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Workplace Accommodations When You Have Kidney Disease

Posted on: July 23, 2017 by in Blog
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Chronic kidney disease (CKD) patients are sometimes the victims of medical malpractice, and when they are, they’ll need the advice and services of an experienced medical malpractice attorney. A misdiagnosis, a wrong prescription, or a surgical mistake can dramatically and negatively impact a CKD patient’s health, and when that happens, that patient is entitled to compensation – and to justice. Medical malpractice, however, is not always the only legal concern that a CKD patient has to face. Kidney disease patients who want to remain in the workforce sometimes encounter employment discrimination.

Chronic kidney disease is usually managed rather than cured. When CKD is diagnosed early and accurately, progress from the early stages to advanced kidney disease can be slowed, and most CKD patients are able to avoid the need for kidney dialysis or a kidney transplant. When CKD patients adhere to the advice of their doctors, most are able to maintain normal lives, keep their jobs, and manage CKD with only minor inconveniences.

Still, thousands in the United States are living with kidney failure. According to the National Institute of Diabetes and Digestive and Kidney Diseases, about 430,000 people in the U.S. are on kidney dialysis, and approximately 185,000 have received a kidney transplant. For decades, disability rights advocates have acted to protect the rights of working people who struggle with chronic diseases and other disabilities. Those rights are now safeguarded by a number of important federal laws.

WHAT LAWS PROTECT WORKERS WITH CHRONIC DISEASES?

The Civil Rights Acts of 1964 and 1991, the Americans with Disabilities Act of 1990, and the Family and Medical Leave Act of 1993 provide substantial legal protections to working persons who struggle with chronic diseases and other disabling conditions. These federal statutes also spell out the guidelines for employer compliance. The law makes it easier for anyone who is struggling with CKD to stay in the work force and to live a more-or-less normal life.

Of course, if you are back at work after a kidney transplant or after beginning dialysis, you and your employer may have to make some reasonable and slight adjustments. Your schedule may need to be re-arranged for dialysis treatments. Continuous ambulatory peritoneal dialysis patients may require a private and sterile area.

Some CKD patients may simply need less strenuous responsibilities. Federal law requires employers to make “reasonable” accommodations. You may feel reticent about asking for something special. Don’t. Reasonable accommodations are your right.

Thousands of CKD patients, dialysis patients, and transplant recipients work part time or full time throughout the United States. Others pursue their educations, raise their children, and volunteer in their communities. Many who start dialysis or receive a transplant want to work and want to return to their everyday routines as soon as possible. Others may need some time off to adjust to kidney dialysis or to recuperate from surgery.

Either way, if you need for your employer to make one or more reasonable accommodations, you need to ask your employer for those accommodations. Most employers know the law and are prepared to comply, but your employer cannot know what you need until you ask. Your employer also may not know that employers can earn tax credits by making certain accommodations to the workplace.

WHAT DOES THE AMERICANS WITH DISABILITIES ACT REQUIRE?

There may also be questions about your health benefits. If your employer seems worried or confused, your doctor or someone else providing your healthcare can probably provide the details about your illness and abilities that will relieve your employer’s concerns.

If your employer is a business with fifteen or more employees, your employer is required by the Americans with Disabilities Act (ADA) to make reasonable accommodations that employees may need, such as:

  • allowing for flexible schedules if possible
  • reassigning a worker to less strenuous work if it is available
  • providing handicapped access to rest rooms, parking areas, and work areas
  • reassigning some of your tasks to others

If you work for at least twenty weeks in a year for an employer with fifty or more employees, you may be eligible for leave under the federal Family and Medical Leave Act, which allows up to twelve weeks of job-protected but unpaid leave for medical reasons. Employers may request medical documentation verifying an employee’s kidney disease and condition, but an employee cannot be penalized for taking medical leave that the employee is entitled to by law. Immediate family members of CKD patients are entitled to the same leave if they need that time off to care for their family member.

If you believe that you are a victim of employment discrimination because of your kidney disease and accommodation needs, the Equal Employment Opportunity Commission (EEOC) recommends that you should first go through whatever procedures the company has established.

Usually, this involves filing a written grievance detailing the discrimination and submitting a copy to management or the HR department. Union members should take their complaints to their locals. Always make and keep copies of your complaint, any responses to it, and any other pertinent documents.

CAN CKD PATIENTS RECEIVE DISABILITY BENEFITS?

When someone can’t work because of chronic kidney disease, disability benefits may be available. The Federal government offers Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI). SSDI provides monthly benefits when someone is unable to work for at least a year due to a disability. The amount of the benefit depends on your work history and your previous Social Security payments. SSI benefits, however, are based on financial need.

Whether you are managing chronic kidney disease in its early stages, dealing with kidney dialysis, or living with a transplanted kidney, your life is full of potential legal challenges and obstacles when you have a kidney disease. Employment discrimination is one of those challenges. Obtaining benefits is another. Don’t hesitate to reach out for an attorney’s help to deal with either of these challenges.

Medical malpractice is also more common than you might think, and CKD sufferers are the frequent victims of medical negligence. If you believe that you are a victim of medical malpractice as a chronic kidney disease patient, let an experienced medical malpractice attorney review the particulars of your case, explain your rights, and provide the sound legal advice you need.

Chronic Kidney Disease and Medication Errors: What To Look For

Posted on: June 23, 2017 by in Blog
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More people today in the United States are dying from drug complications and overdoses than from traffic accidents. Sadly, it is a trend that’s being driven by the pain and anxiety medications such as Vicodin, Xanax, and other drugs that are commonly used by chronic kidney disease (CKD) patients.

According to the Journal of Clinical Pharmacy and Therapeutics, dosing errors occur frequently in patients with CKD, particularly in the disease’s later stages when the body has a harder time processing drugs and other toxic metabolites. Dosing errors over the last two decades have disturbingly increased the death rate for CKD patients who are in their 50s and 60s.

If you struggle with chronic kidney disease, has medical malpractice made your condition worse? Chronic kidney disease is usually manageable with early and accurate diagnosis and proper treatment, but if a doctor prescribes the wrong drug or the wrong dosage – or if a pharmacist accidentally gives you the wrong drug – your health could quickly deteriorate, and at that point, you may want to speak with an experienced medical malpractice attorney regarding your legal rights and options, which could include a medical malpractice lawsuit.

EXACTLY WHAT CONSTITUTES MEDICAL MALPRACTICE?

When healthcare professionals do not provide what the profession considers a reasonable standard of care, those professionals are negligent. If that negligence results in your injury, you are a victim of medical malpractice, and you are entitled under the law in every state to full financial compensation, but you’ll need an attorney’s help to obtain that compensation. You can be compensated for your additional medical care and related expenses, for lost income and lost earning potential, and in some cases for your pain and suffering too.

A number of treatments are available for chronic kidney disease. The appropriate treatment depends of the exact kind of kidney disease and how early the disease is detected. Steroids are effective for some kidney diseases, and prescription pharmaceuticals are commonly used to treat several kinds of kidney diseases. No medicine can reverse CKD, but drugs are used to help treat symptoms and complications and to slow further kidney damage.

