Most of us, even the fitness freaks, feel good about consuming diet soda...that harmless, calorie-free, sugar-free indulgence. What could ever be wrong about a can of zero calorie, carbonated, flavored water?! Possibly a lot, it seems. The potential for harm stems from the various ingredients that go in to conjuring your favorite diet soft drink. Lets break down a typical artificially sweetened beverage (diet soda) in to its bare ingredients that are pertinent for this discussion : artificial sweeteners, caffeine, caramel color, and phosphoric acid. ARTIFICIAL SWEETENERS  Artificial ..read more

You are what you eat. Your kidneys are no different. Diet and lifestyle have a huge influence on the development of kidney disease, as well its rate of progression once it develops. Hence, in my practice, and especially in patients with early stage chronic kidney disease (CKD)  or stage 3/early stage 4,  I place a strong focus on diet (in addition to treating the cause of CKD) which may sometimes go a long way in preventing disease progression. This does not mean that the right diet is not important in advanced stages of CKD. It very well is; however, you will probably need mor ..read more

Kidney disease has a profound effect on sexual health, fertility, the ability to conceive, etc. I will cover the issues related to chronic kidney disease (CKD) and pregnancy in my next post. For today, lets try and understand how and why a reduction in your kidney function could affect your sexual health. Sexual dysfunction does tend to worsen as kidney disease progresses, and is part of the constellation of various signs and symptoms of advanced kidney disease. SEXUAL DYSFUNCTION IN WOMEN WITH CKD 1) Disturbances in menstruation Irregular menses could be present in women with advanced ki ..read more

Toxins present in the environment are a common but under-appreciated cause of kidney disease and kidney failure. Environmental causes typically include chemical agents (eg. heavy metals), physical agents (eg. high temperature/heat, dehydration), and biological/infectious agents (eg. malaria, HIV etc). Here is an overview of some exposures and their sources that you should be aware of: LEAD A common heavy metal, lead has been around in construction industry, paints, battery manufacturing, gasoline, etc for a long time. Its use in some of these industries is being phased out gradually since it ..read more

Certain types of CT scans will often require that the patient get intravenous (iv) "dye" or contrast to make the organs stand out and delineate them better. This usually would lead to better images with greater sensitivity that help the radiologist in picking up features that would otherwise get missed. The downside however is that this very contrast could sometimes cause damage to the kidneys. The medical term for this is "contrast induced nephropathy" (CIN). What do you then do in a situation where iv contrast is necessarily required? Lets try and understand a few nuances about contrast-medi ..read more

BACKGROUND It is estimated that more than 20 million Americans may have chronic kidney disease (CKD). That means roughly 1 in 15 Americans. Subjectively speaking, and for some reason, the rate seems to be even higher where I practice (Bradenton / Sarasota, Florida), but that could be related to the older aged population here. Whether you could "cure" CKD would depend on the cause of kidney disease. Quite often, the cause happens to be a chronic disease that can only be "controlled" (like diabetes or hypertension), but not technically cured. And so is the case with CKD. That is, you can usua ..read more

I set off to try and answer this question after one of my patients brought along an article that claimed that "nettle leaf lowers creatinine level in the blood". This by extension would mean that it could perhaps cure CKD? I was quick to admit that not once during my typical "western medicine" training had I heard of that claim. To me, CKD had always been this inexorable malady that can be, at best, controlled or slowed down from progressing further. "Cure" is not a word that gets thrown around a lot when you talk about CKD. As I had discussed earlier, once kidney function declines chronicall ..read more

I often see patients in my office who refuse dialysis (should it become necessary) for their advancing kidney disease. I divide these patients in to two categories. The more common category is patients who refuse it because of the "fear of dialysis". They could have trouble understanding dialysis and what potential benefits they could derive from it. They would often make good dialysis candidates who have more to lose than gain by refusing dialysis therapies. The other category is the patient who rightfully refuses dialysis because she or he would not make a good candidate for such treatmen ..read more

THE FUTURE IS HERE.....WELL, ALMOST! It has been a while since researchers started working on developing prototypes of artificial kidneys that could literally be implanted in to a human suffering from kidney failure. Theoretically, this kind of artificial kidney would replace the functions of a normal human kidney. It would flush the blood of all metabolic toxins, maintain all body electrolytes in the narrow range necessary for all life processes, produce hormones like erythropoietin (that drives the bone marrow to produce red blood cells), activate vitamin D, regulate blood pressure, etc et ..read more

This is a question that often comes up when I see patients in my office for treatment of chronic kidney disease (CKD). As always, I tend to emphasize the huge role that diet plays in the management of CKD. I noticed that my recent posts might be becoming too wordy, so I am going to keep myself very brief today! Ever since coffee was discovered over a millennium ago in Ethiopia, pages upon pages have been written about the myriad health effects of caffeine. Being a psychoactive substance, caffeine has been regulated and even banned for multiple reasons ranging from the religious, to its effe ..read more