March 2021 Pt 2

March 2021
March 14, 2021
Medication and Hypertension Management
April 16, 2021


Health News March 2021

This is Dr. Barbara, and our March Health News is on Kidney Disease. May be Long BUT reading is good for Brain Health😍.

March is National Kidney Month, and this year the focus is on taking charge of your kidneys and the factors that go into managing your kidney disease.  Kidney disease can either be Acute or Chronic: any kidney disease which lasts for more than 3 months is known as Chronic Kidney Disease, (CKD). CKD will continue to worsen until it develops into Renal Failure or End Stage Renal Disease (ESRD), when the kidney stops working. In countries with the necessary resources, a person with ESRD will go on dialysis or get a kidney transplant.  CKD is a worldwide epidemic affecting about 10% of the world’s population: it increases with age and between one in 4 and 5 of those aged 65-74 years would have CKD.

RISK FACTORS for developing CKD.

• Diseases: Examples are: Hypertension, Diabetes Mellitus, Enlarged Prostate, history of recurrent kidney Infections, Kidney stones, Sickle Cell Disease, and tumors of the kidney. Certain inherited Kidney Diseases like Polycystic kidneys, and diseases of the blood vessels of the kidneys, as well as autoimmune diseases like Lupus (SLE) and autoimmune kidney disease.

• Medications: 💊💊Some of these damage the kidney cells after prolonged use. See below.

• Herbal Supplements: Aristolochia, some Ayurvedic medications and some Chinese Traditional medications contaminated with Mercury, Lead and Arsenic which are toxic. Some African herbal medicines may also affect the kidneys. Examples of supplements which can make kidney disease worse are Astragalus, Licorice Root, Parsley root, Creatine, Yohimbe, Golden Rod, Java Tea leaf, Juniper Berry. Consult your doctor before using any herbal medicines.

• Genetics: About 10% of all CKD is inherited; and being African American (Black), Native American or Asian puts one at increased risk of Kidney Disease.

• Unknown Causes: About 15% of all CKD is unknown or called “Idiopathic”

What To Do to Stop Progression of CKD.

Take control of your health and prevent progression of CKD from say Stage 1 to Stage 5. ( ESRD).

1. HYPERTENSION: Control blood Pressure(BP):  high BP can lead to CKD by damaging the kidney’s blood vessels and CKD can cause high BP due to the fluid retention that can occur.   Optimum BP is 130/80. Several classes of BP medication may be used to manage CKD including those in the group known as ACE inhibitors, or ARBs and Diuretics (water pills) e.g. Furosemide (Lasix) or Aldosterone Receptor Antagonists e.g. Spironolactone. These help the kidneys which are not too severely damaged; however others may be used as well. Ask your doctor if any of these mentioned may be useful for you if you have mild or moderate CKD.  

2. Diabetes Mellitus(DM): If you have DM, make sure your Blood Sugar (BS) is well controlled. Work with your doctor and check your blood sugar often. If readings are too high, let your doctor know so she/he can adjust your medications.

3. GOUT:  Elevated levels of Uric Acid as occurs in gout can worsen CKD, and so uric acid lowering medicine should be prescribed for those with Gout.

4. Decrease SALT INTAKE: Limit salt intake and aim for 2.4g/day of Sodium which is about one teaspoon of salt if you have CKD and Hypertension.  Avoid foods like salted fish, salted Pretzels and popcorn. Buy the unsalted and salt them yourself. Salt can cause fluid retention and further tax the kidneys.

5. Avoid NEPHROTOXIC medicines: These are medications which may further compromise CKD. These include: antibiotics like Cipro or Bactrim, Pain killers called Non-Steroidal Anti-inflammatory drugs (NSAIDs)-examples are Ibuprofen, and Naproxen, (Motrin, Aleve). These may also be found in combination cold medicines. Use acetaminophen (paracetamol) or topical creams for pain instead.  Others are cancer drugs like cisplatin, and malaria drugs like quinine.  Dyes or contrasts used for imaging studies like CT or MRI scans should be avoided as they may cause further damage in CKD.  There are other drugs which are eliminated through the kidneys and usually the doses of these should be reduced for people with CKD.  Always ask your doctor when you are given any medicine if it may affect your kidneys.

6. Practice “Therapeutic Lifestyle Changes” (TLC). These are things you do to lower risk of Hypertension, DM, Cardiovascular disease🫀🧠 and high Cholesterol.  These include (a)exercise such as walking, 🚶🏿‍♀️🚶🏾Zumba, 💃🏿🕺🏽Yoga, Pilates, jogging, going to the GYM etc. (b) Eat healthy, control portion size and avoid too many carbohydrates and fried foods.  Some people with CKD may have to avoid high protein diet or diets rich in potassium depending on their blood work. (c) Weight loss of 5% of your body weight if BMI is greater than 30. (d) Stop smoking if you do (e) Alcohol in moderation (f) Take your medicines as prescribed and check your blood sugar 🩸and BP regularly

Take charge of your health by taking charge of the medical conditions that affect the healthy functioning of your kidneys.  Your kidneys are in your hands. 👐🏾👐🏾Take good care of them.

Thanks. Share with Family and Friends.

Dr. Barbara Entsuah MD. (Family Medicine Physician).

# Loveyourbody 💕💕