Not All Stones Are Created Equal
In addition to calcium oxalate stones, another common type of kidney stones is uric acid stones. Red meat, organ meats, and shellfish have high concentrations of a natural chemical compound known as purines. High purine intake leads to a higher production of uric acid and produces a larger acid load for the kidneys to excrete, said Dr. Jhagroo. Higher uric acid excretion leads to lower overall urine pH, which means the urine is more acidic. The high acid concentration of the urine makes it easier for uric acid stones to form.
To prevent uric acid stones, cut down on high-purine foods such as red meat, organ meats, and shellfish, and follow a healthy diet that contains mostly vegetables and fruits, whole grains, and low fat dairy products. Limit sugar-sweetened foods and drinks, especially those that contain high fructose corn syrup. Limit alcohol because it can increase uric acid levels in the blood and avoid crash diets for the same reason. Eating less animal-based protein and eating more fruits and vegetables will help decrease urine acidity and this will help reduce the chance for stone formation.
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Six Steps To Controlling High Potassium
Everyone needs potassium. It is an important nutrient that helps keep your heart healthy and your muscles working right. But did you know that too much potassium can be dangerous, especially if you have kidney disease? It can cause a condition called hyperkalemia. The good news? There are steps you can take to help keep your potassium levels within normal range. If you think you are at risk for hyperkalemia, speak with your physician on ways to lower your potassium levels. Additionally, below are some things you need to know.
When Life Hands You Kidney Stones
And as the saying goes, make lemonade. Its important to consider dietary remedies alongside prescription medications.
Next time you drive past a lemonade stand, consider your kidneys. Chronic kidney stones are often treated with an alkali citrate, such as potassium citrate to help prevent certain stones, if urine citrate is low and urine pH levels are too low . Citrus juices do contain citrate , but large amounts might be needed. Also, be careful of sugar. Lemon juice concentrate mixed with water can be considered. Alkali citrate can be prescribed and is available over-the-counter. Alkali citrate can be given with a mineral, such as sodium, potassium or magnesium to help prevent stone formation. The aim is to increase urine citrate and increase urine pH . The goal is to keep pH in balance. Speak with a doctor or other healthcare professional about which treatment options are right for you, including over-the-counter products and home remedies. People with kidney disease may need to watch their intake of sodium, potassium or other minerals, depending on the stage of kidney disease or other factors
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Doctors Notes On Hyperkalemia
Hyperkalemia refers to the situation in which the blood level of potassium is abnormally high. An elevated level of potassium can have many causes. The main causes of a high potassium level are kidney problems or kidney failure, diseases of the adrenal gland, loss of potassium from inside of cells into the blood circulation, and taking certain medications.
In some cases, particularly with mild elevations of potassium, hyperkalemia does not produce symptoms . In other cases, signs and symptoms of hyperkalemia include fatigue, nausea, muscle weakness, or tingling feelings. More serious symptoms of hyperkalemia can include a decreased in heart rate and weak pulse. Severe hyperkalemia can lead to heart stoppage and death. A rapid elevation in potassium level is usually more dangerous than one that rises slowly over time.
The Causes Of High Potassium In The Elderly
When blood potassium levels exceed the normal range of 3.6 to 5.2 millimoles per liter, a condition called hyperkalemia develops. A high potassium level can lead to widespread muscle fatigue and weakness. If left untreated, it can cause muscle paralysis and potentially fatal problems with heart rhythm. Although anyone can develop hyperkalemia, the elderly are particularly at risk for high potassium levels.
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When Is Yes Really Yes
In a way, forever. These data will hold, no doubt indefinitely, as will the negative data concerning protein. Others may find differently among different people, in different places, with different techniques. But those who repeat what Curhan and Taylor did will almost certainly find what they found. If not, will ensue the scientific homologue of disagreement as to simple facts, thus calling for more repeated work that inevitably discloses some final consensus.
But what will inevitably fall is the idea underlying this study, that alkali protect against stones, acids promote stones, and the one can offset the other in other words, the mechanistic vision this work arises from. Given the history of science, these mechanistic visions of how nature does things rarely last but are as it were overlain by revelation presently unthought of.
Even so, while we wait for their inevitable demise, these two formulations have met various tests and remain viable explanations for what we can observe. This makes them useful, still, as generators of new research.
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Cardiac And Skeletal Muscle Effects
High levels of potassium cause abnormal heart and skeletal muscle function by lowering cell-resting action potential and preventing repolarization, leading to muscle paralysis. Classic ECG findings begin with tenting of the T wave, followed by lengthening and eventual disappearance of the P wave and widening of the QRS complex. However, varying degrees of heart block are also common.
Just before the heart stops, the QRS and T wave merge to form a sinusoidal wave.
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Eating For High Potassium
If you learn that you have high potassium, your doctor might suggest that you change your diet to take in less potassium.
Talk to your doctor or dietitian about how much potassium you should have and how you can control how much potassium you eat. Your dietitian can recommend foods that are low in potassium that you can eat instead of foods that are high in potassium.
