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Florida Kidney Physicians - Nephrology
Florida Kidney Physicians - Nephrology
19/Feb/2019
High Bood Pressure

Hypertension’s effects

High Blood Pressure Dangers – Hypertension’s effects on your Body- How can I Avoid these Complications?

High blood pressure is a risk factor for more than heart disease. Discover what complications of high blood pressure can cause.

High blood pressure (hypertension) can quietly damage your body for years before symptoms develop. Left uncontrolled, you may wind up with a disability, a poor quality of life or even a fatal heart attack. Fortunately, with treatment and lifestyle changes, you can control your high blood pressure to reduce your risk of life-threatening complications.

Here’s a look at the complications of high blood pressure (hypertension) can cause when it’s not effectively controlled.

Damage to your arteries

Healthy arteries are flexible, strong and elastic. Their inner lining is smooth so that blood flows freely, supplying vital organs and tissues with adequate nutrients and oxygen. If you have high blood pressure, the increased pressure of blood flowing through your arteries gradually can cause a variety of problems, including:

  • Artery damage and narrowing. High blood pressure can damage the cells of your arteries’ inner lining. That launches a cascade of events that make artery walls thick and stiff, a disease called arteriosclerosis or hardening of the arteries. Fats from your diet enter your bloodstream, pass through the damaged cells and collect to start. These changes can affect arteries throughout your body, blocking blood flow to your heart, kidneys, brain, arms, and legs. The damage can cause many problems, including chest pain (angina), heart attack, heart failure, kidney failure, stroke, blocked arteries in your legs or arms (peripheral arterial disease), eye damage, and aneurysms.
  • Aneurysm. Over time, the constant pressure of blood moving through a weakened artery can cause a section of its wall to enlarge and form a bulge (aneurysm). An aneurysm can potentially rupture and cause life-threatening internal bleeding. Aneurysms can form in any artery throughout your body, but they’re most common in the aorta, your body’s largest artery.

Damage to your heart

Your heart pumps blood to your entire body. Uncontrolled high blood pressure can damage your heart in a number of ways, such as:

  • Coronary artery disease. Coronary artery disease affects the arteries that supply blood to your heart muscle. Arteries narrowed by coronary artery disease don’t allow blood to flow freely through your arteries. When blood can’t flow freely to your heart, you can experience chest pain, a heart attack or irregular heart rhythms (arrhythmias).
  • Enlarged left heart. High blood pressure forces your heart to work harder than necessary in order to pump blood to the rest of your body. This causes the left ventricle to thicken or stiffen (left ventricular hypertrophy). These changes limit the ventricle’s ability to pump blood to your body. This condition increases your risk of heart attack, heart failure, and sudden cardiac death.
  • Heart failure. Over time, the strain on your heart caused by high blood pressure can cause your heart muscle to weaken and work less efficiently. Eventually, your overwhelmed heart simply begins to wear out and fail. Damage from heart attacks adds to this problem.

Damage to your brain

Just like your heart, your brain depends on a nourishing blood supply to work properly and survive. But high blood pressure can cause several problems, including:

  • Transient ischemic attack (TIA). Sometimes called a ministroke, a transient ischemic attack is a brief, temporary disruption of blood supply to your brain. It’s often caused by atherosclerosis or a blood clot — both of which can arise from high blood pressure. A transient ischemic attack is often a warning that you’re at risk of a full-blown stroke.
  • Stroke. A stroke occurs when part of your brain is deprived of oxygen and nutrients, causing brain cells to die. Uncontrolled high blood pressure can lead to stroke by damaging and weakening your brain’s blood vessels, causing them to narrow, rupture or leak. High blood pressure can also cause blood clots to form in the arteries leading to your brain, blocking blood flow and potentially causing a stroke.
  • Dementia. Dementia is a brain disease resulting in problems with thinking, speaking, reasoning, memory, vision and movement. There are a number of causes of dementia. One cause, vascular dementia, can result from narrowing and blockage of the arteries that supply blood to the brain. It can also result from strokes caused by an interruption of blood flow to the brain. In either case, high blood pressure may be the culprit. High blood pressure that occurs even as early as middle age can increase the risk of dementia in later years.
  • Mild cognitive impairment. Mild cognitive impairment is a transition stage between the changes in understanding and memory that come with aging and the more serious problems caused by Alzheimer’s disease. Like dementia, it can result from blocked blood flow to the brain when high blood pressure damages arteries.

