kidney damage with a normal kidney function, with an eGFR of 90 or higher Stage 2: Mild loss of kidney function, with an eGFR between 60 and 89 Stage 3: Stage 3 has two sub-stages, 3A and 3B. 3A is moderate loss of kidney function, with an eGFR of 45-59. 3B is moderate to severe loss of kidney function, with an eGFR of 30-44. Stage 4: Severe loss of kidney function, with an eGFR of 15-29 Stage 5: Kidney failure with need for transplantation or dialysis, with an eGFR of <15 Living with CKD can be managed through a number of different options like diet, regular movement, and proper medication usage, as well as managing other contributing factors, like the ones listed above. Munjal’s Musings “Many people can live long, healthy lives with only one healthy kidney. That is only 50% of the kidney function, or Stage 3 CKD.” Chronic Kidney Disease does not mean you are headed for the dialysis chair. Have an open, honest discussion with your care team about where you stand, your options, and how to continue living your best life. If you have questions or concerns about your kidney function, call our office to make an appointment with Dr. Munjal. As always, stay safe and healthy! Kidney problems can be complex, developing suddenly or over a long period of time. The difference lies in the cause and treatment of the acute and chronic kidney problems.
The Difference AKI: Acute Kidney Injury (AKI) is the sudden, severe onset of kidney failure. This is generally caused by or related to a drug, urinary obstructions, dehydration, illnesses, and/or massive blood loss. It is likely that, after treatment, your kidney function will return to your normal baseline. CKD: Chronic Kidney Disease (CKD) is the gradual decline of kidney function over time, usually without symptoms until it is severe. Once we hit our 40s, our kidney function naturally starts to decline. This natural decline can be accelerated by other conditions such as diabetes, hypertension, and heart conditions. With CKD, we hope to keep the decline steady and stable. Treatment AKI: The underlying cause of the kidney injury needs to be identified, assessed, and treated to help the kidney function return to the normal baseline. Additionally, patients may receive fluids, medications, or undergo a few treatments of dialysis until the kidneys can recover adequately. Dialysis is meant to take over the function of the kidneys. Treatment should be temporary, with minimal follow-up needed. CKD: Contributing conditions should be monitored and managed. CKD requires regular monitoring by a nephrologist. CKD can lead to other complications if not properly followed and managed with diet, regular movement, proper medication usage, and regular lab work as prescribed by your physician. Munjal’s Musings “Chronic Kidney Disease (CKD) and Acute Kidney Injury (AKI) are like car maintenance. CKD is normal wear and tear that happens over time. After 10 years of use, your car doesn’t have the same get-up-and-go like it did on the day you got it. AKI is like a flat tire. You patch the hole and you’re back to normal.” Remember to keep your annual appointments with your Primary Care and regular nephrology follow-ups to monitor and detect trends in health changes.If you are concerned about your kidney function, call to make an appointment to discuss with Dr. Munjal. As always, stay safe and healthy! Each year we set out as The Dream Team to walk a 5k with the National Kidney Foundation (NKF) to raise awareness for kidney diseases. As a team, we raise funds to help the NKF provide assistance to those needing treatments and resources. Read more about the kidneys and our fundraising efforts below!
Kidney Facts: Kidney disease is known as the silent killer. It is so important for us to help raise awareness to empower others to keep up with their health. Here are some kidney disease facts from the National Kidney Foundation to kick-start our mission this year:
Our Fundraising Efforts In the past, we have created a variety of activities for our patients, staff, family, and friends to participate in. These include:
As an added bonus this year, our team came together to empower ourselves and get healthy for our kidneys in March. We aimed to walk an average of 7,500 steps a day and a total of 100 miles each by the end of the month. To help facilitate healthy changes, we also learned to track our nutrition and more about getting healthy for our kidneys. At the end of March, we walked 2,668,595 steps, totaling 1,334 miles! Join us on the walk this year virtually or at Riverside Park on Sunday, May 19th, at 7:30am. To learn more, go to https://www.kidneywalk.org/jacksonville or https://www.jaxnephrology.com/dream-team.html. As always, stay safe and healthy! Did you know that, in some cases, kidney disease is preventable? While genetics can play a part, overall general health is one of the biggest factors in the risk for kidney disease. Let’s explore four ways you can get healthy for your kidneys!
