{"id":46364,"date":"2020-06-23T16:21:06","date_gmt":"2020-06-23T16:21:06","guid":{"rendered":"https:\/\/websitedesigns.com.au\/elankanew\/?p=46364"},"modified":"2023-06-28T06:20:27","modified_gmt":"2023-06-28T06:20:27","slug":"discussion-on-chronic-kidney-disease-by-dr-harold-gunatillake","status":"publish","type":"post","link":"https:\/\/websitedesigns.com.au\/elankanew\/discussion-on-chronic-kidney-disease-by-dr-harold-gunatillake\/","title":{"rendered":"Discussion on Chronic Kidney Disease-by Dr Harold Gunatillake"},"content":{"rendered":"<h1 style=\"text-align: center;\"><span style=\"color: #f50a60;\">Discussion on Chronic Kidney Disease-by Dr Harold Gunatillake<\/span><\/h1>\n<p><img loading=\"lazy\" loading=\"lazy\" decoding=\"async\" class=\"alignnone size-full wp-image-12026 aligncenter\" src=\"https:\/\/websitedesigns.com.au\/elankanew\/wp-content\/uploads\/2016\/09\/harold.jpg\" alt=\"Dr Harold\" width=\"160\" height=\"160\" \/><\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: center;\"><iframe loading=\"lazy\" src=\"https:\/\/www.youtube.com\/embed\/XOgCQUPHhJE\" width=\"560\" height=\"315\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 20px; color: #000000;\">Transcript<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">WE are all concerned about our heart-health and cholesterol levels, whilst a silent disease may be brewing up in your kidneys, without symptoms for years.<\/span><\/p>\n<p><span style=\"font-size: 20px; color: #000000;\">So, how can we find out whether our kidneys are healthy or otherwise.Chronic Kidney Disease (CKD) affects 11% of the US population- that is 30 million Americans have CKD. Additional millions are at risk.<\/span><!--more--><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 20px; color: #ff0000;\">Early detection can help prevent or control the progression of CDK. In short slow down the disease in moderately advanced situation.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 20px; color: #000000;\">In Sri Lanka, it is referred to as the silent Killer, and is common in the North Central and Uva Provinces, affecting more than 15% of the population. This includes children and females, in addition to affecting farmers using pesticides in the paddy fields<\/span><\/p>\n<p><span style=\"font-size: 20px; color: #000000;\">It is important to understand and know the lab values if you suspect chronic kidney<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">disease<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Creatinine is a waste product that is formed in the muscles from creatine phosphate and from consumed red meat.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">It is excreted in the urine, but in chronic kidney disease it gradually accumulates in your blood.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 20px; color: #000000;\">If you suspect chronic kidney disease your doctor will check on the blood creatinine level.<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 20px; color: #000000;\">If the kidneys aren\u2019t working well, the serum creatinine level gradually rise, and gives an estimate of how well your kidneys filter. We call this glomerular filtration rate. Also, we call it GFR which is calculated based on your serum creatinine.<\/span><\/p>\n<p><span style=\"font-size: 20px; color: #ff0000;\">In other words, GFR is the rate at which the kidneys filter toxins from the blood.<\/span><\/p>\n<p><span style=\"font-size: 20px; color: #000000;\"><strong>Glomerular filtration rate GFR- an important test to assess the functions of your kidneys.<\/strong><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 20px; color: #000000;\">GFR Number correlates with the overall kidney function<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">This number fluctuates from day to day. In normal kidney functions it is always over<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">60<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">If the number is 40, it means that your kidney function is on an average 40 %. This<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">of course is a rough estimate and referred to as stage 3 state.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Normally when you are dehydrated from not drinking enough water, as we all do,<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">creatinine level may rise temporarily. So, drink plenty of water when you go for this<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">test.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Do not eat too much of meat or take certain medications or exercise, when you go<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">the next morning for your serum creatinine test.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Another test your doctor may request is the blood urea Nitrogen called BUN test.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">This is less reliable than the creatinine test.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Kidney failure is also called the End-stage failure.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Diabetes is the most common cause of kidney failure<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">180 litres of blood are filtered through the kidneys daily, to produce 2 litres of urine.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">It is a process of selective filtration which removes waste and potential toxins from<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">the blood. <\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 20px; color: #000000;\">If you have one kidney that kidney will filter the same amount of blood.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">If a kidney gets damaged, how can the same amount of blood go through the<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-size: 20px; color: #000000;\">kidneys when blood vessels are injured?<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Yes, the body compensates by raising the blood pressure to force the same amount<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">of blood through the<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">damaged kidneys.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">We say, that damaged kidneys produce high blood pressure. So, the doctors give<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">drugs to lower the blood pressure and then the kidneys may not be able to filter all<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">the waste products and toxins.<\/span><\/p>\n<p><span style=\"color: #000000;\"><strong><span style=\"font-size: 20px;\">How does diabetes cause kidney disease?<\/span><\/strong><\/span><\/p>\n<p><span style=\"font-size: 20px; color: #000000;\">Diabetes is the leading cause of kidney disease. About 1 out of 4 adults with<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">diabetes has kidney disease.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Increasing uncontrolled blood sugar seem to damage blood vessels, including those<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">in the kidneys.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">In the kidneys the minute blood vessels get inflamed and the term vasculitis is used.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Blood vessel damage such as thickening -we call arteriosclerosis can lead to high<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">blood pressure which can also damage your kidneys.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Kidneys don\u2019t show damage during the first 10 years having diabetes. About 15 to<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">25 years will pass before kidney failure occurs.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Controlling your diabetes, that is monitoring your blood sugar may help you keep<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">your kidneys healthy.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Arrange a diabetic diet plan with a dietitian.