Treating Chronic Kidney Disease: Philosophy of Care
At NAMG, we realize that treating Chronic Kidney Disease (CKD) goes far beyond just offering symptom relief. We believe in a comprehensive approach that puts heavy emphasis on patient education, as well as compassion and empathy so that our patients are fully prepared to cope with their disease.
Excellence in kidney care starts with listening to our patients and providing personalized solutions that fit their unique needs. Improving the quality of life of our patients is our #1 priority.
Video: Nephrologist, Dr. Jay Agarwal, talks about this philosophy of care
The Role of Kidneys and Your Health
Kidneys plays an important role in keeping a person’s blood pressure in a healthy range, and blood pressure, in turn, can affect the health of the kidneys. High blood pressure can damage the kidney and cause chronic kidney disease.
High blood pressure causes the heart to work harder, and overtime can damage the blood vessels all over the body. If the blood vessels in the kidneys are damaged, they may stop removing wastes and extra fluid in the body. This extra fluid in the blood vessels will also cause the blood pressure to rise even more. Blood pressure can be controlled in several ways or in combination of different ways including, keeping a good weight, controlling the amount of salt intake, eating healthy, getting plenty of exercise, and taking medications to control blood pressure.
Anemia is a condition commonly associated with Chronic Kidney Disease (CKD). It frequently develops as renal function decreases to less than 50% of normal, and is caused primarily by a deficiency in endogenous erythropoietin (EPO), a hormone produced in the kidney. Another factor responsible for this anemia of CKD is increased red blood cell (RBC) destruction. Since non-CKD causes of anemia, such as intestinal bleeding, can also occur, screening for such conditions is also important in patients with CKD and anemia.
Anemia can cause deterioration in cardiac function, result in the need for transfusions and hospitalizations, and contribute significantly to a reduction in quality of life. Therefore it is very important to monitor CKD patients for anemia, recognize it early, evaluate the causes and provide appropriate treatment.
Stimulation of RBC production is the cornerstone of anemia treatment in CKD patients, and 2 medications are available to provide this therapy, each administered via subcutaneous injection, usually every 2-3 weeks, more commonly known by their brand names as Procrit and Aranesp. NAMG provides administration of these medications to patients with CKD and anemia in each of our office locations.
Additionally, it is very common for patients receiving Procrit or Aranesp to develop iron deficiency during the course of their treatment due to accelerated use of existing iron stores in the process of producing new RBCs, even without blood loss.
While oral iron preparations are readily available over the counter, they are largely ineffective in maintaining adequate iron supply, and therefore intravenous iron replacement has become the treatment of choice.
NAMG provides this intravenous iron replacement for our CKD patients with anemia and iron deficiency at our office locations. Typically the treatment is every 1 to 2 weeks for 5 weeks, with additional periodic supplementation as determined by blood test results.