What you need to know about'

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What you need to know about. Kidney
Failure / Renal Failure
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The Facts About Kidney Disease
Kidney disease is one of the costliest illnesses
in the U.S. today. Each year, more than 50,000
Americans die because of Kidney Disease. More
than 260,000 Americans suffer from chronic renal
failure and need dialysis or kidney
transplantation to stay alive. More than 35,000
patients are waiting for kidney transplants, but
only about 11,000 will receive transplants
because of a shortage of suitable organ
donors. Every year 2200 new cases of Malaysians
are diagnosed with end stage renal failure. There
are over 1800 people waiting for a kidney
transplant in Malaysia, the numbers are
increasing each year. This number is
frightening
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Kidneys What are they?

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• How do your kidneys function?
• Your kidneys do some important jobs to keep your
  body healthy
• Balance your body fluids. Excess fluid is
  filtered out as urine.
• Remove waste products from your blood.
• Remove drugs and toxins from your body.
• Release hormones into your blood to
• - Control blood pressure
• - Make red blood cells
• - Keep your bones healthy.

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Kidney diseases are diseases
of the kidney substance that alter the structure
and function of the kidney. There are many
diseases of the kidneys such as
glomerulonephritis, pyelonephritis
polycystic kidney.The treatment and potential for
recovery depends on the type of disease.
Kidney diseases can lead to kidney failure.
What are kidney diseases?
Polycystic kidneys
Normal Kidneys
Healthy kidneys eliminate waste from the blood
maintain the bodys normal chemical balance.
Fluid filled sacs, called cysts, characterize
autosomal Dominant polycystic kidney disease.
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• Kidney failure is a condition where the kidneys
  are incapable of performing its
• normal function. Certain toxic substances
  which should have been excreted such
• as urea and creatinine are accumulated in
  the body.
• The two main causes of kidney failure are
  Diabetes High Blood Pressure.
• Many other conditions can harm the kidneys.
  These include
• Glomerulonephritis, a disease that causes
  inflammation in the kidneys.
• Inherited diseases like polycystic kidney
  disease, which causes many cysts to
• form in the kidneys.
• IgA nephropathy or other nephropathy.
  Essentially an autoimmune problem.
• Exact trigger not well known.
• Very large, long standing kidney stone.

What is kidney failure ?
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• Who is at Risk ?
• Risk factors for chronic kidney disease include
• Diabetes
• High blood pressure
• A family history of chronic kidney disease
• Older age
• Drug overdose, excessive use of alcohol
• Long term use of pain medications such as
  aspirin, panadol, ibuprofen
• and treatment with antibiotic.

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• Blood in urine. Most often not visible. But
  sometimes may appear tea color urine.
• Protein in urine, low urine output.
• Swelling of face and legs
• Tiredness, fatigue
• Pale and sallow complexion
• Have dry and itchy skin
• Poor appetite, sometimes accompanied with nausea
  and vomiting
• High blood pressure. Especially when it is hard
  to bring it to good control.

How to early detect kidney ailments?
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How do you prevent kidney failure?

• Early detection can do a lot in preventing
  deterioration of the kidney function.
• Kidney failure does not go down the drain in 3
  months, or even one year usually.
• But deteriorate very slowly. Thus getting
  screening helps.
• What are the screening test done?
• Simple testing of urine with dipstick for
  protein. If you have 2 positive
• result over several weeks, please consult
  Dr.
• Have a blood test for creatinine. Once creatinine
  exit the high control limit
• of 133 umol/L, the kidney will fail
  expodentially.
• 24 hours urine collection for creatinine and
  urine protein.
• Ultra sound or CT scan of kidney.

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Important message
Since 30 40 of kidney failure in Malaysia is
due to diabetes, it is imprerative that all
diabetics take note of this and screen for this
complication annually. There is an extra urine
test called urine microalbumin, to detect extra
early diabetic kidney disease. Good diabetes
control is important part of prevention of kidney
failure.

• What happens if kidney failure occurs?
• ( End Stage Renal Disease )
• Two successful treatment can be done Dialysis
  or a Kidney Transplant.
• These treatments can help you stay healthy and
  continue your daily activities.

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Dialysis and Kidney Transplant what are they ?

• Dialysis is a type of treatment that removes
  wastes and excess fluid from your
• blood. 3 forms of dialysis can be done
  hemodialysis, peritoneal dialysis and
• continuous ambulatory peritoneal dialysis (
  CAPD ).
• A kidney transplant is an operation to place a
  new kidney in your body to take
• over the work of your failed kidneys.
• The kidney may come from someone who has died or
  from a living donor who
• may be a close relatives, friend or possibly
  a stranger who wished to donate a
• kidney to anyone in need of a transplant.

You need dialysis when you develop End stage
renal disease usually by the time you lose
about 85 90 of your Kidney function.
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• Do you know how much you need to spend if you
  
• have kidney failure?
• Hemodialysis RM 150 RM 250 each time.
  Normally required 3 times /weeks.
• costing the patient
  between RM 1950 RM 3250 per month.(not
• including consultation
  fee and medication).
• Peritoneal dialysis RM 2300 RM 2400/months.
• Continuous ambulatory peritoneal dialysis ( CAPD
  ) RM 2000/month
• Kidney Transplant RM 10,000 in GHKL where
  kidney donated by own relatives.
• - RM 100,000 in oversea, example China,
  Singapore India.

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Subsequently?
Estimated expenses incurred in kidney dialysis
and transplant patients having out-patient
treatment in private hospital
Total expenses per year RM 30,225 which
averages to RM 2500/month (Excluding admissions
to hospitals for other complications)
Average cost after kidney transplant RM3000/mth
for the first 3 months for kidney monitoring
and medicines to prevent kidney rejection. Cost
may be reduced when transplanted kidney is
stabilized. If complications arise or serum
creatinine is high, renal biopsy may be done.
Average cost RM1000 including a stay in
hospital.
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Do you need help ??
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• How do you keep your kidneys healthy and more
  resistant to deterioration?
• Hydrate yourself well. Drink lots of plain water
  to keep your urine pale most of
• the time.
• 2. Avoid unnecessary medication ( esp NSAID
  and on long term ). Look for better alternative
  solution.
• 3. Avoid overloading your kidney with
  protein. Most of us only need about 2 ounces of
  protein a day! Protein leakage thru the kidney
  filter accelerate the deterioration of kidney
  function. Consult a renal dietitian if you need
  help.
• Keep your cholesterol in good level.
• 
  
• 5. Keep blood pressure and sugar in good
  control.

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• What else you can do ?
• Keep yourself in your best health by practicing
  all known health habits, ie
• Good diet, pay special attention to salt intake (
  better use sea salt due to its wider range of
  mineral profile ) and protein intake.
• Handle life stress well
• Regular exercise
• Adequate rest/sleep.
• This article is not meant to diagnose nor treat
  your disease. It is only for general
• information. You should seek a face to face
  consultation with a qualified medical
• practitioner for a proper assessment and
  treatment plan.

HEALTH IS WEALTH