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Diabetes And Kidney Failure Symptoms


RENIN-ANGIOTENSIN-ALDOSTERONE SYSTEM (RAA SYSTEM)

The hormones made by the kidneys and adrenal glands help regulate blood pressure. Unfortunately, they are also hugely responsible for thrusting the kidneys' inflammatory response into overdrive, especially in cases where high blood pressure, diabetes, or various forms of nephritis are involved. One of the mainstays of CKD treatment, no matter the cause, has been the use of certain classes of blood pressure medications that block the RAA system. These medications, called ACE inhibitors and angiotensins receptor blockers - or ARBs for short - can reduce the level of inflammation in the kidneys and help preserve kidney function. They may also reduce the level of TGF-beta. In addition, these same medications have a heart-protective effect.
 



PREVENTING THE INFLAMMATION PROCESS 

I do not want you to think that in regards to inflammation, all is lost and nothing can be done. This is completely untrue. In fact, the inflammatory effects of many of the conditions that can cause CKD, including hypertension and diabetes, can be minimized or even prevented. All it requires is a commitment to change your life and lifestyle. As you know, a healthier lifestyle including exercise and dietary modification can reduce the inflammatory load and help prevent progression of CKD. There are many other things that you can do to help your kidney health and reduce the inflammatory response, as well.

Kidney disease is an inflammatory condition that can have detrimental effects on your health - especially your heart health - and can
shorten your lifespan. What's important is that once you know you have this condition, there are things you can do to assist your body in stopping the inflammatory response. By changing your lifestyle and your diet, you can help prevent inflammation and many of the conditions.

Common Causes Of Kidney Disease

We will explore in detail the medical conditions frequently responsible for causing CKD, some of which were briefly mentioned earlier. Diabetes and hypertension remain the two most common - and in many ways most preventable - causes of kidney disease in this country. Over thirty percent of our population is obese, and obesity is also a very common, yet under-recognized cause of kidney disease. In our aging population, vascular disease, or atherosclerosis, is becoming a more recognized cause of kidney disease. As you read through, keep in mind one important point: While diabetes, hypertension, obesity, and vascular disease are individual conditions, they can and often do frequently occur together.
 

DIABETES 

Diabetes mellitus, commonly called just diabetes, is a devastating medical condition that can affect the eyes, nerves, nervous system, blood vessels, heart, and kidneys. There are two different types of diabetes: type 1 and type 2. In type 1 diabetes, the body does not make insulin. Most people are diagnosed with type 1 diabetes at a young age, and many may develop problems with the blood vessels in their eyes, which is called retinopathy (retin-a-pathie). If left untreated, their vision can worsen. 

In type 2 diabetes, the body is able to make insulin, but the insulin doesn't work like it is supposed to. Because of obesity and other factors, the body develops a resistance to it.


When diabetes leads to kidney disease, it is called diabetic nephropathy (nef-ra-pathie). About one fourth of those diagnosed with type 1 diabetes will go on to develop kidney disease, and many of them will also have retinopathy. About ten percent of those with type 2 diabetes will go on to develop kidney disease, although this may be a low estimation. Diabetic nephropathy is the most common cause of kidney disease in this country, and the number of people diagnosed is skyrocketing as more and more of our younger generation is being affected. To find out more, you can check out Diabetes And Kidney Failure Symptoms.


 

Stage 3 Chronic Kidney Disease Symptoms

Transforming Growth Factor (TFG) - Beta
 
Remember the question that was asked: What if there is ongoing scar formation going on in your kidneys that you can't see or feel? In particular, scar formation is the end result of a cytokine called transforming growth factor (TGF)-beta. TGF-beta is associated with scar-like tissue formation inside the body called fibrosis (fy-bro-siss). Fibrosis, like scars, is permanent and irreversible. TGF-beta is implicated in the worsening of diabetes-related kidney disease, other kidney conditions, and chronic kidney disease itself, all of which are states of chronic inflammation. There is ongoing research regarding this particular cytokine.

 
Stage 3 Chronic Kidney Disease Symptoms


OTHER CAUSES OF INFLAMMATION THAT CAN AFFECT THE KIDNEYS 

In addition to certain medical conditions, there are other circumstances that can activate a similar inflammatory response in the kidneys. These include occupational and environmental exposures, as well as dietary factors. Laboratory research suggests that toxic exposures could perhaps be inherited and passed on from one generation to the next.
 