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Avoid eating foods with high salt.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Exercise daily- 10,000 steps walk<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Keep your weight at healthy level.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Get enough sleep.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-size: 20px; color: #000000;\"><strong>Metabolic functions of the kidneys<\/strong><\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 20px; color: #000000;\">Kidneys play an important role in the metabolism of carbs, proteins, lipids and other<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">nutrients.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Kidney tubules generate glucose, clears insulin from the circulation, perform critical<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">steps of the urea cycle and regulate the metabolism of fat- soluble vitamins such as<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">A and D,<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">In chronic kidney disease, these functions will be disrupted and may cause<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">cardiovascular disease.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Kidney maintains the micronutrients like the minerals within the normal range.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">For instance, Calcium and Phosphorus are needed for bone health. High levels of<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">parathyroid hormone can imbalance calcium and phosphorus and lead to bone<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">diseases.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Other minerals like sodium, potassium is important for nerve and muscle functions,<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-size: 20px; color: #000000;\">including heart muscle.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Bicarbonates maintain acid base balance in blood.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Now you\u2019ll realise the importance of properly functioning kidneys to prevent<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">diseases.<\/span><\/p>\n<p><strong><span style=\"font-size: 20px; color: #000000;\">Symptoms of kidney disease.<\/span><\/strong><\/p>\n<p><span style=\"font-size: 20px; color: #000000;\">In the early stages in stage 1 and 2 there are no symptoms, and this may last for 10<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">years.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">During these stages you may need blood tests to check on your creatinine level to<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">check for kidney disease.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">So, it is important when you are over 60, to do a kidney function test on your blood<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">sample.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">In stages 3 and 4 there are certain symptoms and in stage 5 most symptoms are<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">seen, and this would be the stage that you require dialysis.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Stage 3 is the commonest stage seen by doctors. The GFR would be between 30<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">and 59.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">At this stage you\u2019ll have fatigue, swelling around ankles and frequent urination<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">In stage 4 the GFR is between 15 and 29 when in addition to the symptoms in stage<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">3, loss of appetite and shortness of breath will be seen.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Stage 5 is the most severe stage when GFR comes down between 5 and 15.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p><span style=\"font-size: 20px; color: #000000;\">The symptoms in this last stage are<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">\u2022 Itching<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">\u2022 Trouble sleeping,<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">\u2022 Worse concentration,<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">\u2022 Nausea,<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">\u2022 metallic taste,<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">\u2022 vomiting and<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">\u2022 muscle cramps.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">\u2022 Blood pressure will rise at this stage and your doctor may have to add a<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">second antihypertensive drug.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">\u2022 Your sugar level will be low at this stage.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">The bottom line is be aware that certain drugs and chemicals will damage your<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">kidneys when taken for a long time, such as anti-inflammatory drugs, Aspirin,<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Panadol, alcohol, antibiotics, certain laxatives, illegal drugs, contrast dyes used in X<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">rays, ulcer medicine such as cimetidine, heartburn medications, pesticides,<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">insecticides and so on.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">If you are a diabetic, tightly control your diabetes to prevent diabetic kidneys.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">I hope this talk was valuable.<\/span><br \/>\n<span style=\"font-size: 20px; color: #000000;\">Stay healthy and good luck.<\/span><\/p>\n<p>&nbsp;<\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">Disclaimer:<\/span><\/p>\n<p style=\"text-align: justify;\"><span style=\"font-size: 16px; color: #000000;\">The information contained in this article is for general information purposes only, and whilst the author will endeavour to keep the information up to date and correct, eLanka makes no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability or availability with respect to the eLanka website or the information, products, services, or related graphics contained in this article for any purpose. 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The inclusion of any links does not necessarily imply a recommendation or endorse the views expressed within them<\/span><\/p>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Discussion on Chronic Kidney Disease-by Dr Harold Gunatillake &nbsp; Transcript WE are all concerned about our heart-health and cholesterol levels, whilst a silent disease may be brewing up in your kidneys, without symptoms for years. So, how can we find out whether our kidneys are healthy or otherwise.Chronic Kidney Disease (CKD) affects 11% of the [&hellip;]<\/p>\n","protected":false},"author":3,"featured_media":116942,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"aside","meta":{"footnotes":""},"categories":[20,1103],"tags":[7797],"class_list":{"0":"post-46364","1":"post","2":"type-post","3":"status-publish","4":"format-aside","5":"has-post-thumbnail","7":"category-articles","8":"category-dr-harold-gunatillake","9":"tag-chronic-kidney-disease","10":"post_format-post-format-aside"},"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v25.7.1 (Yoast SEO v25.9) - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>Discussion on Chronic Kidney Disease-by Dr Harold Gunatillake - eLanka<\/title>\n<meta name=\"robots\" content=\"noindex, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Discussion on Chronic Kidney Disease-by Dr Harold Gunatillake\" \/>\n<meta property=\"og:description\" content=\"Discussion on Chronic Kidney Disease-by Dr Harold Gunatillake &nbsp; Transcript WE are all concerned about our heart-health and cholesterol levels, whilst a silent disease may be brewing up in your kidneys, without symptoms for years. 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