Damage to your kidneys

Your kidneys filter excess fluid and waste from your blood — a process that depends on healthy blood vessels. High blood pressure can injure both the blood vessels in and leading to your kidneys, causing several types of kidney disease (nephropathy). Having diabetes in addition to high blood pressure can worsen the damage.

  • Kidney failure. High blood pressure is one of the most common causes of kidney failure. That’s because it can damage both the large arteries leading to your kidneys and the tiny blood vessels (glomeruli) within the kidneys. Damage to either makes it so your kidneys can’t effectively filter waste from your blood. As a result, dangerous levels of fluid and waste can accumulate. You might ultimately require dialysis or kidney transplantation.
  • Kidney scarring (glomerulosclerosis). Glomerulosclerosis is a type of kidney damage caused by scarring of the glomeruli. The glomeruli are tiny clusters of blood vessels within your kidneys that filter fluid and waste from your blood. Glomerulosclerosis can leave your kidneys unable to filter waste effectively, leading to kidney failure.
  • Kidney artery aneurysm. An aneurysm is a bulge in the wall of a blood vessel. When it occurs in an artery leading to the kidney, it’s known as a kidney (renal) artery aneurysm. One potential cause is atherosclerosis, which weakens and damages the artery wall. Over time, high blood pressure in a weakened artery can cause a section to enlarge and form a bulge — the aneurysm. Aneurysms can rupture and cause life-threatening internal bleeding.

Damage to your eyes

Tiny, delicate blood vessels supply blood to your eyes. Like other vessels, they, too, can be damaged by high blood pressure:

  • Eye blood vessel damage (retinopathy). High blood pressure can damage the vessels supplying blood to your retina, causing retinopathy. This condition can lead to bleeding in the eye, blurred vision and complete loss of vision. If you also have both diabetes and high blood pressure, you’re at an even greater risk.
  • Fluid buildup under the retina (choroidopathy). In this condition, fluid builds up under your retina because of a leaky blood vessel in a layer of blood vessels located under the retina. Choroidopathy can result in distorted vision or in some cases scarring that impairs vision.
  • Nerve damage (optic neuropathy). This is a condition in which blocked blood flow damages the optic nerve. It can kill nerve cells in your eyes, which may cause bleeding within your eye or vision loss.

Sexual dysfunction

Although the inability to have and maintain an erection (erectile dysfunction) becomes increasingly common in men as they reach age 50, it’s even more likely to occur if they have high blood pressure, too. Over time, high blood pressure damages the lining of your blood vessels and causes your arteries to harden and narrow (atherosclerosis), limiting blood flow. This means less blood is able to flow to your penis. For some men, the decreased blood flow makes it difficult to achieve and maintain erections — often referred to as erectile dysfunction. The problem is fairly common, especially among men who are not treating their high blood pressure.
Women may have sexual dysfunction as a side effect of high blood pressure, as well. High blood pressure can reduce blood flow to your vagina. For some women, this leads to a decrease in sexual desire or arousal, vaginal dryness, or difficulty achieving orgasm. Improving arousal and lubrication can help. Like men, women can experience anxiety and relationship issues due to sexual dysfunction.

Other possible dangers of high blood pressure

High blood pressure can also affect other areas of the body, leading to such problems as:

  • Bone loss. High blood pressure can increase the amount of calcium that’s in your urine. That excessive elimination of calcium may lead to loss of bone density (osteoporosis), which in turn can lead to broken bones. The risk is especially increased in older women.
  • Trouble sleeping. Obstructive sleep apnea — a condition in which your throat muscles relax causing you to snore loudly — occurs in more than half of those with high blood pressure. It’s now thought that high blood pressure itself may help trigger sleep apnea. Also, sleep deprivation resulting from sleep apnea can raise your blood pressure.

High blood pressure emergencies

High blood pressure is typically a chronic condition that gradually causes damage over the years. In some cases, though, blood pressure rises so quickly and severely that it becomes a medical emergency requiring immediate treatment, often with hospitalization.

In these situations, high blood pressure can cause:

  • Problems with your brain, marked by memory loss, personality changes, trouble concentrating, irritability or progressive loss of consciousness (encephalopathy)
  • Stroke
  • Severe damage to your body’s main artery (aortic dissection)
  • Seizures in pregnant women (preeclampsia or eclampsia)
  • Unstable chest pain (angina)
  • Heart attack
  • Sudden impaired pumping of the heart, leading to fluid backup in the lungs resulting in shortness of breath (pulmonary edema)
  • Sudden loss of kidney function (acute renal failure)

In most cases, these emergencies arise because high blood pressure hasn’t been adequately controlled.

