BRAZOS HYPERTENSION & KIDNEY CARE

Hypertension

High blood pressure, also known as hypertension, occurs when the pressure of the blood flowing against the blood vessel walls is above the normal range. It is written in two sets of numbers, for example, 120/70. The first number is the systolic reading, which is the pressure when the heart is beating. The second number is the diastolic number, the pressure when the heart is resting. High blood pressure occurs when the systolic reading is elevated above 140 or higher and/or the diastolic reading is 90 or above.

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The causes of high blood pressure are not exactly known. It cannot be cured but it can be controlled with changes to your life and medicine prescribed by your doctor. Almost 1 out of 4 Americans have high blood pressure and most of them don't know that they have it.

High blood pressure may be present without any signs. If left untreated, this condition can lead to heart failure, kidney failure, a heart attack or stroke. For most patients, high blood pressure can be managed through lifestyle changes such as losing weight, eating a healthy diet, exercising regularly and limiting alcohol intake. Medications may be prescribed as well to help lower blood pressure

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Chronic kidney disease

Chronic kidney disease is a common condition that involves malfunction of the kidneys, which filter the blood and keep them free of waste and other substances. This condition can affect anyone, but is more common in those with diabetes, high blood pressure or a family history of kidney disease, although it may also be caused by infections or urinary blockages. If left untreated, it may lead to kidney failure.

Patients with CKD may not notice any symptoms during the early stages of this condition, although those in more advanced stages may experience:

• Fatigue

• Difficulty concentrating

• Lack of appetite

• Muscle cramping

• Dry, itchy skin

• Frequent urination

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Once CKD is diagnosed it is important to determine the level of kidney function. The National Kidney Foundation has identified 6 stages of chronic kidney disease. Each stage represents a level of kidney function as defined by a creatinine clearance:

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• Stage 1 CrCl > 90

• Stage 2 CrCl 60-89

• Stage 3 CrCl 30-59

• Stage 4 CrCl 15-29

• Stage 5 CrCl <15

• Stage 6 End Stage Renal Disease

Initial treatment for CKD involves managing the underlying condition which will usually improve kidney function as a result. It is important for patients to eat a healthy, balanced diet and exercise regularly, as well as remain hydrated and avoid smoking. Depending on the severity of your condition, your doctor may prescribe medication for high blood pressure, dialysis or kidney transplant to treat your condition and maintain or improve the function of the kidneys.

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End Stage Renal Disease

End stage renal disease is the final stage of chronic kidney disease, in which the kidneys are functioning at less than 15 percent of their normal capabilities. The kidneys experience complete or near complete failure and are unable to function on their own. It is most often caused by diabetes, but may also be a result of high blood pressure, vascular disease, an autoimmune disease or a genetic disorder.

End stage renal disease causes weight loss, nausea and vomiting, fatigue, difficulty breathing and seizures. If left untreated, end stage renal disease is a fatal condition.

At this stage, dialysis or a kidney transplant is usually needed. Patients will have to undergo dialysis treatments several times a week and may become very weak and fragile. Certain dietary changes may be necessary during dialysis treatment, including limiting fluids and salt and maintaining a low-protein diet. Transplants can often help restore patients' health, but have long waiting lists and require daily supplemental medications as well. We encourage patients with advanced Chronic Kidney Disease to pursue transplant evaluation early in their disease to ensure that those fit to undergo kidney transplant can have a good chance of finding a kidney prior to ESRD.

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 Urinalysis Evaluation

Urinalysis is a longstanding diagnostic tool used by doctors to detect and diagnose a large assortment of systematic ailments. This test gives doctors an incredible amount of information pertinent to the health of the body and its specific systems. The individual disorders that can be indicated by this test include:

• Dehydration

• Urinary Infection

• Diabetes Mellitus

• Kidney Infections

• Kidney Stones

• Various Nephritis and Vasculitis

• Acute Urate Nephropathy

In many cases, urinalysis can detect diseases that may not show any early symptoms through the discovery of increased amounts of glucose, red blood cells, white blood cells and protein within the urine. The mechanics of testing the urine collected in a urinalysis are performed in several different ways. The simpler tests are "dipstick" tests where a test strip or stick can be dipped into the specimen effortlessly, providing a color change to signify positive/negative results.

The doctor may use the specific gravity of various substances within the urine to determine its composition, usually through the aid of a refractometer. Finally, a microscopic analysis of the sample may be initiated, which would begin with a centrifuge to separate larger particles from smaller ones for easier evaluation.

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 Kidney Stone Evaluation

Kidney stones are a common but painful urinary tract disorder that affects over 3 million people in the United States each year. A kidney stone is a hardened mass of mineral and acid salts that separates from the urine and travels through the urinary tract. The urine normally dilutes and dissolves these substances, but when the composition of urine is unbalanced, crystallized stones can form.

There are several different types of kidney stones made up of different components found in the urine. Some of the most common stones are made up of calcium, struvite, uric acid and cystine. But despite their composition, most kidney stones cause terrible pain as they move through the urinary tract and into the ureter. Common symptoms include:

• Pain in the lower side and back

• Pain radiating to the abdomen and groin

• Bloody or cloudy urine

• Painful urination

• Nausea

• Vomiting

• Fever

Kidney stones can be identified by X-rays, CAT scan or Sonogram even when they do not form symptoms. Blood and urine tests may also be used to diagnose this condition. Pain medication may be given to relieve symptoms. Larger stones that cannot pass on their own may require more aggressive methods such as shock wave therapy or surgery. However, often the stone burden (number of stone formation) can decrease significantly by preventive measures; this may lead to a decrease in the number of surgical interventions required.

 

 Anemia Management

Anemia is a condition that occurs when the red blood cell count or hemoglobin is lower than normal. The hemoglobin may be low due to a decrease in production of red blood cells or a loss of blood.

There are several different types of anemia, characterized by the cause of the low blood cell counts. These causes can include:

• Iron deficiency

• Vitamin deficiency

• Associated with a chronic disease

• Autoimmune diseases

• Bone marrow disease

• Genetics (hereditary)

Anemia is much more common in women, especially pregnant women. It also occurs frequently in older people, people with poor diets and those with diseases that can cause anemia.

The main symptom of anemia is fatigue. Other common symptoms include weakness, paleness, fast or irregular heartbeat, shortness of breath, dizziness or headache. Symptoms may start out mild but worsen as the condition progresses.

A physical exam and series of blood tests, including a complete blood count, can confirm anemia. Treatment depends on the cause of the condition, but can include iron and vitamin supplements, blood transfusions, etc. While anemia can be a serious condition, it is often treatable with proper care. Your doctor can recommend the best treatment option for you.

 

​  Acute Kidney Injury/ARF

Acute renal failure (ARF), also known as acute kidney injury, refers to a sudden loss of kidney function as a result of an injury, infection or side effect of medication. ARF may occur due to a loss of blood flow to the kidneys, kidney damage or a blockage that prevents urine from flowing out of the kidneys. Although this condition can affect anyone, it is more common in older patients and those with kidney or liver disease, diabetes, high blood pressure or obesity.

Patients with advanced acute renal failure may experience symptoms such as:

• Swelling

• Lack of appetite

• Nausea and vomiting

• Flank pain

• Confusion or anxiety

• Little to no urination

Treatment for ARF aims to restore kidney function and prevent waste from building up in the body. This can be done with dialysis, which is often administered for a few days or weeks before the kidneys can once again function on their own. Patients will likely need to make adjustments to their diet, and may also be prescribed antibiotics to prevent or treat infection.