Feb 4, 2014|
Angela talks about kidney disease with Dr. Mihran Naljayan of the LSU Health Sciences Center and dialysis patient Thomas Anderson.
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I hope you enjoyed those two young men I learned a lot from them reading that book. I can we just always need to remind ourselves of what they call their own values you don't have to be -- minimalist. But I think we need every once in awhile just look around and say what is important in our lives. What is it that makes us truly happy. Well we are shifting gears here. The numbers are pretty staggering 26 million Americans have kidney disease. Six in ten Americans will develop moderate kidney disease in their lifetime. Really think about that. But the really scary party's patience they have no symptoms and -- there in crisis. Today we're gonna talk about kidney disease what it is and what weakened perhaps due to prevent it. Joining us is Thomas Anderson who is a dialysis patient. And doctor mirror and -- -- Assistant clinical professor at LSU Health Science Center school of medicine and I welcome you both. I showed you I recently read an article about kidney disease and truly opened my eyes I just have no idea of the magnitude. Of how it affects so many people and I certainly didn't know that you didn't have a lot of symptoms so we're gonna get into that a of course if anybody is out there listening if you are going through this process. Where you know someone who is -- you have any questions we've got a real expert here we actually have to. That is mr. Anderson -- this year and he has lived so you can call us at 260187260187. Day. I -- start with you mr. Anderson. If you would tell me when you first realized there was an issue. I didn't really 20 I was gone to conduct. And I was -- this the ten -- And everything. And when I went for exercise that stuff in Emma. -- diet. To a must have some monotony. But the food we've been an -- and on and even though. We -- of that. And allied to -- and one nano into Carnoustie. It's -- you you know you stumped his day in. So when I want to adopt two -- some -- Soon. A two mile wide and that kids my kids in a moment alone. It is Tomasson. You can -- you know I couldn't do this do you know in the Indian. Some -- view view. -- -- -- -- -- And then some and indeed. And I did everything I could stay off the machine. To happen -- My mother was on the -- And me and my sister used it to images. Initiate it just as in dot Tillman to your nerves -- now in our part of their own. UConn had this damn problem onkyo to do you know who's in Eugene. And believe me and that. All -- loves him. At this and probably. Another -- -- cousin. Young and I am obstinacy is. And mean instinctive and -- here -- -- machine I got assistant. And -- she can wall for me. You know I have got Russia via the birth. And I keep telling. You who NC. But that day. And up and over and -- Until. I couldn't very. You wish you were. You change your diet and exercising I was at this. And then it was but it was still happening. And him and -- in the -- that was my game. You know an -- and that. -- -- in Eugene you know Q would you do you know he's a settlement traded in and but even that -- -- it -- mom on the drums just. It the stamper are you -- you are on AM on about how often do you Hugo. Three times a week three times a week for how many hours a day for four hours. And yet you look wonderful yes and and your living right or Korea. Doctor now -- It is typical story but we're hearing. And actually it's very it's very common. You know most patients. They don't even realize. What's going on with their kidneys until time passes by. And as mr. Anderson points out. In his case he started to notice fluid buildup and was having more shortness of breath and fatigue and despite. Making the modifications in his diet. Exercising. The disease process just continued and them. And then your kidneys just. Shut down to the point where you need some kind of replacement and so that's when dialysis comes and -- you know transplant as -- other options -- -- It's it's actually very common. But what mr. Anderson is saying that his. Mother's entire family have it so is -- -- genetic component. Absolutely. There are. Below first and foremost the majority of patients lined up on. With end stage renal disease various ideas we say at this time. Many of them are due to the diabetes and high high blood pressure and hypertension and so. We already know there's a genetic component with both of those diseases so not only your family risk factors. But also. Lifestyle. Diet all these things are -- factors in that process. But we also know that other diseases such as lupus for example. Or some of the other autoimmune diseases. Our kidney related are also found in families. And there's also a lot of work being done right now in the research world looking out. Genetic mutations in patients who develop. What we call hypertensive kidney disease. But. That kidney disease rapidly progresses despite. Having high blood pressure whereas another patients even with a high above -- it's much slower so we do know there are genetic components in this process. Mr. Anderson mean. You had been very upset when they told you when you would obviously fought the fight really you're gonna have to do to dialysis. Correct correct. -- And some not and not -- I am an -- And the thing about it when now when the -- spent the two on the Newmont. And then the pneumonia. You put me on the machine I am not a ten. And then. And then in the game and that