Chronic Kidney Disease Can Cause Anemia

If you look pale, feel tired most of the time, have poor appetite, have trouble sleeping or have decreased energy throughout the day, chances are you have anemia, which is the condition of having reduced blood cells in the body.
While anemia can be caused by numerous factors like HIV, cancers, systemic lupus erythematosus, too little iron or blood loss from an accident or poor diet, a Chronic Kidney Disease can also be an underlying cause for this medical condition. The kidneys make a hormone called erythropoietin (EPO) which tells your body to make the red blood cells. If the kidneys are damaged it cannot make EPO causing the red blood cell count to drop. Most people with kidney diseases develop anemia and this is more common if the patient is at stage 3 or 4 (moderate or severe loss of kidney functions) and stage 5 (kidney failure).
If you have CKD and would like to know if you have developed anemia you need to take a blood test at least once a year to measure your hemoglobin level. Hemoglobin is part of the red blood cells that carry oxygen throughout the body. Normal hemoglobin level for men is 13.5 and for women it is at 12.0. If your blood test result shows that you have lower than normal range then it is an indicator for anemia. You need to talk to your doctor for a treatment plan.
If the anemia is caused by a CKD, the treatment will involve erythropoiesisstimulatong agents or ESAs to help the body create red blood cells. It is usually given through subcutaneous injection (under the skin) at the doctor's office. Your doctor will prescribe enough ESA to increase your hemoglobin to normal range. Just how much you need and how often you get the treatment depends on the following: current hemoglobin level; your response to the ESA treatments; and the ESA type you're receiving (short-acting ESA or long-lasting ESA). To know if you are responding to the ESA treatments, your doctor will conduct a monthly hemoglobin test and increase or decrease the dose depending on the test results.

Another component needed for making red blood cells is iron, which is especially needed during ESA treatments. Iron may be taken orally as a pill or administered into the vein at the doctor's office. During ESA treatments the body uses up iron faster which means you need extra iron. There are two tests that will help you find out if you have enough iron: transferring saturation (TSAT) and ferritin tests. Your TSAT should be at least 20% and your ferritin should be at least 100 ng/ml. If you are receiving treatments for anemia with ESA be sure to get your iron tested on a monthly basis
Iron-rich foods as well as those high in vitamin B content and folic acid may be helpful to patients with anemia. A dietician can help you with a meal plan to ensure that your diet is on track.
Left untreated, anemia can lead to serious complications like the left ventricular hypertrophy (LVH), a heart disease. Many people with CKD develop LVH long before reaching stage 5 of the kidney disease, and sadly die from it. This is why early detection of anemia and its treatment is very important for patients diagnosed with kidney diseases.

By Oankar Kundan

4 Methods For Kidney Stone Removal

Kidney stone removal has four procedures/methods:

1. Extracorporeal Shockwave Lithotripsy (ESWL)

Kidney stone removal of ESWL uses non-electrical shock waves that are produced out of the body to pass through the skin and body tissues until the shockwaves hit the solid stones. The stones turn out to be sand-like and are passed.

For removal of this procedure, patient acre located in a tub of warm, purified water or onto water cushion machine that operates as a means for passing on these non-electrical shockwaves.

2. Percutaneous Nephrolithotomy (PNL)

Different from removal method mentioned above, Percutaneous nephrolithotomy is regularly utilized when the stone is very large or in a place that does not permit effectual use of ESWL.

In this procedure of kidney stone removal, the surgeon makes an insignificant incision in the back and makes a tunnel immediately into the kidney. By means of an instrument called a nephroscope, the stone is positioned and removed. For large stones, an energy probe (ultrasonic or electrohydraulic) perhaps required to break down the stone into smaller pieces for removal.

The benefit of this procedure over lithotripsy is the physical removal of the stone fragments rather than relying on their natural passage from the kidney to the outside.

3. Ureteroscopic Stone Removal

Ureteroscopic stone removal is accomplished by passing a small fiberoptic instrument (an ureteroscope) through the urethra and bladder into the ureter. The surgeon afterward locates the stone and either removes it with a cage-like tool or breaks it with a particular instrument that creates a form of shockwave. A small tube (or stent) possibly left in the ureter for more than a few days after treatment to assist the lining of the ureter to heal.

This removal procedure is operated under common anesthesia to treat stones found in the middle and lower ureter. Small stones are removed and large stones are broken by a laser or similar device.

4. Open (incisional) Surgery

This last removal method includes opening the affected area and removing the stone(s). In this procedure, run in an operating room after a person has been given anesthesia, the surgeon creates an incision in the skin and unlocks the pelvis of the kidney or the ureter in order that the stone can be manually removed. Since open surgery is a principal operation, healing may need four to six weeks.

By MC Raflesia