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Nephrologists, also known as kidney doctors, specialize in the kidneys and the diseases that affect them, including:
- Chronic Kidney Disease
- Polycystic Kidney Disease
- Kidney Failure
- Kidney Stones – Medical Management and Prevention
- Kidney Transplant
- Preparation of Patients, Supervision & Management
- Kidney Transplant Donor Evaluation
- Metabolic Acid-Base Disorders
- Nutritional Information and Support
- Peritoneal Dialysis Training and Support
- Kidney Related Bone Diseases
- Kidney Stones – Medical Management and Prevention
- High Risk Obstetric Patients
The kidneys are vital life-sustaining organs, performing many functions to keep our blood clean and chemically balanced. They have a number of important functions, including:
- Filtering our blood to rid it of metabolic waste products and foreign particles, which helps regulate blood pressure
- Balancing body fluid
- Keeping electrolytes (sodium and potassium being the most important) and water content of the body constant
- Activating vitamin D, which is important for maintaining healthy bones
- Producing erythropoietin (EPO), a hormone needed to make red blood cells
- Tired or low energy
- Trouble concentrating
- Trouble sleeping
- Dry and itchy skin
- Increased urination (especially at night)
- Blood in urine
- Urine is foamy
- Persistent puffiness around the eyes
- Swollen ankles and feet
- Poor appetite
- Cramping muscles
Over time, uncontrolled high blood pressure can cause arteries around the kidneys to narrow, weaken or harden, making them unable to deliver enough blood to the kidney tissue. These damaged kidney arteries do not filter blood well, which is their main function.
People should get checked for kidney disease if they have:
- High blood pressure
- Heart disease
- A family history of kidney failure
Those who have diabetes should get checked every year. Patients with high blood pressure, heart diseases or a family history of kidney failure should talk to their health care provider about an appropriate schedule.
Kidney disease often has no symptoms until the kidneys are badly damaged. So the only way to know how well our kidneys are working is to get tested. And the sooner kidney disease is diagnosed, the sooner treatment can begin to protect the kidneys.
Chronic kidney disease (CKD) means lasting damage to the kidneys has occurred and the condition of the kidneys will worsen over time if the disease is left untreated. This can eventually lead to kidney failure, or end-stage renal disease (ESRD), which will need to be treated with dialysis or a kidney transplant.
Controlling blood pressure and diabetes through a healthy lifestyle is the best way to prevent chronic kidney disease and its progression to kidney failure. Following these tips can lower the risk:
- Follow a low-salt, low-fat diet
- Limit protein and potassium
- Maintain a balance of calcium and phosphorous
- Exercise at least 30 minutes, most days of the week
- Have regular check-ups with your doctor
- Do not smoke or use tobacco
- Keep a healthy weight
- Limit alcohol
- Changes in urination: urinating at night, less often, in smaller amounts, urine is darker in color or foamy, blood in urine or difficulty producing urine
- Swelling in legs, ankles, feet, face or hands
- Bad taste in mouth or food tastes different
- Nausea & vomiting
- Shortness of breath
- Feeling cold/chilled
- Dizziness & trouble concentrating
One or more of these symptoms may be a sign of serious kidney problems, and a doctor should be contacted right away.
Patients can be tested for kidney disease in three ways:
- eGFR (estimated glomerular filtration rate), is a sign of how well kidneys are cleaning blood. A blood test will identify how much creatinine (a type of waste) is in the blood, which is a sign that the kidneys might be having trouble filtering the blood.
- A urine test will determine if there is blood or protein in your urine, which could be a sign that the kidneys are not working well.
- High blood pressure can cause kidney disease, but kidney disease can also cause high blood pressure.
When kidneys fail, it means they have stopped working well enough for the patient to survive without treatment. There is no cure for kidney failure, but many people live long lives on dialysis or with a kidney transplant.
Dialysis is a treatment that helps the body get rid of waste and extra fluids in the blood when the kidneys no longer serve that function.
