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INTRODUCTION 3
tion has already been lost. However, people at risk for kidney disease can
check their own urine using simple tests, and get their physicians to check
their blood for problems early on. If more at-risk people found out earlier that they had kidney disease, they could markedly improve their
future health by taking effective steps immediately.
This book lets people know about the available and effective treatments (many of which can be done in their own home) that can slow the
progression of kidney disease. By these means, people can delay dialysis
or transplantation for as long as possible or even totally avoid either
procedure.
The treatment I describe alleviates symptoms markedly. Appropriate
care for kidney failure includes a very-low-protein diet, with supplements,
as well as blood pressure control and specific therapies to regulate the
metabolism of sodium, potassium calcium, phosphorus, and acid, and to
correct anemia, high blood cholesterol, and high blood uric acid (which
causes gout). Certain drugs are helpful and others are contraindicated.
Transplantation, which has become more successful but is limited by
the number of donors, may become more widely available; this book discusses how.
Note: This book does not discuss children with chronic kidney
disease. As children are treated at Johns Hopkins exclusively by pediatricians, I have no experience caring for them.
Ella Johnson, a 49-year-old schoolteacher came to Johns Hopkins in
1994 for treatment. She suffered from polycystic kidney disease, an
inherited kidney disease that consists of cysts in the kidneys. Her
mother had also had polycystic kidney disease and had been treated
here for several years. Ella also had high blood pressure and recurrent
urinary tract infections. Her left kidney could easily be felt during a
physical exam, and was therefore considerably enlarged. She was placed
on a low-protein diet supplemented by essential amino acids. She also
started fish oil capsules and gets regular exercise. During seven years of
follow-up, her kidney failure has progressed very slowly. The rate of
loss of her kidney filtration capacity, also known as glomerular filtration
rate, is only 1.8 ml per minute per year, compared with an average rate
of about 7 ml per minute per year in patients with polycystic kidney disease. At this rate, she will be well into her 70s before she needs dialysis or a transplant.
Детали
- Год издания
- 2004
- Format