Call you FKP Kidney Doctor to make an appointment and get your Blood Pressure under good control to avoid these Complications. More about High Blood Pressure Treatment

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FKP
19/Feb/2019
High Bood Pressure

High Blood Pressure & Water Intake. How much water do you need?

Hypertension Overview

Hypertension is the medical term for high blood pressure, namely a blood pressure above 140 mmHg systolic (upper value) and/or above 90 mmHg diastolic (lower value). Untreated hypertension increases the strain on the heart and arteries, eventually causing organ damage. Hypertension increases the risk of heart failure, heart attack (myocardial infarction), kidney failure leading to dialysis, and stroke. Fortunately, treatments to lower blood pressure are usually easy to take and can help prevent health problems.

hypertension

High Blood Pressure in the United States

  • Having high blood pressure puts you at risk for heart disease and stroke, which are leading causes of death in the United States.1
  • About 75 million American adults (32%) have high blood pressure—that’s 1 in every 3 adults.3
  • About 1 in 3 American adults has prehypertension—blood pressure numbers that are higher than normal—but not yet in the high blood pressure range.3
  • Only about half (54%) of people with high blood pressure have their condition under control.2
  • High blood pressure was a primary or contributing cause of death for more than 410,000 Americans in 2014—that’s more than 1,100 deaths each day.1
  • High blood pressure costs the nation $48.6 billion each year. This total includes the cost of health care services, medications to treat high blood pressure, and missed days of work.1

Rates of High Blood Pressure Vary by Geography

High blood pressure is more common in some areas of the United States than in others. Below is a map showing the self-reported rate of hypertension by state in 2011. However, this likely underreports the true effect of hypertension in each state. About 1 in 5 adults is unaware of having high blood pressure and would not report having it.2

high blood pressure in us

Risk Factors for High Blood Pressure

Having certain medical conditions can increase your chances of developing high blood pressure. These conditions include

  • Prehypertension.
  • Diabetes.

Unhealthy behaviors can also increase your risk for high blood pressure, especially for people who have one of the medical conditions listed above. Unhealthy behaviors include

  • Smoking tobacco.
  • Eating foods high in sodium and low in potassium.
  • Not getting enough physical activity.
  • Being obese.
  • Drinking too much alcohol.

LIFESTYLE CHANGESwater and hypertension
Making lifestyle changes is an important first step in the treatment of high blood pressure. DO drink the right amount of water. To get the maximum health benefits of drinking water, you need to drink eight to ten 8-ounce glasses of water per day. If you have hypertension and are looking to lower your blood pressure naturally, your ultimate goal should be twelve 8-ounce glasses or 96 ounces of water per day.

Chronic dehydration also can be a cause of high blood pressure by making the body to hold onto sodium. This increases blood volume and thus blood pressure. Make a point of drinking a minimum of eight and preferably 10 to 12 glasses of pure, filtered water every day.

 

Our FKP Hypertension Specialists will give you an eating plan plenty of fruits, vegetables, whole grains, and other foods that are heart healthy and lower in salt/sodium. Call 954-463-0112

If you have prehypertension or diabetes, you can take steps to lower your risk for high blood pressure.

Control Blood Pressure

Measuring your blood pressure is an important step toward keeping a healthy blood pressure. Because high blood pressure and prehypertension often have no symptoms, checking your blood pressure is the only way to know for sure whether it is too high.

If you learn that you have prehypertension or high blood pressure, you should take steps to control your blood pressure to lower your risk for heart disease and stroke.

Manage Diabetes

Most people with diabetes—about 6 out of 10—also have high blood pressure.1 If your health care provider thinks you have symptoms of diabetes, he or she may recommend that you get tested.

If you have diabetes, monitor your blood sugar levels carefully. Talk with your health care team about treatment options. Your doctor may recommend certain lifestyle changes to help keep your blood sugar under good control—those actions will help reduce your risk for high blood pressure.

Take Your Medicine

If you take medication to treat high blood pressure or diabetes, follow your doctor’s instructions carefully. Always ask questions if you do not understand something. Never stop taking your medication without talking to your doctor or pharmacist.