The medicines that are used to treat the symptoms and complications of chronic kidney disease include:

  • erythropoietin therapy and iron replacement (pills or intravenous iron) for anemia
  • medicines for electrolyte imbalances
  • diuretics to treat fluid buildup
  • ACE inhibitors and ARBs: These may be prescribed if you have too much protein in your urine (proteinuria). Regular blood tests are needed to ensure that ACE inhibitors and ARBs do not raise potassium levels or reduce kidney function even more.

CAN CKD PATIENTS HELP DOCTORS AVOID MEDICATIONS ERRORS?

Both erythropoietin therapy and iron replacement therapy are prescribed during dialysis for anemia, which often accompanies advanced chronic kidney disease. Erythropoietin stimulates the production of red blood cells and may reduce any need for transfusions. Iron replacement therapy can help increase iron levels in the body when erythropoietin therapy alone is ineffective.

Chronic kidney disease and dialysis patients can help to improve their health and help to limit any risk of dosage errors by adhering to these suggestions offered by the FDA:

1 – Find out what drugs are being prescribed to you and why. Have the doctor clearly pronounce the name of the drug for you in case there is any confusion with the pharmacist.

2 – If you are in the hospital, ask your doctor – or have a friend or family member ask for you – what drugs you are being given and why.

3 – Learn how the medication should be taken, and be certain that you understand the directions. If you are directed to take a drug three times daily, does that mean precisely at eight-hours intervals, or does it mean taking the drug with your meals? Should the prescription be stored in the refrigerator or at room temperature? Are there other medications, foods, or drinks that you should avoid while taking the prescription?

4 – Always look carefully for any special instructions, and ask your doctor and pharmacist if there is anything else you need to know about any drug that is prescribed to you.

5 – Ask about a medication’s side effects, what you should expect, and what to do about the side effects when you experience them.

6 – Every time you take a medicine, read the label. That helps to ensure that you’ll avoid mistakes. In the middle of the night, or if your vision is poor, you could confuse ear drops with eye drops or take a vitamin when you think you’re taking a painkiller. Have the lights on and read the label every time.

7 – If you have trouble keeping several different prescriptions organized, ask your pharmacist about the plastic containers that have different sections for different drugs and different days. Your pharmacist may be able to recommend something that works for other patients or something that’s just right for you. Family members can also help by not letting you forget to take your medicines at the right times.

8 – Make a list of every drug that you take, including prescribed medicines, over-the-counter drugs, dietary supplements, vitamins, medicinal herbs, and any other substances you take, including alcohol, tobacco, and/or cannabis. Share this list with your doctor and pharmacist. Don’t forget items like vitamins, laxatives, creams, and ointments.

9 – Ask questions, don’t forget to ask questions, and always remember to ask questions. If in doubt, ask questions. You want to keep problems from happening before they become problems. For example, if your pills look different when your prescription is refilled, ask why. Also, be sure to ask why if you’re given a different or new drug or new directions for using a drug. It’s always better to be cautious. There’s nothing at all wrong with being known as “the patient who always asks lots of questions.”

HOW COMMON ARE MEDICATION ERRORS?

Medication errors cause at least one death every day and injure more than one million people every year in the United States. When you’re dealing with chronic kidney disease, you expect that the drugs you take should be helping you. If they harm you, you’ve probably been prescribed the wrong medicine or the wrong dosage, and at that point, you are probably a victim of medical malpractice.

An experienced medical malpractice attorney can fight for the monetary compensation that a malpractice victim needs and for the justice a victim deserves. If you or someone you love is struggling with chronic kidney disease and becomes a victim of medical malpractice, speak immediately to an experienced medical malpractice attorney regarding the case, your rights, and your legal options.

What Are The Stages Of Chronic Kidney Disease?

Posted on: May 23, 2017 by in Blog
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When chronic kidney disease (CKD) is diagnosed early and accurately, its advance from the early stages to the later stages can be slowed and sometimes even stopped. However, far too many CKD patients do not obtain an early diagnosis or appropriate treatment.

As a result, CKD patients may suffer and sometimes die unnecessarily. A doctor’s failure to detect or treat CKD, the late detection or improper treatment of CKD, and the failure to refer a CKD patient to a specialist when it’s called for – all of these may constitute medical malpractice.

When someone suffers from chronic kidney disease, that person’s kidneys seldom fail all at once or unexpectedly. Rather, chronic kidney disease usually progresses at a slow pace over a period of years. This is actually helpful to patients because if CKD is diagnosed early, treatments and lifestyle adjustments can impair its progress and keep patients feeling healthy – and living normal lives – for years, and in some cases, for decades.

Kidneys filter the blood to remove waste products and toxins, and they secrete important hormones that we require for healthy red blood cells, strong bones, and proper blood pressure regulation. The kidneys also remove excess water and calcium from the body.

The stages of chronic kidney disease are determined by the “glomerular filtration rate.” It’s not as complicated as it sounds. Glomerular filtration is simply the process of the kidneys filtering the blood to remove excess fluids and wastes.

HOW IS THE GLOMERULAR FILTRATION RATE DETERMINED?

The glomerular filtration rate (GFR) is a measurement that indicates how well blood is being filtered by the kidneys, and it’s one of the several ways to measure kidney efficiency. The GFR is determined by a formula that considers a patient’s age, gender, and creatinine levels.

Creatinine is a chemical waste molecule that forms as a result of muscle metabolism. Creatinine moves through the blood to the kidneys, which filter out most of the creatinine, which is then expelled in the urine.

Because the human body’s muscle mass barely changes from one day to the next, creatinine production remains essentially unchanged from day to day. When the kidneys are impaired for any reason, the creatinine level in the blood rises because the efficiency of the kidneys has declined. Thus, rising creatinine levels are a generally dependable warning sign of chronic kidney disease.

Standard blood tests measure the level of creatinine in the blood. However, if test results are misinterpreted or not even recognized – due to insufficient medical training, overwork, and stress, or for any other reason – specialists may not be consulted, the appropriate treatment may not be ordered, and a CKD patient’s health can rapidly deteriorate. The failure to read test results properly or to order referrals or treatment based on those test results may constitute medical malpractice.

HOW CAN YOU KNOW IF YOU ARE A VICTIM OF MEDICAL MALPRACTICE?

If you believe that your own kidney disease has been misdiagnosed or that you have not received the proper treatment for CKD, discuss your situation promptly with an experienced medical malpractice attorney. Medical malpractice is the violation of the “reasonable standard of care” provided by most doctors, but it’s often difficult for the average person to know if he or she has been a medical malpractice victim. An experienced medical malpractice lawyer can review your case, provide candid legal advice, and explain your options, which may include a medical malpractice lawsuit.

The exact formula for determining a patient’s GFR – for those who are mathematically inclined – is 140 minus the patient’s age in years, times the patient’s weight in kilograms (or times 0.85 for women), divided by 72 times the creatinine level in milligrams per deciliter (or mg/dL). The lower the GFR number, the more inefficient the kidney function.

While a patient with a GFR of 60 for three months or longer, for example, is very likely to be a victim of kidney disease, for some categories of patients – amputees, the obese, the very young and the very old – the GFR may not be a reliable indicator of kidney health.