Follow these tips to keep your potassium at the right level:
- Avoid salt substitutes because they are usually high in potassium.
- Do not forget about drinks. Many fruit juices, like orange and tomato, have high potassium. Potassium can also be found in other drinks including coconut water.
- Pay attention to serving sizes. Use measuring cups and measuring spoons to make sure you know how many servings you are eating or drinking. Remember that if you eat two servings of a food with potassium, you are eating twice as much potassium!
To manage your potassium intake, you need to know how much potassium is in your food and drinks.
Plan ahead if you know you will be eating a meal that is high in potassium. For example, if you are going out for dinner and you know your meal will be higher in potassium, or you know that it will be hard to measure how much potassium is in your meal, plan to eat meals that are low in potassium for breakfast and lunch.
Medication To Reduce Cholesterol
Studies have shown that people with CKD have a higher risk of cardiovascular disease, including heart attacks and strokes. This is because some of the risk factors for CKD are the same as those for heart attacks and strokes, including high blood pressure and high levels of cholesterol in the blood .
Statins are a type of medication used to lower cholesterol levels. Cholesterol causes narrowing of the arteries that can lead to a blockage of the blood supply to the heart or the brain . Statins work by blocking the effects of an enzyme in your liver , which is used to make cholesterol.
Statins sometimes have mild side effects, including:
Occasionally, statins can cause muscle pain, weakness and tenderness. If you experience any of these symptoms, contact your GP. You may need to have a blood test or change your treatment.
If you have kidney disease, you may be asked to reduce your daily fluid and salt intake. You may develop a build-up of fluid as your kidneys will not be able to get rid of fluid as well as they did before.
If you are asked to reduce the amount of fluid you drink, you must also take into account fluid in foods, such as soup and yoghurt. Your GP or dietitian can advise you about this.
The excess fluid that occurs as a result of kidney disease often builds up in your ankles or around your lungs. You may also be given diuretics , such as furosemide, which will help get rid of the excess fluid from your body.
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What Are The Symptoms Of Hyperkalaemia
Although hyperkalaemia itself doesn’t usually have any obvious symptoms, you may notice some of the effects such as:
- Feeling very tired or weak
- Stomach pain or nausea
- Weakness in the arms and/or legs
- Unusual heartbeat or chest pains
These symptoms may develop slowly over several months. However, if you have CKD and are receiving dialysis, the symptoms can develop very quickly over just a few days. Talk to your doctor if you have any concerns.
How Is Hyperkalemia Managed Or Treated
Treatment varies depending on the potassium level. Options include:
- Diuretics: Also called water pills, these drugs make you pee more often. Your body gets rid of potassium mainly in urine.
- Intravenous therapy: Extremely high potassium levels need immediate treatment. Youll receive an IV infusion of calcium to protect your heart. Next, you get an infusion of insulin that helps move potassium into the blood cells. You may also inhale an asthma medication called albuterol to further lower potassium levels.
- Medication management: Many people see improvement after stopping or changing certain blood pressure medications or other drugs that raise potassium levels. Your healthcare provider can determine what medication changes to make.
- Potassium binders: A daily medication binds to excess potassium in the intestines. You pass the potassium when you poop. Your provider may recommend binders if other treatments dont lower potassium levels. Potassium binders come in oral and enema form.
- Dialysis: If potassium levels remain high, or you experience kidney failure, you may need dialysis. This treatment helps your kidneys remove excess potassium from blood.
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How Is Hyperkalemia Diagnosed
Because most people dont have symptoms, you might not know you have high potassium until you get a routine blood test. A serum potassium test measures potassium levels in blood. Your healthcare provider may also order an electrocardiogram . This test shows changes in heart rhythm caused by hyperkalemia.
What Consult Service Or Services Would Be Helpful For Making The Diagnosis And Assisting With Treatment
If you decide the patient has renal disease, what therapies should you initiate immediately?
The general approach to the treatment of kidney disease includes the following steps. A nephrologist can be helpful at any point in this approach and is particularly helpful when a biopsy is required.
Attempt to identify the cause of the disease noninvasively.
Identify what therapies can be initiated empirically.
Observe the impact of these empiric therapies on urine protein excretion and serum creatinine.
If empiric therapies fail to achieve the desired result , kidney biopsy should be considered to identify the histology of the kidney disease for more specific therapy.
For a person with glomerular disease, the amount of protein in their urine should be used as an intermediate outcome. Instituting therapies with a goal of reducing proteinuria is a key concept in the therapy of glomerular disease. Following the institution of such therapies , a reduction in the quantitative level indicates therapeutic success. Therapies should be titrated up to suppress the proteinuria to the lowest degree possible. It is generally felt that suppression of an elevated urine protein excretion to 1g or less is associated with better kidney survival.
