Posts Tagged ‘Kidney Function’

Blood Disorders That Can Affect Patients with Lupus

Comments: 0December 27th, 2010 by admin



It was shown that, even if it seems hard to believe, the initial signs of lupus may appear in the blood, a blood disorder can be the first sign that comes in patients having systemic lupus erythematosus.Systemic lupus erythematosus can show hematological symptoms like anemia, thrombocytopenia, low white blood cell counts and clotting disturbances. That is why, specialists in disorders of the blood can be of real help.

One of the most usual hematological abnormalities that can appear in persons having lupus is anemia. Anemia consists in a reduction in the number of red blood cells and it is recognized by some tests, such as, the hemoglobin concentration in blood, the hematocrit and the red blood cell count.It is known that anemia can have many causes, and in what concerns persons with lupus, anemia can appear because of a chronic inflammation, iron deficiency, prolonged uremia or hemolytic anemia. It is also known that fatigue, which is suffered by many patients having lupus can contribute to the apparition of anemia.

Prolonged uremia, which appears because of an impaired kidney function can lead to anemia. Anemia caused by prolonged uremia can be treated with androgens or erythropoietin, a recently developed hormone having role in the stimulation of red cell production. Sometimes, chronic uremia can determine the apparition of more severe forms of anemia, and that requires blood transfusions.

Prolonged inflammation, which is an important cause of anemia in patients that have lupus, hinders the production of red blood cells by the bone marrow. Because of this inflammation, iron, which is very important in the production of hemoglobin accumulates unused in the marrow tissue. The solution to restore normal red blood cell production is to ease the inflammatory condition.

Iron deficiency is another cause of anemia that can appear because of the blood loss from the body. Drugs that are used in the treatment of lupus can irritate the stomach and produce bleeding and from there results iron-deficient anemia. Iron deficient can become also women that have heavy or frequent menstrual periods.Anemic patients should take some tests for blood loss from the stomach or intestines. It is important to do that, because the source of bleeding must be found and treated.Iron deficient anemia can be corrected in a short time by taking iron tablets.

Hemolytic anemia is a condition that can appear in some people with lupus, usually due to antibodies directed against red blood cells. In this condition, auto-antibodies interact with the red blood cells, and the result is that the red blood cells are removed in the spleen or liver by scavenger cells.Usually, steroids like Prednisone are effective into treating this type of anemia, but there are cases of patients that do not respond to the treatment, and surgical removal of the spleen may be required. Also in severe cases, it is needed a blood transfusion.It is known that a deficiency of thrombocytes, which are tiny particles in the blood, essential for blood clotting causes thrombocytopenia. This leads to bleeding from the gums, nose, or intestines and excessive skin bruising. As some typical signs of thrombocytopenia, we can mention petechiae and pinpoint hemorrhages in the skin.In person with lupus, usually occurs immune thrombocytopenia. This appears because antibodies destroy the platelets, similarly with the destruction of the red blood cells in the autoimmune hemolytic anemia. As a treatment, we can mention steroids like Prednisone and in severe cases splenectomy may be needed.

It was discovered that patients that have lupus produce an antibody called the lupus anti-coagulant. It was seen that some patients with the lupus anti-coagulant tend to form clots abnormally condition called venous thrombosis. That is a paradox that science can’t explain yet.Sometimes, venous thrombosis can associate with pulmonary embolus, and particularly that situation requires treatment with anti-coagulant drugs such as heparin and Coumadin. Lupus anti-coagulant was also detected in cases of recurrent fetal loss, but it is not known if it causes the so-called habitual spontaneous abortion.

Patients with lupus can experience also some abnormalities , like granulocytopenia, which means there is a low granulocyte count, and lymphocytopenia- when there is a low number of lymphocytes. Usually, these abnormalities are harmless and without symptoms, but there can occur severe granulocytopenia, which is usually caused by a reaction to medication. In this case, there must be stopped the intake of the causative drug, and if there is an infection, treatment with antibiotics is required.

Nowadays, there is a great concern about the risk of getting AIDS by blood transfusions. It is good to know that there were developed tests for antibodies against the virus that causes AIDS, and all the blood donors are screened for such antibodies.Of course, the safest thing that can be done is to store your blood for later transfusion, but this is not always practical.It is also possible in some blood banks to designate a member of the family to donate blood for you, but it must be taken in consideration the possibility of blood incompatibility.

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Assessing Your Hypertensive Patient for Renal Disease

Comments: 0September 2nd, 2010 by admin



Because your hypertensive patient has an increased risk of developing renal disease, monitor his laboratory results for the following.

Stage I: Diminished Renal Reserve

* reduced kidney function with no accumulation of metabolic wastes

* mild elevation in blood urea nitrogen (BUN) and creatinine levels

Stage II: Renal Insufficiency

* mild accumulation of metabolic wastes

* elevated BUN, creatinine, uric acid, and phosphorus levels

* anemia

* mild hyperkalemia

* reduced ability to concentrate urine

Stage III: End-stage Renal Disease

* excessive accumulation of metabolic wastes

* severely elevated BUN, creatinine, potassium, and phosphorus levels

* decreased sodium and calcium levels

* decreased hemoglobin level and hematocrit

* fluid retention

A physician uses renal ultrasonography, excretory urography, and renal arteriography to diagnose renal disease. Renal ultrasonography helps the physician visualize renal structures to evaluate the integrity of tissues and vessels. This procedure is safe for patients with renal insufficiency because it doesn’t use contrast media.

