2016年6月20日星期一

Do You Have Symptoms of Kidney Failure?

Many people may be in the early stages of kidney disease and not have any indication something is wrong with their kidneys. There are certain symptoms, however, that could be a sign you have kidney failure, whether it is acute renal failure or hereditary such as polycystic kidney disease (PKD). When kidney failure (also called renal failure) is detected in the early stages, there are steps you can take to help slow the progression of kidney disease and improve your quality of life.

Below are lists of kidney failure symptoms that are grouped in categories based on a typical cause. If you have any of these renal failure symptoms, you should make an appointment with your doctor as soon as possible and ask that your kidneys be checked.

Kidney failure symptoms from buildup of wastes in the body

  • A metallic taste in the mouth or ammonia breath
  • Protein aversion (no longer wanting to eat meat)
  • Nausea and vomiting
  • Difficulty concentrating
  • Loss of appetite
  • Itchiness (pruritis)

Kidney failure symptoms from buildup of fluid in the body

  • Swelling in the face, feet or hands
  • Shortness of breath (from fluid in the lungs)

Kidney failure symptoms from damage to the kidneys

  • Making more or less urine than usual
  • Blood in the urine (typically only seen through a microscope)
  • Urine that is foamy or bubbly (may be seen when protein is in the urine)

Kidney failure symptoms from anemia

  • Fatigue
  • Shortness of breath
  • Weakness
  • Mental confusion
  • Feeling cold all the time
  • Desire to chew ice, clay or laundry starch (called pica)
To determine if the symptoms you have are because of kidney failure, your doctor will perform specific tests:
  • Urinalysis – An examination of a sample of your urine to check for protein, blood and white blood cells in the urine
  • Blood tests – Particularly a test for creatinine and BUN, waste products that healthy kidneys remove from the bloodstream.

Take action when you have kidney failure symptoms

Often, early kidney problems don't have many symptoms—but if you are experiencing any of the ones mentioned above, you will want to your doctor to determine if your signs are caused by kidney failure. Write down any of the renal failure symptoms you may have and bring that information with you to your next doctor’s appointment. Whether you discover that your kidneys are okay or if you learn you have kidney problems, knowing about it sooner may ease your mind and allow you to take steps to slow the progress of kidney disease, including delay or prevent dialysis or a kidney transplant. To help your loved ones determine if they're at risk, send them an e-Card encouraging them to take the Kidney Disease Risk Quiz today.

Phosphorus and PTH Goals

Maintaining phosphorus and parathyroid hormone (PTH) in safe ranges is important for all dialysis patients. One of the reasons why an increase in PTH is common with kidney failure is because as blood phosphorus levels rise, so do PTH levels. That’s why it’s vital for dialysis patients to have regular blood tests to monitor these two lab values. Diet, adequate dialysis treatments and medications all play important roles in managing phosphorus and PTH.

Phosphorus goal: 3.0 to 5.5

Phosphorus is a mineral found in many foods, but is especially high in dairy products, beans, whole grains, starchy vegetables, chocolate and cola. Strong bones and teeth depend upon phosphorus. It also helps convert food into energy and stabilize the body’s metabolism. Healthy kidneys release extra phosphorus into the urine; however, kidney disease can prevent the body from getting rid of the excess. High amounts of phosphorus cause problems with the bones and heart. Maintaining a phosphorus goal between 3.0 and 5.5 is ideal for dialysis patients. If phosphorus is too high, patients can experience the following:
  • Calcium-phosphorus deposits
    • in heart (early heart attack)

    • in skin, lungs and other organs

    • in blood vessels, including those used for dialysis access and those needed for a transplant
  • Bone disease
  • Red eyes
  • Itching
  • Increased risk of death

PTH (parathyroid hormone) goal for dialysis patients: 150 to 600*

PTH is made by the parathyroid glands. These are small glands located behind the thyroid gland in the neck. The parathyroid glands regulate calcium and phosphorus levels in the blood. If the blood calcium becomes low, the parathyroid gland will respond by producing more PTH. PTH will pull calcium from the bones to correct the low blood calcium level. If dialysis patients don’t keep PTH levels in the safe range of 150 to 600, they risk the following:
  • Bone disease
    • bone and joint pain
    • weak and brittle bones
    • broken bones
  • Loss of independence
  • Increased risk of death
*PTH goal may vary for some individuals. Normal PTH for a person without kidney disease is 10-65 pg/mL.

Preventing high phosphorus and PTH levels

Taking an active role in your healthcare is important in maintaining healthy phosphorus and PTH levels in your blood. Knowing lab results, consulting with a doctor regularly and following a low-phosphorus diet can help. Here are some preventive measures to help you reach phosphorus and PTH goals:
  • Receive adequate dialysis by dialyzing for your full treatment, every time.
  • Avoid high-phosphorus foods.
  • Take phosphate binders with every meal.
  • Take phosphate binders with every snack, if prescribed.
  • If Sensipar® (cinacalcet) — a drug prescribed to treat hyperparathyroidism, a condition that leads the body to produce too much PTH — is prescribed, take as directed.

Summary

Maintaining the proper phosphorus and PTH levels is crucial for people with CKD and those on dialysis. Being proactive, knowing what your phosphorus and PTH levels are, following your prescribed treatments and avoiding food high in phosphorus can help overall health.

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