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”.


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15/Dec/2018

Soft Tacos with Mexican Seasoning

soft-tacos-with-mexican-seasoning1 Recipe submitted by DaVita renal dietitian Lynn, RD, LD, from Minnesota. Watch the video » Portions: 7 Serving size: 2 tacos

Ingredients

  • 1 recipe Mexican Seasoning (under Sauces and Seasoning in Recipe section of DaVita.com)
  • 5 tablespoons onion
  • 2 cups lettuce
  • 1 pound ground beef
  • 1/2 cup low-sodium tomato sauce
  • 14  flour tortillas, 6-inch
  • 5 tablespoons shredded sharp cheddar cheese
  • 5 tablespoons sour cream

Preparation

  1. Make the Mexican Seasoning recipe (below).
  2. Chop the onion and lettuce.
  3. Brown and drain the ground beef. Add the seasoning mixture and the low-sodium tomato sauce. Heat over medium heat. Warm the tortillas.
  4. To assemble soft tacos, take 1 flour tortilla, add 1/4 cup seasoned ground beef, 1 teaspoon cheese, 1 teaspoon onion, 1 teaspoon sour cream and lettuce as desired.

Renal and renal diabetic food choices

  • 2 meat
  • 2 starch
  • 1 vegetable, medium potassium
  • 1 fat

Carbohydrate choices

2

Helpful hints

  • Ground turkey or vegetarian ground meat substitute can be used instead of ground beef.

Mexican Seasoning

mexican_seasoning

Recipe submitted by DaVita dietitian Lynn, RD, LD, from Minnesota.

Portions: 8 Serving size: 1 teaspoon

Ingredients

  • 2 teaspoons chili powder
  • 1-1/2 teaspoons paprika
  • 1-1/2 teaspoons ground cumin
  • 1 teaspoon onion powder
  • 1/2 teaspoon garlic powder
  • 1/8 teaspoon cayenne pepper

Preparation

    1. Mix spices together in a small jar or bowl.
    2. Use to season meat for tacos, fajitas or burritos.

Renal and renal diabetic food choices

  • free

Carbohydrate choices

0

Helpful hints

  •  Use as a dry rub, add to sour cream to make dip or season your favorite homemade salad dressing.
  • Adjust cayenne pepper to suit your taste.

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15/Dec/2018

Evidence of a substantial heritability of diabetic kidney disease (DKD) exists but the genetic background is poorly understood.
diabetic_causesdited
New data confirm that renal complications in type 1 diabetes mellitus (T1DM) are highly heritable and provide insights into the biological mechanisms of DKD.basics diabetic nephropaty
To comprehensively study the genetic architecture of DKD in T1DM, Niina Sandholm and colleagues — on behalf of the SUMMIT consortium — performed a meta-analysis of genome-wide association studies, which included data from 12,540 individuals. They also used whole-exome sequencing to investigate the effects of low-frequency and rare genetic variants in 997 patients with T1DM.
“We found strong heritability estimates for DKD; additive genetic factors were estimated to explain 35% of the phenotypic variance and even higher heritability estimates werobtained for more extreme phenotypic definitions,” says Sandholm. The analyses did not, however, identify novel susceptibility loci with robust evidence or confirm many previously published associations. The findings suggest that there are no low-frequency variants with a major effect on DKD risk.
Using data from their meta-analysis, the researchers show thabasics diabetic nephropatyt sets of alleles thaincrease body mass index and genetic risk scores for type 2 diabetes are associated with an increased risk of DKD, whereas smoking cessation might have a protective effect.
In addition, they identified potential roles of ascorbate and aldarate metabolism and pentose and glucuronate interconversion pathways in the pathogenesis of DKD.
The researchers are now performing a meta-analysis of data from nearly 18,000 patients with T1DM in the JDRF-DNCRI consortium to identify common and low-frequency genetic variation. They hope thathisanalysis will identify novel susceptibility loci for DKD and provide biological information in relation to other traits and diseases.
ORIGINAL ARTICLESandholm, N. etal. The geneticlandscape of renal complications in type 1 diabetes. J. Am. Soc. Nephrol.http://dx.doi.org/10.1681/ASN.2016020231(2016)