Getting healthy looks different for everyone, so start small and don’t overwhelm yourself. Being 1% better than yesterday is still an improvement. If you have questions or concerns about your kidney health, make an appointment with your Primary Care or Dr. Munjal to discuss. As always, stay safe and healthy! Did you know that dialysis isn’t the only option once you need to consider renal replacement therapy? Transplantation is also an option! Let’s break down what a transplant is, who qualifies, and how the process works. What is a kidney transplant? A kidney transplant is when a healthy kidney from a living or deceased donor is placed in the abdomen alongside the failing kidneys. A kidney transplant does not cure kidney disease, but it may allow you to live longer and improve overall quality of life. Who qualifies for a kidney transplant? Patients with Chronic Kidney Disease (CKD) may initiate the process to be evaluated for a kidney transplant. You can begin the evaluation process for a transplant before you need dialysis, usually after you reach Stage 4 CKD. By starting the process early, you may be able to reduce your overall waiting time on the transplant list. How do I get placed on the transplant list? To initiate the evaluation process, your medical history and insurance will be reviewed from a referral sent by your nephrologist to the facility of your choosing. If, after reviewing the preliminary insurance and medical records, you are found to be a candidate, additional testing will be ordered by the transplant center. These typically include but are not limited to:
After you have completed all the screenings, consultations, and testing assigned by the transplant center, your case will be moved to the center’s transplant committee to be reviewed and receive the final approval. Once approved by the transplant committee, you will become active on the transplant list and you have satisfied any additional requirements as communicated by the center, you will be active on the transplant list. It is important that you maintain your health status and update your care team with any new illnesses or hospitalizations, as these can affect your transplant list status. What happens after I get my transplant? After you undergo your kidney transplant, you will be closely monitored by your transplant care team. This includes frequent lab work and examinations. Your ongoing and post-transplant care will be discussed and coordinated by the transplant center. Talk with your nephrologist to learn more and decide what works best for you. You have options. Happy World Kidney Day! We are so excited to help empower our community with information about the kidneys. We want to take today to bring you back to the basics and teach you about all the wonderful things the kidneys do within the body. We’ll share the basics, some fun facts, frequently asked questions, and how our team gets involved with empowering others.
The Basics: Located in the back, just below the ribcage, the kidneys are fist-sized, bean-shaped organs. They have 6 major functions:
Fun Facts:
Q: What do kidneys have to do with my blood pressure? A: Your kidneys play a vital role in your blood pressure management. Your kidneys control your electrolyte balance which, in turn, affects your fluid balance. An increase in fluid volume of the blood increases your blood pressure. Additionally, in some cases, the adrenal glands on top of the kidneys influence certain hormone levels that are connected to blood pressure management within the body. Q: But I don’t have symptoms and I feel fine. How do I have Chronic Kidney Disease? A: Your kidneys and body are miraculous machines. Oftentimes, symptoms of Chronic Kidney Disease do not manifest until you are in the later stages. This is why regular lab tests are critical to keep up with as they can detect changes in your kidney function before the symptoms begin. Q: How much water should I be drinking? A: Let’s start by clarifying: we talk about fluid consumption, not water consumption alone. Water is a fluid and should be calculated into your daily intake, but other fluids need to be included as well. Coffee, tea, milk from cereal, and broth from soup are all examples of fluids that should be calculated into your daily fluid intake. There is no set amount of fluid that a person should be drinking per day, as all of our conditions are different. As a general rule of thumb, if you sweat more, you need to drink more. Dialysis and Congestive Heart Failure (CHF) patients are on a fluid restricted diet and should abide by physicians’ orders. Q: Does cranberry juice work for the kidneys? A: No! Cranberry juice can help to alleviate symptoms of a Urinary Tract Infection (UTI), but does not cure it or make it go away. Untreated UTIs can cause kidney or prostate infections. These are more serious as it can travel to the blood and cause sepsis. UTIs are generally treated by Primary Care or Urologists for chronic infections. How We Get Involved: Our team is working hard at getting healthy for our kidneys. We have embarked on a month-long step challenge that not only includes walking, but nutrition and health tracking. With some knowledge, hard work, and a little friendly competition, we are empowering ourselves to help continue empowering and encouraging our patients. Additionally, we walk with the National Kidney Foundation for their annual Kidney Walk to raise awareness for kidney diseases. Join us or walk virtually this year at Riverside park on Sunday, May 19th, at 7:30am. Learn more at https://www.kidneywalk.org/jacksonville. What: Blood pressure measures the pressure of the circulating blood against the walls of the blood vessels. This is the measurement of the amount of force the body is using to get the blood through the arteries.
Who: Patients with hyper- or hypotension should take their blood pressure daily to monitor for any trends and changes. Patients with other heart or endocrine conditions should check their blood pressure regularly as well. When: Take your blood pressure one-two (1-2) hours after taking any blood pressure medications and when you are relaxed. By doing this, we can measure the effectiveness of the medications and make adjustments as needed. If the blood pressure is taken before medications have been taken and given time to enter the system, there is no way for us to know the effectiveness of your medication or treatment. If your blood pressure reading seems significantly out of your normal range, wait 5-10 minutes, breathe deeply, and then take it again. We will usually go with the second reading as being more accurate. Where: Take your blood pressure at a table or desk setting. You want to be in a seated position with uncrossed legs and with your arm, the cuff, and your heart around the same level. Why: By following these guidelines, we are able to get the most accurate results. Consistent, accurate readings help us make the most informed decisions regarding your care. Readings can be distorted and inaccurate due to body position, clothing/jewelry, altered medications, talking, moving, and more. How: Listed below are step-by-step instructions on how to take a proper blood pressure reading. You can also visit our Kidney Korner post for more information on how to take your blood pressure.