couldn't breathe. And it really you know -- -- really. And and my mobility. And that would push and it worked on. But whereas -- And none of my you know. But gradually. In this hard for me you know it is just how. Thank. The simple life -- and my lesson in let's suppose. And and wonderful -- hit it right correct could -- because a tape about to -- out you know I've been on two. The man campus. And amid doubt that -- the tone that I want the movement Capitol -- from the because among them than. And the who have been area in that area and it takes me about 1015 men and but after. -- that would. And and and each and mouth -- -- it through its development to dialysis can that are. And mic -- moment. And Hungary went. And he didn't meet. On. -- -- Mall drew on that up and he went and -- when. We're hooked especially cam back -- sit there in my. That's not doubt that. He's a doctor that is that indeed that -- got passion. Yes about as he has. It's what it's -- right right you gotta have the knowledge that you gotta have the heart to right. I want everyone to stay with -- we're going to be talking about kidney disease and we have a lot to learn from the good doctor. And mr. Anderson right after this. We're gonna talk about kidney disease today because again an article I read that just really blew my mind and one of the figures was at six intent. Six in ten Americans will develop moderate kidney disease in their lifetime. And -- -- again you put ten people in the room six of us are gonna have this. So I think we need it it was just an eye opener I guess because I've not known many people who had it and yet I'm certainly aware of the a kidney dialysis situation here in New Orleans we all learned about post-Katrina and the need fort. I appreciate Thomas Anderson very much you're telling your story -- And you've got such a wonderful spirit if anybody is and I enjoy life for every -- even on dialysis. But I wanted to act ask a doctor known John Bell John now it's not drink. That's right now -- and thank you very very much. Why aren't there no symptoms mean there -- no symptoms until it's almost too late. Absolutely. Or kidney diseases. You know essentially silent so we call chronic kidney disease. You have. Millions of little filters in your kidney. That the blood processes through and it's cleaning toxins and helping get rid of fluid in managing. Although. Electorally it's in your blood like potassium and sodium. And the fact is we're all born with. Well above what we need we have two kidneys and millions of these filters in what happens is. With these chronic process these or even some of the acute kidney failures that we see. They -- essentially these filters -- often shut down but because you have such a reserve. You don't. Feel any of the symptoms until you are essentially what we calls stage. 34 even stage five chronic kidney disease and these are all. Based on the levels of filtration unit and so the higher the number the more severe and less filters that you have been so this is when you start to feel. The symptoms of kidney disease which are feeling tired and swelling up with fluid and nausea. Vomiting your appetite goes down all these symptoms but. Most patients with what we call chronic kidney disease stage three years -- or moderate kidney disease one ever knowing unless they get the blood and urine test and. Fourth and that's having if you are diabetic. Or if you have high blood pressure which as you -- have talked about that's part of one of the one of the key things would wouldn't you automatically say to a doctor look I've got these my should have I should be tested for us. Absolutely so. So patients who are hypertensive or have high blood pressure. And patients who have diabetes usually routinely get. What we call these blood tests -- -- Crea I mean levels this is what we use to measure kidney function. And also. The urine should be checked for protein in the urine which is another marker of kidney inflammation -- decline in your kidney function. But doctors routinely check this when you already have high blood pressure diabetes the question is is. Being able to catch that early enough so. Not waiting until you've had high blood pressure for ten years before seeing the doctor and then much of the damage has already been done well same goes for diabetes having diabetes for ten years. Not really managing the blood sugars and then finding that you know it's too little too late much of the damage has already been done. The now the issue of of diabetes some some people are born with that -- Some people are are genetically pre disposed to high blood pressure -- food but those are two areas where lifestyle can make a difference. 0100%. Absolutely so. I'm watching the diet. Controlling the blood sugar. Watching the salt intake if your Bible if you have high blood pressure moderate exercise in your regiment and weight loss you know maintaining a good and healthy weight. All of these things. Help slow down that progression of kidney disease due to those diseases disease process that. If you can prevent. Getting diabetes I mean if you're not born with -- a -- prevented through lifestyle and that's a possibility absolutely. You know likewise with hypertension. And very much so I mean watching I am. And -- for example in diabetes we know or what you're talking about -- type two diabetes. These are the patients who. Later in their life developed diabetes the majority of these patients develop diabetes due to obesity so. You know helping decrease obesity we'll help decrease the