Kidney Disease May Boost Odds of Infection

As kidney function declines, infection risk rises, a new study shows.

Infections facing people with advanced kidney disease include lower respiratory tract disease, urinary tract infections and blood poisoning, researchers said.

The findings were published in the Clinical Journal of the American Society of Nephrology.

“Given the fact that chronic kidney disease remains underdiagnosed and unrecognized in most societies, our findings may help patients and clinicians become more aware of chronic kidney disease and its complications,” said co-lead author Juan Jesus Carrero, of the Karolinska Institute in Sweden.

“This in turn may be useful to identify patients at increased risk of infection and inform discussions about prevention strategies, such as vaccination and health service planning,” Carrero said in a journal news release.

The researchers tracked 12 months of data from 1.1 million Swedes who took part in a study examining measures of kidney function.

The researchers found that infection rates grew almost sixfold in people with stage 4 or higher chronic kidney disease, compared to people with normal kidney function. Several types of infection — lower respiratory tract infections, urinary tract infections and sepsis — made up a larger proportion of infections as kidney function worsened.

The study focused on infections that people develop in the community, not hospitals and other health care settings.

Source: HealthDay

Today’s Comic


Kidney Disease May Boost Risk of Abnormal Heartbeat

Dennis Thompson wrote . . . . . . .

People with failing kidneys are at increased risk of developing a life-threatening abnormal heart rhythm, a new report suggests.

Chronic kidney disease can as much as double a patient’s risk of atrial fibrillation, a quivering or irregular heartbeat that can lead to stroke or heart failure, said lead researcher Dr. Nisha Bansal. She is an associate professor of nephrology at the University of Washington’s Kidney Research Institute, in Seattle.

The risk of atrial fibrillation increases as kidney function declines, Bansal said.

“We saw the worse your kidney function, the greater your risk of developing atrial fibrillation. Even mild changes in kidney function were strongly linked to atrial fibrillation,” Bansal noted.

The study included data gathered from three separate research projects focused on heart health in the United States. The three projects created a combined pool of almost 17,000 patients with follow-up periods averaging between 8.5 years and 12.5 years. None of the participants had atrial fibrillation when first recruited.

Each project checked participants’ kidney function when they first joined the study, using one or two different lab tests. One was a blood test that evaluated how well the kidneys were removing toxins from the bloodstream. The other was a urine test that assessed whether the kidneys were properly filtering out a specific protein.

People with worse kidney function at the start of the study were more likely to have atrial fibrillation by the end, the researchers found. Those who did worse on the blood test were twice as likely to develop an abnormal heart rhythm, while those who did worse on the urine test were 76 percent more likely.

While the association doesn’t prove a cause-and-effect relationship, the link remained even after the researchers took into account other risk factors for atrial fibrillation, such as diabetes, tobacco use and a history of heart problems.

“We found that kidney function was independent of all other risk factors,” Bansal said.

Research has not yet been conducted to explain the association between kidney function and atrial fibrillation, Bansal noted, but there are a number of possible explanations.

A poorly functioning kidney can alter blood levels of a number of nutrients needed to maintain proper heart function, such as potassium, vitamin D, calcium and phosphorus, Bansal said.

The kidneys also are responsible for maintaining a steady volume of blood in your body, removing excess fluid by way of urination.

“If your kidney function is impaired, your blood volume increases,” Bansal said. “That increased stress on your heart causes it to stretch and can also trigger this abnormal heart rhythm.”

Dr. Kevin Chan, a nephrologist with Massachusetts General Hospital in Boston, noted that it’s also possible toxins that haven’t been filtered from the blood — thanks to a bad kidney — might have some as-yet-unknown effect on heart function.

Based on this report, doctors treating patients with kidney disease should keep an eye out for potential heart problems, said Chan, who was not involved with the new study.

“Physicians should be cognizant of this relationship so they are attuned to recognizing atrial fibrillation when they see their chronic kidney disease patients,” Chan said.

Doctors can reduce a person’s risk of stroke from atrial fibrillation by putting them on blood thinners, he added. Atrial fibrillation patients also can be fitted with a pacemaker, or undergo a procedure to restore proper heart rhythm.

People with kidney disease could help themselves by adopting a heart-healthy lifestyle, Bansal suggested, for example, eating right, exercising and quitting smoking.

“A heart-healthy lifestyle does improve your risk of all kinds of cardiovascular disease, as well as kidney disease, so I would recommend that,” Bansal advised.

The report was published online in the Clinical Journal of the American Society of Nephrology.

Source: HealthDay

Kidney Disease: Causes

Your kidneys may be small, but they perform many vital functions that help maintain your overall health, including filtering waste and excess fluids from your blood. Serious kidney disease may lead to complete kidney failure and the need for dialysis treatments or a kidney transplant to stay alive. While effective treatments are available for many kidney diseases, people are sometimes unaware that kidney disease can often be prevented. The following are the ten major causes of kidney disease.

In the United States the two leading causes of kidney failure, also called end stage kidney disease or ESRD, are diabetes (also called Type 2, or adult onset diabetes) and high blood pressure. When these two diseases are controlled by treatment, the associated kidney disease can often be prevented or slowed down.

