None of This Matters

Household tips I have learned via prepping the house for the wedding:                                                                 IMAG0208

1. Contact paper works well on bathroom windows for privacy.
2. Adhesive white board paper makes a good privacy screen on the shower door.
3. Trees and bushes cut back due to frost damage do grow back quickly.
4. Things break at the absolutely worst time: dishwasher, solar water heating panel, a/c.
5. None of this matters.

The most important one is #5.  We are preparing for one of the most special days for us – our wedding – and we’ll be married whether we discovered these things or not.

But I may not have been here for my wedding day if my Chronic Kidney Disease had not been discovered.  Once it was, I was given the tools to retard its progression and seemingly reverse it at times.

An even earlier discovery of my ckd would probably have been better. Okay, so I was seeing a Physician’s Assistant who wasn’t all that astute.  The readings were right there in my blood tests almost a year before I changed to a primary care doctor who actually cared.  I really liked the P.A. who had been taking care of me, but learned that liking a person doesn’t necessarily mean she is a good medical practitioner.

There are so many ifs here: If I had known earlier, could I have made sure my eGFR (estimated Glomerular Filtration Rate) didn’t dip as low as it was when I was finally diagnosed? If I had been seeing a doctor rather than a P.A. would she have caught the ckd earlier?  If the blood tests had been read carefully, would I have had the opportunity to get to work on preventing rapid progression in the decline of my kidneys?glomerulus

I will never know the answers to those questions, so – as #5 says – none of this matters … for me.  For you?  That’s another story.

Have you ever heard of KEEP?  That’s the Kidney Early Evaluation Program.  Notice the word ‘Early’ in the title. With ckd, the earlier you can detect the disease, the better. According to the National Kidney Foundation:

                            The goals of KEEP are to:

  • Raise awareness about kidney disease especially among “high risk” individuals
  • Provide free testing for people at increased risk for kidney disease
  • Encourage people “at risk” to visit a clinician and follow the treatment plan recommended
  • Provide educational information so that “at risk” individuals can prevent or delay kidney damage
  • Provide  clinician referrals for follow-up care, if needed
  • Provide ongoing information and support

You can read more about the program at: http://www.kidney.org/news/keep/KEEPabout.cfm

The KEEP Program is for all people, but the ‘high risk’ ones are the ones that may need to take immediate action.  What is ‘high risk’ you ask?

According to The National Kidney Center at: http://www.nationalkidneycenter.org/chronic-kidney-disease/risk-factors/  these are the high risk people:

“High risk groups for chronic kidney disease (CKD) include those with diabetes, hypertension and a family history of kidney disease. African Americans, Hispanics, Pacific Islanders, Native Americans and Seniors are also at increased risk.”

That definition covers quite a bit of ground.  For example, I have hypertension (high blood pressure) and am a Senior (Thank you for the capital letter, National Kidney Center!).  I don’t know if there’s any history of kidney disease in my family since the cousins my age don’t know of any, but our parents would never discuss their health with us.

Alright, so we need early detection.  Now, where can you find that?  On the home page of The National Kidney Foundation, there is an orange bar running across the page.  It has different pages on it. Hit the one that reads “Events.” Once you get to that page, scroll down and you’ll see the words, “Find a KEEP Screening Near You.”  Hit it. Voila!  You’ve found your local KEEP Screening.

The logical question here is, “What if there isn’t one near me?”  You don’t have to travel across state lines to find out if you have CKD.  Speak with your pcp (primary care doctor) and ask him or her to run a blood test and a urine test. While the results may not be crystal clear to a doctor who is not a nephrologist (kidney and hypertension specialist), high or low readings will be marked.  They will let your pcp know there may be a kidney function problem.bmp

The National Kidney Disease Education Program at The U.S. Department of Health and Human Services at http://www.nkdep.nih.gov/resources/kidney-disease-mean-for-me.shtml#results provides the following information and a really nifty diagram of reduced function kidneys for you:

1. A blood test checks your GFR, which tells how well your kidneys are filtering. GFR stands for glomerular filtration rate.

2. A urine test checks for albumin. Albumin is a protein that can pass into the urine when the kidneys are damaged. See picture below.

kidney function

If necessary, meaning if your kidney function is compromised, your pcp will make certain you get to a nephrologist promptly.  This specialist will conduct more intensive tests that include:

Blood:

BUN –

BUN stands for blood urea nitrogen. Urea nitrogen is what forms when protein breaks down.

Creatinine

Creatinine is a breakdown product of creatine, which is an important part of muscle

Urine:

Creatinine clearance

The creatinine clearance test compares the level of creatinine in urine with the creatinine level in the blood. Creatinine is a breakdown product of creatine, which is an important part of muscle.

Thank you to MedLine Plus, part of the U.S. National Library of Medicine,  National Institutes of Health at http://www.nlm.nih.gov/medlineplus/ency/article/003475.htm for the above information about the blood and urine tests.

Well if this blog isn’t enough to get you to check your kidney function, I just don’t know what is.The Table

Before I leave, European sales of the book are surpassing those of U.S. sales.  I don’t know if that means we have more access to specialists and information here or that Europeans are reading more. Do let me know if there is a practice that needs a book donated to it or needs books to use as prizes or give-aways at patient education sessions.

I’m forgetting the world outside of wedding prep and CKD!  Guten Pesach to those who celebrate Passover, which started last night, and a Happy Easter to those who will be celebrating that on Sunday.

Until next week,

Keep living your life!

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