Dr. Nabeel Ahmed, a physician at Tyler Nephrology Associates, leads this week's Walk with a Doc event on Thursday and will discuss screening for renal disease. Walk With a Doc is a project of the Smith County Medical Society.
It will be held at Tyler Junior College's Pat Hartley Field. Registration is at 5:45 pm with a brief health presentation at 6 p.m. followed by walking. For more information on Walk With a Doc, call the Smith County Medical Society office at 903-593-7058 or visit www.walkwithadoc.org/our-locations/tyler-tx/.
Q: What are the root causes of renal disease?
A: Chronic kidney disease is a worldwide public health problem. In the U.S., prevalence of end-stage renal disease is mostly due to under-recognition of earlier stages of CKD and risk factors for CKD which include: history of diabetes, cardiovascular disease, hypertension, hyperlipidemia, smoking, HIV, hepatitis B and C, family history of kidney disease (i.e. polycystic kidney disease), sickle cell trait, long-term use of over-the-counter medications such as non-steroidal anti-inflammatory drugs (Advil, Ibuprofen, Aleve, Naproxen, etc.), and some herbal meds.
Q: What are risks associated with renal disease?
A: Risks associated in children with CKD include growth retardation, poor neurodevelopmental disorders and bone disease. In adults the risks are worsening hypertension, anemia, dyslipidemia, fluid and electrolyte disturbances (especially sodium, potassium, metabolic acidosis), risk of bleeding, proteinuria and cardiovascular disease.
Q: What types of tests and procedures are used to screen for renal disease?
A: Simple basic chemistry panel that your primary care provider may do routinely will pick up abnormalities in kidney functions at an earlier stage and can also can determine the stage of CKD (stages 1-5). Stage 5 is indicative of near end-stage renal disease. A random spot urine analysis will detect any presence of protein or albumin. Renal ultrasound can show any mass, obstruction, cysts and sometimes stones. In some cases, we may do kidney biopsy to determine cause of kidney disease if not able to determine by blood testing or unexplained proteinuria.
Q: If diagnosed with renal disease, what is a patient's prognosis? Does it always lead to kidney failure?
A: Natural history of kidney disease is variable and unpredictable. Acute kidney injury may recover fully with little or no sequelae. A child diagnosed with CKD may have 86 percent chance of progressing to ESRD (end-stage renal disease) needing dialysis. Early referral to the nephrologist is key to delay/minimize risk of progression of CKD and determines reversible causes (nephrotoxic meds). The nephrologist with the patient's primary care provider can come up with plan of treatment of CKD by effective management of diabetes, hypertension, dyslipidemia, weight loss and diet.