Friday, November 22, 2013

High serum creatinine, diabetes, high blood pressure. what can i do?

There are 3 key steps to controlling glucose levels for pre diabetes:
1) EXERCISE- Walking is fine but Nordic Walking is Great. Exercise also lowers Glucose levels , lowers Cholesterol and lowers Blood Pressure. Google it.Exercise is Non-Negotiable !!!Thats why it is Number 1 on the list.
2) Knowledge- http://www.kidneyservicechina.com/  This is a great site for info
3)Diet- A low carb diet is in order. I can't count carbs so I use Mendosa's Glycemic Index Diet. Great for the whole family. http://www.mendosa.com/gilists.htm
Early chronic renal insufficiency (Stages 1 to 2)
Physical symptoms. Usually few or no physical symptoms that you can feel (other than those you may experience if you have heavy proteinuria).
Blood work. Blood work results will show abnormalities - mainly a slightly elevated serum creatinine. Note that there is often a time lag between elevations of serum creatinine, and some progression of the IgAN. By the time serum creatinine is elevated, the person may already have lost 50% of kidney function.
Urinalysis. Urine will show abnormalities. Urine can be checked by dipstick in the doctor's office (as an initial check), and followed up with a more complete urinalysis. The main urine abnormality that will suggest a kidney disease is the presence of protein and/or blood. Either will usually trigger further investigation. However, blood and/or protein in the urine doesn't say anything about actual kidney function.
Treatment. Treatment may involve some mild dietary changes (a lower protein diet may in some cases be recommended), and a blood pressure medication may be prescribed (usually of the ACE inhibitor class, the angiotensin II receptor class, or both, even if blood pressure is not really elevated much).
Blood pressure. Some people start having high blood pressure even in early chronic renal failure. IgAN is one kidney disease that can do this.
Anemia. Anemia may rarely occur at this stage. In this case, it is most often caused by having heavy proteinuria rather than actual chronic renal insufficiency.
Treatment
Diet. Dietary changes may be ordered (renal diet: low protein, low potassium, low phosphorus, low sodium, higher calorie)
Medication
High blood pressure medications. It's common to need more than one at this stage, and often 3 or more.
Other drugs/supplements. May be prescribed if needed, such as vitamin D analog (calcitriol is a common one), renal vitamins (not a regular multi-vitamin, as these contain too much vitamin A for the typical advanced renal insufficiency patient). Drugs for controlling heavy proteinuria if necessary (note that heavier proteinuria does not automatically follow with more advanced chronic renal insufficiency).

Phosphorus binder. You may be asked to begin taking a calcium supplement with meals as a phosphorus binder (or a medication may be prescribed instead of or in addition to calcium).

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