OUR SERVICES

Many patients who have Chronic Kidney Disease also struggle with anemia. Anemia is when your body is not producing enough red blood cells. A lack of red blood cells is an issue as red blood cells carry oxygen through your bloodstream, helping your bones, muscles and organs work properly. The reason CKD and anemia are correlated is that your kidneys help your body make red blood cells with signals from a hormone called erythropoietin (EPO). If you have chronic kidney disease your body will be unable to send the correct signals to produce EPO to create sufficient amount of red blood cells.

Symptoms of anemia may include: fatigue, paleness of the skin, reduced appetite and shortness of breath.

Your nephrologist and healthcare team can work with you to manage your anemia.

Chronic kidney disease, or CKD, is the progressive and gradual decline in kidney function. Our kidneys, like our bodies in general, age and lose function as we get older. Although kidney function slows over time for everyone, it usually does not result in permanent damage. However, certain pre-existing conditions can lead to accelerated kidney deterioration and therefore can lead to chronic kidney disease (CKD). Diabetes and hypertension are by far the two leading causes of CKD. CKD, like many other diseases, has a scale indicating the severity of each case. CKD stage 1 is the most moderate and requires no medical intervention. CKD stage 5 is the most severe level and means the patient’s kidneys are in failure. Patients who are nearing CKD stage 5 will not be able to properly filter waste products and a multitude of systems can potentially develop. Symptoms include:

• Weight loss or excess weight gain
• Fatigue
• Decreased urination
• Loss of appetite
• Swelling of the body
• Increased tendency to bruise or bleed
• Paleness
• Seizures

A nephrologist, a physician that specializes in the function of kidneys, will work with their patients and their care team to help preserve remaining kidney function no matter the stage of CKD. A nephrologist’s #1 priority is to educate their patients on diet, lifestyle, medication and other changes the patient can make to preserve kidney function and keep them off dialysis if possible. In the event a patient is in need of additional therapies, the nephrologist will go over all modality options available to them including dialysis, home or alternative dialysis therapies, transplant and others.

Call us for a nephrology consultation if you or your patient has any of the following conditions:

1. High Creatinine (Creatinine > 1.5 mg/dL or GFR < 45 ml/min)
2. Hypertensive Urgency
3. Proteinuria or Hematuria
4. Severe edema or volume overload
5. Recurrent kidney stones

Patients who progress to stage 5 CKD will need to choose a form of renal therapy to filter the waste from the body their kidneys are no longer able to process. The most widely recognized form of renal replacement therapy is dialysis. Dialysis can be delivered to the patient in two different ways.

Hemodialysis: For hemodialysis treatments, patients are connected to an external machine that operates as an artificial kidney. The patients’ blood is routed through the artificial kidney which replaces crucial kidney function and removes excess fluid, removes waste products, corrects electrolyte balance and buffers acid production before returning blood to the patient.

Peritoneal Dialysis: In peritoneal dialysis, fluid enters the abdominal cavity of the patient. Like hemodialysis, the goal of this treatment is to remove excess fluid, correct electrolyte balance, discard waste products and buffer acids. Once the treatment is complete, the fluid is drained from the abdomen.

In addition to the two different types of dialysis, dialysis can be delivered in a variety of locations. Traditional hemodialysis treatments are required a few times each week in an outpatient facility. Some centers offer a nocturnal program where the patient can dialyze slower while they sleep. Depending on if the patient qualifies, both peritoneal dialysis and hemodialysis may be an option at home. In home hemodialysis, a small portable home machine acts similarly to the traditional machine found in the dialysis centers, but it allows the patient to conduct their own treatments, on their own time, at home, in shorter increments.

If you find yourself needing support renal therapies, please talk with your nephrologist to determine what option works best for you and your lifestyle.

Hypertension, or high blood pressure, is when the patient’s blood pressure is elevated to an unhealthy level.

• Normal blood pressure: systolic
• Prehypertension: >120/80 mmHg
• Hypertension: >140/90 mmHg
• Blood pressure treatment goals for hypertensive patients: <140/90

Other hypertension terminology:

Essential (primary) Hypertension: Physicians are unclear on the exact cause of essential HTN. Many believe it may be caused by a combination of genetic background, race, diet, weight gain, and other environmental factors.

Secondary Hypertension: This type of HTN may have a specific underlying cause such as: sleep apnea, chronic kidney disease, disorders of the adrenal gland, narrowing of the kidney arteries, birth control pills and non-steroidal anti-inflammatory medications (i.e. Ibuprofen or naproxen).

Resistant Hypertension: As the name indicates, resistant hypertension is high blood pressure that is not at a goal (<140/90) despite being treated with 3 medications; one of these which has to be a diuretic.

For many patients with late stage CKD, a kidney transplant is the best option. Long term, having a kidney transplant can provide a better quality of life than remaining on dialysis. Recipients of a kidney transplant typically have more energy and more freedom than those who remain on dialysis. The nephrologists on our team are experienced in guiding patients through the kidney transplant process.