It’s National Kidney Month

Hello, hello, and a belated welcome to National Kidney Month. This year, for a change, I decided to go to a non-medical site for a clear explanation of what this month is. The entire blog [except my introduction, of course.] is from National Today, a site committed to which celebrations are on which day[s]:

“March is dedicated to National Kidney Month. The kidneys, two bean-shaped organs located in the back of the abdomen, perform crucial functions to filter out toxins, produce red blood cells, and regulate pH. They filter about half a cup of blood every hour, creating urine from harmful and unnecessary waste.

When kidneys fail to function properly, waste builds up in the blood and leads to a weakened system and a host of problems like anemia, nerve damage, and high blood pressure. Chronic kidney disease(CKD) affects more than 1 in 7 American adults and is the 9th leading cause of death in the U.S.

HISTORY OF NATIONAL KIDNEY MONTH

National Kidney Month, observed every March, brings awareness to kidney health and encourages people to support kidney disease research and take steps to keep their own kidneys safe and healthy. 

Kidneys filter blood, make urine, and produce the red blood cells that carry oxygen through your body. These vital organs also control blood pressure and produce vitamin D to keep bones strong.

Malfunctioning kidneys can lead to painful kidney stones and infections that, left untreated, require a transplant. Some pre-existing conditions, like high blood pressure and diabetes, put you at increased risk for kidney disease. 

Chronic Kidney Disease(CKD) affects almost 40 million American adults. In 2016, three-quarters of a million people in the U.S. required dialysis or a kidney transplant. Dialysis and kidney transplants, the only treatment options for severe kidney failure, are difficult, expensive, and not always available. Patients seeking new organs may not always get them in time to survive; in the U.S., twelve people die each day waiting for a kidney.

To prevent kidney disease, the National Kidney Foundation recommends taking proactive steps to keep your kidneys healthy and prevent the onset of CKD. You can protect your kidneys by managing high blood pressure, making healthy food and drink choices, and reducing stress. 

The National Kidney Foundation grew out of a mother’s determination to further research into treatment for kidney conditions. When her infant son was diagnosed with nephrosis, Ada DeBold started the Committee for Nephrosis Research to organize efforts to find treatments and connect patients and doctors. DeBold continued crusading for the organization, which eventually became the National Kidney Foundation. The Foundation conducts fundraising to support important research into the treatment and prevention of kidney disease.

NATIONAL KIDNEY MONTH TIMELINE

1984

National Organ Transplant Act Passes

The NOTA establishes the National Organ Procurement and Transplantation Network, which maintains an organ matching registry to address organ shortages and streamline the donation process.

1954

First Successful Kidney Transplant

The first successful kidney transplant is performed between two identical twins in Boston.

1943

Dialysis Invented

Dutch doctor Willem Kolff invents the ‘artificial kidney’ to clean the blood of kidney failure patients.

1902

Animal Experiments

The first successful kidney transplants in animals are performed at the Vienna Medical School.

NATIONAL KIDNEY MONTH FAQS

What month is National Kidney Month?

National Kidney Month is observed annually during the month of March.

Is there a ribbon for kidney disease?

Kidney Disease Awareness is symbolized by the color green. Purchase green ribbons, green wristbands, or green magnets directly from a Kidney Disease Awareness non profit in order to help raise funds for treatments.

What are the symptoms of chronic kidney disease?

Symptoms include difficulty urinating or less urine, sweeping in the extremities, shortness of breath, nausea, and feeling cold and tired. If you experience chronic symptoms that you suspect are related to kidney function, consult your physician.

HOW TO OBSERVE NATIONAL KIDNEY MONTH

1. Join the organ donor registry

Most organ donations come from deceased people. Register to be an organ donor when you die and your healthy organs and tissue can save dozens of lives.

2. Donate to a kidney non-profit

Non-profit organizations do the important work of raising awareness about kidney disease, providing resources and assistance to patients, and connecting patients, doctors, and donors.

3. Be good to your kidneys

Are you keeping your kidneys healthy? Aim for a lower intake of sodium and sugars, more whole grains and low-fat dairy, and regular exercise to reduce your risk of kidney disease, high blood pressure, diabetes, and other diseases.

