What can go wrong with your kidneys?

Kidney disease is a growing epidemic and the number of Australians with kidney disease is on the rise, here and globally. There are often no symptoms in the early stages of many kidney conditions. When they do occur the initial signs may be general such as feeling tired or generalised itching. 

As kidney disease progresses, the symptoms can include changes in the urine (reduced volume, discolouration, blood or pus), nausea and vomiting and appetite loss. Other symptoms include swollen or numb hands and feet (because of water retention), weakness and lethargy, darkened skin and muscle cramps. 

 Read Kidney Disease: Are you one in three?

When the kidneys become damaged, other organs suffer as well. Most kidney diseases attack the nephrons, slowly destroying their filtering capacity, over many years, before the damage you even know it. 

Some kidney diseases, such as polycystic kidney disease are inherited, but the two most common causes of kidney disease are diabetes (diabetic nephropathy) and high blood pressure (hypertension). In diabetes high blood sugar levels damage the nephrons. High blood pressure can prevent the small blood vessels in the kidneys from filtering and cleansing the blood well enough. Read Kidney Health - What you should know......

Make the most of your visit to your doctor

Kidney disease progression can be slowed with medicines that protect your kidneys. Your doctor can prescribe these medicines which are available through your local pharmacist.  When you visit any health provider, remember they are there to advise you about your health so that you can make an informed choice. As a patient you have the right to:

• Ask questions about your treatment.
• Be informed about details of your care, e.g. costs.
• Be informed about treatment options.
• Seek a second medical opinion (doctors expect and understand, and in some instances advise their patients to seek a second opinion. Don't worry about hurting the doctor's feelings if you ask for one).
• Get information from other sources about your condition and its treatment.

Key points are listed below - for other related information:
Check My Kidneys Check online - find out if you are at increased risk of kidney disease?
Chronic Kidney Disease CKD
How our kidneys work
Informed consent for medical testing 
Using the web to research health Information
What does that word mean? 

What can you do before the visit?

• Make a list of your questions so you don’t forget anything.  Add to the list any symptoms, concerns or changes in your life since your last visit. Rank your questions in order of importance in case you run out of time.
• Giving a written record of your major, past medical and surgical events to the doctor on your first visit is an excellent idea. Knowing about your family’s medical history is also helpful.
• Add to the list any symptoms, concerns or changes in your life since your last visit. 
• Rank your questions in order of importance in case you run out of time.
• Know the name and dosage of all your medications including ‘over the counter’ drugs. Consider taking a list of your medications to your doctor or take all the bottles and packets with you if that is easier.
• If you need repeat prescriptions, make a note to ask for them.
• If you don’t know a lot about your condition, try to get some written information. This will help you understand and become familiar with the medical terms so that it’s easier to discuss concerns with your doctor.
• It is not uncommon during the first few office visits to your doctor to be overwhelmed and to forget much of what is said. Consider bringing a family member or loved one to your first few visits. Having
  another person there to ask questions and review your doctor's advice with you afterwards can be extremely helpful.
• If you have a chronic illness, consider keeping a record of your contact with health professionals in an exercise book.

What can you do during the visit

In many instances, your time with your doctor may limited, and as such it is helpful to prepare for the visit in advance. This may include;

• Tell the doctor you have some questions.
• Write down the answers don’t trust your memory. Most people remember less than half the information they are given. You may wish to ask your family member to record the information that is being
  discussed.
• Tell the doctor if you are getting advice or treatment from another health professional including complementary therapies, vitamin supplements or herbal treatments.
• Your doctor should give a clear explanation of your condition, planned treatment, choice of available procedures and a list of possible side effects.
• Ask the doctor to write names of the drugs you must take and details of any treatments.
• If you think you may not be able to follow any instructions tell the doctor immediately to avoid problems later.
• Before leaving, make sure you have a clear idea of your treatment plan. Ask for any written information that may help you understand your condition.

What questions can you ask the doctor?

Good communication is important and asking questions can make your visit more useful.  Remember that writing down questions and making notes about answers can be helpful when reviewing information after your visit. These are sample questions you can ask to get a better understanding of your problem. 

• Can you describe my condition in simple language?
• How will this condition affect me in the future?
• How serious is this condition?
• What sort of tests will be needed?
• How good are the tests for diagnosing the problem and the conditions?
• What sort of treatment will be needed?
• Why do I need this test, treatment, surgery or procedure?
• When will I need to start treatment?
• What is the likely course of this condition?
• Will I need regular check ups?

What are the benefits of this type of treatment?

•  Are there any risks to this treatment?
• What is success or failure rate of this treatment?
• Are there any immediate side effects to this treatment?
• Does this treatment cause any other long-term changes either physical, social, emotional, mental or sexual?
• Are there any other treatment choices?
• What might happen if I don’t have this treatment?
• What happens if I choose to have no treatment?
• How long will I have to undergo treatment?
• What should I expect after treatment?
• When do I need to decide about my treatment?
• How much is this treatment going to cost?
• Are there other health professionals that I need to see?
• Would complimentary therapies help my health?
• Do I need to change my lifestyle, e.g. diet, exercise, weight?
• Is there a dietitian on staff if I have nutritional concerns or difficulties?
• Do you have any information that I can take with me?
• Where can I get written information about my illness?

What about alternative and complementary therapies?

Complementary therapies include a wide range of healing approaches. They may have a supportive approach that can improve well-being and quality of life for people with chronic conditions or terminal illness. These therapies may include meditation, massage, visualisation, aromatherapy, acupuncture or herbs to name a few. Some health professionals see these therapies as useful. However many of them have not been tested in clinical trials in relation to kidney disease.

Ring Medicine Line (1300 888 763) for independent pharmacist advice on prescriptions, over-the-counter, and complementary (herbal/natural/vitamin/mineral) medicines.

Herbal treatments sometimes claim that they may cure or slow down the disease progression but some are harmful to people with kidney disease. Again, few clinical trials have been undertaken to prove claims although this is slowly changing. Always speak with the health care team managing your condition before using any herbal remedies, over-the-counter-medicines or supplements. It is important to let your health care team know you are using complimentary or herbal therapies.

When deciding on complementary or herbal treatments it is very important to gather as much information as possible. It is also a good idea to ask as many questions as possible so that you are able to clearly understand the treatments and possible outcomes in relation to kidney disease.