Why Screen For Kidney Disease?

Add comment October 20th, 2009

The kidneys of people with Chronic kidney disease (CKD) function at less than 60 % of normal.  This effects millions of Americans.  One study showed that more than half of people with CKD do not know they have it.  These are the major risk factors for CKD:  diabetes, hypertension, obesity, smoking, family history of CKD and being over 60 years of age.  Early detection can slow down or even prevent kidney failure.                                     On Saturday, October 24, 2009, the National Kidney Foundation of Illinois will visit the Rockford community with the KidneyMobile, offering free screening for diabetes, hypertension and kidney disease at Rockford Nephrology Associates, 612 Roxbury Road, from 10 am to 2 pm.  For more information call 312-321-1500 or visit www.kidneymobile.org. 

Acetaminophen Can Cause Liver and Kidney Damage

1 comment April 11th, 2009

Acetaminophen, a common over-the-counter pain medication, is safe when used properly.  But it is not completely harmless.  Acetaminophen is the most common cause of acute liver failure.  This can happen if a person takes just 10 grams over 24 hours, an amount which can be found in 20 tablets of 500 mg each.  This is called acute toxicity. Acetaminophen can also be harmful to the kidneys when used regularly over years.  The risk of developing end-stage kidney failure is doubled in people taking more than 1000 tablets of acetaminophen (325 mg each) in their lifetime.  The chance of kidney damage is further increased when acetaminophen is used along with asprin. As with all medications, only use as much as you really need.  And never exceed the recommended dosage. John C Maynard, MD     Rockford Nephrology Associates 

What About Protein Supplements?

Add comment November 26th, 2008

Today I was asked about using protein supplements to help build muscles.  Creatine is sometimes taken as a nutritional supplement in weight lifters.  But it can cause an allergic reaction in the kidneys called interstitial nephritits.  And if you have any early kidney problem, it can make it get worse.   Eating a high protein diet is associated with increased pressure in the kidneys in experimental animals; this is called glomerular hypertension and leads to scarring in the kidneys.   If you know for sure you will never get any problems putting you at risk for kidney trouble - that is, no hypertension, diabetes, weight problem, vascular disease or need to have a kidney removed - then you kidneys will be safe if you eat a high protein diet.  Especially if you do not plan on getting old.  But we don’t know what the future holds for us, do we.  You may want to donate a kidney to someone.  Or maybe you do want to get old, after all.  And you probably will get at least one of the above conditions at some point.  So my advice is to avoid protein supplements that are not prescribed by your doctor, and avoid a high protein diet.  Eat a well-balanced diet, following the “food pyramid” published by our own government.     John C Maynard, MD      Rockford Nephrology Associates 

Diabetes and your kidneys

Add comment July 12th, 2008

Diabetes melitus can lead to kidney damage.  An early indication of this is finding tiny amounts of protein in the urine; this can show up on a simple test of the urine.  People with this finding are more likely to develop a type of kidney damage known as diabetic nephropathy.  This can slowly progress to the need for dialysis or a kidney transplant.    There are things that can be done to stop or slow kidney damage from diabetes:

• Keep your blood sugar under control
• Keep your blood pressure under control (less than 130/80)
• Keep your cholesterol under control (LDL < 100)
• Control your weight
• (Exercise is very helpful to accomplish all the above!)
• Take a prescription medication called an ACE-inhibitor
• Do not smoke cigarettes
• Eat a diet low in protein (protein is high in meat, dairy products and eggs)

So we are talking about a whole lifestyle that will lead to better quality and quantity of life.        John C Maynard, MD       Rockford Nephrology Associates 

Got Kidney Stones?

