Kidney Stones

Polycystic kidney disease (PKD) is a genetic disorder that can lead to chronic kidney disease, hypertension, and kidney failure. Affecting between 500,000 and 600,000 Americans, treatment targets symptom management with diet, medications, and, if needed, dialysis or a kidney transplant.

Polycystic Kidney Disease (PKD) affects about 600,000 people in the United States, according to the PKD Foundation. It is one of the most common genetic kidney disorders, yet many people don't even know they have it until later in life. Today, we'll break down what PKD is, how it's diagnosed, and how people can live well with it.

In this episode of Let's Talk About Kidneys, Dr. Jayasree Grandhi of Dallas Nephrology Associates breaks down kidney stones—what they are, what causes them, and how to prevent and treat them. Affecting up to 1 in 5 men and 1 in 10 women, kidney stones are common but manageable with the right care.

Chronic Kidney Disease (CKD) is a condition that affects how the kidneys work over time. For women with CKD who are planning to have a family, there are important factors to consider to ensure the best possible outcomes. Can I have a baby if I have CKD?

In this episode of Let's Talk About Kidneys, Dr. Lauren McDonald, a nephrologist with Dallas Nephrology Associates, discusses the diagnosis, staging, and common tests for patients with chronic kidney disease (CKD).  Dr. McDonald explains how kidney disease is diagnosed, common symptoms, and some of the key tests, including BUN, creatinine, GFR, hemoglobin A1C, kidney biopsies, and more.  She also discusses the importance of being your own healthcare advocate, family histories, how to maintain health records, and the importance of monitoring your diabetes, and hypertension.  

This episode of Let's Talk About Kidneys, Dr. Saim, a nephrologist with Dallas Nephrology Associates, discusses what is new in kidney transplant.  The podcast discusses advancements in kidney transplantation, focusing on the benefits and risks of living and deceased donor transplant.  Dr. Saim highlights that over 25,000 transplants were performed last year, with nearly 7,000 from living donors.  Living donor transplants offer better survival rates and shorter waiting time.  The waiting list has nearly 100,000 patients, with blood group O having the longest wait.  Deceased donor transplants used KDPI to assess donor quality.  High KDPI kidneys benefit diabetics over 50.  The conversation also covers post-transplant care, recovery, and the use of new immunosuppressive belatacept drugs.  Future prospects include artificial kidneys and xenotransplants. 