To improve the treatment of chronic kidney disease patients, the National Kidney Foundation (NKD) has established guidelines to help doctors and patients recognize and understand each stage of the disease. The National Kidney Foundation guidelines recognize five different stages of CKD. Each stage requires different tests and treatments.

Listed here are the stages of chronic kidney disease as spelled out by the NKD, along with the GFR numbers that are expected with each stage:

Stage 1: Early CKD (with a normal or high GFR of 90 or higher)
Stage 2: Mild CKD (GFR of 60 to 89)
Stage 3A: Mild to Moderate CKD (GFR of 45 to 59)
Stage 3B: Moderate to Severe CKD (GFR of 30 to 44)
Stage 4: Severe CKD (GFR of 15 to 29)
Stage 5: End Stage CKD (a GFR measurement below 15)

Chronic kidney disease treatment in the first four stages concentrates on maintaining kidney function for as long as possible. If chronic kidney disease progresses to the final stage – end stage renal disease or ESRD – a patient will discuss with his or her doctor treatment options that include kidney dialysis and a kidney transplant. More than 600,000 people in the United States have end stage renal disease, according to the National Kidney Foundation.

WHAT IS THE DEFINITION OF MEDICAL NEGLIGENCE?

While medical malpractice cannot cause chronic kidney disease, any failure to obtain a precise and early diagnosis and appropriate treatment for CKD can lead directly to acute renal failure. When healthcare providers do not provide the “reasonable standard of care,” they are negligent. If that negligence causes a patient to be injured, the patient is entitled by law to monetary compensation and has the right to sue for medical malpractice.

Chronic kidney disease patients who are injured by medical malpractice can be reimbursed for their lost income and any lost earning potential linked to the malpractice, any additional medical care and expenses required by the malpractice, and in some cases, patients can be additionally compensated for their malpractice-related pain and suffering.

Victims of medical negligence are entitled to compensation, but compensation isn’t just handed to victims. If you are a kidney disease patient and a victim of medical malpractice, you’ll need to work alongside an experienced medical malpractice attorney who can fight for justice on your behalf.

What To Do When A Kidney Transplant Fails

Posted on: April 24, 2017 by in Blog
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A diagnosis of chronic kidney disease means that a person’s kidneys are damaged and cannot filter blood and wastes the way they should. This damage can cause wastes to build up in the body. Kidney disease can cause other health problems, such as heart disease. If you have kidney disease, it increases your chances of a stroke or a heart attack. If it’s not treated, the eventual result is complete kidney failure.

Our kidneys protect us by functioning as a “filtering” system for our bodies. Kidney disease happens when a kidney begins to stop filtering wastes. While astounding progress has been made, kidney disease still impacts roughly 26 million adults in the United States. The primary risk factors for kidney disease are diabetes, high blood pressure, and a family history of kidney disease, but everyone over the age of 60 should be considered at risk for kidney disease.

In most cases, with an early and accurate diagnosis, kidney disease can be treated and managed successfully. When kidney disease is diagnosed early, the standard treatment is a drug from the family of drugs called ACE inhibitors or another family called ARB drugs. Careful management of high blood pressure and diabetes may also help to prevent kidney disease or keep it from progressing.

WHAT IS THE SUCCESS RATE FOR KIDNEY TRANSPLANTS?

Sometimes, however, and especially if it’s untreated or wrongly diagnosed, kidney disease progresses to complete kidney failure, requiring dialysis or a kidney transplant procedure. More than 468,000 patients receive kidney dialysis in the U.S., and approximately 193,000 people are living in U.S. with a transplanted kidney. 17,600 kidneys were transplanted in the United States in 2013. While the success rate of kidney transplants is quite high, there’s little discussion about what happens when kidney transplants fail.

Approximately seven percent of the kidney transplants in the U.S. fail within a year; seventeen percent fail within three years. And it’s almost impossible to find anything in writing that helps patients and their families cope with a kidney transplant failure.

Many patients end up seeking a second transplant, and twenty percent of kidney transplant operations in the U.S. each year are in fact “re-transplants.” Why do kidney transplants fail? A kidney transplant may fail for one of these reasons:

1. Clotting: When the blood vessels leading to a transplanted kidney clot, the kidney receives no blood. Clotting sometimes happens immediately after the transplant surgery.

2. Infection: If it’s not found and treated at once, an infection can permanently damage a kidney.

3. Fluid collection: If fluid collects around a kidney, without prompt treatment, the pressure can cause serious damage.

4. Problems with donated kidneys: Sometimes unexpected problems emerge with a donor’s kidney, and the kidney never does function properly.

5. Medication’s side effects: A number of drugs can seriously harm the kidneys.

6. Disease recurrence: While it is extremely rare, in some cases the original disease that damaged a kidney re-emerges and damages the transplanted kidney.

7. Acute Rejection: Acute rejection is also extremely rare, when the body rejects a transplanted kidney immediately after surgery.

8. Chronic Rejection: Chronic rejection is simply a result of the long-term damage done by the body’s immune system. Chronic rejection is the leading reason for kidney transplant failures.

9. Patient non-compliance: Unfortunately, a kidney transplant patient may sometimes be responsible for a transplant failure because he or she stops taking or forgets to take the anti-rejection drugs required after transplant surgery. Without those drugs, the body rejects and damages the transplanted kidney. Patient non-compliance may also include missing medical appointments, lab tests, and forgetting or avoiding other treatments.

Most kidney transplant patients are more than willing to comply with all of a doctor’s orders and recommendations after transplant surgery. They want to be healthy, and they want to take care of themselves after receiving a kidney.

Frankly, patient non-compliance is quite rare, and most kidney transplant failures occur for medical reasons that have nothing to do with a patient’s behavior. Obviously, those patients whose transplants fail are disappointed when they learn that they must return to dialysis, but they can usually get right back on the waiting list.

IS ANYONE “AT FAULT” WHEN A KIDNEY TRANSPLANT FAILS?

Of course, kidney transplant recipients must follow prescribed treatments, take prescribed medications, schedule regular checkups, and seek medical attention when they don’t feel well. Still, a transplant patient who does everything right may experience a transplant failure.

Most kidney disease and kidney transplant patients receive the highest-quality medical care from diligent, dedicated doctors and healthcare professionals. Just as a transplant failure is rarely the patent’s fault, it’s rarely the doctor’s fault either.

Even so, kidney disease patients can become the victims of medical malpractice for a number of reasons, and if you struggle with kidney disease, medical malpractice can make your condition worse. An inaccurate early diagnosis or the wrong prescription or treatment can constitute medical malpractice that leads to kidney failure, dialysis, or the necessity for a transplant. The failure to receive a correct, early diagnosis and appropriate treatment can sometimes lead straight to acute renal failure.

WHAT ARE HEALTHCARE PROFESSIONALS REQUIRED TO PROVIDE?

All healthcare professionals must provide their patients with a “reasonable” standard of care. They are not obligated to order every possible medical test, but they are expected to provide the competent and professional medical care that other doctors would provide in similar circumstances.

As a kidney disease patient, you might be victimized by medical malpractice at almost any point in your treatment – from an initial misdiagnosis to a mistake in the operating room during a kidney transplant procedure.