Environmental and Occupational Exposures 

From the air we breathe to the water we drink, our bodies are exposed to multiple toxins on a daily basis that can affect our kidney health. Additionally, certain occupational exposures to heavy metals like cadmium, lead, mercury, uranium, and others, as well as hydrocarbons related to certain types of industrial manufacturing, can cause kidney disease. Heavy metal toxicity of the kidneys causes continuous oxidative stress, subsequent inflammation, and worsening of kidney function over time.
 

Dietary Factors
 
There is strong evidence showing that the cause of some kidney diseases, specifically nephritis and the nephrotic syndrome, may result from an inflammatory reaction due to allergens in the processed foods that we eat. In addition, the low antioxidant value of the food we consume may also have a contributory effect.
 

Prior Toxin Exposures
 
An interesting study performed by Dr. Michael Skinner and his research group at Washington State University examined the question: Could a medical condition that a person has now be a conse
quence of a past generation toxin exposure during pregnancy? It is a known fact that many drugs and toxins can affect the kidney function of a developing fetus early in a pregnancy.

In this animal-based study, Dr. Skinner and his group found that conditions such as kidney disease and disorders of the immune systems were the effects of a toxin that continued through four consecutive generations. Essentially, it suggests that a toxin exposure from past generations could play a role in developing kidney disease, as well as many other diseases, in future generations. This was only a single study, but it does raise some important questions that require further study.
 
THE EFFECTS OF INFLAMMATION ON THE BODY 

Up until this point, we have been focusing specifically on inflammation as it affects the kidneys. It is important to remember that because the body functions as an interconnected unit, the inflammation affects the body as a whole. Thus, the risk of atherosclerosis (ath-iro-sklair-osis) and peripheral arterial disease (PAD) is dramatically increased in CKD.

In CKD, inflammation can become a vicious, never-ending cycle. There is evidence to suggest that regardless of the cause of kidney disease, CKD is itself a potent inflammatory condition. The inflammation from CKD has a toxic and life-altering effect on the heart; it increases the risk of heart disease and can shorten one's lifespan. The damaging effects of inflammation on the heart and kidneys have been described in a condition called the cardio-renal syndrome.


In this syndrome, problems with the heart can cause a worsening of kidney function. The reverse of this is also true - worsening kidney function has been implicated in heart problems, including coronary artery disease and congestive heart failure (CHF). In many instances, it is difficult to determine which organ is the primary culprit; most likely a sizable inflammatory response causes failure in both organs. Significant heart and kidney problems, characterized by congestive heart failure, hypertension, and worsening kidney function, make this syndrome very difficult to treat. To find out more, you can check out Stage 3 Chronic Kidney Disease Symptoms.


Stage 3 Kidney Disease Symptoms

The goal of this post is to think about kidney disease and the conditions that can affect kidney function in a very different way. Why is this so important? Because as doctors and scientists study kidney disease, they are learning about the significance of inflammation; they are finding that it plays a major role in worsening kidney disease.

Stage 3 Kidney Disease Symptoms

Inflammatory changes in the kidneys are not caused only by medical conditions that affect kidney function, but also by the kidneys themselves. I'll focus on the following three important themes:
  • Chronic kidney disease itself is a state of inflammation.
  • The conditions that cause chronic kidney disease, such as hypertension, diabetes, and obesity, are themselves inflammatory conditions and should be thought of as such.
  • The inflammation of kidney disease is not limited to the kidneys; it can affect other organs as well, specifically the heart. A vicious cycle ensues where worsening kidney function can affect heart function and vice versa. 
The current research and future treatment of kidney disease will involve not only treating the specific condition affecting the kidneys, but also managing and reducing the associated inflammatory component as well. Therapies aimed at preventing progression of CKD will be focused on how to reduce the level of inflammation affecting the kidneys. In order to understand how to reduce the inflammatory response, we need to first review what inflammation is and what stimulates the inflammatory response.
 
INFLAMMATION AND OXIDATIVE STRESS 

Inflammation is basically how the body normally responds to any type of illness, disease, or trauma. A cut in the skin, for example, sets in motion a rapid inflammatory response. The body immediately makes proteins called cytokines (site-o-kynes) that begin the healing process. Over time, a scar made of strong fiber-type tissue will form to protect and minimize further injury to the site. This is what the body is supposed to do - work to heal itself.
 
What if, however, the injury was inside of you and you couldn't see it? For example, what if there was ongoing scar formation going in the kidneys that you couldn't see or feel? What if the inflammatory response was never really turned off? How would such a process get started? The answer to this last question is something called oxidative stress. Oxidative stress refers to damage that is occurring inside the cells of your body. It is this continued stress within the cells that stimulates and perpetuates the body's inflammatory response.
 