5 FASCINATING FACTS ABOUT KIDNEYS

1. You only need one kidney to live

Although you’re born with two kidneys, each of which have about 1.5 million blood-filtering units(nephrons), you only need about 300,000 nephrons to filter your blood properly.

2. Your kidneys are lopsided

The right kidney is slightly smaller and sits lower than the left to make room for another important organ, the liver.

3. You can drink too much water

This can cause a condition called hyponatremia, which, though not common, can damage the kidneys.

4. Sausage casing and orange juice cans

Willem Kolff, who invented the first artificial kidney that led to today’s dialysis technology, used sausage casings, orange juice cans, and a washing machine to create a rudimentary blood cleaning mechanism.

5. Climate change may increase kidney disease

As parts of the world get warmer, the dehydration that leads to kidney disease is likely to rise among manual laborers.

WHY NATIONAL KIDNEY MONTH IS IMPORTANT

1. It reminds us to be good to our bodies

Make sure you take care of your body and your vital internal organs so they can continue taking care of you.

2. It’s a chance to express gratitude for our health

If you have fully functional kidneys, be grateful! Take a minute to feel gratitude for all the internal organs that do the invisible, daily work of keeping us alive.

3. It shows that science is awesome

Just a few decades ago, kidney disease could mean a death sentence. Today, although it’s still a serious and frightening illness, we can often fight off kidney failure with dialysis and organ transplants.”

Many thanks to National Today  for their simple, straight forward explanation of National Kidney Month.

Until next week,

Keep living your life!

Now There’s Long Covid

Back in 2021, I wrote a bit about Covid. It’s even on Spotify as a podcast. But now, we have Long Covid. I thought it was time to write about that, but doubted there was much research. Boy, was I wrong! Of course, I only wanted to write about Long Covid and chronic kidney disease. Again, I thought narrowing the topic would leave me with little research. Again, I was wrong.

Let’s start at the beginning. Although Covid has been our constant companion for a bunch of years, let’s see exactly what it is [other than possibly fatal, that is]. If you remember way back in 2019, It was called Covid-19. The 19 refers to the year: 2019. Now for the covid part. That was originally referred to as Coronavirus Disease. It was cleverly shortened to: Co for Corona; Vi for virus; D for disease. Notice I am not citing any sources here. That’s because this is from my memory. I hope I got it right.

So, how did Covid begin? According to Northwest Medicine:

“Though initially discovered in Wuhan, China, in late 2019, COVID-19 entered the conversation in the U.S. in January 2020, when the Centers for Disease Control and Prevention (CDC) alerted the nation of the outbreak abroad. Later that month, the first national case of COVID-19 was reported in the state of Washington; by January 24, the virus had made its way to Chicago.

The outbreak escalated quickly from there, during a period of uncertainty about how the virus was transmitted, how quickly it could spread and how much of a threat it was to public health.

By March 2020, the World Health Organization (WHO) had declared COVID-19 a global health emergency and named the virus ‘severe acute respiratory syndrome coronavirus 2’ or ‘SARS-CoV-2.’ It was also in March that WHO officially declared the COVID-19 outbreak a pandemic.”

But now we have Long Covid. What is that? The American Medical Association [AMA] tells us:

“Most people recover from SARS-CoV-2, the virus that causes COVID-19, within a couple of weeks, but others may experience new or lingering symptoms, even after recuperating from COVID-19. Although, there is no universal clinical case definition for these lingering symptoms the CDC labels long COVID, also known as post-COVID conditions, as a wide range of new, returning or ongoing health problems people can experience four or more weeks after first being infected with SARS-CoV-2.”

Well, how does Covid affect the kidneys. I turned to Johns Hopkins Medicine for the possible answer:

“The impact of COVID-19 on the kidneys is complex. Here are some possibilities doctors and researchers are exploring:

Coronavirus might target kidney cells

The virus itself infects the cells of the kidney. Kidney cells have receptors that enable the new coronavirus to attach to them, invade, and make copies of itself, potentially damaging those tissues. Similar receptors are found on cells of the lungs and heart, where the new coronavirus has been shown to cause injury.

