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Get Educated About Kidney Disease

Treatment for Type 2 Diabetes

7/22/2019

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Type 2 Diabetes Treatment Options

Diabetes is a disease that affects the body's ability to produce or process glucose (you may have also heard glucose referred to as "blood sugar"). When blood sugar levels are too high, insulin distributes it to the cells, converting it to energy that keeps you going throughout the day. Diabetes effectively prevents the body from producing insulin, resulting in excess glucose within the blood and leading to very serious health complications over time. An estimated 29 million people in the United States have some form of diabetes -- type 2 accounts for about 90-95% of the diabetic population. 

The reason it's so much more common is in large part due to the fact that that type 2 is developed in life, whereas type 1 is a genetic defect. This means that type 2 is usually possible to treat with some lifestyle changes. Every treatment regimen is dependent on the patient's situation, but here are some suggestions you can expect to hear from your doctor.

Ditch the Tobacco

One of the most important and immediately beneficial steps you can take (not just for diabetes, but for your overall health, too!) is to quit smoking. According to the Centers for Disease Control and Prevention (CDC), regular smokers are 30–40% more likely to develop type 2 diabetes than nonsmokers. And people who smoke a pack per day are twice as likely to develop diabetes than nonsmokers. 

Smoking can also lead to insulin resistance. This compromises the effectiveness of several treatment options -- many of the medications designed to treat diabetes are centered around producing supplemental insulin. But if your body can't utilize it anyway, those treatments are unviable.

Get the Blood Pumping

Aerobic exercises are your best friends in your fight against type 2 diabetes. The CDC recommends aiming for 150 minutes of aerobics per week. Broken down, that's about 30 minutes a day for 5 days out of the week. It doesn't have to be super rigorous, although the more intense, the better. Weight loss plays a major factor in reversing the effects of diabetes. Combining aerobics, like walking or jogging for 30 minutes, with resistance training, like weight lifting, will help control glucose even more effectively.

Exercise lowers blood sugar levels so it's important to monitor yourself before and after you work out. Eating a snack beforehand may be necessary. Your doctor will discuss your training regimen with you.

Monitor Your Nutrient Intake

Unfortunately there is no "one size fits all" diet for diabetes. Successful diabetes treatment requires constant monitoring of blood sugar, vitamins, fat, fiber, carbs, fat and salt. Generally speaking, diets for diabetics will be low in carbs, fats and calories but high in fiber and nutrients. Be prepared to eat a lot of fruits, vegetables, whole grains and healthy proteins like fish. Portion sizes and a consistent daily meal schedule are also taken into consideration when customizing your diet. Your nephrologist and a dietician will help you plan out a coherent schedule, rich with healthy meals based on your personal tastes.

Medical Intervention

If diet and exercise aren't enough to control blood sugar, medication will be introduced into the mix. There are a number of possibilities, each with their own ways of working. Some medications train your liver to retain more glucose. Some tell your pancreas to produce more glucose. Some lower insulin resistance so your pancreas doesn't have to work as hard. You may also get insulin supplements by injection, inhaler or an insulin pump for continuous treatment. Your doctor will explain what each drug does and makes recommendations on a case-by-case basis.
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Life After Kidney Transplantation

7/22/2019

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Life After A Kidney Transplantation: Now What?

If you've gone through the agony of kidney failure and don't have the capacity to do dialysis, then the only other option is to have a kidney transplant. The process of going through the waiting list, finding a compatible donor, and undergoing a successful surgery can be grueling and take a very long time. But barring those obstacles, if you're one of the lucky 16,000 per year in the US to receive a kidney transplant, there are some things you should know about recovery and your life post-surgery.

Recovery After Kidney Transplantation

Immediately following a kidney transplant, you can expect to be monitored in the hospital for anywhere between 24 hours to a few days, depending on your situation. Doctors will need to ensure that your body doesn't reject the new organ and that you're able to properly produce urine. Beyond that, you can expect to be out of commission during at-home recovery for 5-10 days. Recovery times vary from person-to-person, however it's important to note that your doctor will inform you of all the steps you need to take to make the most efficient recovery -- follow those instructions to a T. You will be able to return to your normal routine after 3-8 weeks.

Adapt and Retain a Healthier Lifestyle

One of the hardest parts of retaining your health after a kidney transplant is avoiding reverting to old habits that may have led to kidney failure in the first place. Changing the way you live is no easy task, but it's necessary if you expect your transplant to increase your lifespan. After all, what good is a brand-new kidney if you're not going to take steps to keep it healthy? Much of maintaining kidney health is connected with maintaining overall health, so you can probably guess what's coming -- that's right, diet and exercise.
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Introducing more exercise into your daily routine is an absolute must. Even a 30-minute walk each day goes a long way to your physical and mental health. Refrain from lifting weights until your doctor gives you permission.

