casareto.jpg
15/Dec/2018

By Doctor Alberto Casaretto.

What do my Kidneys Do?

  1. Clean your blood of waste and toxins.
  2. Regulates the extracellular fluid volume, the kidneys work to ensure an adequate quantity of plasma to keep blood flowing to vital organs.
  3. Regulation of osmolality of blood.
  4. Production of Hormones. Erythropoietin – is made in the kidney and is an important hormone in the production of blood in your bones.
  5. Regulates the concentration of important electrolytes like Potassium, Sodium, and Calcium.

How do I Know if I have Kidney disease?

If you have been to your Primary care doctor recently and had blood work, you have probably had your kidney function checked. The two blood tests that check for Kidney disease is Blood Urea Nitrogen (BUN) and Creatinine. Blood Urea nitrogen is a waste product that your Liver makes when it breaks down protein and Creatinine is a waste product made in your Muscles. When your BUN and Creatinine are elevated, we say you have a kidney problem since the Kidney is the organ that removes these two waste products from your body. Another test that is used to evaluate your kidneys filtering ability is Estimated Glomerular Filtration rate (eGFR).

When do I need to see a Nephrologist (Kidney Doctor)?

Since Kidney disease is typically a silent disease- there are no symptoms until kidney disease is severe, the only way to know if you have kidney disease is to check your blood work- specifically BUN and creatinine. Also if you have blood or protein in your Urine- these are signs that you may have damage to some of your filters in the Kidney. You should also consider seeing a Kidney doctor if your eGFR is less than 60.

What can I do to protect my Kidneys?

  1. Stay Hydrated-One of the easiest ways to keep your kidney healthy is to drink enough water. It is recommended that you drink at least 1 1/2 liters of water per day.
  2. Eat Healthy- Avoid High Salt diets.
  3. Watch your Blood Pressure
  4. Exercise regularly
  5. Stop smoking

Are there medications that could be harmful for my Kidneys?

If you have Chronic Kidney disease you should be careful with Non- steroidal -Anti-inflammatory medications (such as Ibuprofen and Naproxen). Some Antibiotics can also damage the Kidney- especially if the duration of the antibiotics is extended.
Some of the contrast dyes that are used for radiologic test can also be toxic to the Kidney such as the contrast used for CAT scans and Cardiac catheterizations. If you have kidney disease – talk to your doctor before doing these tests.


15/Dec/2018

Promote superior care for patients, provide exceptional services to physicians, and create a fulfilling environment for teammates!  That is the Lifeline mission statement.

At Lifeline Vascular Access Center Fort Lauderdale, the physicians and clinical care team take pride in delivering dedicated, compassionate and highly specialized procedures for those in need of vascular services. Our patients receive proactive care, early intervention, and are able to maintain a quality of life that is all too often compromised by disease.

Through this early detection and timely resolution of access dysfunction, the physicians at our outpatient center are better able to ensure the best possible outcomes for every patient we treat, resulting in fewer missed dialysis treatments and a lower frequency of complications which may lead to hospitalization*.

Since opening in 2014, Lifeline Vascular Access Center Fort Lauderdale has had over 3,500 patient encounters, and has sustained an impressive 99% overall procedure success rate.  Under the new physician leadership of FKP Nephrologist, Dr. Reinaldo Rosario, M.D., our continuing goal is to serve the patients within the community in a dedicated, positive, environment and provide them with superior care.

We are committed to ensuring that that with each and every visit, our patients can expect to be treated the same: as the most important patient in our center!

Lifeline Vascular Access Center Ft. Lauderdale, as part of the Lifeline Vascular Access system of centers, is accredited by The Joint Commission is located 2283 SW 2ndStreet, Pompano Beach, FL, 33069. For more information about the facility and our services, call 954-978-7932 or visit us on the web at ftl.lifelinevascularaccess.com

*Based on a study conducted by Dobson | DaVanzo & Associates, published in Seminars in Dialysis 26.5 (2013), “Clinical and Economic Value of Performing Dialysis Vascular Access Procedures in a Freestanding Office-Based Center as Compared with the Hospital Outpatient Department among Medicare ESRD Beneficiaries”.


feature-768x384.jpg
15/Dec/2018

Open House at Lifeline Vascular Center Fort Lauderdale.

Congratulations to Dr Rosario Reinaldo, our FKP-Kidney Doctor, as the new Interventionist for the Vascular Center.

