Getting Screened For Kidney Disease

Kidney Health Care - David Mangusan Jr., PTRP

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Many people have chronic kidney disease and yet don’t know it. The reason for this might be because chronic kidney disease is a silent disease. You may have the condition for years without any symptoms. As deterioration of kidney function occurs, you may experience fatigue. However, fatigue may also be a sign of other conditions as well. Without actual measurement of kidney function and consultation with your doctor, you may not know that you have an impaired kidney function.

The kidneys play a vital role in cleaning the blood. They help remove wastes, as well as, help maintain normal amounts of fluid in the body. When kidney function fails, wastes and excess fluid accumulate in the body. Available treatments for kidney failure include dialysis or kidney transplantation.

Getting tested is the only way to know whether your kidneys are working well. Getting screened for kidney disease is important if you have the following key risk factors.
  • Diabetes
  • High blood pressure (hypertension)
  • Cardiovascular (heart)disease, or
  • A family history of kidney disease
Screening procedures or tests to detect kidney disease include blood and urine tests.
Blood tests helps to measure your glomerular filtration rate (GFR). GFR measures how much blood your kidneys filter each minute.

Urine tests. This test is used to look for high amounts of protein or albumin, a specific type of protein. Albumin is too big to pass through a healthy kidney. If your kidneys are damaged, albumin can pass into the urine. You can’t see or feel albumin in your urine. So, a urine albumin test is important.

In general, the less albumin in your urine, the better. Your doctor may give you medicines to lower the amount of albumin in your urine and to keep your kidneys healthy.
The earlier kidney disease is detected, the better chances of preventing complications. If you think you are at risk for kidney disease, you should talk to your doctor about getting tested.
Related Readings: Kidney Health Care


Reference: U.S. National Kidney Disease Education Program (www.nkdep.nih.gov)

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Kidney Cancer Drug Approved by the FDA

Kidney Health Care - David Mangusan Jr., PTRP

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March 30, 2009
Posted by: David Mangusan Jr., PTRP


The U.S. Food and Drug Administration today approved Afinitor oral tablets (everolimus) for the treatment of patients with advanced kidney cancer whose disease has progressed after treatment with other cancer therapies.

Renal cell cancer is the most common type of kidney cancer. It originates in the lining of the small tubules in the kidney that filter waste products from the blood. The cancer is resistant to such standard treatments as radiation therapy and chemotherapy, and the initial treatment for most patients is surgical removal of the kidney. If the cancer is confined to the kidney, the five-year survival rate is 60 to 70 percent; but the survival rate is considerably lower after the cancer has spread to other parts of the body.

"Afinitor provides an option for patients with advanced renal cell cancer after failure of treatment with the cancer therapies sunitinib or sorafenib," said Robert Justice, M.D., director, Division of Drug Oncology Products in the FDA's Center for Drug Evaluation and Research. "Targeted cancer therapies like Afinitor have increased the number of months patients can live without the tumor progressing."

Afinitor belongs to a class of drugs called kinase inhibitors, which interfere with cell communication, preventing tumor growth. The drug is intended for those patients with advanced renal cell cancer who have already tried another kinase inhibitor, Sutent (sunitinib) or Nexavar (sorafenib).

While Sutent and Nexavar are multiple kinase inhibitors (acting on a number of cellular targets), Afinitor works by blocking a specific protein known as the mammalian target of rapamycin or mTOR. The protein blocking action disrupts the growth, division and metabolism of cancer cells.

A clinical trial studying the safety and effectiveness of Afinitor was discontinued after an interim analysis showed that, in patients receiving the drug, the growth or spread of the tumor was delayed when compared to patients who did not receive the drug. In addition, disease progression was delayed approximately five months in half of the patients who received Afinitor. In contrast, disease progression was delayed two months in patients who did not receive the drug.

The most frequent adverse reactions in the trial (occurring in at least 20 percent of patients) included inflammation in the mouth, loss of strength, diarrhea, poor appetite, fluid buildup in the extremities, shortness of breath, coughing, nausea, vomiting, rash, and fever. Laboratory tests of blood samples determined that at least half of all patients experienced anemia, low white blood counts, high cholesterol and high triglycerides and high blood sugar.

Afinitor is manufactured by Novartis International AG of Basel, Switzerland. Sutent is manufactured by Pfizer Inc. of New York. Nexavar is manufactured by Bayer HealthCare AG, Leverkusen, Germany.

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Kidney Health - About Kidney Health

Kidney Health Care - David Mangusan Jr., PTRP

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Your kidneys play a very important role in keeping your body healthy. Each of your kidneys is about the size of your clenched fist. They are located in the middle of your back, just below your rib cage. These excretory or urinary system organs play an important role in filtering blood and removing waste products and even extra water from your body. As a result, wastes and excess water are eliminated from the body in the form of urine.