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How The Kidneys Work
The kidneys are like the body’s garbage collection and disposal system. Through microscopic units called nephrons, the kidneys remove waste products and extra water from the food a person eats, returning chemicals the body needs back into the bloodstream. The extra water combines with other waste to become urine, which flows through thin tubes called ureters to the bladder, where it stays until it exits through the urethra when someone goes to the bathroom.
The kidneys also produce three important hormones:
- erythropoietin, which stimulates the bone marrow to make red blood cells
- renin, which helps regulate blood pressure and
- the active form of vitamin D, which helps control the calcium balance in the body and maintain healthy bones.
Kidney failure, which is also called renal failure, is when the kidneys slow down or stop properly filtering wastes from the body, which can cause buildups of waste products and toxic substances in the blood. Kidney failure can be acute or chronic .
How Does Ckd Affect Other Nutrients
A person with CKD may be less tolerant of high sodium levels in their body. A high sodium diet can cause a large amount of fluid in the body, which can result in symptoms of swelling or shortness of breath. Doctors typically use drugs called diuretics to treat these symptoms.
People with CKD also tend to retain more hydrogen in their body.
In the body, hydrogen ions act as acids. If the kidneys are not working properly, there will be higher levels of hydrogen ions in the body. Doctors refer to this as metabolic acidosis. Individuals with metabolic acidosis may require bicarbonate supplements.
The inability of the kidneys to filter blood effectively can result in higher levels of phosphate and lower levels of calcium. This imbalance can cause bone weakness and increase the risk of heart disease and stroke.
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What About Peanut Butter And Other Nut Butters
Now that weve gone over potassium in nuts, what about potassium in peanut butter, almond butter, and other nut butters?
These are packaged foods, meaning there is some processing that occurs when making these delicious spreads. It doesnt mean they need to be avoided!
What it does mean is that there can be additives like phosphorus, potassium, sodium, and even sugar to watch for.
There are plenty of other nut butters, and they can easily be made at home! The nutrition information on these other nut butters is still limited as potassium has only recently been added to the nutrition information requirements.
This Kevala cashew butter* has just 164 milligrams of potassium per 2 tablespoon serving.
Nomz hazelnut butter* has 6% DV of potassium per 2 Tbsp serving.
The pecan butter from Purely Pecans* has 135 milligrams of potassium per 2 Tbsp serving.
Treating Chronic Kidney Disease
There is no cure for chronic kidney disease, although treatment can slow or halt the progression of the disease and can prevent other serious conditions developing.
People with CKD are known to have an increased risk of a heart attack because of changes that occur to the circulation.
In a minority of people, CKD may cause kidney failure, also known as established renal failure or end-stage kidney disease. In this situation, the usual functions of the kidney stop working.
To survive, people with ERF may need to have artificial kidney treatment, called dialysis, or a kidney transplant.
Read more about treating chronic kidney disease
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How Is Hyperkalaemia Diagnosed
Hyperkalaemia is diagnosed by a blood test that measures the potassium levels in your blood. If your nurse or doctor is worried about your potassium level, they may suggest that you have an electrocardiogram . This is a test that can be used to check your heart’s rhythm and electrical activity. Patches are stuck to your skin to record the electrical signals produced by your heart each time it beats. A high potassium level can cause changes to your heart rhythm that can be seen on ECG.
Why Does It Happen
The kidneys are 2 bean-shaped organs, the size of your fist. They’re located on either side of the body, just beneath the ribcage. The main role of the kidneys is to filter waste products from the blood before converting them into urine. The kidneys also:
- help maintain blood pressure
- maintain the correct levels of chemicals in your body which, in turn, will help heart and muscles function properly
- produce the active form of vitamin D that keeps bones healthy
- produce a substance called erythropoietin, which stimulates production of red blood cells
Chronic kidney disease is the reduced ability of the kidney to carry out these functions in the long-term. This is most often caused by damage to the kidneys from other conditions, most commonly diabetes and high blood pressure.
Read more about the causes of chronic kidney disease
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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.
Causes Of Acute Kidney Injury
Most cases of AKI are caused by reduced blood flow to the kidneys, usually in someone who’s already unwell with another health condition.
This reduced blood flow could be caused by:
- low blood volume after bleeding, excessive vomiting or diarrhoea, or severe dehydration
- the heart pumping out less blood than normal as a result of heart failure, liver failure or
- certain medicines that reduce blood pressure or blood flow to the kidneys, such as ACE inhibitors, certain diuretics or NSAIDs
AKI can also be caused by a problem with the kidney itself, such as inflammation of the filters in the kidney , the blood vessels , or other structures in the kidney.
This may be caused by a reaction to some medicines, infections or the liquid dye used in some types of X-rays.
It may sometimes be the result of a blockage affecting the drainage of the kidneys, such as:
A doctor may suspect AKI if you:
- are in an “at risk” group and suddenly fall ill
- get symptoms of AKI
AKI is usually diagnosed with a blood test to measure your levels of creatinine, a chemical waste product produced by the muscles.
If there’s a lot of creatinine in your blood, it means your kidneys are not working as well as they should.
You may also be asked to give a pee sample.
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