ARE RESTLESS LEGS KEEPING YOU UP AT NIGHT? CLICK HERE TO LEARN MORE...

Restless legs syndrome(RLS)is a neurological disorder that affects movements of the legs and sometimes arms. It is considered a sleep disorder as it often disrupts sleep and affects fully 10% of the adult population.
Persons with RLS have an itch, pins and needles sensation an an irresistible urge to move their limbs to relieve this sensation. It affects walking as well, causes sleep deprivation, daytime drowsiness and untold stress.
The severity ranges from mild to severe. 2/3 of persons with RLS will get progressively worse if not treated. Generally milder in younger patients , by age 50 the sensations and sleep disruption can very negatively impact on quality of life.
RLS is more common with advancing kidney failure and iron deficiency anemia. It often takes 10-20 years for some persons to get a proper diagnosis. This doesn't have to be the case. If you experience this phenomenon, speak to your nephrologist and get a referral to a neurologist who specializes in this disorder. Here in Fort Lauderdale there are several. We want to help you get the rest you need. Click on the link for more information on how to treat this common and frustration disorder.

STAGES OF CHRONIC KIDNEY DISEASE

You've had it happen..you get in the elevator after leaving the doctor. You look at the lab request he gave you and it says "CKD Stage 3". What in the world does that mean? We want to demystify what the stages of chronic kidney disease are. If you are not sure what your GFR is you can figure it out by using our GFR calculator on our blog.(You will need your latest creatinine level to do this).
Adverse outcomes of chronic kidney disease can often be prevented or delayed through early detection and treatment. Earlier stages of chronic kidney disease(CKD)can be detected through routine labwork, often before any symptoms occur.
The presence of CKD should be established based on kidney damage and level of kidney function(GFR), irrespective of diagnosis.

STAGES OF CHRONIC KIDNEY DISEASE
stage 1 Kidney damage with normal or above normal GFR greater than 90
Stage 2 Kidney damage with mild decrease GFR 60-89
stage 3 moderate decrease GFR 30-59
stage 4 severe decrease GFR 15-29
stage 5 Kidney failure GFR less than 15 or dialysis

Chronic kidney disease is defined as either kidney damage or GFR less than 60 for greater than 3 months. Kidney damage is defined as pathologic abnormalities or markers of damage, including abnormalities in blood or urine tests or imaging studies

HEMATURIA

Hematuria (blood in the urine) has many causes. It can appear as frank..producing abnormal colored urine ranging from tea colored to grossly bloody. It can also be microscopic and detectable only by urinalysis. Causes include strenuous exercise, trauma, infection, kidney stone, cysts, glomerular diseases of the kidney and tumors of the urinary tract. Sometimes despite an exhaustive workup no cause is found.
Tests you can expect include urinalysis, urine culture(to check for infection), blood chemistries, and urinary diagnostic tests which may include kidney and bladder ultrasound, CT scan, IVP, or cystoscpy.
Once the reason for the hematuria is discovered your nephrologist will outline a plan of treatment which may also include a referral to a urologist(surgical specialist of the kidney and bladder).
It is important for all adults to have a yearly screening of their urine at their annual physical. Hematuria-if detected-can be best treated when discovered promptly.

HIGH POTASSIUM (HYPERKALEMIA)

Potassium is an electrolyte(mineral salt)important to the functioning of our bodies.People can suffer from insufficient potassium(hypokalemia)or too much potassium(hyperkalemia). Hypokalemia can cause weakness, fatique, confusion and heart irregularities. This can occur with starvation, excessive sweating or use of laxatives and diuretics.
More common in the kidney patient is high potassium or hyperkalemia. A failing kidney-even in the early stages of kidney disease-can in some cases fail to metabolize minerals properly resulting in a need to restrict dietary intake of potassium. Left untreated, new research suggests, hyperkalemia may cause nerve damage and can cause cardiac instability and even be fatal in extreme cases.
That's why we take your potassium level so seriously. The first time it is high we may simply repeat it and discuss your diet with you. Often it is one or two high potassium foods that need to be curtailed in order to bring the level down. If following our diet suggestion fails to bring your potassium down(or does not keep it down consistently,) we will refer you to a renal(kidney)dietcian who can more specifically work on your diet with you.
In some cases we will prescribe a medicine which helps to pull potassium from your body in your stool. We do not use this method until diet manipulation has failed as it can produce other side effects such as diarrhea.
We will review your diet with you. It may be possible another doctor gave you a potassium supplement(it has happened!) or you maybe taking a drug that raises the level such as certain blood pressure drugs. We ask that you bring in the OTC drugs and vitamins you take so we can assess them. Salt substitue can also elevate the value if it is made of potassium.
Luckily since 2001 potassium content is required on food labels making it easier to follow the amount you are taking in.
The attached link gives suggestions on foods that are high-moderate-or low in potassium. You can also print out such a list from the main page of our website. For more specific dietary suggestions we reccommend you check with a dietcian who can creat a diet plan for you.
Together-your doctor, nutritionist and YOU-we can conquer your high potassium(or low)problem. We ask that you follow the diet, comply with requests for labs and keep us informed of any new drugs you may be taking-prescribed or otherwise.