If you have been harmed by medical malpractice as a kidney disease patient – or if you’re not sure that what happened to you constitutes medical malpractice – discuss the details with an experienced medical malpractice attorney who can explain your legal rights and options. When healthcare professionals do not provide a reasonable standard of care, they are negligent, and an injured victim of medical negligence may file a medical malpractice claim.

Medical malpractice victims – who can prove that they are medical malpractice victims – are entitled by law to full reimbursement for all necessary additional medical care, all related expenses, and in some cases for their pain and suffering as well after an incident of medical malpractice. Not every medical mistake or transplant failure is the result of malpractice, but an experienced medical malpractice attorney can examine your own case to determine if medical malpractice has occurred.

Researchers Discover Potential Treatment For Polycystic Kidney Disease

Posted on: March 22, 2017 by in Blog
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Healthy kidneys are essential for everyone. If your kidneys don’t function properly, you’ll be at risk for a variety of other health problems that can include nerve damage, heart disease, bone disease, and infertility. However, for most people, a precise and early diagnosis can often reduce and sometimes even reverse the consequences of kidney disease.

In other cases, early diagnosis and proper treatment can help patients manage their kidney disease so that it does not progress to end-stage kidney failure. For every kidney disease patient, an early and accurate diagnosis is imperative. A doctor’s failure to diagnose kidney disease may harm a patient’s health and may constitute medical malpractice. If you are a kidney disease sufferer and you are concerned about malpractice or believe that you may be a victim – or if you’ve been harmed or injured while seeking kidney disease treatment – you should discuss your concerns and circumstances with an experienced medical malpractice attorney.

Approximately 600,000 people in the United States are afflicted with polycystic kidney disease (PKD), a genetic disorder that causes abnormal cysts to develop and grow in the kidneys. According to the National Institute of Diabetes and Digestive and Kidney Diseases, the cysts typically cause back pain, high blood pressure, problems with blood vessels in the heart and brain, and eventually lead to kidney failure. Polycystic kidney disease is a general term for these two types of kidney disease: autosomal dominant polycystic kidney disease (ADPKD) and autosomal recessive polycystic kidney disease (ARPKD).

PKD is the world’s most frequently inherited kidney disease, affecting about 12.5 million persons globally. It is responsible for nearly ten percent of all cases of end-stage renal disease. Fifty percent of PKD patients suffer complete kidney failure by age 60. PKD affects men, women, and children of all ages and races equally. Polycystic kidney disease causes abnormal kidney growth due to the proliferation of fluid-filled cysts. These cysts continue to expand and grow until the kidney no longer functions properly and loses its capacity to filter blood and remove bodily waste.

WHAT HAVE RESEARCHERS RECENTLY DISCOVERED ABOUT PKD?

PKD has been considered incurable, but researchers at the University of Texas Southwestern Medical Center have found what may be an effective new treatment. Their research was published in Nature Communications in February. Assistant professor Vishal Patel, who was the senior author of the study, says the drug that may cure PKD is called RGLS4326, which is currently in the clinical testing stage.

The researchers tell us that polycystic kidney disease patients may unknowingly have the disease for many years until a symptom – like blood in the urine, for example – shows up. Until now, no drug has been available to treat polycystic kidney disease. When the disease reaches the point of complete kidney failure, the only options until now have been kidney dialysis and kidney transplants.

Dr. Patel’s research led him, back in 2009, to investigate microRNAs (called “MiRs”) that might offer researchers a better understanding of PKD. MiRs are extremely tiny strands of RNA – ribonucleic acid – that can interfere with normal genes. Kidney researchers became interested in MiRs in the 1990s, reasoning that if MiRs are responsible for PKD, then creating an “anti-MiR” with the exact opposite chemical sequence should neutralize the effect of MiRs on kidneys. In a 2013 research study, scientists discovered a microRNA sequence that they believe promotes the growth of kidney cysts, the “17~92” sequence.

In the current study led by Dr. Patel, researchers inhibited the 17~92 microRNA sequence in mice and found that the deletion of the 17~92 sequence not only slowed cyst growth but extended – in fact, almost doubled – the lifespan of the mice. “In support of this conclusion,” Dr. Patel’s researchers write, “we show that genetic deletion of miR-17∼92 attenuates disease progression in ADPKD mouse models irrespective of the mutated gene, the type of mutation (null or hypomorphic) or the dynamics of cyst growth (rapidly fatal, aggressive but long-lived or slowly progressing).”

WHAT DID EARLIER PKD RESEARCH FIND?

The University of Texas Southwestern Medical Center’s research follows up on earlier PKD research conducted by the University College London Institute of Child Health. The London-based researchers noted that tiny blood vessels surrounding the cysts are altered very early in cyst development. They targeted the blood and lymphatic vessels inside the kidneys of mice with a growth protein called VEGFC.

The blood vessel patterns quickly normalized and the function of the kidneys improved. The researchers in London published their results in 2015 in the Journal of the American Society of Nephrology. “If we could target these blood vessels early in the development of the condition it could potentially lead to much better outcomes for patients,” according to Adrian Woolf, who is a professor of pediatric science and was the co-author of the study.

Because polycystic kidney disease is caused by an inherited gene, it is not preventable. If one parent carries the gene, a child has a fifty percent chance of developing PKD. Inevitably, if someone carries the PKD gene, he or she will develop the disease at some point in his or her life. Although there is no cure at the present time, RGLS4326 and VEGFC offer real hope for the immediate future.

WHAT IF PKD IS MISDIAGNOSED?

While there is no PKD cure for now, treatments and surgeries can help those who struggle with PKD manage the pain and deal with the infections associated with the condition. However, the misdiagnosis of PKD can lead to a swift deterioration of a patient’s medical condition, and such a misdiagnosis may constitute medical malpractice. When you receive a routine medical examination, urine tests and blood tests are standard. Those test results should indicate to your doctor if you are in the early stages of kidney disease.

If you are a PKD patient and you have been misdiagnosed or otherwise victimized by medical negligence, speak at once with an experienced medical malpractice attorney. Kidney disease patients are entitled to full compensation for any injuries they suffer as a result of medical malpractice. A medical malpractice lawsuit is often the only way to hold a healthcare professional accountable for carelessness or negligence.

The importance of an early and accurate diagnosis of kidney disease cannot be overstated. Some people don’t even realize they have kidney trouble until that trouble becomes severe, but with the proper medical approach, PKD can be diagnosed accurately and managed effectively. However, when a doctor fails to diagnose any kidney disease accurately or fails to treat kidney disease appropriately, it may constitute the kind of medical malpractice that puts a patient’s life at risk. If you are the victim of medical malpractice involving PKD or any other type of kidney disease, don’t wait – discuss your situation promptly with an experienced medical malpractice attorney.

The symptoms of kidney disease include blood in the urine, foamy urine, or discolored urine; high blood pressure; and/or the swelling of the hands and ankles. If you are over age 60, if you suffer from diabetes, high blood pressure, or heart disease, or if there is a history of kidney disease in your family, get tested for kidney disease, even if you feel healthy. In its earliest stages, kidney disease manifests no definitive signs or symptoms. Without a precise early diagnosis, a patient’s kidney disease may become more difficult and burdensome to manage or treat.