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15/Dec/2018

National Emergency Nurse’s Day is observed annually on the second Wednesday in October. We take this day to say “thank you” to the emergency room nurses for their hard work, dedication, service and commitment to their patients and families and their loyalty to the emergency nursing profession. They work hard to put us at ease and eliminate pain and discomfort. This is a day to let them know just how important they are in keeping hospitals running smoothly. Happy Day to all the nurses that dedicate their life to this hard job. Our nurse Lorianne English is the loved nurse that has dedicated her life to our patients. Lorianne is a certified Nephrology Nurse Practitioner loved for every REHC patient. Masters of Science in Nursing – the University of South Carolina –Certfication: Family Nurse Practitioner from the American Nurses Credentialing Center She was previous Charge Nurse – Davita South Broward Artificial Kidney Center, one of the largesthemodialysis clinics in our region. She loves working with patients and taking care of them: “I love REHC practice because we all work together and my patients become like my family” said Lorianne English in this video.

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15/Dec/2018

Most people take drinking water for granted, but keeping hydrated has a huge impact on overall health. Despite how crucial water is, a significant number of people fail to consume recommended levels of fluids each day. Around 70 percent of the body is comprised of water, and around 71 percent of the planet’s surface is covered by water. Perhaps it is the ubiquitous nature of water that means drinking enough each day is not at the top of many people’s lists of priorities. Does the U.S. drink enough water? A study carried out by the Centers for Disease Control and Prevention (CDC) in 2013 analyzed data from the National Cancer Institute’s 2007 Food Attitudes and Behaviors Survey. Out of a sample of 3,397 adults, the researchers found the following: ▪ 7 percent of adults reported no daily consumption of drinking water ▪ 36 percent of adults reported drinking 1-3 cups of drinking water a day ▪ 35 percent of adults reported drinking 4-7 cups of drinking water a day ▪ 22 percent of adults reported drinking 8 cups or more a day People were more likely to drink less than 4 cups of drinking water daily if they consumed 1 cup or less of fruits or vegetables a day. The study only measured the intake of drinking water and, of course, fluid can be gained from other beverages. However, water is the ideal source of fluid because it is calorie-free, caffeine-free, and alcohol-free. Because 7 percent of respondents reported drinking no water at all daily, and those who drank a low volume of water also consumed less fruit and vegetables, it suggests that there is a certain number of people who are risking their health by not getting enough fluid. Even if the respondents reporting low levels of water intake were obtaining enough fluid, it is likely that they would be obtaining it from sources that could potentially compromise their health in other ways. “The biologic requirement for water may be met with plain water or via foods and other beverages,” write the study authors. “Results from previous epidemiologic studies indicate that water intake may be inversely related to volume of calorically sweetened beverages and other fluid intake.” Why do we need to drink water? The Institute of Medicine recommends that men achieve a daily fluid intake of around 3 liters and that women take in 2.2 liters. To function properly, all the cells and organs of the body need water. It is also used to lubricate the joints, protect the spinal cord and other sensitive tissues, regulate body temperature, and assist the passage of food through the intestines. Although some of the water required by the body is obtained through foods with a high water content – soups, tomatoes, oranges – the majority is gained through drinking water and other beverages. During every day functioning, water is lost by the body, and this needs to be replaced. It is noticeable that we lose water through activities such as sweating and urination, but water is even lost when breathing. Drinking water, be it from the tap or a bottle, is the best source of fluid for the body. Beverages such as milk and juices are also decent sources of fluid, but beverages containing alcohol and caffeine, such as soft drinks, coffee, and beer, are not ideal because they often contain empty calories. It was previously thought that caffeinated beverages had diuretic properties, meaning that they cause the body to release water. However, studies show that fluid loss because of caffeinated drinks is minimal. screen-shot-2016-10-21-at-10-14-02-am