The body is designed to maintain harmony and balance, especially at the cellular level. The cell is the tiniest, most basic unit of life. Each cell performs its tasks in perfect harmony with the body's other cells. Knowing this is important because oxidative stress and inflammation begin at the cellular level.
 
Our cells normally exist in a natural or "reduced" state. Any disturbance in the natural state of the cell causes the production of toxic materials called free radicals. Examples of disturbances could include any type of illness or injury. When this happens, our cells make antioxidants whose job is to stabilize the cells and "defuse" these toxic oxygen radicals. But the more free radicals that are formed, the more damage that is caused to the cell. 

If the disturbance to the cell is continuous and severe enough, too many free radicals are formed and the damage to the cell is significant. The cells themselves become "oxidized," which means the checks and balances within the cells deteriorate, and individual cells are no longer able to effectively repair the damage.

As this cellular domino effect happens, the body's inflammatory response is over-stimulated. These toxic oxygen radicals are catalysts for even more inflammation. Cytokines, or pro-inflammatory proteins, are produced. Examples of these include endothelin (en-doethiel-ien), interleukins, and transforming growth factor (TGF)-beta. Many cytokines can go on to produce chronic inflammatory changes in the body, including scarring that begins at a microscopic level.


Several conditions, such as diabetes, hypertension, glomerulonephritis (glom-are-ulo-nef-ritis), nephrotic (nef-rot-ik) syndrome, and CKD itself, can cause oxidative stress to the cells and are potent simulators of the inflammatory response. This can lead to scarring of the kidneys because the inflammatory response is never really turned off. Therefore, treating the underlying condition affecting the kidneys will ultimately preserve kidney function and decrease the level of inflammation. To find out more, you can check out Stage 3 Kidney Disease Symptoms.


Stage 3 Kidney Disease Treatment


HOW TO MAXIMIZE AN OFFICE VISIT WITH YOUR KIDNEY DOCTOR
 
Being healthy, especially concerning kidney health, is not a passive process. It is important that you are an active member in the process. One example of this is knowing how to get the best out of your doctor visits. Doing so involves two steps. The first is preparing for the visit, and the second is the actual visit itself. The following information is geared towards visits with your kidney specialist specifically, but this process can and should be used with all of your healthcare providers.
 
Stage 3 Kidney Disease Treatment


Preparing for an Office Visit

Preparing for an office visit involves performing some of your own background checks. There are different ways of evaluating if a doctor may be the right fit for you, even before your first scheduled visit. For instance, you may know some friends or family members who can give you their opinions of the doctor. There are also websites you can go to, such as www.healthgrades.com, where you can see how the doctor is rated.
 
Many people are apprehensive the first time they are told they need to see a kidney doctor. When scheduling an initial visit with one, make sure she gives you enough time; in my practice, new patients are given an hour for their first visit. To prepare, write down a list of any questions you have and bring it with you. You should also bring a list of all of the medications you are taking, including dosages. Be sure to add any vitamins, herbs, supplements, and over-the-counter medications, as well, as everything you take matters.
 
During an Office Visit
 
Your office visits should be organized and efficient. Here is a checklist of what you should do during your appointments to maximize your time:
  • If possible, bring a friend or family member with you. They can be a great source of support, ask questions you may not have even thought of, and provide comfort during visits.
  • Be specific about any signs or symptoms you may have. Examples include those previously mentioned, including difficulty with urination or edema.
  • Review your blood work with your doctor. Nephrology is a lab-based specialty, and it is important to understand your blood test results. Ask specifically about the GFR level, blood count, potassium level, and urine studies. 
  • Always get copies of your blood work and maintain your own file. 
  • Pay attention to the blood pressure obtained in the office, so that you can correlate it to what your readings have been at home. (Hint, hint. It is important to take your blood pressure at home.) 
  • Bring a pad and pencil, and write down everything the doctor says in terms of prescribed treatment. Make sure it makes sense to you. 
  • Ask any questions you have regarding prescribed treatment, especially medication. If something is prescribed, ask if it is brand name or generic. With blood pressure medication, for example, there may be a difference between the efficacy of the generic medication and the brand name. Also ask about what side effects you should look out for. 

You should feel comfortable during the visit with your kidney doctor. If you do not, seek out other health professionals until you find one that meets your needs. Remember, your doctors work for you.

The relationship between you and your team of healthcare specialists is special. Adequate "face time" with your doctors is important in helping you make the best treatment decisions possible. Remember that you are responsible for your own healthcare. Your doctors and other healthcare providers can help you and give informed decisions; however, it is important to take an active role in your own kidney health, as it is ultimately in your hands. You are the MVP of your team. To find out more, you can check out Stage 3 Kidney Disease Treatment.