If your kidneys fail to do their function or act normally, wastes can build up in your blood and eventually can cause damage to your body.

People with family members who have diabetes, high blood pressure, heart disease, or kidney disease are at high risk for kidney disease. If you are at risk, you should inform your doctor. Early detection of kidney disease is important to prevent future complications. If you find out that you have kidney disease, you can do certain things to prevent your kidneys from failing.

Your kidneys play a very important role in keeping your body healthy. Each of your kidneys is about the size of your clenched fist. They are located in the middle of your back, just below your rib cage. These excretory or urinary system organs play an important role in filtering blood and removing waste products and even extra water from your body. As a result, wastes and excess water are eliminated from the body in the form of urine.

If your kidneys fail to do their function or act normally, wastes can build up in your blood and eventually can cause damage to your body.

People with family members who have diabetes, high blood pressure, heart disease, or kidney disease are at high risk for kidney disease. If you are at risk, you should inform your doctor. Early detection of kidney disease is important to prevent future complications. If you find out that you have kidney disease, you can do certain things to prevent your kidneys from failing.

Related Readings

Source:National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). November 2008. Retrieved: March 27, 2009.

Kidney Dysplasia (Overview)

Kidney Health Care - David Mangusan Jr., PTRP

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Kidney dysplasia is a condition that occurs when structures within the kidney do not develop normally. This kidney disorder occurs during the development of the baby in the womb.

The condition is also known as renal dysplasia or multicystic dysplastic kidney (MCDK).

Kidney dysplasia usually affects one kidney. And many infants survive and grow normally with one working kidney. Infants with kidney dysplasia affecting both kidneys may not survive outside the womb. Those who do survive birth will eventually need early dialysis or kidney transplantation.

Use of certain prescription and illegal drugs by the pregnant mother, as well as genetic factors may cause kidney dysplasia to develop.

Treatment of kidney dysplasia depends on whether one or both kidneys are affected. If only one kidney is affected and no symptoms develop, treatment may not be necessary. However, children and adults with one working kidney should have regular checkups to monitor changes in blood pressure or check for kidney damage.

Surgery to remove the abnormal kidney may be recommended only if the kidney
•causes pain
•causes high blood pressure
•shows abnormal changes on ultrasound

See Also:

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Lupus Nephritis - What Is Lupus Nephritis?

Kidney Health Care - David Mangusan Jr., PTRP

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Lupus nephritis is an inflammation of the kidney that occurs as a result of systemic lupus erythematosus (SLE). Systemic lupus erythematosus, or simply lupus, is a disease of the immune system. SLE typically affects the skin, joints, kidneys, and brain.

Causes of SLE are not fully understood. However, many factors may play a role, including
•gender—SLE is more common in women than men

•heredity—a gene passed down by a parent

•infections

•viruses

•environmental causes
What are the symptoms of lupus nephritis?

Signs and symptoms of lupus nephritis may include
•weight gain

•high blood pressure

•dark urine

•swelling around the eyes, legs, ankles, or fingers.
Some people with SLE have no obvious symptoms of kidney disease, which must be diagnosed by blood and urine tests.

How is lupus nephritis diagnosed?

In addition to learning about your symptoms, family history and medical history, your doctor may also perform tests to aid in the diagnosis. Diagnosis may require urine and blood tests as well as a kidney biopsy.
•Urine test: Blood or protein in the urine is a sign of kidney damage.

•Blood test: The kidneys remove waste materials like creatinine and urea from the blood. If the blood contains high levels of these substances, kidney function is declining. Your doctor should estimate your glomerular filtration rate based on your creatinine score.

•Kidney biopsy: A biopsy is a procedure to obtain a tissue sample for examination with a microscope. To obtain a sample of your kidney tissue, your doctor will insert a long needle through the skin. Examining the tissue with a microscope can confirm the diagnosis of lupus nephritis and help to determine how far the disease has progressed.
How is lupus nephritis treated?

Treatment of lupus nephritis depends on the symptoms and test results. Medicines called corticosteroids can decrease swelling and inflammation by suppressing the immune system. Additional immunosuppressive drugs related to cancer and drugs used to prevent rejection of organ transplants may also be used. In severe cases, your doctor may prescribe cyclophosphamide (Cytoxan, Neosar) or mycophenolate (CellCept). Newer experimental treatments include a drug called rituximab (Rituxan).

You may need one or more medicines to control your blood pressure.

Your doctor may recommend that you limit protein, sodium, and potassium intake.

See Also:

Source: Adapted from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIDDK is a part of the National Institutes of Health (NIH). NIH Publication No. 07–4622, June 2007. Available at: http://kidney.niddk.nih.gov/Kudiseases/pubs/lupusnephritis/index.htm

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IgA Nephropathy - What Is IgA Nephropathy?

