Chronic Disease Consults in Marmaduke, AR

Chronic diseases are conditions that last for more than a year and require ongoing medical attention or limit the activities of daily life.

According to the Centers for Disease Control and Prevention (CDC), six in ten adults in the US have a chronic disease and four in ten adults have two or more. The top three chronic conditions - heart disease, cancer, and diabetes - are the leading cause of death and disability in the US.

Many chronic diseases are brought on by factors under our control. These include:

Tobacco use: Tobacco is the leading cause of preventable disease, disability, and death in the US. Each year 480,000 people die from smoking cigarettes with an additional 41,000 dying from secondhand smoke exposure.

Poor nutrition: Diets in the United States tend to be high in added sugars, sodium, and saturated fats, which can lead to high blood pressure, heart disease, heart attacks, and stroke. Fewer than 1 in 10 adults and adolescents living in the US meet their requirements for fruits and vegetables.

Lack of physical activity: Only 1 in 4 adults and 1 in 5 high school students in the US get the recommended levels of physical activity. Lack of activity combined with poor nutrition can lead to obesity. 40% of US adults have obesity, which puts them at increased risk for cardiovascular disease, heart failure, type 2 diabetes, and some cancers (primarily endometrial, colorectal, and breast cancer). Additionally, obesity costs the US health care system $147 billion each year.

Excessive alcohol consumption: Excessive use of alcohol can lead to serious health problems such as alcohol use disorder and problems with learning, memory, and mental health. Chronic health conditions linked to excessive alcohol consumption include high blood pressure, heart disease, stroke, liver disease, and cancer.

Making a few positive lifestyle changes and practicing some self-care can not only help to prevent chronic diseases but also enhance your overall quality of life. Some suggestions from the CDC include:

• Quit smoking
  
• Eat a healthy diet
  
• Get regular physical activity
  
• Avoid excessive alcohol use
  
• Get regular screenings
  
• Get enough sleep
  
• Know your family history (so that you can take steps to catch conditions early or possibly even prevent them)
  

Treatment plans are as diverse and varied as the chronic conditions they fight.

However, for many chronic conditions, there are a few actionable steps that can help a great deal with chronic disease management. Here a just a few:

- Take time to learn about your disease. It will be helpful to know what you can expect, what is happening, and why.

- Build a team. Your doctor is a great resource, but may not be as helpful to you for making key changes to your diet as a dietician might be or to an exercise regimen as a physical therapist.

- Make healthy choices. If you smoke, quit. If you drink, stop. Not getting enough exercise or proper nutrition? Fix that too! Small steps can affect big change.

- Get better at stress management. Meditate, do yoga, find a support group, get a message or book an acupuncture session.

- Recruit your family. Changes to ease a chronic condition such as high cholesterol, hypertension, or heart disease are generally good for everyone. Making healthy changes will not only help to hold you accountable, but it might keep them from getting a chronic illness as well.

The most common chronic diseases in older adults includes:

• Hypertension (high blood pressure)
  
• High Cholesterol
  
• Arthritis
  
• Coronary Heart Disease
  
• Diabetes
  
• Chronic Kidney Disease
  
• Heart Failure
  
• Depression
  
• Alzheimer's Disease/Dementia
  
• Chronic Obstructive Pulmonary Disease (COPD)
  

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Chronic kidney disease (CKD), sometimes referred to as chronic renal failure (CRF), encompasses all 5 stages of decreased kidney function. The job of the kidneys is to filter extra water and waste products out of your blood and to make urine.

The National Kidney Foundation defines kidney disease as "either kidney damage or a decreased glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m2." Translation: Your kidneys are too damaged and can't filter blood the way they should.

You may be at increased risk of developing kidney disease if you have high blood pressure, heart disease, a family history of kidney failure, or are a diabetic. If you have any of these risk factors, it is a good idea to get tested for kidney disease and to protect your kidneys by making healthy food choices, getting plenty of physical activity, maintaining a healthy weight, and managing any conditions that might cause kidney damage.

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It is possible to have no signs or symptoms in the early stages of CKD. The kidneys have a tremendous capacity to keep us healthy, and slight decreases in function can often go unnoticed.

As kidney disease worsens, a person may experience swelling (called edema) as the kidneys struggle to get rid of extra fluid and salt.

Some symptoms of advanced chronic kidney disease include:

• Chest pain
  
• Sleep problems
  
• Trouble concentrating
  
• Itching or numbness
  
• Weight loss
  
• Feeling tired
  
• Headaches
  
• Vomiting
  
• Increase or decreased urination
  
• Loss of appetite
  
• Muscle cramps
  
• Nausea
  
• Shortness of breath
  

A doctor can use two simple tests to diagnose chronic kidney disease - a blood test and a urine test.

The doctor will be testing to get an idea of your ACR or Albumin to Creatinine ratio.

An excess amount of protein (albumin) in your urine may mean that your kidney's filtering units (glomeruli) have been damaged by disease.

The blood test will show the level of waste products, such as urea and creatinine, in your blood.

The doctor will then use these results along with your age, race, gender, and other factors to calculate your glomerular filtration rate (which shows how much kidney function you have).

Chronic kidney disease can be caused by many different factors.

Some of the common causes of CKD include:

• Type 1 or 2 diabetes
  
• High blood pressure (hypertension)
  
• Glomerulonephritis
  
• Vesicoureteral reflux
  
• Recurrent kidney infection (pyelonephritis)
  
• Interstitial nephritis
  
• Polycystic kidney disease
  
• Prolonged obstruction of the urinary tract
  

Some other risk factors include:

• High blood pressure
  
• Heart and blood vessel (cardiovascular) disease
  
• Ethnicities such as African-Americans, Native Americans, and Asian-Americans
  
• Abnormal kidney structure
  

In many ways, we are as healthy as our kidneys. The kidneys drive a significant number of bodily functions, and loss of kidney capacity can cause side effects like:

• Fluid retention, which causes swelling in your arms and legs, also known as pulmonary edema
  
• A sudden rise in potassium levels in your blood. This can impair your heart's ability to function and may be life-threatening
  
• Cardiovascular disease (Heart and blood vessel)
  
• Weak bones
  
• Anemia
  
• Negative impacts on sexual health
  
• Decreased immune system function
  
• Potential pregnancy complications
  
• Irreversible damage to your kidneys (end-stage renal disease), eventually requiring either dialysis or a kidney transplant for survival
  

Yep! Most kidney diseases can be successfully treated. Proper management of ailments like diabetes and high blood pressure can keep kidney disease from getting any worse (or even prevent it altogether). Kidney stones and urinary tract infections can also be treated successfully. However, the exact cause of some kidney diseases are not yet known and treatments aren't available.

Some kidney disease complications may also be controlled with medications, such as:

• High blood pressure medications, such as angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers

• Cholesterol medications

• Medications to protect your bones. Calcium and vitamin D supplements can prevent weak bones and may lower your risk of fractures. A medication known as a phosphate binder can lower the amount of phosphate in your blood and protect your blood vessels from damage from calcium deposits.

• Erythropoietin can be used to stimulate red blood cell production in patients with anemia as a result of kidney dysfunction.

If your kidney disease has advanced to end-stage renal disease (ESRD), it may be treated with hemodialysis, peritoneal dialysis, or kidney transplantation.