Chronic Kidney Disease and Autoimmune Diseases

Chronic Kidney Disease and Autoimmune Diseases

Kidney
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Chronic Kidney Disease affects thirty million people. Think about that number. It’s equivalent to 9% of the population of the United States. Many more people are at risk of developing CKD.

The causes are varied, but the leading causes are hypertension (high blood pressure) and diabetes. For those who have autoimmune diseases, the causes can range from the disease itself (for example, Lupus Nephritis), to comorbid conditions (coexisting diseases) like hypertension or diabetes to the treatment for the autoimmune disease.

Types of Kidney Disease

There are two types of kidney disease. Chronic (CKD) and Acute. In this post, we are concentrating on CKD because that type of kidney disease has long-term consequences. Acute Kidney disease is treated in a hospital setting as an emergency.

Prevention

One in three adults is at risk for developing chronic kidney disease. This insidious disease can develop without the victim realizing it. If you have diabetes or hypertension, work with your doctor to keep those diseases under good control. Hypertension or high blood pressure damages the small blood vessels in the kidneys. It’s the second leading cause of chronic kidney disease. Diabetes is the leading cause.

For those who have autoimmune diseases, limit the anti-inflammatory drugs such as naproxen, ibuprofen, etc to the prescribed amount. These drugs are eliminated through the kidneys. Overuse of the drugs can lead to CKD.

Work with your physician to identify CKD early. Have routine blood pressure, blood glucose and/or A1C testing to identify these risk factors in addition to the autoimmune disease. This can be done by urine testing for ACR (Albumin Creatinin Ration) and blood testing for GFR (glomerular filtration rate).

Symptoms of CKD

Many of the symptoms of CKD are the same as those of Autoimmune diseases so they can be easy to ignore thinking they’re part of the same stuff you deal with off and on.

The symptoms include:

Image courtesy of photostock at FreeDigitalPhotos.net
Image courtesy of photostock at FreeDigitalPhotos.net
  • Fatigue and weakness
  • Difficult and/or painful urination
  • Foamy or frothy urine 1Lupus Foundation of American – www.lupus.org
  • Pink, dark urine (this is an indication of blood in the urine)
  • Increased thirst
  • Increased need to urinate especially at night
  • Swelling – puffy eyes, swollen face, abdomen, ankles, feet
  • Unusual weight gain – related to fluid retention.2National Kidney Foundation – www.kidney.org

Lupus nephritis

Approximately 40% of those with Lupus will develop Lupus Nephritis (or glomerulonephritis). In Lupus Nephritis, the nephrons (parts of the kidney that filter the blood become inflamed and the kidneys can no longer eliminate the toxins. They begin to build up in the bloodstream. The patient begins swell or gains unexplained weight.

CKD and Heart Disease

Heart disease is very common in CKD. If you have CKD, learn about heart disease and preventing it. Many of the same diseases that cause CKD also cause heart disease.

While the link between heart and kidney disease isn’t completely clear, it has been shown that damage to either organ affects the other one. If you develop CKD, you are much more prone to developing heart disease. 3National Kidney Foundation – www.kidney.org4National Institute of Diabetes and Digestive and Kidney Diseases – www.niddk.nih.gov

Heart disease is the leading cause of death in Chronic Kidney patients at all stages. In addition to normal cardiac risk factors, those with CKD have unique risk factors.

  • Protein in the urine (proteinuria or albuminuria)
  • Elevated phosphorus levels in the blood – in CKD the body is often unable to eliminate the excess phosphorus found in some food. As this build up in the bloodstream, it can cause de-calcification of the bones and hardening of the arteries.
  • Elevated calcium levels – Calcium and parathytroid often go hand in hand. When the calcium levels are too high, it can cause calcium deposits in the arteries.
  • High levels of parathyroid hormone (PTH) – Often in CKD the parathyroid gland produces too much of the hormone and causes elevated calcium levels.
  • Electrolyte imbalances (especially potassium) – Potassium levels must be kept within strict ranges. In CKD the kidneys are often unable to eliminate excess potassium resulting hyperkalemia (elevated potassium). Hyperkalemia or hypokalemia(low potassium) can result in the cardiac arrest (heart failure).
  • Fluid overload – When the kidneys aren’t working correctly, they fail to filter and excrete excess fluid. Excess fluid in the bloodstream places extra strain on the heart and causes elevated blood pressure)
  • Anemia – When a patient is anemic, their level of red blood cells becomes low. the red blood cells carry oxygen to the various organs including the heart muscle.
  • Malnutrition
  • Inflammation 5Davita Dialysis Centers – www.davita.com
Image courtesy of cooldesign at FreeDigitalPhotos.net
Image courtesy of cooldesign at FreeDigitalPhotos.net

