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Health Blog

Coping with Chronic Conditions

March 3, 2023
Harvard Health Publishing provides 10 steps for coping with a chronic condition like chronic kidney disease.  Some of these steps are summarized here:
The first step is to make your doctor a partner in care. However, it is important to take responsibility for your care and not leave everything to your doctor. Listening to your body and tracking its changes can help you do this. For example, if you have hypertension, ...   read more

Prevent or Reduce Problems Associated with My Health

January 8, 2023
Many health problems are caused by key risk factors, like poor nutrition, physical inactivity, poor sleep, excess alcohol use, or smoking tobacco. Some health problems are inherited and runs in the families like chronic kidney disease, high blood pressure, diabetes, and high cholesterol. Knowing your family history is important so you can make healthy choices early on. You can reduce your likelihood of getting a chronic ...   read more

Managing Chronic Kidney Disease-How Can I Help?

December 30, 2022
Having chronic kidney disease (CKD) means your kidneys are not working 100% and kidneys are not doing their tasks as usual and there is decreased function. There are many causes of decreased kidney function, aging, health related conditions like high blood pressure or diabetes, and familial cystic kidneys are the common ones. However, whatever the cause, it should be taken seriously and managed carefully to delay ...   read more

Diabetes and Kidney Disease

November 23, 2022
What is diabetes?
Having high blood sugars all the time can cause a disease called Diabetes which happens when your body does not make enough of a hormone called insulin or cannot use insulin properly to use up or store the extra sugar. High blood sugar can give you symptoms of being hungry all the time, thirsty all the time and urinating frequently. A high blood sugar can lead to problems in many parts ...   read more

Getting To Know Your Medicines - Phosphate Binders

October 3, 2022
Phosphate is a mineral in the body used to form bone and teeth. Phosphate is also used in your body cells in substances used for energy, cell membranes, and your DNA. The body gets phosphate from foods and gets rid of its excess in the urine and stool. People with kidney failure tend to have higher phosphate levels as they cannot get rid of it normally. This can lead to bone problems, ...   read more


August 25, 2022
There are many kinds of medicines available to bring down your blood pressure if it is elevated. Different people respond differently to each type of medicine. Your doctor probably has chosen specific tablets most suitable for your situation. A combination of Blood Pressure Medicines is often needed to control one’s blood pressure to a goal and target levels.
A lot of times there are no warning signs with ...   read more

How Can I Be More Engaged in My Healthcare?

July 8, 2022
Tips for Kidney Patients
To get a good quality healthcare, kidney patients and their advocates need to be engaged and be an active member of their healthcare team. Kidney patients are the center piece of their care. More timely care, accurate diagnoses and better outcomes are more often seen in patients who are inquisitive and understand their medications and treatment plans.
Use these tips ...   read more

How to find a living kidney donor?

March 7, 2022
Many don’t know where to begin looking for a living kidney donor. It may be overwhelming trying to deal with CKD or ESRD, let alone thinking about kidney transplantation. It may be wise to gather as much information as possible about living donation and kidney transplant first. You can learn more about living donation by talking to your nephrologist or other members of your healthcare team. You can also get more ...   read more

Value-based care is here.

March 1, 2022
A simple and bold idea of improving healthcare for patients is value-based care. Value-based care is supposed to improve healthcare results and to reduce care costs by focusing on overall wellness of the population and preventive treatments.
Value-based care is simply the idea of better quality care at a lower cost with better results for patients. A set of changes is necessary in the way people receive care to ...   read more

What is the Value Based Care Model for kidney patients?

January 7, 2022
East Bay Nephrology Medical Group participates in Medicare Value Based Care, Kidney Care Choices model, in affiliation with Integrated Kidney Care of Northern California. 
Kidney Care Choices (KCC) model which builds upon the existing Comprehensive End-Stage Renal Disease Care (CEC) Model was announced by the Centers for Medicare & Medicaid ...   read more

How do I get engaged as a kidney patient?

October 3, 2021
It is necessary to integrate the patient’s point of view in the health outcome and the measures of satisfaction. Only then patient engagement is full. Patient engagement in health care consists of the actions they take to benefit from that care. It is no longer the case in modern medicine that patients can passively receive health care and assume that this will produce the best result and optimal impact.
There ...   read more

SGLT2 inhibitors – What are they and do I need them if I have Kidney Disease?

August 2, 2021
Sodium-glucose co-transporter 2 (SGLT2) is a channel in the kidney cells that reabsorb sodium and sugar. SGLT2 inhibitors are a new class of medications that inhibit these channels and result in decreased absorption of filtered sugar by the kidney as well as sodium. As a result, there is loss of sugar, sodium and water in the urine and thereby modestly lower elevated blood glucose levels in patients with type 2 ...   read more

What is a glomerular disease, and how do I know I have one?