Better nutrition will play a larger role in your life from now on, as well. Dialysis carries harsher dietary restrictions than post-transplant life. And since you probably will have experienced dialysis while waiting for a donor, you can easily manage your new dietary requirements. Your diet will also heavily depend on the types of medication prescribed. For instance, while it's important to eat plenty of fruits and veggies each day, your nutritionist may advise you to avoid grapefruit because it can negatively affect certain immunosuppression medications, which are normally prescribed after a kidney transplantation.

Medications for Kidney Disease Transplants

You will need to take medications for the rest of your life, mainly consisting of immunosuppressants. These help the body "accept" the donated organ into the body seamlessly. Every person is different and immunosuppressants help to level the playing field, making the body more receptive to transplanted organs. Now, you may be thinking, "immunosuppressant -- does that mean it suppresses the immune system? Why would I want that?" First off, yes, you're correct. Immunosuppressants are drugs that reduce the strength of your immune system. However, the reason you need them is fascinating: when you receive a transplant, your immune system immediately recognizes the new kidney as a hostile foreign entity and begins to attack it, as it would any other unidentified bacteria or object. Without immunosuppressants, your body's immune system is capable of damaging or destroying the new kidney, bringing you back to square one. This process is called "organ rejection."

Strictly following your medication regimen is crucial to maintaining kidney function, so get to know the names of your meds, the dosage and any other details outlined by your doctor. You will probably have many different meds to take, so don't be shy about calling your doctor to explain the regimen again. Skipping or forgetting a dose should NOT be taken lightly. If you do forget a dose, call your doctor immediately to inform them and ask what steps to take.
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What are the Signs of Transplant Rejection?

After the procedure is complete and you're spending time in recovery (and beyond), it's important to keep tabs on your body to ensure proper acceptance of the new kidney. Even if you're properly taking your meds, the body can still reject transplanted organs. Here are the signs of rejection -- if you experience any of these following a transplant, immediately call your doctor:
  • Decrease in urine
  • Fever (100° Fahrenheit or more)
  • Pain
  • Nausea
  • Weight Gain
  • Flu-like symptoms​
Keep in mind that the likelihood of rejection is highest in the weeks following the surgery, but it can still occur at any point in time. You will have frequent checkups with your doctor, meaning that if your body DOES reject your new organ, they'll probably catch it during blood work. But nevertheless, call your doctor IMMEDIATELY if you experience any of these. 

Don't be alarmed -- organ rejection doesn't mean that you'll lose your kidney. It is often fixed by adjusting the type or dosage of medications. If you do experience rejection, you'll be hospitalized for a few days as doctors try alternative immunosuppressants and monitor your progress.

Despite having its share of potential complications, kidney transplant is the optimal way to cure kidney failure. Patients experience a much higher quality of life than those on dialysis and are able to go on living healthily for the rest of their lives. If you have any questions about kidney failure or feel that you may be at risk, feel free to get in touch with us. We'll be happy to schedule a consultation.
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5 Things You Should Know About Kidney Dialysis

7/16/2019

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5 Things You Should Know About Kidney Dialysis

Around 30 million Americans have chronic kidney disease and 96% don't even know it, according to the Centers for Disease Control and Prevention (CDC). The most severe stage of kidney disease is called kidney failure -- for which around 660,000 Americans are being treated. About 468,000 of people are treated via kidney dialysis. Besides transplantation, dialysis is the most common and effective treatment for CKD (Chronic Kidney Disease). It is a medical process wherein machines take on the functions and responsibilities of the kidneys, allowing artificial regulation of hydration, hormone production and waste filtration in the blood. If you find that your doctor or nephrologist recommends dialysis, there are some things you should know going in.

The Types of Dialysis and How They Work

We went in-depth about the two types of dialysis treatment -- hemodialysis and peritoneal dialysis -- in a previous article. They both serve the same function, but in different ways and are prescribed on a case-by-case basis.
  • Hemodialysis - blood is funneled out of the right arm via IV tubes and fed into a machine called a dialyzer, which cleans the blood. It then pumps the newly cleaned blood back into the right arm. This can be done at a dialysis center, hospital or at home if conditions are permitting.
  • Peritoneal Dialysis - a special cleaning fluid is inserted into the abdomen via a catheter. It's left to sit for several hours to clean the blood and is later drained. This is done 3-5 times a day. A similar method is also available that utilizes a machine to pump/drain the cleansing fluid as the patient sleeps at night.

Side Effects of Dialysis

Like many medical procedures, dialysis also may come with it's fair share of side effects. These include:
  1. Nausea/vomiting
  2. Dry and itchy skin
  3. Low blood pressure
  4. Fatigue
  5. Muscle cramps
It's worth noting that your doctor and/or dietician will be able to change your diet or provide supplemental medication to counteract these side effects.

