Transcript Kidney Notes

Kidney Notes™
Angie Johnson, MD, Mary
Hunter Benton, Maria Ferris,
MD, MPH, PhD, and the
STARx team at the UNC
Chapel Hill
Introducing the
Kidneys
Module 1
Where Are the Kidneys?
• There are two kidneys, one on
each side of your back…near your
rib cage.
• Each kidney is about the size of
your fist
• Each kidney contains a million
little machines called nephrons.
How Much Fluid do the
Kidneys Handle?
• About 189 liters of fluid
every 24 hours. This is
about 50 gallons of fluid!
– One gallon is the size
of a big jug of milk
Fluid the Kidneys Handle
Every Day
The kidneys
work so fast!!
What do the kidneys do?
K eep up vitamin D levels that helps you
have strong, healthy bones
I nstruct your body to make red blood cells
D ispose of drugs from your body
N eutralize the body’s fluids
E liminate waste from your body
Y ield hormones that control blood pressure
S upervise the amount of salt, potassium and
acid in the body
You will learn more about this in the
next module. Time for your quiz!
Quiz 1
Why Your Kidneys Are
So Important!
Module 2
What We Know From
Module 1
• Most people have 2 kidneys.
• The kidneys are located around the area
of your waist and are the size of your
fist.
• Kidneys filter 50 gallons of fluid a day.
• Kidneys act as laboratories for your
body, eliminating wastes, cleaning blood,
and producing hormones and cells that
your body needs to stay healthy.
That was a lot of
information!
Let’s break it down, and learn
more!
The Kidneys and Chemical
Balance
• Your kidneys control salt,
potassium and acid in your
body.
• EVERYTHING you eat has
these ingredients
The Kidneys and Chemical
Balance
• One of your kidney’s jobs is to get
rid of the acid in your body
– If your kidneys are sick, they can’t do
their job.
• You may have to take bicarbonate
(baking soda) to neutralize the acid!!
Why Do I need to Get Rid
of Acid?
• If your kidneys fail, they
can’t get rid of acid.
• In time, you may have too
much acid. This condition is
called acidosis.
Why is Acidosis bad?
• Acidosis sends the wrong message
to your body-- it tells your bones
NOT to grow!
• Your bones may get thin, become
weak, and even break!
The Kidneys and Acid
• When your kidneys fail, they can’t
get rid of acid
• Your cells don’t like all that acid, and
your body cannot grow well.
• If you have this problem, a daily shot
of growth hormone can help you grow.
Kidneys and Phosphorus
• If your kidneys fail, they cannot get
rid of the phosphorus that you eat.
• High phosphorus causes bone pain or
weak bones that may break
The Kidneys and
Phosphorus
When your kidneys fail, you will
need to:
• Change what you eat (less
phosphorus)
• Take medicines that stick to the
phosphorus in your stomach and
intestines, before it gets into
your blood!
The Kidneys-Heart
Connection
• The heart pumps
your blood
• Blood pressure is
how strong your
heart beats
• Your kidneys help
control your
blood pressure
What Do Those Numbers
Mean?
Your doctors will tell you what your blood
pressure numbers are and what your
blood pressure numbers should be
You need good blood
pressure numbers to
protect your heart
and brain!
Why Are Your Kidneys
Important to your Heart?
• When your kidneys fail, your
blood pressure may go up
• High blood pressure can lead to
health problems, like heart
attacks and strokes that can
damage your brain
The Kidneys-Bone Marrow
Connection
Kidneys make a hormone called
erythropoietin. It is also called
EPO for short…( sounds like a
hipo!)
• EPO tells your bone marrow to
make new red blood cells
Why Do I Need EPO?
When kidneys fail, they stop making
EPO.
• Without EPO, your bone marrow
cannot make enough red blood cells.
This is called anemia.
• Shots of EPO help make red blood
cells go back up!
The Kidneys-Brain
Connection
When your kidneys fail, learning in school
may be hard because:
• Your kidneys cannot get rid of waste in
your body which may slow down your brain
• Anemia (low red blood cells) keeps your
brain from doing the best job it can
• High blood pressure can cause bleeding
inside your brain
Quiz 2
What is Chronic Kidney
Disease?
Module 3
A problem with the kidneys that gets
worse and worse. It can’t be cured, but
it can be controlled.
Did you know that Chronic
Kidney Disease (CKD) is
what is called “silent?”
• This means that you do not feel different
because your body problems that you do not
notice.
• Doctors can tell how sick your kidneys are with
blood and urine tests
• By the time you feel sick, your kidneys may
already be very sick
What should I learn
about CKD?
• What makes CKD happen?
• Why did I get CKD?
• What are the stages of
CKD?
• How can we fix CKD?
What Makes CKD
Happen?
There are two possible answers:
(1) You were born with kidney
problems
OR
(2) Your kidneys became sick when
you got older
There are ways to treat both types
of CKD!
Why did I get CKD?
• It is something that just happens,
like having blonde hair or brown eyes.
• It did not happen because you did
something wrong.
What are the Stages of CKD?
There are 5 stages of CKD.
• Stages 1 & 2: Your kidneys work mostly
OK.