If you suffer from kidney disease, and if medical professionals did not accurately diagnose or treat your condition from the start, speak at once with an experienced medical malpractice attorney. New treatments and breakthroughs are providing plenty of hope for the victims of polycystic kidney disease, but even when these treatments become widely available, PKD patients will still need to seek an accurate early diagnosis and receive the proper treatment.

Research Suggests Protein Deficiency May Be Responsible For Chronic Kidney Disease

Posted on: February 22, 2017 by in Blog
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Millions of us in the United States and an estimated 200 million people around the world struggle with chronic kidney disease (CKD). It’s a condition that emerges incrementally over a number of years. Anyone can develop chronic kidney disease, and it’s a growing concern in the United States. New research, however, points to a circulating protein that may be responsible for the decline in kidney function.

Our kidneys filter the wastes and extra water from our blood. When chronic kidney disease emerges, the kidneys cannot filter the blood properly. Chronic kidney disease cannot be “cured,” but if it is detected in its early stages, it can often be adequately managed with the proper medications. If kidney disease is not properly treated, a complete kidney failure is eventually inevitable.

A team of researchers at the Tufts Medical Center studied the link between levels of a protein called soluble klotho and kidney function. The research was published in the Journal of the American Society of Nephrology. Researchers state that “CKD appears to be a condition of soluble klotho deficiency.” Decreased blood levels of the protein were linked with a higher likelihood of declining kidney function in a group elderly, well-functioning adults.

HOW WAS THE RESEARCH CONDUCTED?

Researchers assayed serum soluble klotho in 2,496 participants in the National Institutes of Health’s ongoing “Health, Aging, and Body Composition” study, evaluating the link between soluble klotho and the emergence of chronic kidney disease over a ten-year follow-up period. The average age of the participants was 75. Just over half – 52 percent – of the participants were women.

Lead researcher Dr. David Drew said, “We found a strong association between low soluble klotho and decline in kidney function, independent of many known risk factors for kidney function decline. This suggests that klotho could play a role in the development of chronic kidney disease, although additional research will need to confirm this. This also raises the possibility that klotho could be an important therapeutic target for future clinical trials.”

Specifically, for each two-fold higher level of soluble klotho, the scientists found a 20 percent lower risk of kidney function decline throughout the follow-up period. The researchers’ results did not change after adjustment for key variables including demographics, comorbidities, and a number of kidney disease risk factors. Higher levels of soluble klotho are associated independently with a reduced risk of declining kidney function.

HAS PREVIOUS RESEARCH LINKED PROTEIN LEVELS TO KIDNEY DISEASE?

The study of soluble klotho levels follows a 2015 study of another protein, TMIGD1, and its impact on kidney function. When researchers at Boston University reduced the TMIGD1 protein in kidney epithelial cells, the cells became more prone to injury. When they increased the levels of TMIGD1, the increase seemed to protect the cells from being injured. Researchers thus determined that increasing the level of the TMIGD1 protein reduces kidney epithelial cell death, thus possibly helping patients to avoid chronic kidney disease and declining kidney function.

Here in the United States, approximately 20 million of us suffer from chronic kidney disease, which, according to the Wall Street Journal, currently costs Medicare more than $41 billion every year. Many people don’t even know that they have chronic kidney disease until their kidney problems become severe. It’s imperative for chronic kidney disease sufferers to be swiftly and accurately diagnosed and to receive the appropriate medical treatment. With an early and accurate diagnosis, the progress from early-stage chronic kidney disease to complete renal failure can be slowed and in some cases halted altogether.

If a urine test finds blood and protein in a patient’s urine, it probably means chronic kidney disease, and the patient should be retested. If the same levels of blood and protein are found in a second test, the patient should be sent to a nephrologist – a kidney specialist. If a blood test finds a reduced protein level in a patient’s blood, the kidneys may not be adequately filtering the blood. A number of tests are available for identifying kidney disease, including:

  • tests for blood (hematuria) and protein (proteinuria) in the urine
  • blood tests for decreased protein, increased creatinine, and abnormal blood urea nitrogen
  • blood pressure measurements
  • glomerular filtration rate tests
  • MRIs, CT scans, and kidney biopsies

HOW IS MEDICAL MALPRACTICE DEFINED?

However, if a patient’s test results are misread or go unrecognized because a doctor has been inadequately trained – or for any other reason – that constitutes medical malpractice. In such circumstances specialists may not be consulted, treatment may not be ordered, and a patient’s health can rapidly decline. Medical malpractice is the violation of the “reasonable standard of care” provided by most doctors, but it’s often difficult for the average person to know if he or she is a victim of medical malpractice. A CKD patient may need to speak with an experienced medical malpractice attorney to determine if medical malpractice has occurred.

Every malpractice case is different, and any allegation of medical malpractice must be thoroughly considered from both the legal and medical angles. Providing a reasonable standard of care does not obligate doctors to order every possible test. Instead, physicians are expected to offer competent, professional care comparable to what other doctors would offer in similar situations:

  • Doctors should order the tests that are “reasonable” and standard.
  • Doctors should study the results of those tests in a timely manner.
  • In difficult cases, a doctor should consult a specialist.
  • If a chronic kidney disease is identified, the patient should be sent to a nephrologist.

If a doctor does not provide a reasonable standard of care, he or she may be considered negligent. If that negligence causes injury or harm to a patient, that patient is entitled to financial reimbursement and may file a medical malpractice claim. Medical malpractice victims can be compensated for lost income and earning capacity, for the cost of additional medical treatment, related expenses, and sometimes for pain and suffering as well.

Malpractice itself cannot cause kidney disease, but the failure of a patient to have an accurate early diagnosis and appropriate continuing treatment can lead directly to acute renal failure. Anyone who believes that medical malpractice has exacerbated his or her kidney disease – and anyone whose health has deteriorated after kidney treatment that should have improved it – should consult an experienced medical malpractice attorney regarding his or her rights and the possibility of legal action.

Is Heartburn Medicine Responsible For Kidney Complications?

Posted on: January 28, 2017 by in Blog
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Is your heartburn medicine bad for your kidneys? The use of certain heartburn drugs may increase the risk of developing kidney disease, according to research recently published in the Journal of the American Society of Nephrology. The research is the most recent of several studies pointing to the risks associated with proton pump inhibitors (PPIs) that include Nexium®, Prilosec®, and Prevacid®. PPIs treat heartburn, indigestion, and acid reflux by reducing the amount of acid produced by the stomach.

Doctors and researchers aren’t exactly sure why PPIs appear to damage the kidneys, and there is still there is no direct proof that the heartburn medicines are responsible for kidney diseases. The researchers determined that patients using PPIs were more apt to suffer kidney disease or kidney failure over a five-year period than patients using other heartburn medicines. One of the researchers and a kidney specialist with the Veterans Affairs St. Louis Health Care System, Dr. Ziyad Al-Aly admits, “I cannot say for certain that this is cause-and-effect.”

Despite the lack of a “smoking gun” that ties PPIs directly to kidney disease, Dr. Al-Aly recommends that patients should use PPIs only when it’s genuinely a medical necessity, and only for the shortest possible length of time. PPIs are usually effective heartburn remedies, so many people turn to them when they’re really not needed, or when the need is real, they use too much. “I think people see these medications at the drug store and assume they’re completely safe,” Dr. Al-Aly explained. “But there’s growing evidence they’re not as safe as we’ve thought.