Self-Discipline is Key

If you want to live a longer, more fruitful life that include the activities you love, you need to show up for the dialysis as often as the doctor prescribes. There's no skipping out on treatment -- dialysis is literally taking on a failed organ's duties. Depending on the type of dialysis you receive, you should expect to be in dialysis for as long as 3-4 hours, around 4 times a week. Strictly follow your doctor's and/or nutritionist's health and diet plan that they gave you. Kidney failure leads to a myriad of other health issues including hypertension, diabetes, anemia, bone problems, etc. Dialysis will help to control these, but it's just as crucial for you to take your wellbeing into your own hands to get healthier.

How to Maintain Your Dialysis Equipment

Proper care and maintenance of dialysis is important especially to those that have in-home care. It's not as relevant to those that receive their treatment in hospitals or dialysis centers, although those patients will still need to clean their access site (i.e. where the IV tubes enter/exit the arm or abdomen). Your doctor will recommend the antibacterial soaps that are needed before and after every dialysis session. They will also train you on how to clean your catheters, maintain your hemodialysis fistula or graft. Frequently check all tubes for cracking, wash them with proper soap before and after each session and do not tug on them during treatment.

You Can Still Travel

Dialysis centers are all over the US and in foreign countries. Treatment is globally standardized, so if you plan a business trip or vacation, be sure there is a hospital or dialysis center available with the necessary access and equipment.

If you anticipate going on dialysis, these are some of the basic, universal things to keep in mind. Since treatment is so personalized and based on case-by-case, your nephrologist will explain everything in great detail and make recommendations to ensure that you understand exactly what's happening. If you have any questions about the different dialysis types and what they entail, feel free to contact us or schedule a consultation.
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Chronic Kidney Disease Statistics in the US

7/16/2019

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Chronic Kidney Disease Statistics in the US

Chronic kidney disease (CKD) is a very serious condition that affects millions of Americans. In fact, it's the 9th leading cause of death in the United States, yet many people don't even know they have it. Although it's not the most uplifting subject, it is important to know the prevalence of the disease and the statistics surrounding diagnosis, treatment and demographics. One of the best ways to combat diseases is to raise awareness and understand them in order to help curb their presence.

Chronic Kidney Disease by the Numbers

  • An estimated 31 million Americans, or 1 in 10, have some stage of CKD
  • There are 5 stages of CKD, although symptoms don't surface until stage 3
  • 9 out of 10 patients that have stage 3 CKD are not aware of it
  • Over 570,000 Americans have stage 5, or end stage renal disease (aka kidney failure)
  • Each year, kidney disease kills more people than breast or prostate cancer. In 2013, more than 47,000 Americans died from kidney disease
  • CKD shortens life expectancy by an average of 5–11 years.
  • It's not just the US that's affected -- in 2005, 58 million people across the globe died from CKD complications.

Kidney Disease Treatment Statistics

  • More than 2 million people worldwide receive dialysis
  • 17,600 kidney transplants were performed in the United States in 2013. Less than one-third of the transplanted kidneys were from living donors.
  • In 2009, the median waiting time to transplant was 3.6 years.

Demographics: Who is at Risk of Chronic Kidney Disease?

  • 1 in 3 adults are at risk of CKD in the US
  • Nearly 10,000 children and adolescents have kidney failure or end stage renal disease (ESRD)
  • Young adults with ESRD since childhood have a life expectancy of 38 years if they are treated with dialysis and 63 years if they receive a kidney transplant.
  • African Americans are 3.5 times more likely to have ESRD.
  • Native Americans are 1.5 times more likely to have ESRD.
  • Hispanics are 1.5 times more likely to have ESRD.

The Cost of Kidney Disease

Per person average annual Medicare expenses attributable to CKD: 
  • $1700 for stage 2 
  • $3500 for stage 3 
  • $12,700 for stage 4
  • A 2010 USRDS report shows that Medicare spent $29 billion in 2009 -- 6% of the annual Medicare budget -- for people with ESRD
  • Across all stages of CKD, the 2011 USRDS report shows that annual Medicare spending among adults aged 65 years or older was $20,432 per person

Kidney Waiting List Statistics

  • ​There are currently 100,791 patients awaiting kidney transplants in the US
  • People die all the time waiting for a donor to come through because the average wait time for any patient is 3.6 years
  • The average wait time for a live donor is around 1 year
  • The average wait time for a deceased donor is around 4 years
  • The majority of live donors are family or friends of the patient, accounting for about 7,000 donors per year
  • Around 13,000 kidneys per year are donated from deceased donors
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