Add comment June 15th, 2008

12 % of men and 5 % of women develop a symptomatic kidney stone by the age of 70.  50 % of people will then have another within 10 years.  Kidney stones are bad because they can cause pain, infection and kidney damage.To figure out why kidney stones form, it is helpful to examine urine that has been collected over a 24 hour period.  Low urine volume is bad, as are high amounts of calcium, oxalate, uric acid and sodium.  High urine volume is good, as is a high amount of citrate; citrate inhibits stone formation.  A treatable cause can found 95 % of the time.  Sometimes medication may be helpful.  But for all people who have had a kidney stone, it is worthwhile making dietary changes.  Here are some examples:

• Drink more than 2 liters per day
• Eat less animal protein.  Animal protein increases urine calcium, decreases urine pH, and reduces urine citrate.  Together these can cause stones to form.
• Eat more foods high in calcium.  This lowers urine oxalate by binding oxalate in the intestine.
• Reduce supplemental calcium intake.  Calcium pills tend to increase urinary calcium without lowering urinary oxalate.
• Eat foods rich in potassium.
• Do not take supplemental vitamin C, because it increases oxalate in the urine.
• Avoid grapefruit juice; the reason for this is not understood.
• Drink orange juice, which is high in citrate.
• Eat less sodium.

The goal is to quit forming new stones and to stop making small stones bigger.  These changes are effective, but need to be lifelong.        —   John C Maynard, MD       Rockford Nephrology Associates  

•  www.nlm.nih.gov/medlineplus/healthtopics.html 
•  www.uptodate.com/patients 
•  www.niddk.nih.gov 
•  www.kidney.org 

Hypertension – It’s Not Just For Ignoring Anymore

Add comment May 26th, 2008

Normal blood pressure (BP) is less than 120/80 mm Hg.     High BP (hypertension) is:

• the most common office visit for a non-pregnant adult
• present in 50 % of adults over the age of 65
• present in 75 % of African Americans over the age of 65
• an important cause of chronic kidney disease
• the most common risk factor for heart attack and stroke

So why do only one third of people with hypertension have control of their BP?  …… because as individuals and as a society we are not trying hard enough.  We worry more about dying this year in a plane crash (much less than 1 chance in a million!), than about our blood pressure.    What causes hypertension? 

1. Chronic kidney disease – can be either the cause or the result of hypertension
2. Kidney artery stenosis – this is narrowing of the arteries to the kidneys  
3. Endocrine disorders – hypothyroidism and hyperthyroidism are 2 examples            
4. Drinking too much alcohol – most people don’t know this
5. Sleep apnea – suggested by loud snoring and excessive daytime drowsiness
6. Essential hypertension -  not well understood but partially hereditary

What can you do?

1. Limit your sodium intake – 2.3 g sodium per day is recommended
2. Control your weight – BP falls 1 mm Hg for each weight loss of 2.2 lbs
3. Limit daily alcohol intake to 2 drinks per day for men, 1 per day for women
4. Exercise on most days – lowers BP 5-15 mm Hg
5. Don’t smoke – cigarettes cause kidney disease, heart attack and stroke
6. Take your prescribed BP medication
7. Check your BP

A chain is only as strong as it’s weakest link.  Do all the above to improve your blood pressure and lower your risk of kidney disease, heart attack and stroke. Next time:  Kidney stones – or fun photos of my vacation.  I’m not sure which.                                                    John C Maynard, MD - Rockford Nephrology Associates 

Kidneys are People too: Show You Care!

Add comment May 18th, 2008

Your kidneys are the most important organs in your body.  Well OK, maybe not be the most important, but stay tuned, because they do a lot!  They affect things like energy, breathing, thinking, sexual function.  That’s because your kidneys help manage your fluids, sodium, potassium, calcium, vitamin D, phosphate, blood pressure, hemogloblin, blood vessel health, heart health, bone health and of course toxin removal – just be glad you don’t have to do this all on your own.  When would you find the time?

Let’s start at the beginning.

What do your kidneys do for you?  How do they do it?  How can you help keep your kidneys healthy so they keep up the good work?  What can go wrong with the kidneys and what happens then? 

That’s what I will be droning on (I mean writing) about in this blog.  The bottom-line: stay as healthy as possible.  That means make healthy behavior a habit; don’t make unhealthy behavior a habit.  And when (when, not if) you have health problems, manage them in the best way possible.

For now, appreciate your kidneys.  And check my next blog when we will talk about blood pressure.

John C Maynard, MD - Rockford Nephrology Associates