Samir Sutaria, MD

2177 Oaktree Road
Suite 204
Edison, NJ 08820

Phone: (908) 769-4735
Fax: (908) 769-4736
Email: [email protected]

                         

Listed As One Of The "Top Doctors" In New Jersey - NJ Monthly Magazine


          

Chronic Kidney Disease (CKD)

     More than 20 million Americans have kidney disease and another estimated 20 million are at risk and don't know it. Our kidneys function to remove extra water and wastes, help control blood pressure, keep body chemicals in balance, keep bones strong, and tell your body to make red blood cells.

     Chronic kidney disease occurs when kidneys are no longer able to clean toxins and waste product from the blood and perform their functions to full capacity. This can happen all of a sudden or over time. Chronic kidney disease (CKD) means that the kidneys have been damaged by conditions or diseases, such as diabetes or high blood pressure and this usually occurs gradually, over months to years. As a result of this, the kidneys become less able to do the following jobs that keep us healthy:

 - Remove wastes and extra fluid from your body
, Release hormones that help to:
Control blood pressure
Promote strong bones
, Prevent anemia by increasing red blood cells
, Maintain the correct balance of important minerals and chemicals in your blood, such as potassium, sodium, phosphorus and calcium
.

    There are many reasons why kidneys fail. The two major causes of chronic kidney disease are diabetes and hypertension. Some kidney diseases are inherited, while others are caused by pre-existing health conditions. Some additional causes of kidney disease may include glomerulonephritis, nephrotic syndrome, polycystic kidney disease, systemic lupus erythematosus, chronic kidney infections, and kidney stones. Our main goal at AKDH is to help improve or delay the progression of kidney disease over time all the while maintaining a quality of life. Treatment options in kidney disease including a combination of particular, select healthy diets, exercise, and medications. If kidney function is severely impaired, patients may require the assistance of dialysis or a kidney transplant to help maintain good health. 

Symptoms of CKD:



     Fatigue with decreased energy,
loss of appetite, muscle cramping at night, difficulty sleeping, mental changes such as inability to concentrate, headaches, swelling (edema, swelling of the face, feet, ankles, puffiness around eyes, especially in the mornings, dry, itchy skin, increased frequency in urination
.

Are You at Increased Risk for Chronic Kidney Disease?

    Your doctor or clinic should check to see if you have any risk factors for chronic kidney disease. These include: diabetes, high blood pressure, family history of chronic kidney disease, older age, certain ethnic groups (African Americans, Hispanics, Asians), autoimmune disease (lupus, rheumatoid arthritis), kidney stones, exposure to medications or environmental toxins, recurrent urinary tract infections.    

     Your doctor can determine the stage of kidney disease based on the presence of kidney damage and glomerular filtration rate (GFR), which is the measurement of your level of kidney function. Early detection and treatment of CKD by standardized blood tests to estimate renal function and monitoring of urine protein excretion can stabilize and delay the progression of CKD.

 There are six stages of CKD, with Stage 6 being the most severe, requiring dialysis.

     The National Kidney Foundation estimates that about 20 million adults in the U.S. have some degree of chronic kidney disease (CKD). Of these, about 300,000 people have severe renal failure - Stage 5 CKD (near dialysis), or Stage 6 (on dialysis or have a glomerular filtration rate (GFR) of less than 15 mL/min. Another 400,000 have Stage 4 CKD (severe), and about 7.5 million are at Stage 3 (moderate). The rest have some kidney damage, but have normal or only mildly reduced kidney function (CKD Stages 1 and 2). Many people with CKD do not know they have it. Symptoms are normally subtle until late in the course of the disease. With early detection, the course of CKD can usually be slowed.

How can I slow the progression of Chronic Kidney Disease (CKD)?:

There are many ways to help delay or prevent kidney failure, especially when CKD is diagnosed in the mild to moderate stages. These include:

1) Blood pressure control

•Keep your blood pressure at 125/75 or lower if you have diabetes and/or protein in your urine. Keep your blood pressure at 130/85 or lower if you have kidney problems but not diabetes.

Studies have shown that certain types of blood pressure medications such as angiotensin converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) can help slow progression of kidney disease in people with diabetes, and even if they do not have high blood pressure. The generic names of some common ACE inhibitors are captopril, enalapril, and lisinopril. Some common ARBs are telmisartan, losartan, candesartan, and valsartan.

2) Diabetes control

If you have diabetes, strict controls of your blood glucose levels can help slow the progression of kidney disease.

3) Repairing the damage

In some cases, the kidney disease itself can be treated. If you have an obstruction that blocks your urine flow, surgery may help. If you have an infection, antibiotics may clear it up. If damage is due to the effects of prescription or non-prescription medications, your doctor may be able to suggest a different medication that is less harmful to your kidneys. If you have CKD and are prescribed antibiotics talk to your doctor about the effect it may have on your kidneys. Painkillers (even over-the-counter medicines) can cause damage your kidneys. Smoking is a risk factor for faster progression of kidney disease, so stopping smoking can also help slow progression. Avoiding too much protein and phosphorus in the diet may help, as well.

4) Diet and drugs

Ongoing research continues on dietary changes and drugs that may help to slow the progression of CKD. Examples include: Fish Oil, Low protein diet, Antioxidants.

When should a patient be referred to a nephrologist (Kidney Specialist)?

     If your Glomerular Filtration Rate GFR between 30-60 ml/min you should be under the care of a Nephrologist. Early referral to a nephrologist has been show to slow the decline of chronic kidney disease and to delay or even avoid the need for dialysis.

When should dialysis start?

     National Kidney Foundation guidelines recommend that you start dialysis when your kidney function drops to 15% or less-or if you have severe symptoms caused by your kidney disease, like shortness of breath, fatigue, muscle cramps, or nausea and vomiting. Private insurance generally covers treatment for kidney failure whenever your doctor says it is needed. If you don't have private insurance, you may be able to get coverage through federal or state funded healthcare programs, such as Medicare or Medicaid. If you are not having symptoms, you may be able to wait a bit longer.

     However, some doctors believe that starting dialysis as soon as Medicare or insurance covers it is wise, since it can take a long time to recover if you let yourself get very ill. Since chronic kidney disease often happens slowly, sometimes people do not even know how bad they feel-until they start dialysis and begin to feel much better.   It is important to start getting ready for dialysis or a transplant well in advance-when your kidney disease reaches Stage 4 (severe, with glomerular filtration rate, or GFR, less than 30 mL/min). Learning about the types of dialysis and transplant options will help you make a choice that is for you. 

                    For more information on chronic kidney disease click here! 

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