Frequently Asked Questions

For your convenience, our most common customer questions will be answered on the patient resources, new patient and qkidney.com.

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WHAT IS CLINICAL NEPHROLOGY?

Clinical nephrology is the study of kidney diseases. We diagnose patients with a variety of kidney related diseases, and also manage them. Many of the diseases we deal with are secondary to hypertension or diabetes. We strive to prevent the progression of chronic kidney disease. An excellent resource about chronic kidney disease can be reviewed at MedlinePlus

WHAT IS CHRONIC KIDNEY DISEASE (CKD)?

Chronic kidney disease is a disorder that occurs when the kidneys do not function properly. The kidneys handle waste and fluids, help control the blood pressure, and keep many of the minerals and electrolytes (minerals with an electrical charge) in balance. They also activate hormones such as vitamin D, and make another hormone, erythropoietin, that is important in anemia.

As we age, kidney function normally becomes reduced, but it is very rare for persons, even with moderately advanced kidney disease, to require renal replacement therapy.

At Kidney Associates, our primary objectives are to prevent patients who have been diagnosed with chronic kidney disease from progressing. Also, we want to prevent the complications and other conditions that are associated with kidney disease from interfering with your life.

In some situations the kidneys will fail and renal replacement therapy will be necessary. If this happens, we want to assure that you will be able to select the modality of therapy that best fits your lifestyle, that you start kidney therapy in the best condition possible, and that you remain as healthy as you can during the course of your therapy.

WHAT IS ACUTE KIDNEY INJURY (AKI)?

Kidney Associates physicians work as consultants, and care for patients in one of the local Houston hospitals with a variety of kidney disorders. Acute Kidney Injury is a condition that arises when the kidney function decreases over a few hours or days. It can occur in patients who are in the intensive care unit, and may occur after surgery, or in those who are elderly or very ill. Acute kidney injury is discussed in more detail on the National Kidney Foundation Website.

WHAT IS DIALYSIS?

Dialysis is among the renal replacement therapies that some patients require when their kidneys fail. Although nearly one in nine patients have chronic kidney disease (CKD) only a very few actually require renal replacement therapy.

 

At Kidney Associates our goal is to prevent or delay the progression of kidney disease, but when it becomes so advances that replacement therapy is needed, we optimally encourage a kidney transplant. Some patients undergo a transplant early and never require dialysis therapy.

 

If dialysis needed, our first choice is home dialysis – either peritoneal dialysis (performed through a catheter in the abdomen) or home hemodialysis (that you can do with a partner at your home).

 

For some patients, in center hemodialysis is the preferred option. This is staff assisted and can be performed during the day, or at night (nocturnal dialysis)

WHAT IS A HOSPITAL CONSULTANT?

Many Kidney Associates physicians work as consultants in local Houston hospitals, and care for patients with a variety of kidney disorders. We see patients with chronic kidney disease and with acute kidney Injury. Often we see patients with congestive heart failure, or for acute disorders in fluid, electrolyte or acid-base balance. Many of the patients we will see are in the intensive care unit or are being managed in relation to surgery.

WHAT IS A KIDNEY TRANSPLANT?

When kidneys no longer function, patient have either the choice of dialysis or a kidney transplantation. If you are eligible for a kidney transplant, your doctor will refer you to a kidney transplant center for further evaluation. Patients may either receive a transplant from a living donor or a deceased donor. Living donors may be relatives or friends. The potential donor must match, and also be healthy. In some situations, a kidney paired donation may be necessary. When a suitable living donor is not available, you may be placed on a transplant list to receive a deceased donor kidney. More information about kidney transplantation can be found from The United Network for Organ Sharing (UNOS).

HOW CAN PATIENTS WITH CKD STAY HEALTHY?

Management strategies must be focused on the individual patient, and should start early to prevent disease progression. The major approach is to treat the underlying disease, control the blood pressure, use ACE or ARB therapy when possible, control metabolic acidosis, avoid toxic medications and focus on lifestyle modification.

 

Lifestyle modifications include dietary restriction (salt, sugar, protein phosphorus, uric acid and fat), the judicious use of vitamins, cigarette smoking cessation and exercise.

Source: Essentials of Chronic Kidney disease, SZ Fadem, Editor, Nova Biomedical, New York, 2015.

WHAT IS THE EGFR?

The glomerular filtration rate measures the rate that waste products are filtered through the glomerulus (kidney filter), and is a generally a valid index of kidney function.

 

The estimated glomerular filtration rate is a routine part of medical practice. It was derived from four variables (age, race, gender and serum creatinine) and developed in 1999. It is based on data obtained from the 1628 patients in the MDRD clinical trial, and compares the GFR with the urinary clearance of iothalamate.

 

It has evolved over the years, and the most current equation is the CKD-EPI 2012, taken from a diverse population of 5,352 patients. It again uses the urinary clearance of iothalamate as the standard.

