Nephrology and Hypertension Specialists Lake Success Nephrology and Hypertension Specialists Lake Success

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Chronic Kidney Disease/CKD

Chronic kidney disease is a common condition that involves malfunction of the kidneys, which filter the blood and keep them free of waste and other substances. This condition can affect anyone, but is more common in those with diabetes, high blood pressure or a family history of kidney disease, although it may also be caused by infections or urinary blockages. If left untreated, it may lead to kidney failure.

Patients with CKD may not notice any symptoms during the early stages of this condition, although those in more advanced stages may experience:

  • Fatigue
  • Difficulty concentrating
  • Lack of appetite
  • Muscle cramping
  • Dry, itchy skin
  • Frequent urination

Once CKD is diagnosed it is important to determine the level of kidney function. The National Kidney Foundation has identified 6 stages of chronic kidney disease. Each stage represents a level of kidney function as defined by a creatinine clearance:

  • Stage 1 CrCl > 90
  • Stage 2 CrCl 60-89
  • Stage 3 CrCl 30-59
  • Stage 4 CrCl 15-29
  • Stage 5 CrCl <15
  • Stage 6 End Stage Renal Disease

Initial treatment for CKD involves managing the underlying condition which will usually improve kidney function as a result. It is important for patients to eat a healthy, balanced diet and exercise regularly, as well as remain hydrated and avoid smoking. Depending on the severity of your condition, your doctor may prescribe medication for high blood pressure, dialysis or kidney transplant to treat your condition and maintain or improve the function of the kidneys.


Hypertension

High blood pressure, also known as hypertension, occurs when the pressure of the blood flowing against the blood vessel walls is above the normal range. It is written in two sets of numbers, for example, 120/70. The first number is the systolic reading, which is the pressure when the heart is beating. The second number is the diastolic number, the pressure when the heart is resting. High blood pressure occurs when the systolic reading is elevated above 140 or higher and/or the diastolic reading is 90 or above.

The causes of high blood pressure are not exactly known. It cannot be cured but it can be controlled with changes to your life and medicine prescribed by your doctor. Almost 1 out of 4 Americans have high blood pressure and most of them don't know that they have it.

High blood pressure may be present without any signs. If left untreated, this condition can lead to heart failure, kidney failure, a heart attack or stroke. For most patients, high blood pressure can be managed through lifestyle changes such as losing weight, eating a healthy diet, exercising regularly and limiting alcohol intake. Medications may be prescribed as well to help lower blood pressure.


End Stage Renal Disease / ESRD

End stage renal disease is the final stage of chronic kidney disease, in which the kidneys are functioning at less than 15 percent of their normal capabilities. The kidneys experience complete or near complete failure and are unable to function on their own. It is most often caused by diabetes, but may also be a result of high blood pressure, vascular disease, an autoimmune disease or a genetic disorder.

End stage renal disease causes weight loss, nausea and vomiting, fatigue, difficulty breathing and seizures. If left untreated, end stage renal disease is a fatal condition.

At this stage, dialysis or a kidney transplant is usually needed. Patients will have to undergo dialysis treatments several times a week and may become very weak and fragile. Certain dietary changes may be necessary during dialysis treatment, including limiting fluids and salt and maintaining a low-protein diet. Transplants can often help restore patients' health, but have long waiting lists and require daily supplemental medications as well. We encourage patients with advanced Chronic Kidney Disease to pursue transplant evaluation early in their disease to ensure that those fit to undergo kidney transplant can have a good chance of finding a kidney prior to ESRD.


Urinalysis Evaluation

Urinalysis is a longstanding diagnostic tool used by doctors to detect and diagnose a large assortment of systematic ailments. This test gives doctors an incredible amount of information pertinent to the health of the body and its specific systems. The individual disorders that can be indicated by this test include:

  • Dehydration
  • Urinary Infection
  • Diabetes Mellitus
  • Kidney Infections
  • Kidney Stones
  • Various Nephritis and Vasculitis
  • Acute Urate Nephropathy

In many cases, urinalysis can detect diseases that may not show any early symptoms through the discovery of increased amounts of glucose, red blood cells, white blood cells and protein within the urine. The mechanics of testing the urine collected in a urinalysis are performed in several different ways. The simpler tests are "dipstick" tests where a test strip or stick can be dipped into the specimen effortlessly, providing a color change to signify positive/negative results.

The doctor may use the specific gravity of various substances within the urine to determine its composition, usually through the aid of a refractometer. Finally, a microscopic analysis of the sample may be initiated, which would begin with a centrifuge to separate larger particles from smaller ones for easier evaluation.

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