• Stage 3: You need some medicines.
• Stage 4: You need more medicines & maybe
shots.
• Stage 5: You need extra help to clean your
blood (called dialysis) or you need a kidney
transplant.
How Do The Kidneys Get
Extra Help in Stage 5?
Two ways to help the kidneys
1. A kidney machine: Dialysis
2. A new kidney: Transplant
What Kinds of Dialysis
Are There?
There are 2 kinds of dialysis for
chronic kidney failure:
• Hemodialysis – blood leaves your
body, gets filtered by a machine and
returns
• Peritoneal dialysis – fluid goes in your
belly and leaves with toxins, acid, etc.
Hemodialysis
Peritoneal Dialysis
What is a Transplant?
• A transplant is the most common
way to help people sick with
Stage 5 Kidney Disease.
• A transplant is where you get a
new kidney from someone else
• Sounds weird right? It’s ok!
How Can You Get a
Transplant?
Many people are “waiting in line” to get
a new kidney. This is really through a
waiting list.
You can get a kidney transplant from
• A family member
• A friend
• From someone who died.
How Long Can You Keep
Your Kidney Transplant?
• You can keep a kidney transplant for many,
many years.
– It will last longer if you take
your medicines!
Loss of a Kidney
Transplant
“Loss” means your new kidney stops
working.
• Why does this happen to teenagers?
– The #1 reason you lose your new
kidney is NOT taking your
medicines
What happens if you
“lose a transplant?”
• What happens then?
– You wait (years) for another kidney
transplant.
– In the meantime, you may go back
on dialysis.
– SO, IF YOU HAVE A
TRANSPLANT, TAKE CARE
OF IT AND TAKE YOUR
MEDICINES!!
Quiz 3
Module Four
Why Patients Don’t Take
Their Medicines
(and why they should!)
Why do patients not take
their medicines?
There are several reasons you might not:
• You don’t understand your medical
condition
• You believe that nothing bad will happen
• You want to be “normal,” like everyone else
• You “don’t feel sick” to begin with, so not
taking the medicines doesn’t feel any
different.
More reasons patients don’t
take their medicines?
• You don’t see any “real problems” or
direct consequences if you miss your
medicines.
– “It’s no big deal.”
• You don’t think that the health team
can tell when you’re not taking
medications.
Guess What?
When patients don’t take
medications doctors
notice changes.
What are some of these
changes?
There are several:
• Patients don’t grow as they should
• Blood tests show your kidneys aren’t
working
• Problems are found during your visits
at the doctor’s office
So can health providers
really tell when patients
don’t take their medicines?
• YES, without a doubt.
• But….doctors, nurses, and
pharmacists can also help you
remember to take your
medicines…ask them for suggestions!
What can you do to
remember your medicines?
• Put all your medicines in a
container that has little
cubbies for each day of the
week.
What can you do to
remember your medicines?
Pick something you do every day and take
medicines at the same time. You can
take your medicines every day when you
are:
– Getting dressed
– Eating your breakfast
– Brushing your teeth
Do you have suggestions
to other patients about
how to remember to take
your medicines?
Quiz Four!
Module Five
What YOU Need to
Know as you Grow Up
With CKD
You will be on your own!
• You need to learn how to manage your disease without the
help of your parent(s).
– You will need to keep track of your
medications and be responsible for
taking them.
– You will need to know how to get in
touch with your health care team and
keep track of medical appointments.
– You will need to understand how your
health insurance works.
What do you need to know
about your medicines?
• Why do you take them
• What they do
• When and how to take them
– Read the label on the pill
bottle
• Which other medicines “don’t
mix” with yours
What about Medicine
Refills?
• Call for refills 2
weeks before you
run out.
• Ask your doctor how
to refill your
medicines.
Your Medical
Appointments
• Don’t miss your medical appointments!
• Come to the appointments with at
least 3 questions for your doctor
• Before you leave each appointment,
make sure the next appointment is
already set up and you can make it
Are You on a Special
Diet?
YOU SHOULD KNOW:
• WHAT TO EAT: Learn about the food you
can eat
• WHY: Understand the reasons you have to
avoid certain kinds of food
• WHAT NOT TO EAT: You should avoid
pre-packaged and pre-made food. Fresh
food will help keep your kidneys healthy.
Learn How to Read
Food Labels!
Ask your
doctor what
foods and
ingredients
are good and
which ones
are bad!
Exercise!
• The more active you
are, the healthier your
kidneys and heart will
be.
• Make sure to check
with your doctors
before playing
physically demanding
or contact sports.
Do not smoke!
• Smoking can damage your
kidneys, even if you’re doing
everything else perfectly!
Do Not Drink Alcohol
• Alcohol can make your blood
pressure go up and can cause
your kidneys not to work as well.
Do Not Use Illegal Drugs
• Drug use may get in the way with your
needed medications.
– They may make them not work or cause side
effects
• Other drugs may be “kidney poisons”
• Protect your kidneys. Do not take risks.
Quiz 5!
PROTECT YOUR KIDNEYS: TAKE
YOUR MEDICINES AND DO NOT
TAKE RISKS!
Thank you for your attention,
The UNC STARx Team