We had a great time with our colleagues!
Kidney doctors liflinekidney doctors at vascular center

 

Lifeline Vascular Access History

A Broken System

End-Stage Renal Disease (ESRD) patients all too often received sub-optimal vascular access care. Few physicians were dedicated to this area of practice and there was little coordination between specialists, patients and dialysis facilities. Access problems were often identified and treated only after they had become severe. As a result, costs for care were high, patient quality of life suffered and outcomes were poor.

In 1998, Lifeline Vascular Access was created to specifically address these deficiencies and improve the delivery and coordination of vascular access care to ESRD patients. Over the years, four key studies have proven the safety, quality, efficiencies and economical advantages that are found in the Lifeline Vascular Access approach.

  • Effectiveness and safety of dialysis access procedures
    Kidney International (KI); 66:1622, 2004
  • Risk of sedation analgesia in hemodialysis patients undergoing interventional procedures
    Seminars in Dialysis; 24:97-103, 2011
  • Radiation dose associated with dialysis vascular access interventional procedures
    Publication pending
  • Clinical and economic value of performing dialysis vascular access procedures in a freestanding office-based center as compared with the hospital outpatient department among Medicare ESRD beneficiaries
    Seminars in Dialysis; 26:624-632, 2013

Validation and Accreditation

In 2006, Lifeline Vascular Access was awarded its first system-wide accreditation by The Joint Commission and received the Gold Seal of ApprovalTM, which is recognized nationwide as a symbol of quality that reflects a commitment to meeting high healthcare performance standards. Re-accreditation has been granted two additional times (in 2009, and most recently in 2012) since the original accreditation was awarded.

Growth and Expansion

Through Lifeline Vascular Access’s innovative approach, delivering vascular access care in a dedicated outpatient environment is now the accepted standard for care within the dialysis industry. Physicians in the Lifeline network of centers have now performed more than 1 million interventional procedures, with an overall procedure success rate of 98%.

But the importance of timely and appropriate interventional care isn’t limited to just vascular access for dialysis. We have begun to apply the same quality and economic efficiencies achieved in our centers to the treatment of other medical conditions, including Peripheral Arterial Disease (PAD) and Chronic Venous Insufficiency (CVI). Our fifteen-year history of successful and efficient performance reconfirms the Lifeline pledge: to improve the delivery and coordinator of interventional vascular care to patients throughout the United States and abroad.

FKP-Kidney Doctors are leading the Lifeline Vascular Center of Fort Lauderdale. Reinaldo Rosario is the new Interventionist for the Vascular Center. We are proud of our Doctors.

For more information regarding this post, please refer to: http://lifelinevascularaccess.com

 


shining-star-award-1-768x306.jpg
15/Dec/2018

Dr. Alberto Casaretto was Honored with the Shining Star Physician Award at the recent Davita Physician Leadership Meeting held at the Wynn Hotel in Las Vegas on February 21st of 2010.

Dr. Wayne Kotzker and Dr. Reinaldo Rosario were also in attendance for this prestigious award honoring Renal Electrolyte & Hypertension Consultants (now FKP) commitment to Service excellence.

The Shining Star Physician Awards was founded in 2003, and promotes DaVita’s Core Value of Service Excellence; at DaVita, that means high-quality clinical care coupled with a personalized approach. Winners are recognized annually at the Davita Physician Leadership Meetings. Only five doctors are honored every year.

76a75a_faaa77f0f5474b35ac0ea53084d66cbf

76a75a_c60937e0c20e4e369b882310de71eab9


hallandale-office-kidney-768x303.jpg
15/Dec/2018

FKP Opens New Office in Hallandale. Need a Kidney Doctor in Hallandale – visit one of our Nephrologist Do you need a #KidneyDoctor and live in Hallandale? Do you Chronic Kidney Disease, Hypertension, Kidney Stones, Kidney Transplant, Electrolyte abnormalities? Come and visit one of our doctors. Now you can see one of our FKP Nephrologists conveniently located in Hallandale. Dr. Parham Eftekhari has office hours in our Hallandale office. Office Location: 2100 E Hallandale Beach Blvd, Suite 202 Hallandale Beach, FL 33009 Call us now at 954-463-0112 to make an Appointment We have Quick appointments available. We accept all insurances, Medicare, Medicaid, Medicare Advantage, Medicaid HMO’s, Obamacare insurances and self-pay. FKP is South Florida’s Premier Nephrology Practice. We are a group of 8 Board Certified Nephrologist and 1 Advanced Nurse Practitioner. This FKP Hallandale Office has convenient Accessible Parking.