In conclusion:

For more information on kidney disease, please visit the National Kidney Foundation – http://www.kidney.org

The NKF has local chapters that offer free screenings and education on kidney failure. The website contains a wealth of information on kidney disease and transplantation. They offer free memberships to the organization and online communities for those on dialysis or who have been diagnosed with CKD.

The NKF also provides information on clinical trials and how to find one that might be right for you.

Your kidneys are essential to your overall health. Know your numbers: glucose, blood pressure, and glomerular filtration rate. Know the symptoms of kidney failure, and don’t assume that any symptoms you’re experiencing are caused by your autoimmune disease. The earlier you catch kidney failure, the better the outcomes.

Rheumatoid Arthritis Complications

rt hand 5

Rheumatoid Arthritis Complications

 

Rheumatoid Arthritis is an autoimmune disease that can cause widespread complications.

Muscles and Joints: 

Joint deterioration and deformities making it difficult to perform daily tasks, like buttoning a shirt, pulling up a zipper, tying shoes, or even just pulling on clothing.

Carpal tunnel syndrome

Inflammation may cause tendon rupture. This most commonly affects the tendons on the back of the hands.

Cervical myelopathy – a dislocation of the cervical spine which can put pressure on the spinal cord.

Muscles may become weak and patients may have severe muscle spasms. In the photo below, the toes are spasming and pulling downward.

Spasming Toes

Nerves: Peripheral Neuropathy can result in numbness, tingling, and burning tingling in the hands and feet from nerve damage

Blood/Blood Vessels: Many patients with RA develop anemia, and some of the medications used to treat RA can affect other blood components, like the white blood cells. Anemia can lead to dizziness, weakness, and fatigue.  Decreased white count can make the RA patient more prone to infection.

Inflammation of the blood vessels, or vasculitis is a rare complication of RA. It causes thickening, of the blood vessel walls leading to problems with blood flow through the vessels.

Eyes: Scleritis and Episcleritis – inflammation of the blood vessels of the eye – can cause a gritty sensation and redness of the eyes. This can result in corneal damage.

Increased Risk of Infection: Just having RA makes the patient more prone to infection, but also the medications taken can put the person at a higher risk of developing an infection.

Skin: Rheumatoid nodules develop in about one fifth of RA patients. These nodules are usually under the skin and appear on the forearms, heels, fingers, and elbows. They may develop gradually or appear suddenly. These nodules may also occur in the lungs and heart.

Osteoporosis: Loss of bone density is more common in RA patients.

Lung Issues: Chronic lung diseases like interstitial fibrosis, pulmonary hypertension, pleural effusion, and nodules.

Rheumatoid Lung is a group of lung conditions commonly found in RA patients. It includes nodules, fibrosis, and pleural effusions.

These lung issues may present with symptoms of shortness of breath, chest pain, and cough.

Heart: RA patients have an increased risk for developing heart disease, heart attack, stroke, and blood clots. They also have a higher risk for developing pericarditis – inflammation of the sac surrounding the heart and myocarditis – inflammation of the heart muscle.

Cancer: RA patients have an increased risk of developing lymphoma, leukemia, and other cancers. Use of TNF blockers may possibly lead to an increased risk.

Emotional: Living day to day with a chronic, painful illness may lead to depression and anxiety, yet many RA sufferers don’t discuss this with their physicians.

While there are many complications of RA, getting an early diagnosis and following the treatment plan may help lower your risk of developing any of them.

If you have symptoms of any of the complications of this disease, please talk to your physician about it right away. Delaying may lead to worsening of the condition.

 References:

http://www.nhs.uk/Conditions/Rheumatoid-arthritis/Pages/Complications.aspx

http://umm.edu/health/medical/reports/articles/rheumatoid-arthritis

http://www.nytimes.com/health/guides/disease/rheumatoid-arthritis/complications.html

http://www.healthline.com/health/rheumatoid-arthritis-complications#1

http://www.webmd.com/rheumatoid-arthritis/guide/rheumatoid-arthritis-complications