Talk with Your Health Care Team

You and your health care team can work together to prevent or treat the medical conditions that lead to high blood pressure. Discuss your treatment plan regularly, and bring a list of questions to your appointments.

Call FKP – Florida Kidney Physicians: 954-463-0112

 

 

References:

www.uptodate.com

www.cdc.com

 

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FKP
19/Feb/2019
Chronic Kidney DiseaseHigh Bood PressureKidney Disease

High Blood Pressure and Kidney Disease

High blood pressure

The kidneys play a key role in keeping a person’s blood pressure in a healthy range, and blood pressure, in turn, can affect the health of the kidneys. High blood pressure, also called hypertension, can damage the kidneys and lead to chronic kidney disease (CKD).

What is high blood pressure?

Blood pressure measures the force of blood against the walls of the blood vessels. Extra fluid in the body increases the amount of fluid in blood vessels and makes blood pressure higher. Narrow, stiff, or clogged blood vessels also raise blood pressure.
Hypertension can result from too much fluid in normal blood vessels or from normal fluid in narrow, stiff, or clogged blood vessels.
People with high blood pressure should see their doctor regularly.

How does high blood pressure hurt the kidneys?

High blood pressure makes the heart work harder and, over time, can damage blood vessels throughout the body. If the blood vessels in the kidneys are damaged, they mfay stop removing wastes and extra fluid from the body. The extra fluid in the blood vessels may then raise blood pressure even more. It’s a dangerous cycle.
High blood pressure is one of the leading causes of kidney failure, also called end-stage renal disease (ESRD).

People with kidney failure must either receive a kidney transplant or have regular blood-cleansing treatments called dialysis. Every year, high blood pressure causes more than 25,000 new cases of kidney failure in the United States-United States Renal Data System. USRDS 2007 Annual Data Report.Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, U.S. Department of Health and Human Services; 2007.

What are the signs and symptoms of high blood pressure?

Most people with high blood pressure have no symptoms. The only way to know whether a person’s blood pressure is high is to have a health professional measure it with a blood pressure cuff. The result is expressed as two numbers. The top number, called the systolic pressure, represents the pressure when the heart is beating. The bottom number, called the diastolic pressure, shows the pressure when the heart is resting between beats. A person’s blood pressure is considered normal if it stays at or below 120/80, which is commonly stated as “120 over 80.” People with a systolic blood pressure of 120 to 139 or a diastolic blood pressure of 80 to 89 are considered prehypertensive and should adopt lifestyle changes to lower their blood pressure and prevent heart and blood vessel diseases. A person whose systolic blood pressure is consistently 140 or higher or whose diastolic pressure is 90 or higher is considered to have high blood pressure and should talk with a doctor about the best ways to lower it.

What are the signs and symptoms of chronic kidney disease (CKD)?

Early kidney disease is a silent problem, like high blood pressure, and does not have any symptoms. People may have CKD but not know it because they do not feel sick. A person’s glomerular filtration rate (GFR) is a measure of how well the kidneys are filtering wastes from the blood. GFR is estimated from a routine measurement of creatinine in the blood. The result is called the estimated GFR (eGFR).
Creatinine is a waste product formed by the normal breakdown of muscle cells. Healthy kidneys take creatinine out of the blood and put it into the urine to leave the body. When the kidneys are not working well, creatinine builds up in the blood.
An eGFR with a value below 60 milliliters per minute (mL/min) suggests some kidney damage has occurred. The score means that a person’s kidneys are not working at full strength.
Another sign of CKD is proteinuria or protein in the urine. Healthy kidneys take wastes out of the blood but leave protein. Impaired kidneys may fail to separate a blood protein called albumin from the wastes. At first, only small amounts of albumin may leak into the urine, a condition known as microalbuminuria, a sign of failing kidney function. As kidney function worsens, the amount of albumin and other proteins in the urine increases, and the condition is called proteinuria. CKD is present when more than 30 milligrams of albumin per gram of creatinine is excreted in urine, with or without decreased eGFR.

How can kidney damage from high blood pressure be prevented?
The National Heart, Lung, and Blood Institute (NHLBI), one of the National Institutes of Health (NIH), recommends that people with CKD use whatever therapy is necessary, including lifestyle changes and medicines, to keep their blood pressure below 130/80.

How can blood pressure be controlled?