eftekhari-the-consultant-768x268.jpg
15/Dec/2018

Dr Eftekhari’s Article is Published in the medical journal “The Consultant” Journal – Acute Renal Failure Secondary to Synthetic Cannabinoids Young teenager admitted to Broward General Medical Center ICU multiorgan failure including renal failure, respiratory distress and altered consciousness as a consequence of synthetic marijuana. This was amongst the earliest published public health case reports of synthetic marijuana induced renal failure Acute Renal Failure Secondary to Synthetic Cannabinoids Thu, 01/23/14 – 16:00 Authors: Julietta Militello, DO, Aaron B. Heath, DO, Kevin Weiss, Natasha Bray, DO, Naomi Montague, MD, Guillermo A. Herrera, MD, Parham Eftekhari, DO Broward Health Medical Center, Ft. Lauderdale, FL A 26-year-old Caucasian male with no past medical history presented to the emergency department with increasing abdominal pain, vomiting, and polydipsia. Social history revealed recent abuse of synthetic marijuana blend called “cloud nine.” On presentation, his vital signs and physical exam were unremarkable. Pertinent laboratory date is reviewed in the table. Despite aggressive IV fluid hydration, the patient’s renal function deteriorated leading to initiation of hemodialysis. The patient received a total 3 hemodialysis sessions with subsequent improvement in his renal function. A renal biopsy was performed(Figures 1-6) revealing acute tubular interstitial nephritis. The patient denied any drug allergies, ingestion of nonsteroidal anti-inflammatory drugs, antibiotics, and herbal products. He was treated with a 4-week course of prednisone. Renal function returned to normal on outpatient follow-up (see Table). Discussion. Synthetic cannabinoids are a class of new designer drugs that have grown in popularity since appearing in the United States in 2009. Introduced as “spice” in Europe in 2005, these drugs were developed to investigate cannabinoid receptor pharmacology.1,2 Often advertised as herbal mixtures, they are distributed under numerous names and packaging.1 Although similar to Δ-9 tetrahydrocannabinol (THC) in their psychoactive effects, synthetic marijuana is more likely to be associated with sympathomimetic effects and hallucinations.1 It produces its effects by binding to the same receptor in the brain and peripheral organs as cannabis, but has a longer duration of action and greater potency.3 Because they do not contain cannabis and cannot be detected by routine drug screens, they have been referred to as “legal highs.”2,3 Prevalence among college-aged students is particularly striking; a recent university study revealed that 8% of students admitted to a history of synthetic marijuana use.2,4 In 2010, the National Poison Data System reported 1,898 exposures to THC homologs with an average age of 22.5.2,5 Recently, case reports have revealed acute renal failure as a potentially lethal side effect of synthetic marijuana.1,2 The exact nature by which these drugs cause renal failure remains poorly understood.1,2 Many of the ingredients found in synthetic marijuana contain heavy metal elements, which may result in kidney injury.2 Other side effects include tachycardia, seizures, altered mentation, dependence, withdrawal, myocardial infarction, stroke, and death.3,6,7 ■ References: 1.Centers for Disease Control and Prevention. Acute kidney injury associated with synthetic cannabinoid use—multiple states, 2012. MMWR. 2013;62:93-98 2.Bhanushali GK, Jain G, Fatima H, et al. AKI associated with synthetic cannabinoids: a case series. Clin J Am Soc Nephrol. 2013;8:1-4. 3.Fattore L, Fratta W. Beyond THC: the new generation of cannabinoid designer drugs. Front Behav Neurosci. 2011;5:60. 4.Hu X, Primack BA, Barnett TE, Cook RL. College students and use of K2: an emerging drug of abuse in young persons.Subst Abuse Treat Prev Policy. 2011;6:16. 5.Hoyte CO, Jacob J, Monte AA, et al. A characterization of synthetic cannabinoid exposures reported to the National Poison Data System in 2010. Ann Emerg Med. 2012;60:435-438. 6.Mir A, Obafemi A, Young A, Kane C. Myocardial infarction associated with use of the synthetic cannabinoid K2. Pediatrics. 2011;128:e1622-e1627. 7.Zdanowicz C. Teen narrowly escapes death after smoking synthetic marijuana. CNN Health. 2013 Feb 5. Available at:www.cnn.com/2013/02/04/health/synthetic-marijuana-irpt/. Accessed February 6, 2013.