A physician uses excretory urography to identify the absence or presence of lesions, areas of restricted blood flow, and areas of vascular occlusion. He also may use renal arteriography to evaluate renal blood flow. Excretory urography and renal arteriography require the use of contrast media, placing your patient with renal insufficiency at risk for worsening kidney function.

Treatment for Peripheral Vascular Disease

The treatment of peripheral vascular disease may include drug therapy, surgery, or both. If your patient has peripheral artery occlusive disease, the physician may prescribe pentoxifylline, which is the only effective drug for treating the condition. Pentoxifylline increases erythrocyte flexibility and reduces blood viscosity, thus increasing the oxygenated blood supply to the ischemic muscle.

The physician may prescribe an antihypertensive drug to control your patient’s blood pressure. If your patient undergoes arterial bypass surgery for peripheral vascular disease, his physician also may prescribe aspirin and warfarin to maintain graft patency.

To treat peripheral vascular disease, a surgeon may perform patch graft angioplasty. In this procedure, the surgeon opens the occluded artery and removes the atherosclerotic plaque. Then he places a patch over the opening to widen the vessellumen.

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Ovulation And Conception

Comments: 0May 25th, 2010 by admin



Conception and Ovulation are two sides of same coin and a crucial stage in the delicate balance of hormonal system, sperm production and pregnancy. A man produces sperm every day, while women ovulate only once during an ovulation cycle. In this short time period of 7 to 21 days, the egg is fertilized or destroyed, and conception takes place.

During Conception several eggs are released by both ovaries. Ovulation is triggered by the body releasing luteinizing hormone, or LH. If sperm is successful in fertilizing the egg, it results in a series of cell divisions increasing in number every 14 to 18 hours. The embryo, containing about 50 to 100 cells, reaches the uterus about five days after ovulation. It then expands and hatches through the accompanying eggshell to implant and replicate.

Timing the cycle from Ovulation to Conception is important, in that women sometimes are too stressed out or physically unfit to go through with the process. A woman’s emotional and physical health plays a major role in her productivity quotient. To test this quotient, instruments such as Fertility Monitors, Ferning Microscopes or basal body thermometers are useful. Sometimes these tests or instruments prove ineffective if women are going through menopause symptoms, impaired liver or kidney function or polycystic ovarian syndrome. Certain antibiotics, like tetracyclines, affect a woman’s cycle of hormonal contraception, fertility treatments or hormone replacement therapy. Equally important is the timing of birth control pills. Traveling, change of jobs, illness, weight loss or vigorous exercising can affect Ovulation.

On occasions, such as sex during fertile time, some women do not conceive immediately, or the egg does not implant even with Ovulation. The problem is the timing of intercourse, since Conception takes place with Ovulation and it is spoiled by hard work, stress or problems. So plan sex on the day of ovulation or, at most, two days before it, taking into account that men need up to two days to regenerate their sperm reserves. Strategize Conception and Ovulation by maintaining an Ovulation calendar to predict fertile dates, end of menstrual cycle and possible due dates.

Ovulation and Conception are major issues in a woman’s life, Conception is more likely to be successful if a woman maintains a calm attitude through activities and diet that enhance fertility.

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Diet For Kidney Failure – Are They Really Effective in Reducing the Progression of Kidney Diseases?

Comments: 0September 17th, 2009 by admin



As a nurse for many years now, a lot of people complain to me that their diet for kidney failure is so hard to follow. They tell me that this type of diet has too many restrictions and that it is so rigid and unforgiving.

My reply to the above statement is that maybe the asking patient didn’t consider other possibilities of the diet? Or maybe he or she was not able to research enough to realize that this diet is in fact easy to follow.

Before I start talking about the diet for kidney failure, I will first talk a little about the kidney. The kidneys play key roles in body function, not only by filtering the blood and getting rid of waste products, but also by balancing levels of electrolytes in the body, controlling blood pressure, and stimulating the production of red blood cells.

Now, renal failure results when the kidneys cannot remove the body’s metabolic wastes or perform their regulatory functions. The substances normally eliminated in the urine accumulate in the body fluids. As a result of this impaired renal excretion, there are electrolyte and acid-base disturbances.

Renal failure is a systemic disease and is final common pathway of many different kidney and urinary tract diseases. Each year, the number of deaths from irreversible renal failure increases.

Kidney disease diet is an important consideration for those with impaired kidney function. Consultation with a dietitian may be helpful to understand what foods may or may not be appropriate. Various kidney disease recipes are available in the market right now.

Since the kidneys cannot easily remove excess water, salt, or potassium, they may need to be consumed in limited quantities. Foods high in potassium include bananas, apricots, and salt substitutes.

Phosphorus is a forgotten chemical that is associated with calcium metabolism and may be elevated in kidney failure. Too much phosphorus can leech calcium from the bones and cause osteoporosis and fractures. Foods with high phosphorus content include milk, cheese, nuts, and cola drinks.

This diet is usually done with other treatments for kidney failure. The two major treatments for kidney failure are dialysis and transplantation. The former has two kinds of procedures-hemodialysis (accessed via IV route) and peritoneal dialysis (done via the abdomen). The latter, on the other hand, involves a more complex pre-operation.

With a research based diet for kidney failure, renal recovery is almost guaranteed. It is, however, important to be started as immediately as possible to prevent long term damage.

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Posted in anemia