References:

Levey, AS, et al. Ann Int Med 1999;130:461-70.
Inker et al Am J Kidney Dis 2011;58:782-84.

 

Calculator: mdrd.com

HOW IS CHRONIC KIDNEY DISEASE DIAGNOSED AND CLASSIFIED?

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WHAT ARE THE MOST COMMON CAUSES OF KIDNEY DISEASE?

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WILL HELPING TO CONTROL MY HYPERTENSION AND DIABETES HELP PREVENT CKD PROGRESSION?

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WHAT IS END STAGE RENAL DISEASE?

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WHAT ARE THE COMMON THERAPIES FOR ESRD?

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WHAT IS AN AV FISTULA?

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WHEN SHOULD THE PATIENT WITH CKD HAVE A FISTULA PLACED?

Ideally the AV fistula should be placed at least 6 months prior to starting dialysis. This is because it may take up to four months for the fistula to mature and be ready to use. Prior to placement of the fistula, it will be important to map out the dimensions of your arteries and veins to determine which is most suitable. You will need a preoperative evaluation. Scheduling a procedure with the surgeon may take extra time.

WHY IS THE FISTULA BETTER THAN THE GRAFT OR CATHETER?

A well placed fistula lasts longer and has a lower rate of infection than a graft. Both are far better than a catheter. The catheter is a plastic tube that extends into the border of your heart. It can introduce bacteria into your blood system and cause infections. Also, it can lead to blockage known as thrombosis or a narrowing of a major vein, also referred to as stenosis. It promotes chronic inflammation that makes you sicker.

SHOULD I DO PERITONEAL DIALYSIS OR HEMODIALYSIS?

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CAN HEMODIALYSIS BE DONE AT HOME?

Absolutely. In many circumstances, provided you have a suitable partner, you can both learn how to operate a dialysis machine at home. The advantages are that you can dialyze when you want to and do not need to stick to a rigid schedule. Kidney Associates doctors and assist with your training, and after you go home,  will still closely follow you and make sure your treatments are going well.

I AM A DIALYSIS PATIENT. HOW MUCH TREATMENT DO I NEED?

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WHY TO PATIENTS WITH KIDNEY DISEASE OFTEN HAVE ANEMIA?

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WHAT ARE ACIDOSIS AND ALKALOSIS?

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WHAT ARE ELECTROLYTES AND WHY ARE THEY IMPORTANT?

Electrolytes are simply fluids that can carry an electrical charge or an electron. They are important to help transfer the tiny electrical forces that drive the chemical reactions that make your body function smoothly. There are many chemical reactions constantly taking place inside your body. Many of these involve the transfer of energy from the food that you eat and oxygen from the air you breath. The oxygen and broken down food products are carried by blood to the cells that make up your body tissues. The oxygen donates an electron that causes energy to be stored for when it will be needed. The electron then passes through a chain of chemical reactions where it combines to form carbon dioxide and water. The carbon dioxide is then exhaled.

WHY ARE CALCIUM AND PHOSPHORUS IMPORTANT IN KIDNEY DISEASE?

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MY SERUM ALBUMIN IS LOW. SHOULD I EAT MORE PROTEIN?

Albumin is a protein. We are all familiar with albumin because it makes up the yolk of the eggs we eat or cook with. Our body makes albumin when we are healthy, but when we become ill, it must make molecules that are associated with inflammatory processes associated with illness. The inflammatory processes also cause a loss of appetite. A low serum albumin is a sign of chronic illness. Although we should try to maintain good nutrition when we are sick, unless we successfully fight the underlying chronic illness, the serum albumin levels will remain low.

WHAT IS ACUTE KIDNEY INJURY (AKI)?

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HOW IS AKI RELATED TO CHRONIC KIDNEY DISEASE?

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WHAT ARE THE MOST COMMON CAUSES OF AKI, AND HOW CAN I PREVENT IT?

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WHAT IS GLOMERULONEPHRITIS?

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WHAT ARE THE MOST COMMON CAUSES OF GLOMERULONEPHRITIS?

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WHAT SYSTEMIC DISEASES CAN CAUSE GLOMERULONEPHRITIS?

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WHAT IS INTERSTITIAL NEPHRITIS?

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WHY CAN'T I TAKE NSAIDS WHEN I HAVE CKD?

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WHEN IS AN MRI DANGEROUS?

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WHAT ARE THE DIFFERENT TYPES OF KIDNEY TRANSPLANTATION?

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WILL IT HURT ME TO DONATE A KIDNEY?

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DOES GOUT CAUSE KIDNEY DISEASE?

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HOW IS HIV RELATED TO KIDNEY DISEASE?

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I JUST PASSED A KIDNEY STONE? WHAT CAN I DO TO PREVENT ANOTHER?

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WHAT ARE SOME OF THE INHERITED DISEASES OF THE KIDNEY?

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WHAT IS APOL1?

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