parham-osteo-meet-768x311.jpg
15/Dec/2018

Dr Parham Eftekhari, DO presents at the American Osteopathic Internal Medicine Annual Conference Dr Parham Eftekhari  presented  at the American Osteopathic Internal Medicine Annual Conference held on October 12-14th in Palm Springs California. He gave two lectures – 1) Hospital Acquired Acute Kidney Injury  2) Cardiovascular disease in Chronic Kidney Disease. Dr. Parham Eftekhari is one of the Board certified Nephrologists associated with FKP Consultants.

rrsoc-neph-768x317.jpg
15/Dec/2018

Dr Reinaldo Rosario from Florida Kidney Physicians is Elected Treasurer of Florida Society of Nephrology at 2013 Annual meeting The 2013 Florida Society of Nephrology Annual meeting was held October 4-6th 2013 in Manalapan Florida . One of FKP  Consultants  Nephrologists, Reinaldo Rosario , MD was elected Treasurer of the Florida Society of Nephrology.  Dr Reinaldo Rosario has been an active Member of the Florida Society of Nephrology for many years. FSN 2013 Speakers at the Florida Society of Nephrology Annual Meeting Including Richard Glassock, MD, Gerald Appel, MD, and Marc Pohl, MD The Florida Society of Nephrology is a statewide organization of physicians who care for patients with renal disease. Established in 1966 to represent the interests of physicians and their patients, the Florida Society of Nephrology is active in many areas affecting the treatment of renal disease. The Society represents Nephrologists in the state of Florida.

ALBERTO-CASARETTO-M.D-768x302.jpg
15/Dec/2018

Dr Casaretto is Installed as the 83rd President of the Broward County Medical Association

Broward County Medical Association Foundation presented the 83th Presidential Inauguration and Dinner on Saturday, October 26th,2009 at 6:00 p.m. at the W Hotel , Ft. Lauderdale, Florida There were 250 guests in attendance .

 The Broward County Medical Association unites 1,700 allopathic and osteopathic physicians, of all specialties, as well as Physician Assistants, toward the fulfillment of a common goal: To secure access to health care of the highest quality for the residents of Broward County. To maintain the integrity of medical practice and care delivery for the citizens of Broward. To advocate in legislative, regulatory, and economic forums for the interests of the patients of Broward County in securing and maintaining access to medical care of high quality from the physicians of their choice, and for the interests of practicing physicians in caring for their patients.

The Broward County Medical Association (BCMA) has a long history dating back to 1926 with a defined mission to promoter and preserve the highest standards of medical care and foster the ethical principles of the medical profession. The BCMA has a positive impact on the lives of the citizens of Broward County in a number of ways. The BCMA maintains a referral service for residents of the county, and is involved in a number of community organizations. The BCMA, through its many committees and volunteer organizations, continues to serve the profession and the citizens of Broward County. We are indeed proud that Broward County has a health system second to none in the United States.


peritoneal-dialysis-book-768x305.jpg
15/Dec/2018

Congratulations to Dr. Casaretto , Dr. Kotzker and Dr. Rosario. “Urgent Start Peritoneal Dialysis: Report from a US Private Nephrology Practice” was published in Advances in Peritoneal Dialysis (2012) Congratulations to Dr. Casaretto , Dr. Kotzker and Dr. Rosario. “Urgent Start Peritoneal Dialysis: Report from a US Private Nephrology Practice” was published in Advances in Peritoneal Dialysis (2012). Dr. Casaretto also presented this data at the Annual Conference on Peritoneal Dialysis in San Antonio, Texas in February 2012. To view complete article:  http://www.advancesinpd.com/adv12/Part3/102.pdf Conclusion: Urgent-start PD is an acceptable alternative for the late-referred dialysis patient. It avoids the need for temporary vascular access and repeated vascular procedures to establish a permanent access. Urgent start PD allows for the better preservation of residual kidney function and for the lifestyle benefits that can be achieved with a home-based therapy. Urgent-start PD regimens are based on timely catheter placement followed by lower dwell volumes instilled while the patient is in the recumbent position. Staff-assisted intermittent regimens allow for acceptable clearance and catheter maturation before training and transition to the home setting. Developing an urgent-start PD capability should be a priority in PD programs dedicated to offering the full range of treatment options for the late-referred patient deemed appropriate for PD therapy. Please Like REHC on Facebook and also visit our web page at www.mykidneydr.com

Copyright by Florida Kidney Physicians.