https://www.jaxnephrology.com/blog/kidney-korner-how-to-take-your-blood-pressure We are here to help get you on the right track. By understanding why and how to take your blood pressure, you are making the most important steps in the right direction. Do not make any significant changes without consulting your physician or care team. As always, stay healthy! Once every four years, we experience what we call a “leap year.” This is a year when an extra day is added to the month of February to account for the technicalities of rounding time when counting the days of the year. While we’ll leave the science of time to the pros, we’ll take you through some traditions and superstitions that have come about due to this special day as well as some ideas on how to spend your extra time.
Traditions and Superstitions: Still in the season of love, many leap year traditions are focused around love and relationships.
How to Spend Your Extra Time:
How do you plan on celebrating the special day? Share your leap year activities with us on Facebook! We hope you have a hopping time! Starting dialysis is a huge lifestyle change. Additionally, it means seeing new faces and trusting new members of your care team. Let’s get to know who is involved in your care at DialySuites and how they help you on your journey. Physician Your nephrologist, the kidney specialist, is the person who will prescribe your treatment and monitor your ongoing care. They will visit at least once a month to assess your health and the effectiveness of the dialysis prescription, making changes as necessary. Dialysis Nurse The dialysis nurses are responsible for overseeing the entirety of your care and the effectiveness of your treatment in conjunction with your nephrologist. They also provide monthly education to all patients to increase understanding of the treatment process, patient rights and responsibilities, dialysis access care, among a variety of other topics. Patient Care Technician (PCT) Your PCT is going to be the teammate that will be starting and ending your treatment. They assist with taking your vitals, connecting and disconnecting you, and monitoring your machine throughout your treatment. Social Worker The social worker plays a vital role in your care team. Your social worker is responsible for helping to navigate your and your family through the changes dialysis can bring. They are able to help find community resources and support. Dietitian Your dietitian is responsible for assisting you in finding the foods that meet your needs. Your dietitian will review your labs and make recommendations based on your personal needs. Additionally, they will work with your physician to find a medication regimen that works best for you to get you to your goals. Facility Coordinator The Facility Coordinator will be your point of contact for all things related to the facility. Your care team at DialySuites is dedicated to seeing our patients thrive on dialysis. Should you have any questions or concerns, please do not hesitate to reach out to a member of our team for assistance. The kidneys are a complex part of the body, playing a vital role in maintaining a variety of bodily functions. Nephrologists track a few major pieces of information that determine the kidney function. Since we cannot physically examine the kidneys, lab tests and blood pressure logs are the most vital pieces of information that we need to understand your kidney function. Let’s learn about what these pieces of information are and why they are so important to your kidney care.
Blood Tests Since we cannot physically examine the kidneys, we rely on blood tests to determine how the kidneys are actually functioning. There are four (4) main factors that paint a picture of the kidney function:
Urine Tests Since the kidneys create urine, urine tests are another good indicator to help determine kidney function. One of the most important factors included is protein. If protein is present in the urine, it can indicate that the kidneys are not functioning as they should be. One of Dr. Munjal’s analogies for this is as follows: “Think of your kidneys as a coffee filter. It has two jobs: let the coffee through and keep the grounds in. Similarly, kidneys want to get rid of waste, but keep the good things in. We check protein levels in the urine. Protein particles are large and should not be spilling through the filter. High protein levels in the urine are indicative of kidney damage.” Blood Pressure A number of factors can contribute to a change in blood pressure such as stress, anxiety, caffeine, medications, sleep, “White Coat Syndrome,” and more. To get the best picture of what your blood pressure is normally, we advise taking readings regularly at home. At home, you are more relaxed and in a familiar environment thus giving us a better understanding of what your day-to-day looks like. This gives Dr. Munjal the ability to make a more informed decision, rather than basing decisions on a single reading that could be altered by the factors listed above. Additionally, by taking readings on a schedule at home, 1-2 hours after medication is taken, we are able to better judge the effectiveness of the medication regimen. We request that labs ordered by Dr. Munjal be completed no less than one (1) week prior to your appointment. This, along with a record of regular blood pressure readings, gives us the most accurate picture of your current health status. As always, stay safe and healthy! |
About The BeanThe Bean is a blog on a mission to share valuable information in the world of Nephrology. We believe in empowering through education and The Bean is a great place to find resources and information on topics related to high blood pressure, kidney disease, dialysis, and topics that enhance the kidney minded lifestyle. Enjoy and be sure to subscribe! Archives
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