Chronic Kidney Disease and Diabetes
Chronic Kidney Disease
is an all too common factor in diabetics. High blood glucose destroys the filters in each kidney over time, and thus begins the loss of function. Chronic kidney disase has stages which I am going to describe in this article and what happens as the kidneys slowly decline. There will also be video discussions of kidney disease and the dialysis process.
What are the stages of chronic kidney disease?
Stage 1-In stage 1, there is very mild kidney damage with normal or high GFR (glomular filtration rate) of 90 ML or more. There is really not much to panic about at this point as kidneys are doing pretty good.
Stage 2-With stage 2, there will be a mild decrease in GFR, and some mild kidney damage has taken place at this point. The GFR score is usually between 60-89, still not too bad, but needs to be rechecked every so often with a blood creatnine test.
Stage 3-In stage 3, things are getting a little more serious. There is another decrease in the GFR rate, which is between 30-59 ML. You may start seeing blood test results show anemia, which is a shortage of red blood cells, and early bone disease may peak. This is where some treatment should begin to reduce more bone troubles and iron given for the anemia present.
Stage 4-Stage 4 is very serious. It now means time to think about dialysis.
You may feel unwell, have itchy skin, many kidney infections, or urinary tract problems by now. There may also be blood in the urine, and less urine produced.
Stage 5-Kidney failure is beginning in stage 5 and chances are you will not feel well, have itchy skin all the time, not be urinating much, if at all, (maybe a teaspoon per day), have nausea, headaches, and vomiting. Pushing a lot of fluids will make this problem worse at this point when urination has come to almost a complete stop.
So as you can see, kidney disease does NOT have too many symptoms until the later stages of progression. You can slow this progression down by controlling your blood sugars, and watching your hemoglobin A1C levels every three months.
To elaborate more on creatnine. Creatnine is a waste that healthy kidneys are able to remove from your blood. A creatnine clearance test is done by taking a 24-hour urine sample and a blood sample. This test will calculate how quickly your kidneys clear your blood of this waste product. The other way to measure creatnine clearance is to have a blood creatnine test which measures the GFR as I mentioned above. The GFR rate tells how quickly, or slowly, your kidneys are cleaning your blood. If your kidneys are entirely normal functioning, then your GFR should not really be under 90 or better.
If your kidney's are declining at stage 3 or more, you really need to be under the care of a nephrologist, which is a kidney specialist. A kidney doctor like this can help you slow the rate of decline of your kidney function, decide if you may or may not need a kidney biopsy, diagnose for sure the type of kidney trouble you are having, and manage complications of CKD such as anemia, hypertension, metabolic acidosis, and your body's vitamin and mineral balance. Dialysis can hopefully be delayed for a long time, and also with the proper diet with CKD which I will talk about later and will be talked about in the videos I plan to put up.
Hemoglobin A1C helps detect diabetic problems.
The Dialysis Process and How it Works
The biggest job of the kidneys is to filter wastes and produce urine. But when kidneys slack off, and begin to fail, they will no longer make anymore urine or get rid of toxins inside the body. Toxins build up and then there is a condition called uremia, a fancy name for renal failure. Hemodialysis is one way of replacing your kidney function until a transplant becomes available that is a suitable match.
With the process of hemodialysis, your blood is removed from your body, cleaned with dialysate, (the artificial kidney fluid), and returned to you. On the average, a person has around 10-12 pints of blood. During the hemodialysis procedure, only a little bit of blood, (1 pint at a time), is removed from your body to the dialyzer, cleaned by the artificial kidney dialysate and returned to you.
For access to get dialysis treatments, you will need a port of some type. They are arteriovenous fistula, or arteriovenous graft, or a central venous catheter. The most recommended is usually the AV fistula. You and your nephrologist will decide what's best though.
The first thing that happens in hemodialysis is the nurse or technician will take your blood pressure and other vitals. Your weight is also recorded, which tells how much excess fluid you need to have removed during the dialyzing process. You then go to the dialyzer and get hooked up to the machine. If you have a central venous catheter, two tubes will be connected to the blood transport tubes that are attached to the dialyzer and back into the body from there after processing. The dialyzer is programmed to your needs.
The dialysis machine keeps track of your blood flow, blood pressure, (some people get really low blood pressure), and how much fluid is being taken from your body. The blood does not go through the dialysis machine. The dialysis machine mixes dialysate solution, the fluid that goes into it. This fluid pulls out toxins from the blood, and then the bath goes down the drain. A blood pump is in the machine that keeps the blood flowing by creating a pumping action on the blood tubes that carry the uncleansed blood from the body, and then back to you after the "bath."
Hemodialysis is usually done three times a week for 4-5 hours each time. In the following video, you will learn more.
Click here for comprehensive information about kidney diseases
Urinary tract problems cause kidney dysfunction.
For kidney diet information see my article here.
Analgesics.Over the counter painkillers are another major cause of chronic kidney disease. Are you taking more than half a dozen analgesics per week for headaches? Perhaps it's try to think about the cause of your headaches. Read more about headaches.
Has Diabetes Caused You to Have Kidney Failure?
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