June 21, 2021
Kidneys have about one million tiny filter units called nephrons. Each nephron has a glomerulus and tubule. Blood passes through these million glomeruli and each glomerulus acts as a filter- it filters and retains the necessary components of blood such as red blood cells and proteins and drains the rest in the tubule. The tubule then fine-tunes the filtered blood further and ultimately produces urine. 
Injury to ...   read more

Looking for a Kidney Donor?

June 14, 2021
When you have advanced kidney failure one of the treatment options is to receive a kidney transplant. Transplants can come from two sources, living donors or deceased donors. You can be put on a waiting list after compete evaluation when your GFR falls below 20 ml/min. If your kidney doctor recommends that you pursue a kidney transplant, you must first be referred and evaluated for a transplant by a transplant center ...   read more

Which Vaccinations are Needed with Kidney Disease?

May 3, 2021
Which vaccinations do I need?
Your primary care provider is the best person to ask about which vaccinations you should get.  Another good source is Center for Disease Control and Prevention website, https://www.cdc.gov/vaccines/, which provides schedules for adults and children alike. COVID-19 Vaccination information can also be found at this website. Different forms of vaccines may be needed in patients ...   read more

Ten Ways to Cut Out Salt

January 18, 2021
Low salt or sodium intake reduces blood pressure and with improves cardiovascular outcomes in those with and without chronic kidney disease (CKD) with less heart attacks, heart failure or strokes. Patients with CKD are often salt sensitive and unable to control blood pressure and/or swelling when there is  a high salt intake. Therefore, patients with diabetes and CKD could benefit from restricting salt intake in ...   read more

Why Choose Home Dialysis?

December 1, 2020
Did you know that 93% of Nephrologists and 89% of nurses will choose home dialysis if their kidneys fail according to a report in Nephrology News and Issues in 2010? With home dialysis, the treatment fits into your life—not the other way around. Treatment times are more flexible and based on your lifestyle. You don’t have to show up at a specific time at a dialysis center for treatment like in-center dialysis. ...   read more

How long can dialysis continue?

January 10, 2019
The simple answer would be as long as you live and willing to stay with the treatment plan. Many patients live long, dynamic, and gratifying lives with kidney disease for many years, some for 20-30 years or more. Time on dialysis depends on many factors including the person’s other medical problems, their age, their gender, their stamina, and how well they take care of themselves and follow their physician’s ...   read more

Chronic Kidney Disease

August 5, 2018
Chronic Kidney Disease (CKD) is a common medical problem in United States that causes decreased kidney function. Around 30 million Americans (1 in 7 U.S. adult population) have CKD. CKD has many causes. CKD has been divided into 5 stages depending on a blood test called creatinine, with stage 3 (moderate kidney disease) being the most common. Scientists predict there will be a rise in CKD due to a link to diabetes, uncontrolled ...   read more

Foods to Avoid or Limit if You're on Dialysis or Late Stage Kidney Disease

November 1, 2017
When you are on dialysis your diet is restricted, as certain foods have substances that your kidneys used to get rid of and now dialysis has to do that. Foods that you eat get metabolized in your body and waste products are generated that are removed from the body either through the GI tract or through the kidneys. When the kidneys fail, they cannot clean these wastes and they tend to build up in the body and make you ...   read more

Learn more about Potassium

September 29, 2017
Potassium is one of the minerals in the body. Most of the potassium is inside the body cells and a small but important percentage circulates in the blood. A potassium blood test can measure how much potassium is in the blood. Normal levels are between 3.5 to 5 meq/L. The body needs potassium to work normally. It keeps the heart beating and helps the nerves and muscles work. Potassium is found in most foods that you eat. ...   read more

What is involved in a Kidney Biopsy?

November 30, 2016
A kidney biopsy is done to remove a small piece of kidney tissue to examine under a microscope to find out what is causing the kidney disease and its severity so appropriate treatment plans are chosen by your kidney doctor.
Most often this is done under direct picturing and guidance of an ultrasound or CT scan by inserting a thin needle through the skin of the back to the kidney for obtaining a small sample tissue.
Why ...   read more

Vitamin D and Chronic Kidney Disease

August 24, 2016
Vitamin D is a common supplement and many people incorporate it in their medical regimen, either at the recommendation of their primary care physician or based on ads seen in the media.
Vitamin D comes as Vitamin D2 (ergocalciferol) and Vitamin D3 (cholecalciferol); in the liver they become calcidiol (25-hydroxyvitamin D); the kidneys further transform  calcidiol into Calcitriol ...   read more

What is Home Hemodialysis?