How much water should you drink? The recommended amount of water to be drunk per day varies from person to person, depending on factors such as how active they are and how much they sweat. There is no universally agreed upon amount of water that must be consumed daily, but there is a general level of consensus as to what a healthy amount is. According to the Institute of Medicine (IOM), an adequate intake for men is approximately 13 cups (3 liters) a day. For women, an adequate intake is around 9 cups (2.2 liters). Many people will have heard the phrase, “drink eight 8-ounce glasses of water a day,” which works out at around 1.9 liters and is close to the IOM’s recommendation for women. Drinking “8 by 8” is an easy-to-remember amount that can put people on the right track regarding water consumption. Remember, all non-alcoholic fluid counts towards this recommendation. Water also helps dissolve minerals and nutrients so that they are more accessible to the body, as well as helping transport waste products out of the body. It is these two functions that make water so vital to the kidneys. How does not drinking enough affect the kidneys? Every day, the kidneys filter around 120-150 quarts of fluid. Of these, approximately 1-2 quarts are removed from the body in the form of urine, and 198 are recovered by the bloodstream. Water is essential for the kidneys to function. If the kidneys do not function properly, waste products and excess fluid can build up inside the body. Untreated, chronic kidney disease can lead to kidney failure, whereby the organs stop working, and either dialysis or kidney transplantation is required. Urinary tract infections (UTIs) are the second most common type of infection in the body and account for around 8.1 million visits to health care providers in the U.S. every year. If infections spread to the upper urinary tract, including the kidneys, permanent damage can be caused. Sudden kidney infections (acute) can be life-threatening, particularly if septicemia occurs. Drinking plenty of water is one of the simplest ways to reduce the risk of developing a UTI and is also recommended to those who have already developed a UTI. Kidney stones interfere with how the kidneys work and, when present, can complicate UTIs. These complicated UTIs tend to require longer periods of antibiotics to treat them, typically lasting 7-14 days. The leading cause of kidney stones is a lack of water; they are commonly reported in people who do not drink the recommended daily amount of water. As well as complicating UTIs, research has suggested that kidney stones also increase the risk of chronic kidney disease. In November 2014, the American College of Physicians issued new guidelines for people who have previously developed kidney stones, stating that increasing fluid intake to enable 2 liters of urination a day could decrease the risk of stone recurrence by at least half with no side effects. Dehydration – using and losing more water than the body takes in – can also lead to an imbalance in the body’s electrolytes. Electrolytes, such as potassium, phosphate, and sodium, help carry electrical signals between cells. The levels of electrolytes in the body are kept stable by properly functioning kidneys. When the kidneys are unable to maintain a balance in the levels of electrolytes, these electrical signals become mixed up, which can lead to seizures, involving involuntary muscle movements and loss of consciousness. In severe cases, dehydration can also result in kidney failure, a potentially life-threatening outcome. Possible complications of chronic kidney failure include anemia, damage to the central nervous system, heart failure, and a compromised immune system. Effects on other organs Of course, it is not just the kidneys that are affected by a lack of water; below is a small sample of the other negative consequences dehydration can bring: ▪ Blood is more than 90 percent water, therefore, if water is in short supply, blood can become thicker and increase blood pressure. ▪ When dehydrated, airways are restricted by the body in an effort to minimize water loss, potentially making asthma and allergies worse. ▪ The skin can become more vulnerable to skin disorders and premature wrinkling. ▪ The bowel needs water to function correctly. If dehydrated, digestive problems and constipation can become an issue. Dehydration can lead to an overly acidic stomach which makes heartburn more common and can encourage the development of stomach ulcers. ▪ Cartilage, found in joints and the disks of the spine, contain around 80 percent water. If dehydration is ongoing, joints can become less good at shock absorption, which leads to joint pain. ▪ Dehydration can affect brain structure and function. If dehydration is prolonged, cognitive ability is impaired.  

