Coffee or no Coffee

Coffee or no Coffee

Coffee is a brewed beverage with a dark, slightly acidic flavor prepared from the roasted seeds of the coffee plant, colloquially called coffee beans. The beans are found in coffee cherries, which grow on trees cultivated in over 70 countries, primarily in equatorial Latin America, Southeast Asia, South Asia and Africa. Green (unroasted) coffee is one of the most traded agricultural commodities in the world.[1] Coffee can have a stimulating effect on humans due to itscaffeine content. It is one of the most-consumed beverages in the world.

I believe that a lot of people fall in love with coffee, and I am one of them. However, coffee is hard on kidney when you already have Renal Failure. Some patients with Renal Failure strictly follow it. And some people may oppose to it. This is an old argument. Why do I say coffee is bad for patients with Renal Failure? There are three reasons as follow.

Ⅰ Coffee contains much caffeine, which is common sense. Many patients with Renal Failure maintain that caffeine has not bad effect on kidney disease, but we should not forget that coffee can always let spirit rouse, and then difficultly in falling asleep. Low quality of sleep and body can not get well rest, which may arouse the relapse of kidney disease.

Ⅱ Coffee restrains the absorption of ferrum, which is reported by dietitian. Patients with Renal Failure may know there will be renal anemia when Chronic Kidney Disease (CKD) develops into stage 3. At this moment, coffee plays a role in stopping the absorption of ferrum, which is bad for treating renal anemia
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The Confusion of a Patient with Renal Failure

Here is a message from a patient with Renal Failure, in which she expressed the confusion about her medical conditions.

Hi doctor, my creatinine clearance was 17.26ml/mins, my 24 hour urinary protein was 342 and the machine value was 21.6, but I have no symptoms of a kidney failure person, like blood in urine, swelling of feet and shortness of breathe. I want to know why and I wonder where I stand.

From what she said, we can feel that she is very surprised about the severity of her disease and confused why she did not present some symptoms of Renal Failure. Actually, many patients have the similar experience that no obvious symptoms attract their attention, but it has been at the late stages of Renal Failure when it is diagnosed.

Renal compensation

The kidneys in the body boast a great compensation. Even if we lost one kidney, we still can feel normally. Only when more than half function of kidney fails emerge the obvious symptoms. The common urine test includes creatinine, ptrotein and blood in urine. The patients usually never know about creatinine clearance test or GFR (glomeruli filtration rate). GFR is the best one reflecting the function of kidney and even more precise than the value of clearance creatinine test.

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The causes of Chronic Renal Failure

Do you know Chronic Renal Failure? 

The causes of Chronic Renal Failure

Chronic Renal Failure refers to the damaged renal parenchyma with various causes. Kidney atrophies obviously, which can not maintain renal fundamental function. The clinical manifestations of Chronic Renal Failure are retention of metabolin, imbalance of water, electrolyte and acid-base as well as the involvement of the whole body.

Ⅰ Common causes:

① Infectious nephropathy: Chronic Pyelonephritis, nephrotuberculosis, etc.

② Chronic glomerulonephritis: IgA Nephropathy, Mesangial Proliferative Glomerulonephritis and focal segmental sclerosing glomerulonephritis, etc.

③ Toxic nephropathy: toxic nephropathy due to heavy metals, nephropathy due to analgesics, etc.

④ Vascular renal lesion: renal vascular hypertension, hypertension, renal arterial sclerosis, etc.

⑤ Genetic kidney disease: Polycystic Kidney Disease, Alport syndrome, etc.

⑥ Systemic disease: renal damage due to vasculitis, Multiple Myeloma and Lupus Nephritis,etc.

⑦ Renal damage due to abnormal metabolism: Diabetic Nephropathy, Amyloidosis Kidney Disease and Gouty Nephropathy, etc.

⑧ Obstructive Nephropathy: ureteral obstruction, reflux nephropathy and lithangiuria,etc.

Ⅱ Pathogenesis

① Surviving nephron theory: The majority of nephrons are damaged by various causes. And the surviving small part of nephron which is slight damaged and has normal function, has to do compensative work to maintain normal needs of the body, which causes the surviving nephrons to become compensatory hypertrophy. On this condition, both glomerular filtration rate and the function of renal tubules will increase. If this condition can not be prevented, glomerulosclerosis will occur. At last, the surviving nephrons will gradually decrease, as well as renal function.

② Uremia toxins theory: Uremic toxins may be the various substances which are accumulated in the stage of Renal Failure, such as PTH, phosphorus, urea, creatinine, guanidines, phenols and indole, etc. These substances have the following features:

1. Concentration content in the body is higher than that of normal.

2. High content is related to Uremia.

3. These substances can be detected by chemical analysis and quantitative determination.

4. The content of these substances is similar with that of the patient with Uremia.

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Is My Medical Condition dangerous?

Do you know Medical Condition dangerous?

Is My Medical Condition dangerous?

Diabetes is an important primary disease of Kidney Failure, in particular, II type Diabetes. High blood sugar is undermining kidneys. As Diabetes can arouse many complications, the problems of kidney are usually ignored by most of patients. They often find Kidney Failure in checking or treating high blood pressure or other symptoms of Diabetes. Without the ideals about Diabetic Nephropathy and Kidney Failure, most patients pay little attention to their medical conditions about kidneys.