- In hemodialysis, an artificial kidney (hemodialyzer) is used to remove waste and extra chemicals and fluid from the blood. This process begins with minor surgery to the arm or leg, as the surgeon will need access to the blood vessels. Hemodialysis treatments are typically done three times a week and last about four hours.
- Peritoneal dialysis is a treatment that cleans the blood inside the body by using the lining of the abdomen, (called the peritoneum) and a cleaning solution called dialysate. There are several types of peritoneal dialysis, but two of the most common are:
- Continuous Ambulatory Peritoneal Dialysis (CAPD), which involves the patient putting a bag of dialysate into the peritoneal cavity through a catheter, usually four or five times a day. The patient can go about normal routines while the dialysate is in the peritoneal cavity.
- Automated Peritoneal Dialysis (APD) is typically done at home with a special machine called a cycler, which operates at night while the patient is asleep. Each cycle lasts between an hour and an hour and a half.
Dialysis becomes necessary once a patient has lost about 80 to 85 percent of their kidney function.
A kidney transplant is often the treatment of choice for kidney failure, compared with a lifetime on dialysis. Compared with dialysis, kidney transplant is associated with:
- Better quality of life
- Lower risk of death
- Fewer dietary restrictions
- Lower treatment cost
People of all ages (children to seniors) can get kidney transplants, but they must be healthy enough to have the operation, and free of cancer or infection. Every potential recipient is given a physical and psychosocial evaluation to ensure they’re a good candidate for the surgery. Most people will need more than one kidney transplant in a lifetime.
Since we have two, living donors (blood relatives, spouses, friends or even strangers) can donate a kidney, though they’ll have to go through a screening to ensure there’s a match and that they’re healthy enough for the operation. Donated kidneys could also come from someone who has died and donated healthy kidneys. Both work well but getting a kidney from a living donor could work faster and last longer.
It could take many years to find a matching donor, and the patient will likely need to be on some form of dialysis during this time. Once a kidney becomes available, surgery must happen as soon as possible.
Kidney health is critical to our overall health. If you have additional questions, please give us a call at (775) 322-4550 to set up a consultation.
Endocrinology is a branch of medicine that deals with the endocrine system, which controls the hormones in your body. Endocrinologists diagnose and treat a wide range of conditions affecting the endocrine system, including diabetes mellitus, thyroid disorders, osteoporosis, growth hormone deficiency, infertility, cholesterol problems, hypertension (high blood pressure), and obesity.
There are a variety of hormone-related conditions that may warrant a referral from your primary care physician (or a self-referral) to an endocrinologist, including:
- Thyroid dysfunction
- Obesity or Adiposity-Based Chronic Disease (ABCD)
- Adrenal disorders
- Lipid disorders
- Growth disorders
- Low testosterone
- Polycystic Ovary Syndrome
An endocrinologist may be able to help with the following symptoms:
- Unexplained weight gain or loss
- Anxiety or depression
- New or increased hair growth
- Changes in menstrual periods
- Muscle weakness
- Feeling cold
- Hot flashes
- Difficulty concentrating
- Dry skin
- Breaking hair
- Bone or joint pain
- Feeling jittery or shaky
- Decreased sex drive
Common test used by endocrinologists to diagnose disease are:
- Urine tests to rule out other problems, such as infections or kidney problems
- Imaging studies, including CT and MRI, to evaluate tumors or cancer and plan treatments
- Genetic testing to check for gene abnormalities that raise your risk for endocrine disease or affect your response to treatment
- Hormone testing to determine whether you have abnormally high or low levels of specific hormones
Some hormone disorders, such as an under active thyroid, can be treated with daily hormone medication. Other diseases may require more complex treatment, such as surgery. An endocrinologist can review treatment options and help you choose the best one for you. Treatments may include:
- Medication for overactive (hyperthyroidism) or under active (hypothyroidism) thyroid
- Radioactive iodine for hyperthyroidism
- Oral medicine or injectable insulin to treat diabetes
- Testosterone replacement in the form of topical gels or injections for those with low testosterone
- Surgical removal of thyroid gland