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15/Dec/2018

Recipe submitted by DaVita dietitian Bonnie from Texas.

Portions: 10 Serving size: 3 ounces base plus 3 ounces water

Ingredients

  • 2-1/2 cups water
  • 1-1/4 cups sugar or Splenda® sugar substitute
  • 1/2 teaspoon finely shredded lemon or lime peel
  • 1-1/4 cups fresh lemon or lime juice
  • ice cubes

lemonade-wallpaperPreparation

  1. In a medium saucepan, stir water and sugar or sugar substitute over medium heat until sugar is dissolved. Remove from heat; cool 20 minutes.
  2. Add citrus peel and juice to sugar mixture. Pour into a jar or pitcher; cover and chill. Keeps for up to 3 days.
  3. For each glass of lemonade or limeade, combine 3 ounces base and 3 ounces water in ice-filled glasses. Stir and sip slowly to enjoy. Freeze leftover base in ice cube trays and add to beverages instead of ice.

Renal and renal diabetic food choices

  • 1/2 fruit, low potassium
  • 1 high calorie

Carbohydrate choices

2

Helpful hints

  • 3 ounces liquid is 6 tablespoons.
  • Base made with Splenda® instead of sugar has 20 calories and 5 grams carbohydrate. Count as 1/2 carbohydrate choice.
Source: www.davita.com

15/Dec/2018

The kidney is one of the most important organs in our body. It is typically a two-shaped organ, located at the rear of the abdominal cavity in the retroperitoneal space. The Kidney’s are typically between 8-12 cm long .

What do your kidneys do for your body?

The Kidney performs several roles in your body. The essential functions are:
  • Getting rid of the toxins in your blood: The kidney does this by filtering your blood through the glomerulus. The glomerulus is a network of capillaries located at the beginning of a nephron in the kidney. Your kidney filters your blood, all day long, 24-hours a day.
  • Formation of blood: Another function of the kidney is that it produces erythropoietin (a variety of hormones) which is vital for your bones to make blood.
  • Activation of Vitamin D: The Kidney also activates Vitamin D which controls the calcium level in your blood.
  • Deposition of calcium: The Kidney regulates the deposition of the calcium in your bones.

How to keep your kidneys healthy

healthykidneysLike the majority of organs in our body, the kidneys are also susceptible to infections and tumors. Some of which include Nephrolithiasis (Kidney Stones), Pyelonephritis (infection of the kidney pelvis), Kidney Cancer and Diabetic nephropathy. However, to keep your kidneys healthy and free from infections, you should do the following:
  1. Eat healthily: As much as you can, ensure that you only take diets that are balanced and low in sodium (salt). Furthermore, avoid eating high protein foods.
  2. Drink water regularly: We recommend that you drink at least 1.5 – 2.5L of water or more every day.
  3. Quit smoking: It is also important to stop smoking if you wish to keep your kidneys healthy. Smoking has been shown to cause significant damage to the kidneys.
  4. Be careful of the medications you take: Certain medications can damage your kidneys. For instance, long-term use of NSAIDS (Nonsteroidal anti-inflammatory drugs) is very harmful to your kidneys. NSAIDS are anti-inflammatory medications that include ibuprofen and naproxen which can affect the flow of blood to your kidneys. You should also be careful of other medications like chemotherapeutic agents and contrast dyes that are used for most radiologic tests.
  5. Control your blood sugar: If you have diabetes, it is also imperative to keep your blood sugar controlled. This is because the higher your blood sugar, the more damage will likely occur to your kidney.
  6. Control your blood pressure: High blood pressure can damage the blood vessels in the kidneys. Thus, we advise you always to ensure that you keep your blood pressure below 135/85mmHg.
  7. Visit your physician regularly: We encourage you to visit your physician on a regular basis and get blood testing at least every six months.
IN A NUTSHELL All the things that we have discussed are important in keeping your kidneys healthy. So, make sure that you are drinking enough water, avoid cigarettes, and be careful of the medications that you take. Additionally, make it an obligation to visit your doctors on a regular basis and ask how your kidneys are doing. At FKP, we are always available to help you in keeping your kidneys healthy. Visit us at our physical offices and also don’t forget to check out our social media pages.  