Kidney Health Care - David Mangusan Jr., PTRP

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What is IgA nephropathy?

IgA nephropathy is a disorder affecting the kidney or kidneys. It occurs when IgA—a protein that helps the body fight infections—settles in the kidneys. These IgA deposits may cause the kidneys to leak blood and sometimes protein in the urine.

Many people with IgA nephropathy leak blood in the urine, but this leakage does not mean they will have long-term problems. Others leak both blood and protein in the urine. If too much protein leaks into the urine, the hands and feet can swell.

After many years with IgA nephropathy, the kidneys may show signs of damage. About 25 percent of adults with IgA nephropathy develop total kidney failure. Only 5 to 10 percent of children develop total kidney failure. Symptoms of kidney failure include swelling in the hands and feet, nausea, fatigue, headaches, and sleep problems. By the time these symptoms occur, total kidney failure is near. Total kidney failure means the kidney damage is permanent. People with kidney failure need dialysis or a kidney transplant.

What are the signs and symptoms of IgA nephropathy?

Early stages of IgA nephropathy has no symptoms. In fact, IgA nephropathy can be silent for many years, even decades wihout symptoms. The first sign of IgA nephropathy may be blood in the urine, a condition called hematuria. The blood may appear during a cold, sore throat, or other infection. At times, blood in the urine can only be detected by a doctor or nurse using special tests. If the amount of blood increases, urine may turn pink or the color of tea or cola.

If you notice blood in your urine, you should see your doctor or health care provider. However, having blood in your urine does not always mean that you have a serious disease. For example, heavy exercise can cause blood in the urine.

Who is at risk for IgA nephropathy?

The condition can occur at any age, affecting more men than women. It is more common among Caucasians and Asians. IgA nephropathy is one of the most common diseases of the kidney, other than those caused by diabetes or high blood pressure.

What causes IgA nephropathy?

The cause of IgA nephropathy is not fully understood. However, IgA nephropathy may run in families. Experts believe that it may also be related to respiratory infections. No consistent trigger for the disease has been found.

How is IgA nephropathy diagnosed?

A urine test called urinalysis usually provides the first clues. In a urinalysis, the doctor or nurse dips a special strip with chemicals into the urine sample. The strip changes color when blood or protein is present in the urine. If the test strip is positive, the urine will then be examined with a microscope to look for red blood cells. The red blood cells may be clumped together to form little tubes. These tubes are called casts because they are formed or molded inside the kidneys’ tiny draining structures. If casts are found, it usually means the kidney filters are damaged.
Blood tests measure the waste products in the blood that the kidneys usually get rid of. Two examples are creatinine and blood urea nitrogen (BUN). If the BUN and creatinine levels are high, it means the kidneys are not working well. If the creatinine level is high at the time of diagnosis, the patient is more likely to develop kidney failure.

If there is kidney damage, the doctor will probably recommend a kidney biopsy. In this procedure, a needle is used to retrieve a small piece of kidney tissue for examination with different microscopes. Only a biopsy can show the IgA deposits in the kidney filters. The biopsy can also tell how much kidney damage has already occurred. The biopsy results can help the doctor determine the best treatment. Once a diagnosis of IgA nephropathy is established, a person should have regular blood tests to monitor kidney function.

How is IgA nephropathy treated?

Kidney disease usually cannot be cured. When the kidneys are damaged, they cannot be repaired. Treatment focuses on slowing the disease and preventing complications.

One complication is high blood pressure, also called hypertension. Hypertension damages the kidneys. Two types of blood pressure medicines called angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) protect kidney function. These medicines not only lower blood pressure but also decrease the loss of protein into the urine. Because of this effect, they are often used in IgA nephropathy to protect the kidneys. They are good medicines but have certain side effects. Pregnant women should not take ACE inhibitors or ARBs because they can damage the unborn baby.

People with IgA nephropathy may develop high cholesterol. By watching their diet and taking medicine, they can help lower their cholesterol level. Lowering cholesterol may help slow kidney damage.

Medicines such as prednisone may help treat IgA nephropathy. Prednisone belongs to a class of medicines called corticosteroids, which can have harmful side effects. In research studies, fish oil supplements containing omega 3 fatty acids also slowed kidney damage in some patients. Vitamin E may help lower protein in the urine but not blood. One of the newer immunosuppressive agents called mycophenolate mofetil (MMF) is also being tested in treating IgA nephropathy.

Source: Adapted from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). NIDDK is a part of the National Institutes of Health (NIH). Available at: http://kidney.niddk.nih.gov/Kudiseases/pubs/iganephropathy/index.htm
NIH Publication No. 08–4571
February 2008


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