Treating Conditions Related to Kidney Disease
Some of the risk factors and symptoms of kidney disease aren't just markers for the disease but actually exacerbate it. For example, hypertension is a cause of kidney disease but kidney disease can also aggravate hypertension. Thus, some of the unhealthy effects of kidney disease can have a feedback effect and intensify the disease itself. This makes it even more imperative that the disease, its symptoms and related conditions all be treated.
Doctors sometimes simply refer to the range of conditions that can define kidney-disease illness as "uremia." As part of treating kidney disease, or preventing this illness or its worsening, doctors help patients manage these conditions:
- diabetes. Diabetes is the number one cause of kidney failure. But working with their healthcare providers, patients can control blood sugar and thus manage diabetes through diet and lifestyle changes, weight control, medications and insulin use. Find out more about diabetes and Lourdes' extensive diabetes services.
- hypertension. Patients can control blood
pressure through a combination of diet, lifestyle changes or medication.
If patients are suffering from hypertension and kidney disease due to a narrowing in the renal artery, interventional radiologists may use a minimally invasive, nonsurgical, balloon-catheter technique (like that used in coronary arteries) to expand compromised section of artery.
- anemia. The kidneys have an important role in assuring adequate production of red blood cells. They manufacture and secrete a hormone called erythropoietin (EPO) that signals bone marrow to produce red blood cells. Compromised kidneys don't make enough of this hormone and the resulting anemia can cause loss of energy and heart problems. Fortunately, EPO can be produced synthetically and receiving EPO supplementation is an important treatment for many kidney disease patients.
- bone metabolism. Kidneys have an important
function in maintaining the balance of minerals in blood, including calcium and
phosphorus, which are essential for the ongoing healthy structure and strength
in bone and other musculoskeletal structures. (Calcium interacts with phosphorus
to form calcium phosphate, the hard, dense material from which bone and teeth
are built.) Disrupted metabolism of these minerals can lead to deformity, injury
and pain in these tissues, as well as calcification (hardening in vessels) in
the heart, the vascular system and the lungs.
Patients who act early can help to prevent this process. Healthy kidneys convert vitamin D to its active form (which is important in the body's deposit of calcium from food into the bone) and respond to parathyroid hormone (PTH, necessary for both the formation and breakdown of bone) to adjust blood calcium. Medications that help correct disruptions in this delicate balance include vitamin D supplements and also phosphorous binders that remove excess phosphorous in food so that it is not availabile for absorption in the GI tract. Dietary adjustments to control amount of phosphorous intake are also important.
- nutrition. For individuals with chronic
kidney disease, diet is an important part of treatment. Doctors can advise on
this and can refer patients to dieticians for more in-depth help. Dietary adjustments
for kidney disease focus on assuring that patients get the right amount of calories,
protein, electrolytes, minerals and fluids. These diets help individuals maintain
a healthy body weight and adjust for any special diet needs such as those for
diabetes. Such diets require patients to keep records of what they eat.
Diet is especially important for dialysis patients, as dialysis can't completely remove all waste products from the blood. Generally kidney disease patients will want to restrict intake of protein, salt, fluid, potassium and phosphorus.
- cardiovascular related. Because heart, lung
and vascular problems are closely linked to kidney failure and its associated
conditions of hypertension and diabetes, cardiovascular evaluation and care is
important for the kidney failure patient. Because of their susceptibility to
cardiovascular disease (especially coronary artery disease), kidney-failure
patients are more likely to die from heart attack or stroke than from kidney
Kidney patients should undergo special screening for cardiovascular disease, peripheral vascular disease (especially in the legs and feet) and respiratory function. And they should have aggressive lifestyle, medical, interventional or surgical care, as appropriate, to counter heart disease. Learn more about Lourdes' comprehensive and respected cardiac services.
- drug sensitivity. Kidney disease patients should avoid, or only use with caution, a number of prescription and over-the-counter medications that can be toxic to kidneys. They should consult with their healthcare provider about this list of medications, which includes certain analgesics,laxatives, antacids and decongestants, among other types of agents.
- acidosis. By excreting (into the urine) the acids that build up as a result of food and muscle breakdown, the kidneys maintain the acid/base balance in the blood. Kidney problems may lead to acidosis, a condition in which the blood is too acidic. Acidosis can disrupt body function, inhibit body growth and lead to kidney stones, heart damage, bone disease, muscle breakdown and malnutrition – and a further decline in kidney function. Medical therapy can neutralize blood acid. Other drug treatment or dietary steps may be necessary to address the underlying causes of acidosis.
Patients with chronic kidney disease need to manage their condition in close collaboration with their healthcare provider. They cannot depend on self-care alone. For example, they must have regular check-ups to monitor blood levels of creatinine, urea nitrogen, potassium, phosphorus, parathyroid hormone, hemoglobin and cholesterol.