The NHLBI recommends five lifestyle changes that help control blood pressure. People with prehypertension or high blood pressure should
maintain their weight at a level close to normal.
eat fresh fruits and vegetables, grains, and low-fat dairy foods.
limit their daily salt, or sodium, intake to 2,000 milligrams. They should limit frozen foods and trips to fast food restaurants. They should read nutrition labels on packaged foods to learn how much sodium is in one serving. Keeping a sodium diary can help monitor sodium intake.
Get plenty of exercises at least 30 minutes of moderate activity, such as walking, cycling, or swimming, most days of the week.
avoid consuming too much alcohol. Men should have no more than two drinks-two 12-ounce servings of beer or two 5-ounce servings of wine or two 1.5-ounce servings of hard liquor a day. Women should have no more than a single serving a day because differences in the way foods are broken down in the body make women more sensitive to the effects of alcohol.

Can medicines help control blood pressure?

Many people need medicine to control high blood pressure. Several effective blood pressure medicines are available. The most common types of blood pressure medicines doctors prescribe are diuretics, angiotensin-converting enzyme (ACE) inhibitors, angiotensin receptor blockers (ARBs), beta blockers, and calcium channel blockers. Two of these medicines, the ACE inhibitors, and ARBs have an added protective effect on the kidneys. Studies have shown that ACE inhibitors and ARBs reduce proteinuria and slow the progression of kidney damage. Diuretics, also known as “water pills,” help a person urinate and get rid of excess fluid in the body. A combination of two or more blood pressure medicines may be needed to keep blood pressure below 130/80.

Who is at risk for kidney failure related to high blood pressure?

Everyone has some risk of developing kidney failure from high blood pressure. African Americans, however, are more likely than Caucasians to have high blood pressure and its related kidney problems—even when their blood pressure is only mildly elevated. In fact, African Americans are six times more likely than Caucasians to develop hypertension-related kidney failure.2
People with diabetes also have a greater risk of developing kidney failure. Early management of high blood pressure is especially important for African Americans with diabetes.

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FKP
19/Feb/2019
High Bood Pressure

How much sodium per day? Daily sodium intake? Find it out

Salt! Find out how much sodium you really need, what high-sodium foods to avoid, and ways to prepare and serve foods without adding sodium

If you’re like many people, you’re getting far more sodium than is recommended, and that could lead to serious health problems.
You probably aren’t even aware of just how much sodium is in your diet. Consider that a single teaspoon of table salt, which is a combination of sodium and chloride, has 2,325 milligrams (mg) of sodium. And it’s not just table salt you have to worry about. Many processed and prepared foods contain sodium.

See how sodium sneaks into your diet and ways you can shake the habit.

Sodium: Essential in small amounts

Your body needs some sodium to function properly because it:

-Helps maintain the right balance of fluids in your body
-Helps transmit nerve impulses
-Influences the contraction and relaxation of muscles
-Your kidneys naturally balance the amount of sodium stored in your body for optimal health. When your body sodium is low, your kidneys essentially hold on to the sodium. When body sodium is high, your kidneys excrete the excess in urine.

But if for some reason your kidneys can’t eliminate enough sodium, the sodium starts to build up in your blood. Because sodium attracts and holds water, your blood volume increases, which makes your heart work harder and increases pressure in your arteries. Such diseases as congestive heart failure, cirrhosis and chronic kidney disease can make it hard for your kidneys to keep sodium levels balanced.

Some people’s bodies are more sensitive to the effects of sodium than are others. If you’re sodium sensitive, you retain sodium more easily, leading to fluid retention and increased blood pressure. If this becomes chronic, it can lead to heart disease, stroke, kidney disease and congestive heart failure.

Sodium: How much do you need?
The Dietary Guidelines for Americans recommend limiting sodium to less than 2,300 mg a day — or 1,500 mg if you’re age 51 or older, or if you are black, or if you have high blood pressure, diabetes or chronic kidney disease.

Keep in mind that these are upper limits, and less is usually best, especially if you’re sensitive to the effects of sodium. If you aren’t sure how much sodium your diet should include, talk to your doctor or dietitian.

Sodium: What are the major dietary sources?
The average American gets about 3,400 mg of sodium a day — much more than recommended. Here are the main sources of sodium in a typical diet:

-Processed and prepared foods. The vast majority of sodium in the typical American diet comes from foods that are processed and prepared.
These foods are typically high in salt and additives that contain sodium. Processed foods include bread, prepared dinners like pasta, meat and egg dishes, pizza, cold cuts and bacon, cheese, soups, and fast foods.