Many effective drugs are available to treat high blood pressure. In addition, healthy lifestyle changes, such as losing weight and regular exercise, often help to control, and may even help to prevent, high blood pressure.

Careful control of blood sugar in diabetics helps to prevent such complications as kidney disease, coronary heart disease and stroke. When diabetics have associated high blood pressure, special drugs called angiotensin converting enzyme (ACE) inhibitors may help to protect their kidney function.

The third leading cause of end stage kidney disease in the U.S. is glomerulonephritis, a disease that damages the kidneys’ filtering units, called the glomeruli. In many cases, the cause of this disease is not known, but some cases may be inherited and others may be triggered by an infection.

Some of the other diseases that may affect the kidneys include infections, kidney stones and inherited diseases such as polycystic kidney disease. The kidneys can also be damaged by overuse of some over-the-counter pain killers and by taking illegal drugs such as heroin. Some of these diseases can be cured. In other cases, treatments can help to slow the disease and prolong life.

End stage kidney disease occurs when about 90 percent of kidney function has been lost. People with kidney failure may experience nausea, vomiting, weakness, fatigue, confusion, difficulty concentrating and loss of appetite. It can be diagnosed by blood and urine tests.

Source: National Kidney Foundation

Heart Disease Can Also Affect Your Feet, Kidneys and Brain

In February, American Heart Month raises awareness about heart disease. But “heart disease” is a catch-all term that refers to numerous problems, many of which are related to hardening of the arteries.

Hardening of the arteries doesn’t just happen in the heart, noted Dr. Ali AbuRahma, secretary of the Society for Vascular Surgery, it happens all over the body. The progressive disease, also known as arteriosclerosis, causes plaque to start clogging up the arteries, making it more difficult for oxygen-rich blood to flow throughout the body. That is bad for the heart, but also dangerous for the legs, feet, kidneys and the brain.

Arteriosclerosis usually doesn’t affect every blood vessel uniformly, Dr. AbuRahma said. In most people with arteriosclerosis, there will be a general hardening of the arteries throughout the body, but some arteries will have more plaque than others.

When this disease gets worse in the legs and feet, it is called peripheral arterial disease, also known as PAD. Unfortunately, PAD is very common in the U.S. According to the Centers for Disease Control, about 8.5 million Americans have PAD, including up to 20 percent of those older than 60. When not enough oxygen-rich blood is pumping through the legs and feet, the feet may develop wounds that won’t heal. In advanced cases, patients may face amputation.

Hardening of the arteries may have no symptoms at all until the disease has become advanced. However, some people may have leg pain when they walk, a symptom of PAD. These patients should inform their physician, who may order a painless, non-invasive test called an ankle-brachial Doppler test that measures the blood pressure in the ankles.

The good news is that hardening of the arteries is manageable.

“We recommend that everyone take a few sensible health measures to keep their veins and arteries healthy,” said Dr. AbuRahma. “First, know your ‘numbers,’ that is, manage your blood pressure, blood sugar and cholesterol. Don’t smoke and get regular physical activity. Try to lower your stress level, too.”

For those whose disease has advanced, there is still hope, he added.

“Vascular specialists are trained to restore blood flow,” he said, “but most of our long-term patients never need anything other than medication and good health habits. But if non-invasive treatments no longer work, we can install minimally invasive balloons or stents to unblock blood vessels, or perform open procedures, in which we create bypasses around a blocked artery.”

Those who have vascular disease should be under the care of a vascular specialist for the rest of their lives, he added. “But if you want to live to be a healthy old age, the best thing you can do is to really follow your doctor’s orders. Don’t tune it out when your doctor repeats advice you may have heard before. Knowing your numbers, exercising and not smoking can make a world of difference.”

Source: The Society for Vascular Surgery

Today’s Comic

Healthy Diet May Mean Longer Life for Kidney Patients

A healthy diet may help people with kidney disease live longer, researchers report.

They analyzed seven studies that included more than 15,000 people with chronic kidney disease, to assess the effects of a diet high in fruits, vegetables, fish, legumes, cereals, whole grains and fiber.

In six of the studies, a healthy diet was consistently associated with a 20 percent to 30 percent lower rate of early death, and with 46 fewer deaths per 1,000 people over five years. But the study did not directly prove that a healthy diet would lengthen life.

The international team of researchers found no significant association between a healthy diet and risk of kidney failure.

The findings were published in the Clinical Journal of the American Society of Nephrology.

“Chronic kidney disease now affects about 10 percent to 13 percent of the adult population and substantially increases risks of cardiovascular complications and early death,” said study leader Dr. Giovanni Strippoli, from the University of Bari in Italy.

“In the absence of randomized trials and large individual cohort studies, this study is the best available evidence to drive clinical decision-making by patients and doctors on whole dietary approaches in chronic kidney disease,” Strippoli said in a journal news release.

Chronic kidney disease patients are told to restrict their intake of certain nutrients such as phosphorus, potassium, protein and sodium. But evidence suggests these restrictions — which can be difficult to follow — may do little to reduce patients’ risk of premature death, the researchers said.

Source: U.S. Department of Health and Human Services

Today’s Comic