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15/Dec/2018

REHC-Nephrologist, Dr. Parham Eftekhari, M.D. was on CBSMiami News talking about Synthetic Drug Fentanyl “The Florida House of Representatives passed a bill Thursday to add the drug fentanyl and other dangerous synthetic opioids to Florida’s drug trafficking statute, clearing the way for law enforcement and prosecutors to pursue stricter punishment against the sellers of the drugs, including felony murder charges in the case of an overdose death. Dr. Eftekhari believes people need to know that by taking these drugs they are playing Russian Roulette. He said people buying street level pills have no idea what’s in them.”
Dr. Efetkhari has dedicated a big part of his life to the fight against Synthetic Drugs and keeps doing this. Everything started with a patient that came to the office with Kidney issues and was close to death because of Synthetic Drugs intake. Thank you Dr. Parham Eftekhari for dedicating your life to keep everyone healthy. #rehcnephrologistparhameftekhari#rockstardoctorkeepingkidneyshealthy#nodrugskeepyourkidneyshealthy http://cbsloc.al/2osbptu

15/Dec/2018

Kidney Stones (also known as lithiasis or nephrolithiasis) is a disease that is characterized by the occurrence of a small, hard mineral deposits (called kidney stone) in the urinary tract. These materials are usually formed inside the kidney. Typically, kidney stones form when the urine is concentrated, thus, allowing the materials to crystallize and stick together. This disease is a common problem with more than 200,000 cases reported in the United States of America each year. As we have seen recently in the media, there has been an increased incidence of Kidney Stones, mainly in the teen population. This has been attributed to several factors like:
  • High intake of animal protein, sodium (salt) and refined sugars
  • Hereditary
  • Electrolyte problems
  • An underlying metabolic condition such as gout, diabetes, distal renal tubular acidosis, Dent’s disease and hypercalciuria (high calcium in the urine).
  • Continuous usage of certain medications or supplements
  • Obesity
  • Dehydration
The most important thing about Kidney Stones you should know is that they are preventable and treatable.

Kinds of Kidney Stonesstones

There are different kinds of Kidney Stones. The major ones include:
  • Calcium oxalate stones: This is the most common type of kidney stones. This stone is usually comprised of calcium and oxalate. About 90% of patients living with the Kidney Stones disease are reported to have the calcium oxalate. One unfortunate thing about the calcium oxalate stones is that they cannot be dissolved.
  • Uric acid stones: Uric acid stones usually form when the urine is too acidic. However, they can be dissolved with proper treatment.
  • Struvite stones: Struvite stones typically occurs when the urinary tract is infected with a special kind of bacteria which produces ammonia that builds up in the urine. This type of stones is usually composed of magnesium, ammonium and phosphate.

Symptoms of Kidney Stones

Typical symptoms of Kidney Stones include:
  • Flank pains that often radiate to the groin and the inner thigh
  • Restlessness
  • Abnormal urine rate
  • Persistent need to urinate
  • Hematuria (presence of blood in the urine)
  • Pain on urination
  • Nausea (feeling sick) coupled with vomiting

Diagnosis and Treatment of Kidney Stones

The most important thing to do is for you to determine if you have Kidney Stones and what kind of Kidney stones you have. Answering both questions will guide your therapy.  

 CONCLUSION

We encourage you to visit a nephrologist if you have at one time or the other experienced any of the symptoms listed above, or you have a family history of the Kidney Stones disease. Here in REHC, we treat and attend to those suffering from the Kidney Stones disease. Most importantly, we have the expertise for proper care and to avoid the disease from recurring in the future.

Copyright by Florida Kidney Physicians.