-Natural sources. Some foods naturally contain sodium. These include all vegetables and dairy products, meat, and shellfish. While they don’t have an abundance of sodium, eating these foods does add to your overall body sodium content. For example, 1 cup (237 milliliters) of low-fat milk has about 100 mg of sodium.

-In the kitchen and at the table. Many recipes call for salt, and many people also salt their food at the table. Condiments also may contain sodium. One tablespoon (15 milliliters) of soy sauce, for example, has about 1,000 mg of sodium.

Tips for cutting back on sodium
Virtually all Americans can benefit from reducing the sodium in their diet. Here are more ways you can cut back on sodium:

Eat more fresh foods. Most fresh fruits and vegetables are naturally low in sodium. Also, fresh meat is lower in sodium than are luncheon meat, bacon, hot dogs, sausage and ham. Buy fresh or frozen poultry or meat that hasn’t been injected with a sodium-containing solution. Look on the label or ask your butcher.

Opt for low-sodium products. If you do buy processed foods, choose those that are labeled “low sodium.” Better yet, buy plain whole-grain rice and pasta instead of ones that have added seasonings.

Remove salt from recipes whenever possible. You can leave out the salt in many recipes, including casseroles, soups, stews and other main dishes that you cook. Look for cookbooks that focus on lowering risks of high blood pressure and heart disease.

Limit use of sodium-laden condiments. Soy sauce, salad dressings, sauces, dips, ketchup, mustard and relish all contain sodium.
Use herbs, spices and other flavorings to season foods.Use fresh or dried herbs, spices, zest from citrus fruit, and fruit juices to jazz up your meals. Sea salt, however, isn’t a good substitute. It has about the same amount of sodium as table salt.

Use salt substitutes wisely. Some salt substitutes or light salts contain a mixture of table salt and other compounds. To achieve that familiar salty taste, you may use too much of the substitute — and get too much sodium. Also, many salt substitutes contain potassium chloride. Although potassium can lessen some of the problems from excess sodium, too much potassium can be harmful especially if you have kidney problems or if you’re taking medications for congestive heart failure or high blood pressure that cause potassium retention.

Sodium: Be a savvy shopper
Taste alone may not tell you which foods are high in sodium. For example, you may not think a bagel tastes salty, but a typical 4-inch (10-centimeter) oat-bran bagel has about 600 mg of sodium, and even a slice of whole-wheat bread contains about 100 mg of sodium.

So how can you tell which foods are high in sodium? Read food labels. The Nutrition Facts label found on most packaged and processed foods lists the amount of sodium in each serving. It also lists whether the ingredients include salt or sodium-containing compounds, such as:

-Monosodium glutamate (MSG)
-Baking soda (also called sodium bicarbonate)
-Baking powder
-Disodium phosphate
-Sodium alginate
-Sodium citrate
-Sodium nitrite

Try to avoid products with more than 200 mg of sodium per serving. And be sure you know how many servings are in a package — that information is also on the Nutrition Facts label.
Sodium: More tips to cut back

The supermarket is full of foods labeled “reduced sodium” or “light in sodium.” But don’t assume that means they’re low in sodium. For example, a can of chicken noodle soup that claims to have 25 percent less sodium still has a whopping 524 mg in 1 cup. It’s only lower in salt compared with regular chicken noodle soup that has more than 790 mg of sodium in a cup.

Here’s a rundown on common sodium claims and what they really mean:
Sodium-free or salt-free. Each serving in this product contains less than 5 mg of sodium.

Very low sodium. Each serving contains 35 mg of sodium or less.
Low sodium. Each serving contains 140 mg of sodium or less.
Reduced or less sodium. The product contains at least 25 percent less sodium than the regular version.

Lite or light in sodium. The sodium content has been reduced by at least 50 percent from the regular version.
Unsalted or no salt added. No salt is added during processing of a food that normally contains salt. However, some foods with these labels may still be high in sodium because some of the ingredients may be high in sodium.

Go low and take it slow
Your taste for salt is acquired, so you can learn to enjoy less. Decrease your use of salt gradually and your taste buds will adjust.
After a few weeks of cutting back on salt, you probably won’t miss it, and some foods may even taste too salty. Start by using no more than 1/4 teaspoon of salt daily — at the table and in cooking. Then throw away the salt shaker. As you use less salt, your preference for it diminishes, allowing you to enjoy the taste of the food itself, with heart-healthy benefits.