WHAT SHOULD YOU KNOW ABOUT GERD?

One heartburn specialist agrees. Dr. F. Paul Buckley is the surgical director of the Heartburn & Acid Reflux Center at the Scott & White Clinic in Round Rock, Texas. Dr. Buckley says that for occasional heartburn, PPIs are not the appropriate medication. Before using PPIs, you should be certain that you are suffering gastroesophageal reflux disease (GERD), with stomach acids routinely rising into the esophagus.

Actually, according to figures from the U.S. National Institute of Diabetes and Digestive and Kidney Diseases, about one in five adults in the United States suffers with GERD. Heartburn is a GERD symptom, and anyone who experiences heartburn twice or more a week may have GERD, according to the Institute. Dr. Buckley says that PPIs work well for patients with more serious reflux, and if someone has inflammation in the esophagus or an ulcer, PPIs can give those situations the opportunity to heal.

Previously, PPIs have been linked to an inflammatory kidney disease called acute interstitial nephritis, according to Dr. Pradeep Arora, an associate professor and nephrologist at the SUNY Buffalo School of Medicine and Biomedical Science. Dr. Arora’s own study looked at more than 24,000 patients who developed chronic kidney disease between 2001 and 2008. The doctor says, “It is very reasonable to assume that PPIs themselves can cause chronic kidney disease.”

The recently published findings are derived from a study of more than 173,000 VA patients who were given a PPI and 20,000 other patients given heartburn drugs called H2-blockers. H2-blockers include Pepcid®, Tagamet®, and Zantac®. Over the study’s five-year period, 15 percent of the PPI users were diagnosed with a kidney disease but only 11 percent of those using H2-blockers were diagnosed with a kidney disease.

Fewer than 0.2 percent of the patients studied suffered end-stage renal failure, but the odds for end-stage renal failure were nearly doubled among the patients using PPIs. And according to Dr. Al-Aly, the risk of kidney disease grows as patients continue to use PPIs over time. Patients using the drugs for more than a year had three times the risk of kidney failure as those who used the drugs for a month or less.

HOW DO THESE DRUGS CAUSE OR EXACERBATE KIDNEY DISEASE?

How do PPIs cause or contribute to kidney disease – if they’re a factor at all? Previous research has linked PPIs with acute kidney inflammation, and some persons taking PPIs may develop kidney inflammation that leads to chronic kidney disease. Other researchers believe that PPIs reduce the body’s magnesium level and that a higher magnesium level is necessary for healthy kidneys. PPIs block stomach acids and reduce the body’s ability to absorb particular nutrients including magnesium.

Thousands of heartburn sufferers take proton pump inhibitors for heartburn without reporting any additional medical complications, but Dr. Buckley insists these people should be aware of the possible risks of PPIs, adding that, “They should also be aware we have really good alternatives.” Even TV’s Dr. Oz says, “Trouble is, up to two-thirds of people who take PPIs don’t really need them.”

If you suffer from a kidney disease and a physician prescribes the wrong medication, and if your condition declines as a result, you may be a victim of medical malpractice, and you should discuss your situation with an experienced medical malpractice attorney. With over twenty million chronic kidney disease sufferers in the United States, the opportunities for medical malpractice are abundant, and it happens much too often to kidney disease patients.

WHAT IS THE DEFINITION OF MEDICAL MALPRACTICE?

When someone struggles with chronic kidney disease, you rightly expect that the medications that are prescribed will help you. If they don’t, you’ve probably been given an improper medication, and you’re probably, at that point, a victim of medical malpractice. If you or someone close to you is struggling with kidney disease and becomes a medical malpractice victim, discuss your case, your rights, and your legal options with an experienced medical malpractice attorney.

The law precisely defines medical malpractice. It is a violation of the “reasonable standard of care” provided by most physicians and other healthcare professionals. Sometimes, it’s difficult for a kidney disease patient to know if he or she is a malpractice victim. Every medical malpractice case is different, and every claim of malpractice must be comprehensively examined from both the medical and legal perspectives.

If you don’t treat them, diseased or damaged kidneys may stop working – completely. Loss of kidney function is a serious and sometimes fatal condition. The good news is that a number of treatment alternatives are available for kidney disease patients, and there is no reason to avoid a test for CKD if you are in a high-risk group – if you are over 60, African-American, or have a family history of kidney disease. These include dialysis, kidney transplants, and more. For more info, head to The Kidney Foundation’s website.

Hospitalizations And Deaths From Kidney Disease Continue To Decline

Posted on: December 21, 2016 by in Blog
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“USRDS” stands for the U.S. Renal Data System, a data registry system located at the University of Michigan in Ann Arbor. USRDS collects comprehensive data about patients with kidney disease across the United States and publishes the data each year in an annual report. The most recent report is relatively good news regarding kidney disease. The USDRS data tells us that kidney disease-related hospitalizations and deaths have incrementally decreased over the last twenty years.

Researchers compiling the report determined that more kidney dialysis patients now receive arteriovenous fistulas, lowering the risk of infection. More “paired” kidney donations are being made, and paired donations now constitute about 10 percent of all of living kidney donor transplants. Annual admissions to hospitals for patients suffering end-stage renal disease (ESRD) declined by about 19 percent in the decade from 2005 through 2014. From 1996 through 2014, mortality rates for patients undergoing kidney dialysis dropped by about 32 percent, and among kidney transplant patients in those same years, mortality rates fell a full 53 percent.

Dr. Rajiv Saran is a professor of internal medicine at the University of Michigan and the director of the USRDS Coordinating Center in Ann Arbor. Dr. Saran says the kidney disease numbers are improving for a variety of reasons. Primary care providers now provide more care to kidney disease patients, and “we are seeing healthier patients coming into the ESRD pool.” Dr. Saran also believes that falling infection rates among dialysis patients – because of better infection control in dialysis units – is another partial explanation of the overall improving picture for kidney disease patients.

WHY IS THE USE OF THE ARTERIOVENOUS FISTULA AN IMPROVEMENT?

The declining use of temporary dialysis catheters is an important and helpful development. Temporary catheters are prone to carry infections. Use of the arteriovenous fistula, a safer alternative to catheters that is also more permanent and provides better vascular access, increased from 32 percent to 63 percent among dialysis patients from 2003 through 2014. During the dialysis process, the arteriovenous fistula is also less likely to cause blood clots.

Kidney transplants still usually succeed for end-stage renal disease patients, but the number of patients needing kidney transplants still far exceeds the number of available kidneys. Wait times are long and are getting longer. At the end of 2014, the transplant waiting list numbered 88,231 candidates – 246 more candidates than the waiting list at the end of 2013 or about a 3 percent increase. Yet fewer than 18,000 kidney transplant operations were conducted in the U.S. in 2014.

Many healthcare professionals who work with kidney disease patients had hoped that the rise in paired kidney donations would help to alleviate the shortage of available kidneys and reduce waiting times. A paired kidney exchange – essentially a “kidney swap” – occurs when a living donor is incompatible with a proposed recipient, so the donor exchanges kidneys with another donor/recipient pair, resulting in two live donor transplants. In 2015, 552 paired transplants were performed in the United States. “We think it’ll increase over time,” Dr. Saran says.