July 15, 2016
If your kidneys have started to fail, your kidney doctor will present you with the options to replace the job of the kidneys. One of these options is dialysis that can be done at home or place of residence. Home hemodialysis can be done on a schedule convenient to you or your care partner.
There are three types of home hemodialysis: traditional, short daily and nocturnal. All of them require a hemodialysis machine ...   read more

What is Peritoneal Dialysis and How Does it Work?

April 15, 2016
To replace the kidney function of getting rid of waste products and excess fluids, there are two types of dialysis. One is Hemodialysis which involves blood and the other peritoneal dialysis (or PD) which does not involve any blood. When the kidneys fail, PD is a great option for dialysis. PD involves putting some dialysis fluid inside the belly. There is a natural membrane around the bowels and abdominal wall that does ...   read more

How do I get started with Advance Care Planning?

January 15, 2016
Planning for the future can be challenging, especially if it is about your healthcare.  You can start by thinking about what kind of treatments you would or would not want in a medical emergency. See discussions regarding “Planning for future care in advance” in our past blogs about this. It might help to talk with your doctor about how your present health conditions including kidney disease might influence ...   read more

Planning for your future care in advance

December 15, 2015
One thing is for sure, we are all aging. Even if you are not sick now, making healthcare plans for the future is an important step toward making sure you will be treated the way you would want, even when doctors are making recommendations for your care. At any age, a medical crisis could leave someone too ill to make his or her own healthcare decisions. More than one out of four older Americans face questions about medical ...   read more

What Can A Dialysis Patient Do To Reduce Chances Of Infections?

October 5, 2015
Infections are one of the leading causes of hospitalizations, dialysis access loss and death for dialysis patients, but fortunately they can be prevented, and when they happen and identified in time, treated with antibiotics.  The key to infection prevention is cleanliness.  Here are some of the things you can do as a patient to decrease the chance of infections.
Knowing when you have an infection is ...   read more

Taking Care of your Dialysis Access

August 15, 2015
To get hemodialysis we need a way to repeatedly reach your blood so it can go to the artificial kidney (dialyzer) to be cleaned.  For this one needs a dialysis vascular access. There are three kinds of access: fistulas, grafts and catheters.  A fistula is blood vessel that is formed by linking an artery and a vein under your skin in your arm (or leg). Arteries have fast blood flow. ...   read more

Dialysis Access Q&A

June 30, 2015

Why is a dialysis vascular access important to me?
Your access is your dialysis lifeline. You have only a few sites for dialysis access. It is important to care for your access so it will last as long as possible.
How can I keep my access working?
You can help keep your access working by avoiding infection, avoiding blockage, and injury to your access.
How can I prevent infection?
Keep ...   read more

How much protein should I eat?

May 14, 2015
The current recommendation for protein intake in healthy adults is around 0.8-1.0 gm per kg of body weight. That translates to about 55 gm of protein for males and 45 gm for women per day. The typical western diet supplies more than the recommended daily amount of protein.
For persons with chronic kidney disease, restricting protein can delay progression of the kidney disease and the need to start dialysis.
Protein passing ...   read more

How much water should I drink?

April 27, 2015
One of the most common questions I am asked, both by patients and friends is how much water they should drink. I always cringe, because the answer is not what people want to hear, and that is an absolute number – half a gallon, 32 oz, 8 cups, etc.
The kidney is extremely adept in regulating our body’s water content. The concept of ‘flushing the kidneys’, while sounds appealing, does not exist. ...   read more

Living with Kidney Disease: What are the Numbers and What You Can Do

March 18, 2015
Chronic kidney disease (CKD) is on the rise and it has become a major public health problem. CKD is defined as damage or a decrease in kidney function that persists for longer than 3 months.
Although the exact numbers are hard to know, it is estimated there are 19 million people in this country living with kidney disease. CKD is divided in stages 1 through 5 depending on the severity of the dysfunction.
There ...   read more

When to Refer to Nephrology

February 15, 2015

To answer this better please refer to the list of items below:

All patients with calculated GFR < 60 and concomitant proteinuria, hematuria and/or pyuria or GFR declining.
All patients with GFR < 30.
A patient expected to need dialysis
Incidental diagnosis of polycystic kidney disease on CT, US or MRI
Unexplained proteinuria quantitated greater than 500 mg/day.
Nephrotic syndrome (Heavy proteinuria, edema, ...   read more

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