Let's Talk About Kidneys Dialysis Patients and Their Diet In this episode of Let's Talk About Kidneys, Dr. Rao, a nephrologist at Dallas Nephrology Associates, discusses the importance of diet for all dialysis patients. She emphasizes the need for dietary modifications even before dialysis, focusing on reducing salt intake, managing potassium and phosphorus levels, and maintaining adequate protein consumption. Introduction Dr. Rao shares her background, mentioning that she joined Dallas Nephrology Associates fifteen years ago and sees patients mostly in Mesquite, Sunnyvale, and Garland.  Dr. Rao explains her role in caring for CKD patients and dialysis patients, emphasizing the importance of dietary guidance for kidney disease management. Importance of Diet in Kidney Disease Dr. Rao highlights the significance of diet in managing kidney disease, noting that dietary changes are necessary even in early stages of CKD.  She discusses the impact of risk factors like diabetes and high blood pressure on kidney function and the need for balanced mineral intake.  Dr. Rao emphasizes the importance of reducing salt intake and avoiding processed foods, canned items, and fast food for better kidney health. Dietary Changes for CKD Patients Dr. Rao explains that dietary modifications should begin early in the CKD journey to delay disease progression and improve patient wellness.  She outlines common dietary changes for CKD patients, including reducing salt intake, avoiding processed foods, and managing potassium and phosphorus levels.  Dr. Rao stresses the importance of maintaining a balance of minerals in the body to prevent toxic effects and ensure overall wellness. Protein Intake for Dialysis Patients Dr. Rao discusses the importance of protein for dialysis patients, noting that protein levels can fluctuate due to kidney disorders and inflammation.  She recommends consuming adequate protein in every meal, with examples like egg whites, lean meats, fish, lentils, and beans.   Specific Dietary Needs for Hemodialysis Dr. Rao explains the dietary needs for hemodialysis patients, emphasizing the importance of fluid management and avoiding fluid overload.  She provides practical tips for managing fluid intake, such as choosing smaller portions, avoiding extra salt, and using smaller cups at restaurants.  Dr. Rao discusses the impact of salt consumption on fluid retention and the importance of planning ahead when eating out.    Peritoneal Dialysis Dietary Restrictions Dr. Rao contrasts the dietary needs for hemodialysis and peritoneal dialysis, noting that peritoneal dialysis allows for slightly more flexibility in potassium intake.  She explains that the ongoing nature of peritoneal dialysis makes it gentler on the body and less restrictive in terms of diet.  Dr. Rao emphasizes the importance of individualized dietary guidelines based on the patient's unique medical condition and cultural background. Meal Planning for Dialysis Patients Dr. Rao outlines a typical meal plan for dialysis patients, starting with a breakfast of egg whites, oatmeal, and low-potassium fruits.  For lunch, she suggests grilled chicken, salad, low-sodium dressings, and low-potassium vegetables.  Dinner can include lean meat, rice, and low-potassium fruits for dessert, with a focus on avoiding high-sodium and high-phosphorus foods. Dining Out and Restaurant Tips Dr. Rao provides tips for dialysis patients dining out, recommending planning ahead by reviewing menus online and making specific requests for low-sodium options.  She advises using steamed vegetables, avoiding soy sauce, and choosing smaller portions to manage fluid and sodium intake.  Dr. Rao suggests packing half of the meal before starting to help with portion control and avoid overindulging. Grocery Shopping Tips Dr. Rao offers practical tips for grocery shopping, recommending fresh fruits and vegetables with lower potassium content.  She advises avoiding bananas, oranges, potatoes, and sweet potatoes, and opting for green vegetables.  Dr. Rao highlights the importance of reading labels for sodium and phosphorus content, and choosing fresh, lean meats and soy protein. Prepared Meals and Additional Resources Dr. Rao discusses the benefits of prepared meals, emphasizing the importance of choosing grilled meat over fried and low-sodium options.  Dr. Rao encourages patients to utilize online resources from the National Kidney Foundation and other dialysis organizations for additional dietary guidance. Conclusion and Encouragement Dr. Rao summarizes the importance of maintaining a proper diet for managing CKD and dialysis, emphasizing the role of nutrition in treatment and management.  She advises patients to communicate with their healthcare providers, dietitians, and nephrologists for ongoing support and guidance.          

In this episode of the Let's Talk About Kidneys podcast, Dr. Roberto Collazo addresses the development of new treatments for kidney disease that are essential for slowing disease progression, improving patient outcomes, and preventing kidney failure. Throughout his discussion, he will examine various therapeutic options currently available, as well as those expected in the future.   What types of treatments have there been in the past for patients with Chronic Kidney Disease (CKD)? Dr. Collazo addressed the medications available during the 1990s and early 2000s. He also discussed newly introduced medications aimed at slowing the progression of kidney disease and enhancing patient outcomes.       What are the new types of treatments?  Dr. Collazo discussed several new treatment therapies currently available, which have led to positive outcomes.  These treatments include: ·       Angiotensin-converting enzyme (ACE)  Inhibitors / Angiotensin receptor blockers (ARBs) ·       Flozins (also known as sodium-glucose co-transporter 2 or SGLT-2 Inhibitors) ·       Non-steroidal mineralocorticoid receptor antagonists (nsMRAs) ·       Glucagon-like peptide-1 agonist (GLP-1)   What research has been completed regarding the benefits in treatment of other conditions related to kidney disease? Dr. Collazo addressed the recent statement issued by the American Heart Association, which acknowledges a new syndrome known as cardio-kidney-metabolic (CKM) syndrome. Cardio-kidney-metabolic (CKM) syndrome is a health condition that impacts the heart, kidneys, and metabolism.   Would you provide me with an example of one of your patients who have benefitted from one of these new treatment therapies? Dr. Collazo spoke about a recent patient who received a diagnosis of both hypertension and heart disease. He also discussed the measures undertaken to address the patient's condition using new therapies.     How can kidney patients get involved?  Dr. Collazo emphasizes the significance of cultivating a relationship with one's primary care physician and nephrologist. Patients are encouraged to ask about new therapies that may assist in managing or slowing the progression of their condition during their appointments with their physician.   Dr. Collazo concludes the podcast by noting that advancements in nephrology are progressing. New medications and updated therapies are becoming available that will assist in preventing patients from needing dialysis or transplantation.

