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Has chronic kidney disease. Diagnosed hypertension. Have nausea and vomiting. Found large concentration of protein in urine. Help?

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Practicing since : 2005
Answered : 614 Questions
XXXXXXX is 70 years old and has chronic kidney disease. He worked as a trade
person as well as manual laborer, often smoking during outdoor work, as he
mainly worked alone. In addition, XXXXXXX drinks heavily and consumes at least 16
cans of beer each night. XXXXXXX was diagnosed with hypertension 15 years ago and his medication dosage
has increased over that time. More recently, he has been short of breath, has
periods of nausea and vomiting, and has been generally tired.
At a check-up with Nick’s renal specialist, it is found that XXXXXXX has large
concentrations of protein in his urine, his creatinine level is 500 mmol/L and his
estimated GFR is only 11 mL/min. The specialist recommends that XXXXXXX
commences dialysis.
Could you please give me your opinion in detail.
1 Provide a rationale for the strong link between cardiovascular disease and
chronic kidney disease.
2 Discuss the lifestyle choices that XXXXXXX has taken that have contributed to the
development and progression of chronic kidney disease.
3 Describe why Nick’s symptoms (nausea, vomiting, tiredness) have
Posted Thu, 10 Oct 2013 in Kidney Conditions
Answered by Dr. Manuel C See IV 1 hour later
Brief Answer:
Please see detailed explanation below.

Detailed Answer:
1. Hypertension is the second cause of chronic kidney disease (1st is diabetes). The reason for this would be hypertension damages the small blood vessels in the kidney thereby causing it to malfunction over time.(10-20 years).

2. Lifestyle changes is the only way to prevent diabetes and hypertension from developing and thereby protect our kidneys. A low salt low fat diet would definitely decrease the risk of hypertension and diabetes. You mentioned XXXXXXX consumes alot of alcohol and is also a smoker. Smoking and alcohol consumption causes a very high risk to develop hypertension, not to mention heart attack and stroke.

3.Nausea, vomiting and fatigue is symptoms of what we call uremia. Anorexia is also a prominent symptom of this condition. It is when the solutes (excess particles) that should have been filtered by the kidney stays in the body. This happens during end stage renal disease like in Nick's case. Instead of the excess solutes being excreted in the urine, it poisons the body slowly causing the uremic symptoms. The dialysis would function as the kidney of XXXXXXX removing the excess solutes and cleaning his blood.

I hope I was able to answer your question clearly. Thank you very much.
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