Nephrologists Tampa – Nephrologists Fort Lauderdale

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FKP
19/Feb/2019
High Bood PressureKidney DiseaseRenal Failure

Polycystic Kidney Disease Inheritance (PKD)

Do I have Autosomal Dominant Polycystic Kidney Disease if my father has it?

You have a 50% chance of having Polycystic Kidney Disease.  Autosomal Dominant Polycystic Kidney Disease is a Genetic Disorder.

The phrase “autosomal dominant” means that if one parent has the disease, there is a 50 percent chance that the disease gene will pass to a child. In some cases-perhaps 10 percent-autosomal dominant PKD occurs spontaneously in patients. In these cases, neither of the parents carries a copy of the disease gene.

Polycystic kidney disease (PKD) is a genetic disorder characterized by the growth of numerous cysts in the kidneys. The kidneys are two organs, each about the size of a fist, located in the upper part of a person’s abdomen, toward the back. The kidneys filter wastes and extra fluid from the blood to form urine. They also regulate amounts of certain vital substances in the body. When cysts form in the kidneys, they are filled with fluid. PKD cysts can profoundly enlarge the kidneys while replacing much of the normal structure, resulting in reduced kidney function and leading to renal failure.

When PKD causes kidneys to fail-which usually happens after many years-the patient requires dialysis or kidney transplantation. About one-half of people with the most common type of PKD progress to kidney failure, also called end-stage renal disease (ESRD).

PKD can also cause cysts in the liver and problems in other organs, such as blood vessels in the brain and heart. The number of cysts as well as the complications they cause help doctors distinguish PKD from the usually harmless “simple” cysts that often form in the kidneys in later years of life.

In the United States, about 600,0001 people have PKD, and cystic disease is the fourth leading cause of kidney failure. Two major inherited forms of PKD exist:

  • Autosomal dominant PKD is the most common inherited form. Symptoms usually develop between the ages of 30 and 40, but they can begin earlier, even in childhood. About 90 percent of all PKD cases are autosomal dominant PKD.
  • Autosomal recessive PKD is a rare inherited form. Symptoms of autosomal recessive PKD begin in the earliest months of life, even in the womb.

Autosomal Dominant PKD

What is autosomal dominant PKD?

Autosomal dominant PKD is the most common inherited disorder of the kidneys. The phrase “autosomal dominant” means that if one parent has the disease, there is a 50 percent chance that the disease gene will pass to a child. In some cases-perhaps 10 percent-autosomal dominant PKD occurs spontaneously in patients. In these cases, neither of the parents carries a copy of the disease gene.

Many people with autosomal dominant PKD live for several decades without developing symptoms. For this reason, autosomal dominant PKD is often called “adult polycystic kidney disease.” Yet, in some cases, cysts may form earlier in life and grow quickly, causing symptoms in childhood.

The polycystic kidney roughly retains the same shape as the healthy kidney.

The cysts grow out of nephrons, the tiny filtering units inside the kidneys. The cysts eventually separate from the nephrons and continue to enlarge. The kidneys enlarge along with the cysts-which can number in the thousands-while roughly retaining their kidney shape. In fully developed autosomal dominant PKD, a cyst-filled kidney can weigh as much as 20 to 30 pounds. High blood pressure is common and develops in most patients by age 20 or 30.

What are the symptoms of autosomal dominant PKD?

The most common symptoms are a pain in the back and the sides-between the ribs and hips-and headaches. The pain can be temporary or persistent, mild or severe.

People with autosomal dominant PKD also can experience the following complications:

  • urinary tract infections-specifically, in the kidney cysts
  • hematuria-blood in the urine
  • liver and pancreatic cysts
  • abnormal heart valves
  • high blood pressure
  • kidney stones
  • aneurysms-bulges in the walls of blood vessels-in the brain
  • diverticulosis-small pouches bulge outward through the colon

How is autosomal dominant PKD diagnosed?

Autosomal dominant PKD is usually diagnosed by kidney imaging studies. The most common form of diagnostic kidney imaging is ultrasound, but more precise studies, such as computerized tomography (CT) scans or magnetic resonance imaging (MRI) are also widely used. In autosomal dominant PKD, the onset of kidney damage and how quickly the disease progresses can vary. Kidney imaging findings can also vary considerably, depending on a patient’s age. Younger patients usually have both fewer and smaller cysts. Doctors have therefore developed specific criteria for diagnosing the disease with kidney imaging findings, depending on patient age. For example, the presence of at least two cysts in each kidney by age 30 in a patient with a family history of the disease can confirm the diagnosis of autosomal dominant PKD. If there is any question about the diagnosis, a family history of autosomal dominant PKD and cysts found in other organs make the diagnosis more likely.