In this episode of the Let's Talk About Kidneys podcast, Dallas Nephrology Associates Dietitian, Nadiya Lakhani, RDN, CSR, LD, FNKF,  explains why weight management is important to the general population and how it affects the kidneys.   How does weight affect the kidneys? When the body carries more weight than it can handle, it increases the demand on the kidneys to hyper filtrate. In other words, it forces your kidneys to work harder, which will eventually cause them to be overworked. On the flip side, unintentional weight loss increases the risk of that person having increased days in hospital which in turn increases the risk of infection. In addition, weight loss often means losing muscle mass which is also very hard on the kidneys.    How do doctors determine healthy weight? Oftentimes formulas are used to determine a healthy weight, but Nadiya explains that what determines a healthy weight must take a wider view than just a formula like body mass index (BMI).  Healthy weight should be determined by what is healthy for that specific person and should also take into consideration weight history, musculature, weight distribution, as well as gender, age and body frame.    Treatment Interventions for Overweight and Underweight Treatment for weight loss is pretty straightforward and includes eating well and moving your body.. Sometimes it is also necessary to also consider pharmaceutical interventions or surgical intervention.  Nadiya also discusses in detail the importance of understanding an individual's routines and mindset to help identify small things that will help with weight loss and how to understand and identify hunger cues. Treatment for being underweight starts first with determining what is causing the weight loss. If they are losing weight unintentionally or because of illness, there is more cause for concern. Weight loss can be caused by gastrointestinal issues (GI), getting full too easily, little to no appetite, etc. In general, treatment could include small changes to add additional calories like drizzling good oils on food, having an extra serving, eating more frequent but smaller meals throughout the day, or adding nutritional supplements.   Rely On the Experts To wrap up this episode. Dietitian Nadiya Lakhani emphasizes the need to allow the experts to help you. Dietitians have the experience and education to guide each patient and provide an individualized plan for weight management that takes into account lifestyle, allergies, culture, financial situation, and so much more.   

In this episode of the Let's Talk About Kidneys podcast, Dr. Muhammad Qureshi talks about the benefits of a kidney transplant, why it's a good choice after kidney failure, and what the process looks like before, during and after.  Why should a CKD patient consider a kidney transplant?  Dr. Qureshi talks about the fact that there are both mortality and morbidity benefits of a kidney transplant. In other words, not only do you live longer, but you live better.  Who qualifies for a kidney transplant? Anyone who has a kidney function less than 20% or someone who has already started dialysis on a chronic basis can potentially qualify for a kidney transplant. At that point they will visit a transplant center for a thorough evaluation to be sure they meet the minimum criteria for a transplant. That includes being sure they have a healthy heart and can handle the immunosuppressive medications, as well as age-appropriate screening for cancer, pre-existing infections, etc. Who is involved in the pre-transplant process? A nephrologist, transplant surgeon, dietitian, and social worker will all be involved in the pre-transplant process. They each have a role in evaluating the patient and making sure they have adequate coverage for their medications and care plan. What happens when a patient is matched with an organ? Once an organ is available, the first person the patient typically sees is a transplant nephrologist. They will again perform screenings to ensure nothing has changed - no active infections or wounds, blood testing to ensure organ compatibility, COVID screening, etc.  What happens after the transplant is complete? Dr. Qureshi walks through the importance of immunosuppressive medications. The patient will take some immunosuppressive medications immediately following transplant and some will be lifelong, which are called maintenance immunosuppressive medications.  Once the patient is discharged from the hospital, the nephrology team still follows them very closely. They will see the patient three times a week for the first couple of weeks, twice a week for two weeks, and then once a week for about another month. In that time medications will be monitored and adjusted, the wound will be monitored for infection or complications, and more.  The kidney transplant process is a lifelong journey. The number of appointments and medications will decrease over time, but the patient will have ongoing monitoring and adjustments for the rest of their life. What types of kidney transplants are available? Dr. Qureshi talks about both living donor and deceased donor transplants. Living transplant is the better option when it is available since it is a more controlled setting. Both the recipient and the donor are present for the surgery so it happens more quickly and the organ is more immediately transplanted. If necessary, the deceased donor kidney will be connected to a machine that provides it with oxygen and nutrients or it will be stored on ice for a period of time before the patient is ready.  How does a patient find a living donor? A living donor can be a friend or family member and donate their kidney directly to a patient. But if they aren't a good match, there are also paired exchange programs available. In paired exchange, an incompatible donor/recipient pair is matched with another incompatible donor/recipient pair for a "swap". Each donor gives a kidney to the other person's intended recipient. Dr. Qureshi wraps up the podcast by encouraging patients to understand that kidney transplant is an option worth considering if they have less than 20% kidney function. He also encourages people to help educate others on the benefits of kidney donation so we can help more patients with kidney disease.