HOW MANY IN THE U.S. STRUGGLE WITH KIDNEY DISEASE?

While the recent U.S. Renal Data System report is good news, chronic kidney disease continues to afflict approximately 15 percent of the adults in the United States. As 2014 ended, 678,383 dialysis and transplant patients were receiving treatment for end-stage renal disease in the U.S., a 3.5 percent rise from the end of 2013. High-risk groups for kidney disease include people over age 60, African-Americans, and anyone with a family history of kidney disease. The U.S. National Institute of Diabetes and Digestive and Kidney Diseases says that chronic kidney disease remains the ninth-leading cause of death in the United States.

About 20 percent of all Medicare spending – roughly $50 billion in 2014 – is dedicated to chronic kidney disease treatment. Thus, Dr. Saran is insistent that more work must be done. He said patients require better care as they transition into end-stage renal disease. “People aren’t getting the preparatory care they need in the transition to dialysis. That is a practice pattern that needs to change if we are going to continue reducing mortality,” Dr. Saran says.

Four out of five dialysis patients in the U.S., for example, still begin dialysis with a temporary catheter because an arteriovenous fistula is not made ahead of time, and too many patients still do not learn that they even have kidney disease until the condition is advanced. “Even though mortality rates are going down, there’s no room for complacency,” Dr. Saran told Medscape Medical News.

WHAT’S THE ADVANTAGE OF EARLY DETECTION?

Properly functioning kidneys are essential to everyone’s health. When the kidneys are not functioning as they should because of kidney disease, a patient is also at risk for a number of other serious medical conditions including heart disease, a life event and/or infertility. However, with early detection, chronic kidney disease is manageable – for most patients – with medications. If you belong to a high-risk group, you should see your primary care doctor and be tested regularly for kidney disease.

When a kidney disease diagnosis is early and accurate, a kidney disease patient’s life usually does not need to be entirely disrupted. Research author Dr. Chi-yuan Hsu, a professor of nephrology at the University of California, says that “Kidney disease takes years to decades to develop, and several decades ago, we started developing better ways of halting or slowing kidney disease. Control is much better than it used to be.” Still, with kidney disease afflicting approximately 15 percent of the adults in the United States, there are plenty of opportunities for medical mistakes and for injuries to patients due to medical malpractice.

Medical malpractice is the violation of the “reasonable standard of care” provided by most doctors, but if you are not a doctor, it’s genuinely difficult to know if you are a medical malpractice victim. Every malpractice case is unique, and every allegation of medical malpractice must be thoroughly examined from the legal perspective by an experienced medical malpractice attorney.

If you are a kidney disease sufferer and your doctor or your healthcare providers failed to diagnose your kidney disease early and accurately, or if you were given improper treatment or were prescribed the wrong medications, discuss your situation with an experienced medical malpractice attorney. If you were injured or if your health declined due to medical malpractice, you are legally entitled to compensation.

New Research Links First Kidney Stone With Kidney Disease

Posted on: November 30, 2016 by in Blog
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Passing a kidney stone is extraordinarily painful, and kidney stones affect just over seven percent of the adults in the United States, although that percentage has been on the rise in recent decades. The American Urological Association reports that as many as twelve percent of us in the United States may be affected by kidney stones in our lifetimes. However, new research from the Mayo Clinic is suggesting that even after passing kidney stones, kidney-related health issues may persist, and chronic kidney disease may already be developing in patients with kidney stones.

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This year, nephrologists at the Mayo Clinic in Rochester, Minnesota, have confirmed a link between first-time kidney stone formations and the development of chronic kidney disease, according to new findings published in the journal Mayo Clinic Proceedings. A Mayo Clinic team led by Dr. William Haley and Dr. Andrew Rule assessed a group of 384 kidney stone patients three months after their first kidney stone event to study the effect of kidney stones on kidney function and the development of chronic kidney disease.

WHAT ARE THE SIGNS OF CHRONIC KIDNEY DISEASE?

Compared to the control group, kidney stone formers had higher levels of the blood marker cystatin C and higher levels of albumin, a protein in the urine: both are linked to a higher risk of chronic kidney disease. “Even after adjusting for other risk factors, including urine chemistries, hypertension and obesity, we still found that those with a kidney stone episode had subsequent abnormal kidney function,” Dr. Rule explained in a press release. “This helps us better understand the long-term implications of kidney stones beyond recovery time.”

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A progressive loss in kidney function characterizes chronic kidney disease and reduces the body’s ability to eliminate waste products. The symptoms of chronic kidney disease may include a general feeling of fatigue, a reduced appetite, nerve damage, high blood pressure, anemia, and weak bones. The National Kidney Foundation estimates that 26 million people in the United States suffer from kidney diseases.

HOW ARE KIDNEY STONES FORMED?

Older studies had already concluded that kidney stone sufferers have an increased risk of developing chronic kidney disease, but the new study establishes that the risk increases even with the initial kidney stone event. A kidney stone begins as a tiny mineral deposit and grows in size if the urinary tract cannot push it out of the body. Large kidney stone deposits may cause serious pain, nausea, and difficulty while urinating.

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“This research shows that the implications of kidney stones may go beyond the discomfort they are so often associated with,” Dr. Rule added. “Prevention of kidney stones may be beneficial for a person’s overall kidney health.” Generally speaking, the formation of kidney stones is the result of a heightened concentration of chemicals in the urine that form crystals. This heightened concentration of chemicals may be triggered by any of the factors listed here:

• a family’s genetic predisposition to form kidney stones
• excessive calcium in the diet, sometimes caused by local water or soil conditions
• excessive uric acid, certain medications, Vitamin C, or Vitamin D
• residing where high temperatures routinely cause excessive sweating and loss of fluids
• a diet of fruits and vegetables high in oxalate
• long-term dehydration
• a urinary infection
• a sedentary lifestyle

The kidneys are always collecting the ingredients that form kidney stones – calcium, oxalate, and uric acid. In a healthy person, these minerals remain in suspension until they pass out of the body during urination. A high quantity these metabolic byproducts combined with insufficient fluid (that is, urine) makes a person likely to begin kidney stone formation.

HOW IS CHRONIC KIDNEY DISEASE DIAGNOSED?

A blood test for creatinine is typically used to diagnose chronic kidney disease. Creatinine is a chemical waste product produced by the metabolism in your muscle and by consuming meat. Healthy kidneys filter the creatinine, so higher levels are indicative of a reduced capability of the kidneys to eliminate waste. Chronic kidney disease may also be diagnosed if urinalysis shows that the kidneys are allowing excess protein or excess red blood cells into the urine.

Because so many struggle with kidney stones and kidney disease, it is inevitable that many patients will encounter medical malpractice and require the counsel of an experienced medical malpractice attorney. If your kidney disease originally was undiagnosed or misdiagnosed, proper treatment was probably delayed. A proper early diagnosis and the appropriate treatment make kidney disease manageable for many patients, but any medical malpractice – a misdiagnosis, the wrong prescription drug, or an unnecessary surgical procedure, for example – could cause your medical condition to deteriorate rapidly.