There is a case of patient who is suffering from Diabetes and has problems of kidney.

I have had Diabetes for five years. When I was hospitalized for high blood pressure, urine protein shows + + + in my test report. My doctor said nothing else except advising me the injection of protein. Without flank pain and fatigue, I am just unwilling to eat something. I want to know whether my medical condition is dangerous or not.

Kidney damages caused by Diabetes can be separated into five courses: high glomeruli filtration rate, damaged glomeruli without symptoms, microalbuminuria, clinical proteinuria and the End Stage Kidney Failure. As kidney functions are normal in early two stages, Diabetic Nephropathy includes microalbuminuria, clinical proteinuria and the End Stage Kidney Failure, excluding high glomeruli filtration rate, damaged glomeruli without symptoms.

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The Dilemma of Kidney Transplantation in China

The Dilemma of Kidney Transplantation in China

Recently, a young man has attracted the attention of many Chinese people. This young man, called Liu Fei, has being suffering from the End Stage Renal Failure for one year. His mother’s kidney is suitable to him for transplantation, but his mother refused and left home, which provokes a heated discussion among Chinese people.

Liu Fei was born in a poor family in Sichuan province. Their life mainly depends on the money made by his parents in taking part time jobs. When he was diagnosed as the End Stage Renal Failure, he left school and leased a tricycle to make money for dialysis. In China, there are many people without medical care in some poor areas, which means that some treatments are usually unaffordable to them, such as dialysis and kidney transplantation. The problem of kidney transplantation lies not only in the shortage of money but also in the limited kidney source. Chinese people who are unwilling to donating their kidney is not the persons without loving hearts but they owning a traditional thought that they must have a intact body to rebirth after their death and their children consider it is an important filial piety to keep their parents in whole bodies. In addition, many people hesitate to donate their kidneys because they think it is harmful to their health and may make them lose the ability of working.

Condemned by so many people, the mother of Liu Fei expressed her thought that if she donates her kidney to her son, there will be two patients in this poor family and they can not afford the medical fee after transplantation. Maybe this mother indeed has no choice but to make money and wait for another suitable kidney towards her son, or maybe she is scared to take the responsibility as a mother, but it is really a dilemma in China among patients with the End Stage Renal Failure. Besides complaining the underdeveloped economic conditions, what else can we do? Is there really no other choice for those patients apart from kidney transplantation and dialysis?

Actually, according to each patient’s medical conditions, as long as their surviving nephrons are in protection and the damaged nephrons can be recovered enough or even partially, there is a chance for them to get rid of dialysis, prolong their lives and even need not to receive kidney transplantation.

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Stage-4 Chronic Kidney Disease and Kidney Failure

More and more patients are diagnosed with Chronic Kidney Disease because of the poor living habits. Chronic Kidney Disease is divided into five stages according to Glomerular Filtration Rate (GFR). The decrease of Glomerular Filtration Rate is closely related to the declining of kidney function. Stage-4 Chronic Kidney Disease means patients have entered into the stage of Kidney Failure. GFR in stage-4 CKD is 15-29 ml/min. Stage-4 Chronic Kidney Disease can be seen a Kidney Failure. Patients with Kidney Failure should treat disease as soon as possible. Some patients are diagnosed with stage-4 Chronic Kidney Disease when they saw a doctor for the first time. They feel confused that before they go to see a doctor, there are no uncomfortable feelings or symptoms.

Do you know the compensatory ability of kidneys?

The kidneys are a pair of bean-shaped organs that lie on either side of the spine in the lower middle of the back. Each kidney weighs about ¼ pound and contains approximately one million to two million filtering units called nephrons. Each nephron is made of a glomerulus and a kidney tubule. The glomerulus is a miniature filtering or sieving device while the tubule is a tiny tube like structure attached to the glomerulus.

Compensatory ability of kidneys means 50% kidney function is enough for the normal work of the whole body. Normal people can give one kidney to another people. Generally speaking, if patients’ kidney function is damaged slightly or less than 50% percent, there are usually no symptoms so that people will ignore the existence of kidney disease. Therefore, people should take routine tests so as to guarantee the healthy body. As for patients with stage-4 CKD, they have already in a serious condition so there are many symptoms.

Do you know the symptoms of stage-4 Chronic Kidney Disease?

◆ Fatigue: Feeling tired is common for people with CKD and is often caused by anemia.

◆ Swelling: A person may notice swelling (edema) in their lower legs, hands or face around the eyes. With too much fluid, someone could even feel short of breath.

◆ Urination changes: Urine may be foamy if there is protein in it, or dark orange, brown, tea colored or red if it contains blood.

◆ Sleep problems: Some people have trouble falling asleep or staying asleep. Itching, muscle cramps or restless legs can keep them awake.

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Beneficial Porridge for Patients with Kidney Failure

Patients with kidney failure should restrain the intake of sodium, phosphorus and potassium. Patients usually confused with the diet. Here are two kinds of porridge and one soup which are good for patients with kidney failure. Family members of patients can prepare the foods for them.
Porridge with Peanut and small red bean

Raw material:
peanuts 60grams (with red skin), cogongrass rhizome 50g (fresh), sticky rice 30g, small red beans 60g, proper white sugar (not too sweet).
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