Chronic kidney disease (CKD)
CKD is a long-term condition where the kidneys don't work as well as they should. It is a type of kidney disease that gradually causes loss of kidney function. Complications can relate to hormonal dysfunction of the kidneys and include high blood pressure, bone disease, and anemia. Furthermore, CKD patients have markedly increased cardiovascular complications with increased risks of death and hospitalization.
CKD is broken down into 5 stages based on the amount of damage to kidneys and how well they still work.
Stage 1: Kidney damage with normal or increased GFR (>90 mL/min/1.73 m2)
Stage 2: Mild reduction in GFR (60-89 mL/min/1.73 m2)
Stage 3a: Moderate reduction in GFR (45-59 mL/min/1.73 m2)
Stage 3b: Moderate reduction in GFR (30-44 mL/min/1.73 m2)
Stage 4: Severe reduction in GFR (15-29 mL/min/1.73 m2)
Stage 5: Kidney failure (GFR < 15 mL/min/1.73 m2 or dialysis)
Causes of CKD include diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease. Early detection can help prevent the progression of kidney disease to kidney failure. CKD affected 753 million people globally in 2016. In 2015, it caused 1.2 million deaths, up from 409,000 in 1990.
Because there is no cure for CKD, Options for the end stages of CKD include dialysis and kidney transplantation.
• Hemodialysis: Blood is circulated through a machine that removes waste products, excess water and excess salt. The blood is then returned to the body. Hemodialysis requires three to four hours three times a week and is performed at a clinic, hospital or dialysis center.
• Peritoneal dialysis: In peritoneal dialysis, a dialysis solution is run directly into the abdomen. The solution absorbs waste and then is removed via the catheter. A fresh solution is added to continue the process of cleaning. Patients can perform this type of dialysis themselves.
• Kidney transplantation involves placing a healthy kidney into the body where it can perform all of the functions that a failing kidney can’t. Kidneys for transplantation come from two sources: living donors and deceased donors. All donors are carefully screened to make sure there is a suitable match and to prevent any transmissible diseases or other complications.
Type 2 diabetes
Type 2 diabetes is a condition in which the body becomes resistant to the normal effects of insulin and gradually loses the capacity to produce enough insulin in the pancreas. The condition has strong genetic and family-related risk factors and is also often associated with modifiable lifestyle risk factors.
Symptoms include:
• Being excessively thirsty
• Passing more urine
• Feeling tired and lethargic
• Always feeling hungry
• Having cuts that heal slowly
• Itching, skin infections
• Blurred vision
• Gradually putting on weight, or some people will lose weight
• Mood swings
• Headaches
• Feeling dizzyLeg cramps
Causes: Type 2 diabetes is primarily the result of two interrelated problems:
1. Cells in muscle, fat and the liver become resistant to insulin. Because these cells don't interact in a normal way with insulin, they don't take in enough sugar.
2. The pancreas is unable to produce enough insulin to manage blood sugar levels.
Usually, a combination of things causes type 2 diabetes. They might include Genes.
• Extra weight.
• Metabolic syndrome.
• Too much glucose from the liver.
• Bad communication between cells.
• Broken beta cells.
Heart Failure
Heart failure is a long-term condition that the heart is unable to pump blood around the body properly. It usually happens because the heart has become too weak or stiff. It can occur at any age, but is most common in older people. It cannot usually be cured, but the symptoms can often be controlled for many years.
Symptoms: The symptoms of heart failure may include:
• fatigue
• sudden weight gain
• a loss of appetite
• persistent coughing
• irregular heart rate
• heart palpitations
• abdominal swelling
• shortness of breath
• exercise intolerance
• leg and ankle swelling or abdomen
• sleeping on extra pillows
• getting short of breath while lying down
• protruding neck veins
Causes: Heart failure is most often related to another condition. The most common cause of heart failure is coronary artery disease (CAD). Other conditions that may increase the risk of developing heart failure include:
• cardiomyopathy
• congenital heart disease
• heart attack
• heart valve disease
• certain types of arrhythmias, or irregular heart rhythms
• high blood pressure
• emphysema, a disease of the lung
• untreated sleep apnea
• diabetes
• an overactive or underactive thyroid
• HIV
• severe forms of anemia
• certain cancer treatments, such as chemotherapy
• substance misuse disorder
Risk factors: Heart failure can happen to anyone. However, certain factors may increase the risk of developing this condition.
• hypertension
• sleep apnea
• diabetes
• coronary artery disease
• valve disease
• anemia
• hyperthyroidism
• hypothyroidism
• emphysema
• Certain behaviors can also increase your risk of developing heart failure, including:
• smoking
• eating foods that are high in fat or cholesterol
• not getting enough exercise
• having overweight or obesity
Treatments: Treatment for heart failure usually aims to control the symptoms for as long as possible and slow down the progression of the condition. Common treatments include:
• lifestyle changes – including eating a healthy diet, exercising regularly and stopping smoking
• medicine – a range of medicines can help; many people need to take 2 or 3 different types
• devices implanted in your chest – these can help control your heart rhythm
• surgery – such as a bypass operation or a heart transplant
Heart failure can cause some serious problems.
• Kidney or liver damage is caused by reduced blood flow and fluid buildup in organs.
• Fluid may build up in or around the lungs.
• Malnutrition from nausea and swelling in the abdomen can make it uncomfortable to eat. Reduced blood flow to the stomach can make it harder to absorb nutrients from food.
• Other heart conditions such as an irregular heartbeat, leaking heart valves, or sudden cardiac arrest, can be caused by heart failure.
• Pulmonary hypertension may also be caused by this condition.
Diagnosis: A hemoglobin test measures average blood sugar levels and is typically used to diagnose and monitor type 2 diabetes. It is the measurement of the glucose attached to hemoglobin and reflects the average blood glucose for the previous 2-3 months.
The result is given in percentages. Typically indicated by a hemoglobin A1C of 6.5% or higher. A1C levels between 5.7 and 6.4% can indicate prediabetes.