If you are a kidney disease sufferer who has experienced medical malpractice, discuss your legal rights and options with an experienced medical malpractice attorney who works exclusively with kidney disease patients. Misdiagnosis or improper treatment of kidney disease is medical malpractice, and per Jeffrey Nadrich, one of the top San Bernardino personal injury lawyers states, “malpractice victims are entitled by law to compensation for their additional medical care and related costs.”

In some cases, patients may also receive compensation for the pain and suffering caused by medical malpractice related to kidney disease. If a patient can prove that his or her health declined as the direct result of an incident of medical malpractice, that patient can be compensated. Statutes of limitation in each state restrict the amount of time that a patient has to file a malpractice claim, so taking action at once is imperative for any victim of medical malpractice.

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When a physician discovers abnormally high levels of protein or blood in the urine, that physician should test you again after a short interval. A high level of protein in the blood is typically the first indication of chronic kidney disease. If a second test again shows high levels of protein or blood in the urine, you should be referred immediately to a kidney specialist – a nephrologist. A general practitioner should know when a patient should be sent to a nephrologist.

Nephrology is the field of medicine that deals with kidney diseases. Anyone with a kidney disease must receive the appropriate medical treatment, or the condition will progress until dialysis or a kidney transplant are the only remaining treatment options. The screening of individuals who are at risk – those with diabetes or high blood pressure, those over 60, those with a family history of kidney disease, and now those with a first kidney stone event – is imperative.

Slight Blood Sugar Elevation Linked To Kidney Damage

Posted on: October 7, 2016 by in Blog
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Kidney diseases are an enigma. A single, conclusive cause for any individual patient’s kidney disease is usually impossible to isolate and identify. However, it’s established that diabetes and a high blood sugar level directly contribute to kidney disease. Those with higher than normal blood sugar levels are more likely than the average person to have too much albumin (a protein) in the urine and to have problems with abnormal blood filtration.

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Around the world in the 21st century, more than ten percent of all adults have diabetes, which develops when the body can’t properly use or make enough insulin to convert sugar into energy. Diabetes is often linked to kidney disease, but now, researchers in Norway have determined that even people with borderline blood sugar levels – high but not diabetic – have an increased risk for kidney disease.

The relationship between chronic kidney disease and diabetes is well-established, but doctors disagree about how much sugar in the blood might pose a kidney disease risk to people who have not developed chronic kidney disease. There’s also disagreement among the experts regarding how to diagnose and treat patients with mildly high blood glucose levels and whether it is appropriate to refer to this condition as “pre-diabetic.”

WHO WERE THE SUBJECTS OF THE NORWEGIAN RESEARCH?

Norwegian researchers assessed the blood sugar levels and indications of kidney damage in 1,261 people ages 50 to 62 who didn’t have diabetes. Researchers determined blood sugar levels by measuring the blood glucose in patients who were fasting and by measuring blood levels of hemoglobin A1c. The hemoglobin A1c test estimates the average blood sugar level over several months based on the percentage of hemoglobin – the protein in red blood cells that carries oxygen – coated with sugar.

At the beginning of the research, according to lead researcher Dr. Toralf Melsom of the University of North Norway, 595 people had a slightly high blood sugar level based on U.S. guidelines, which are fairly stringent. European guidelines require more sugar before glucose levels are considered elevated, so under those criteria, only 169 of the study participants had a “slightly high” blood sugar level.

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After a five-year follow-up period, participants with slightly high blood sugar – under either set of guidelines – were more likely to have kidneys working harder to filter their blood, a condition called hyperfiltration. Those individuals were also more likely to have elevated levels of albumin in the urine, indicating early kidney damage. Those with slightly higher blood sugar under the European guidelines were 95 percent more apt to have hyperfiltration and 83 percent more likely to have high albumin levels in the urine.

WHAT DIFFICULTIES DID THE NORWEGIAN RESEARCHERS FACE?

Writing in the American Journal of Kidney Diseases, the Norwegian researchers admitted that only middle-aged white subjects participated in the study, so the results may differ significantly for patients in other populations. Another twist in the research is the difficulty in defining hyperfiltration. That’s because the nephrons, the kidney’s waste-processing units, vary by age and gender. On the positive side, the study reaffirms the need for doctors to focus on patients with slightly elevated blood sugar levels.

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Dr. Laura Rosella, a public health researcher at the University of Toronto, says those patients should focus on lifestyle changes that include a better diet, regular exercise, and for some, weight loss. She says, “If someone adopts the necessary changes that would prevent the onset of diabetes, it is likely to protect against the progression to kidney disease as well – just like it will prevent cardiovascular disease and many cancers.”

HOW CAN YOU MAINTAIN A HEALTHY BLOOD SUGAR LEVEL?

The World Health Organization says that around the world in 2012, over 2.2 million deaths could be attributed to high blood sugar in people who did not have diabetes. Maintaining a healthy blood sugar level one of the best strategies for avoiding chronic kidney disease. Here are some basic diet and exercise suggestions to help you get started:

  • Limit the consumption of foods that cause blood sugar levels to spike. Reduce your intake of carbohydrates and eat more fruits, vegetables, and lean protein. According to the Joslin Diabetes Center in Boston, an average adult should consume between 20 and 35 grams of fiber each day.
  • Drink eight 8-ounce glasses of water or some other sugar-free liquids every day. Limit consumption of drinks with caffeine. Put some pizazz in your drinking water by infusing it with lemon or fresh fruit.
  • Put some pizazz in your diet, too. Substitute unsweetened applesauce for butter or oil in cookie and cake recipes. You’ll lower your calorie intake and increase your vitamins and minerals. In creamy recipes like vegetable dips, replace mayonnaise or sour cream with Greek yogurt to reduce your fat intake. Substitute white flour with whole-wheat flour and whole milk with skim milk.
  • Take advantage of the abundant online resources for making a healthy diet a routine part of your lifestyle. The Department of Agriculture’s ChooseMyPlate.gov site provides quick and easy reference tools on healthy eating. Kidney disease patients will also want to visit MySpiceItUp.ca, a site that provides kidney-friendly recipes approved by a team of licensed renal dietitians.

According to a National Kidney Foundation estimate, approximately 26 million people in the United States have chronic kidney disease and another 20 million are at risk. That creates abundant opportunities for medical errors and medical malpractice. While general practitioners may not be expected to have a kidney specialist’s knowledge, they are supposed to know when a patient should be seen by a specialist. If you or someone you love has been misdiagnosed, improperly treated, or injured by medical malpractice related to kidney disease, discuss your legal rights and options at once with an experienced medical malpractice attorney.

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Kidney disease can be accurately diagnosed only with a renal biopsy. If you are in a high risk group for kidney disease – that is, if you’re more than 60 years old or if you have a history of kidney disease in your family – have your doctor examine you for kidney disease. If your own physician finds a high blood sugar level or high albumin levels in your urine, he or she should immediately refer you to a nephrologist.

If a doctor fails to diagnose or treat your kidney disease, speak at once with an experienced medical malpractice attorney. An accurate and early diagnosis can often reduce and sometimes even reverse the consequences of kidney disease, but a misdiagnosis can exacerbate your medical condition, delay your treatment, and cause your health to deteriorate. When you’re a kidney disease patient, guarding your health is imperative, and sometimes, protecting your legal rights is just as important.