Too little oxygen can cause kidneys to malfunction

Another possibility is that kidney problems in patients with the coronavirus are due to abnormally low levels of oxygen in the blood, a result of the pneumonia commonly seen in severe cases of the disease.

Cytokine storms can destroy kidney tissue

The body’s reaction to the infection may be responsible as well. The immune response to the new coronavirus can be extreme in some people, leading to what is called a cytokine storm.

When that happens, the immune system sends a rush of cytokines into the body. Cytokines are small proteins that help the cells communicate as the immune system fights an infection. But this sudden, large influx of cytokines can cause severe inflammation. In trying to kill the invading virus, this inflammatory reaction can destroy healthy tissue, including that of the kidneys.

COVID-19 causes blood clots that might clog the kidneys

The kidneys are like filters that screen out toxins, extra water and waste products from the body. COVID-19 can cause tiny clots to form in the bloodstream, which can clog the smallest blood vessels in the kidney and impair its function.”

We need a definition of Long Covid before we continue.

“Long COVID, also known as Post-COVID Conditions (PCC), refers to the wide range of symptoms and conditions that some people experience four or more weeks after an initial infection by SARS-CoV-2, the virus that causes COVID-19. The symptoms and conditions, which may last for weeks, months, or years, can be persistent (meaning they developed during an acute COVID-19 illness and haven’t gone away), recurrent (meaning they may go away after the initial illness then return), or new (meaning they were not present initially but developed later).”

Thank you to Yale Medicine for the definition .

And CKD? What’s the connection with Long Covid? The National Institutes of Health’s The National Center for Biotechnology Information tells us:

“There is a bidirectional relationship between chronic kidney disease and COVID-19 disease. Chronic kidney diseases due to primary kidney disease or chronic conditions affecting kidneys increase the susceptibility to COVID-19 infection, the risks for progression and critical COVID-19 disease (with acute or acute-on-chronic kidney damage), and death. Patients who have survived COVID-19 face an increased risk of worse kidney outcomes in the post-acute phase of the disease. Of clinical significance, COVID-19 may predispose surviving patients to chronic kidney disease, independently of clinically apparent acute kidney injury (AKI).”

There is so much more information about CKD and Long Covid that I urge you to go to each of the links and poke around on that website. It’s amazing how much, yet how little, is known about Long Covid.

Let me leave you with this succinct information from the National Library of Medicine:

“… COVID-19 can directly infect kidney cells and induce cell injury with subsequent fibrosis [Gail here: that’s scarring.] …. data may explain both acute kidney injury and transition to chronic kidney disease in long-COVID-19.”

You couldn’t be more clear if your life depended on it… and it just might.

Until next week,

Keep living your life!

There is a Difference, You Know

I usually write the blog on Friday since that’s the quietest day of the week in my house. Not this week, though. Bear had doctors’ appointments in two different offices. That sort of blew the day for us since we had lunch in-between and I’m just no good after 3:30. My brain and my body seem to shut down then. 

Photo by Andrea Piacquadio on Pexels.com

More often than not, I don’t know what I’m going to write about until I wake up that morning. I have not only the topic in my mind then, but also the opening paragraphs. I hadn’t realized how lucky I am to have this sort of, well, magic until I started talking with other writers about it. 

Today is all about diabetes. Here’s why: Last May, I wrote about CGM or Continuous Glucose Monitor. This sentence is from that blog: 

“The fluid mentioned in discussing the CGM is not your hemoglobin, but your blood serum.”  

I remember being surprised and wondering what the difference was. Today, we find out. How about a few definitions first? 

