Posts

Showing posts from 2021

I do not want dialysis: how long can I expect to live, and how would I feel?

Image
I often see patients in my office who refuse dialysis (should it become necessary) for their advancing kidney disease. I divide these patients in to two categories. The more common category is patients who refuse it because of the "fear of dialysis". They could have trouble understanding dialysis and what potential benefits they could derive from it. They would often make good dialysis candidates who have more to lose than gain by refusing dialysis therapies. The other category is the patient who rightfully refuses dialysis because she or he would not make a good candidate for such treatment. There could be multiple reasons for that. It could be advanced age and frailty, presence of other severe disease conditions like heart failure or metastatic cancer, etc. In such cases, it is hard to always predict if dialysis would add anything to the quality/quantity of life. And often, patients are simply looking at the "big picture". So the questions that come up in

What is "Chronic Kidney Disease", or CKD?

Image
In my previous  post , I had talked about how physicians check your kidney function, as well as the concept of glomerular filtration rate (a measure of your kidneys' function, or more accurately, its filtration capacity), or GFR. I want to talk today about an entity that you might have heard before: chronic kidney disease, or CKD.  CKD is a generic, umbrella term. Nephrologists define it as " kidney damage or reduction in kidney function that persists for 3 or more months ". The definition does not include the cause of kidney disease. In other words, whether you have reduction in kidney function from diabetes, or high blood pressure, or a genetic cause, you could still carry a common diagnosis of CKD. This diagnosis is then further subdivided in to stages 1 thru 5, depending on the disease severity. This is where the concept of GFR that I talked about  before  becomes useful.    Take a look at the above picture (courtesy of The National Kidney Disease Educa

When do you really need to start seeing a nephrologist (a kidney doctor)?

Image
I often call kidney disease the "Rodney Dangerfield of Medicine". It gets no respect! Well, outside of the medical community, the same could be said for nephrologists (to a certain extent)! No one is quite sure what they do, or why does anybody need to see one anyway.  For some, we are just another version of urologists. Nephrologists, as the readers of this blog know are physicians who specialize in the diagnosis and treatment of kidney disease, electrolytes, high blood pressure, dialysis, kidney stones, etc. 

Is drinking coffee/caffeine bad for your kidneys?

Image
This is a question that often comes up when I see patients in my office for treatment of chronic kidney disease ( CKD ). As always, I tend to emphasize the huge role that diet plays in the management of CKD. I noticed that my recent posts might be becoming too wordy, so I am going to keep myself very brief today!

How do physicians check your kidneys' function?

Most people know that getting a stress test is a way to test your heart's function. But how do you test your kidney function? You might have heard doctors mention words like "creatinine", or "GFR" when checking how good or bad your kidneys are doing. Although there are a lot of methods by which the kidneys' performance can be measured, I will explain the ones that are used most often in clinical setting

Diet for patients with kidney disease: A little sweet, a little salty, and what to eat more/less of?

Image
You are what you eat. Your kidneys are no different. Diet and lifestyle have a huge influence on the development of kidney disease, as well its rate of progression once it develops. Hence, in my practice, and especially in patients with early stage chronic kidney disease (CKD)  or  stage 3/early stage 4 ,  I place a strong focus on diet (in addition to treating the cause of CKD) which may sometimes go a long way in preventing disease progression. This does not mean that the right diet is not important in advanced stages of CKD. It very well is; however, you will probably need more aggressive medical management in those stages. I have emphasized before that, like many other things in life, prevention is not only better than cure, it is much much easier too. Once GFR (glomerular filtration rate, a measure of your kidney function) permanently declines, it is unlikely that it will increase. Hence GFR decline is often a " one way highway ".

How does kidney disease affect your sexual health and reproductive function? What are your treatment options?

Image
Kidney disease has a profound effect on sexual health, fertility, the ability to conceive, etc. I will cover the issues related to chronic kidney disease (CKD) and pregnancy in my next post . For today, lets try and understand how and why a reduction in your kidney function could affect your sexual health. Sexual dysfunction does tend to worsen as kidney disease progresses, and is part of the constellation of various signs and symptoms of advanced kidney disease .