In most cases of autosomal dominant PKD, patients have no symptoms and their physical condition appears normal for many years, so the disease can go unnoticed. Physical checkups and blood and urine tests may not lead to early diagnosis. Because of the slow, undetected progression of cyst growth, some people live for many years without knowing they have autosomal dominant PKD.

Once cysts have grown to about one-half inch, however, diagnosis is possible with imaging technology. Ultrasound, which passes sound waves through the body to create a picture of the kidneys, is used most often. Ultrasound imaging does not use any injected dyes or radiation and is safe for all patients, including pregnant women. It can also detect cysts in the kidneys of a fetus, but large cyst growth this early in life is uncommon in autosomal dominant PKD.

More powerful and expensive imaging procedures such as CT scans and MRI also can detect cysts. Recently, MRI has been used to measure kidney and cyst volume and monitor kidney and cyst growth, which may serve as a way to track the progression of the disease.

An ultrasound imaging device passes harmless sound waves through the body to detect possible kidney cysts.
Diagnosis can also be made with a genetic test that detects mutations in the autosomal dominant PKD genes, called PKD1 and PKD2. Although this test can detect the presence of the autosomal dominant PKD mutations before large cysts develop, its usefulness is limited by two factors: detection of a disease gene cannot predict the onset of symptoms or ultimate severity of the disease, and if a disease gene is detected, no specific prevention or cure for the disease exists. However, a young person who knows of a PKD gene mutation may be able to forestall the loss of kidney function through diet and blood pressure control. The genetic test may also be used to determine whether a young member of a PKD family can safely donate a kidney to a family member with the disease. Individuals with a family history of PKD who are of childbearing age might also want to know whether they have the potential of passing a PKD gene to a child. Anyone considering genetic testing should receive counseling to understand all the implications of the test.

How is autosomal dominant PKD treated?

Although a cure for autosomal dominant PKD is not available, treatment can ease symptoms and prolong life.
Pain. Pain in the area of the kidneys can be caused by cyst infection, bleeding into cysts, kidney stone, or stretching of the fibrous tissue around the kidney with cyst growth. A doctor will first evaluate which of these causes are contributing to the pain to guide treatment. If it is determined to be chronic pain due to cyst expansion, the doctor may initially suggest over-the-counter pain medications, such as aspirin or acetaminophen (Tylenol). Consult your doctor before taking any over-the-counter medication because some may be harmful to the kidneys. For most but not all cases of severe pain due to cyst expansion, surgery to shrink cysts can relieve pain in the back and sides. However, surgery provides only temporary relief and does not slow the disease’s progression toward kidney failure.

Headaches that are severe or that seem to feel different from other headaches might be caused by aneurysms-blood vessels that balloon out in spots in the brain. These aneurysms could rupture, which can have severe consequences. Headaches also can be caused by high blood pressure. People with autosomal dominant PKD should see a doctor if they have severe or recurring headaches-even before considering over-the-counter pain medications.
Urinary tract infections. People with autosomal dominant PKD tend to have frequent urinary tract infections, which can be treated with antibiotics. People with the disease should seek treatment for urinary tract infections immediately because the infection can spread from the urinary tract to the cysts in the kidneys. Cyst infections are difficult to treat because many antibiotics do not penetrate the cysts.

High blood pressure. Keeping blood pressure under control can slow the effects of autosomal dominant PKD. Lifestyle changes and various medications can lower high blood pressure (High Blood Pressure Treatment). Patients should ask their doctors about such treatments. Sometimes proper diet and exercise are enough to keep blood pressure controlled.

End-stage renal disease. After many years, PKD can cause the kidneys to fail. Because kidneys are essential for life, people with ESRD must seek one of two options for replacing kidney functions: dialysis or transplantation. In hemodialysis, blood is circulated into an external filter, where it is cleaned before re-entering the body; in peritoneal dialysis, a fluid is introduced into the abdomen, where it absorbs wastes and is then removed. Transplantation of healthy kidneys into ESRD patients has become a common and successful procedure. Healthy-non-PKD-kidneys transplanted into PKD patients do not develop cysts.

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