Blood serum – “the clear yellowish fluid that remains from blood plasma after clotting factors (such as fibrinogen and prothrombin) have been removed by clot formation” [Merriam-Webster Dictionary] 

Continuous Glucose Monitor – “Continuous glucose monitoring (CGM) devices help you manage Type 1 or Type 2 diabetes with fewer fingerstick tests. A sensor just under your skin measures your glucose levels 24 hours a day. A transmitter sends results to a wearable device or cell phone. It takes time to learn how to use CGM, but it can help you more easily manage your health.” [Cleveland Clinic] 

Hemoglobin – “Hemoglobin is an iron-rich protein in red blood cells. Oxygen entering the lungs attaches to hemoglobin in the blood, which carries it to tissues in the body.” [MedicalNewsToday] 

I like how I got to use my favorite dictionary of all time just now. Back to CGMs. I stumbled across a manufacturer’s site that explained quite a bit about CGMs. I am not endorsing the product, but am thankful for Medtronic’s explanation: 

“Your sensor glucose (SG) readings are taken from your interstitial fluid, and not from your blood, like fingersticks. Interstitial fluid is the fluid that surrounds the cells of your tissue below your skin, and usually glucose moves from your blood vessels and capillaries first and then into your interstitial fluid. It’s helpful to think about it like a rollercoaster where the front car is the blood glucose (BG) and the car in the back is the sensor glucose (SG): 

When on the rise, the BG value is greater than the SG that follows behind it. But when moving down the tracks, the BG in front is now less than the SG value. 

A few points to remember when using CGM with your MiniMed® 530G with Enlite® [Gail here – I’m guessing this holds true for other CMGs, too, since it makes sense. Also, the picture is of my Libre Freestyle 2, not a MedTronic product.]: 

SG and BG readings will rarely match and are expected to be different 

A greater difference between SG and BG will be seen when your glucose is changing quickly, such as after eating or after taking a bolus of insulin 

And most importantly, always confirm with your BG value before deciding to correct a high or treat a low glucose 

Here’s A Tip: Knowing the direction and speed of your glucose changes will be more useful than focusing on individual BG or sensor readings. When using continuous glucose monitoring (CGM) trends are the key. In fact, seeing trends and patters in your glucose is likely one of the primary reasons you started using CGM therapy. Trends highlight the direction that your sensor glucose readings are moving and the speed at which they are changing. Fingerstick blood glucose readings and sensor glucose readings are only snapshots of your glucose at that very moment. Trends can tell you if your glucose has been rising, falling, or appears to have been stable over several minutes, hours, and even the day. 

So it’s important not to focus too much on the individual sensor glucose numbers (as it is likely to be different from your BG meter reading) and more on trends and patterns in your glucose levels.” 

NewsMedicalLifeSciences has an interesting bit of information for us: 

“Whole blood and serum blood glucose is often different. Red blood cells have higher concentration of protein than serum and serum has higher water content and more dissolved glucose than whole blood. To obtain blood glucose in serum from figures in whole blood, it is multiplied by 1.15.” 

Between pre-diabetes and diabetes type 2, I’ve been in the diabetes world for years. Yet, no one – nephrologist, PCP, nor endocrinologist – has ever mentioned this to me. You’d think at least the endocrinologist would. 

I also find it interesting that I’d never been told about the 5-10 minute delay in accurately reporting serum blood glucose. What 5-10 minute delay, you ask. Whoops, I neglected to explain it, didn’t I? No problem. ResearchGate can do that for us: 

“This delay is the consequence of the process of glucose diffusion across the walls of capillary vessels and through the interstitial space to the sensor. This process requires some time, and the delay can be observed during both rising and decreasing BG values, probably with varying impact.” 

The National Institutes of Health offer a succinct summary of the advantages and disadvantages of serum blood glucose testing: 

“Advantages: In patients requiring insulin therapy (both type 1 diabetes and in patients with type 2 diabetes requiring intensive insulin therapy and or sulfonylureas, flash monitoring has been demonstrated to be cost-effective when compared to CBG self-monitoring of blood glucose (SMBG). Interstitial glucose measurements are recorded as frequently as every 5 minutes every hour, which has the benefit of monitoring for hypoglycemia during sleep at night. 

Disadvantages: Glucose is first seen in blood before it is seen in the interstitial fluid, which the CGM measures hence may not always be a reliable indicator in rapidly changing blood glucose levels. The high cost of sensors and machines (approximately $5000 per annum) may not make this a viable option in economically less advantaged clients and communities where health care is not subsidized by insurance or the government.” 

As for me, I’m glad not to have those finger pricks anymore. I’m only human, after all. 

Until next week, 

Keep living your life!