numbers of diabetes. Nowadays we're seeing more and more. Young adolescents 1215 years old. Morbidly obese developing diabetes this is -- -- this is just gonna further increased chronic kidney disease down the road in these and these young young young people. I know that time. In the African American community I read a story and a half times more likely end in the Hispanic community one and a half times more likely why is snapped. It's it's a great question. You know one of the things. -- We think about is access to healthcare so. Seeing the doctor early on in the disease process getting routinely checked getting the medicines I'm keeping the blood pressure on the controlled these things are all. Issues that we find. That may be more difficult -- minority populations of patients -- actively going to see their regular physician so that's one issue that we worry about. From a public health perspective. The other issue though is as I mentioned. Genetics may be playing a role so especially in African Americans for example. There is current research to suggest that specific gene mutations increase your risk significantly. Of developing. And stage kidney disease. If you have high blood pressure so at a much faster rate and so that's a genetic. Issue right there but I think it's it's multi for tutorial. And reliable down. When when someone is diagnosed with high blood pressure who endorse diabetes. Are they told you know this isn't just about diabetes high blood pressure this is about. Other events that can happen that could be. Rough. I would hope so I think most most physicians probably do discuss this with there with their patients I mean diabetes and high blood pressure. Not only affect the kidneys but increased service for heart disease and -- heart failure. Peripheral vascular disease in the in the the legs in and there's many many things that can. Many organ systems affected by these prophecies so. You know I'm -- as you're talking about the protein in the urine so many people I know -- on high protein diets. Can match -- him. No this is -- this is very different I'm Dave actually looked at. There's been large scale studies looking at protein in the diet and whether that affects kidney disease. This type of protein that we look for in. Especially in diabetics for example or even high blood pressure. Is is a marker of the small tiny blood vessels in those filters of the kidney. Being damaged and so protein leaks out of the blood into the year and so it's not necessarily a diet related -- it's more. That the small blood vessels being damaged by these disease processes. One can live with one -- think that's true. And and we're gonna talk about transplantation at center center about if one kidney is failing. You don't necessarily have to have removed he just couldn't function with the other -- That's correct. Although the idea of one kidney failing. Is dependent on the process going on so for example if you have. These systemic diseases and diseases that affect the whole body lake high blood pressure diabetes. Or lupus for example. That's not -- just. Affect one kidney it's gonna followed by affect both equally. That the places where we think about one kidney being. Affected is. You know patients who get repeated infections in one -- due to some and atomic. Issue or kidney stones -- trauma for example which may affect that one kidney vs the other one being healthy. Think Kevin we have to but it it was a while you'll hear a story of somebody donating her kidney but the father gives it to the son -- the mother to them. And you know and they can still function of absolutely. You know thank -- -- whoever designed this did well -- government and you're saying that's right. Stay with us we're gonna continue our talk on kidney disease hope -- give us a call and Alice says stay with -- -- We're gonna go the newsroom right now and Christmas. We are talking about kidney disease was so wonderful man Thomas Anderson who is a dialysis patient and doctor Algerian. Knowledge any doctor know -- and then again I got a but such a good sport if we are also joined by Alice Alice on. Alice and I actually -- this is so wonderful that you -- -- -- We -- Yeah. Yes I'm sure yet that you wanted age of -- the -- twenty years from other. Our seventeenth and market Nike contract signed on your shall not. What you -- immediate treatment for he had me he would column. -- -- -- -- -- -- -- -- -- In black and that is very difficult -- Two do. Keep it and I have a lot of rain and it wanted to speak there. I try to milk that might it's fine chief. Be hit it too. In February she did great is. No problem. Aaron. And that it could -- not -- the eclectic kidney -- and the -- when -- you know and it's confined. But anyway like that's it -- survival. Between nine year eight of -- on seventeen. That is fantastic and you bring up something else that that the doctor was saying in the commercial about the the African American community why transplants needs to -- -- act exactly and down and it it a person that I know are -- content option. Alex's analysis China to let you know. That and they -- she. They -- legally it can't it is no problem. And you do firm it up in the freedom. Familiar walking example of that and I really appreciate you calling. And I'm glad to hear that you don't great that your daughter is doing great. Great. Okay thank Q -- -- -- -- -- I'm content and edit it might like it -- move to roll back in 2006. Right it it was all on the fact it wasn't fully developed. And as a result of that it cannot function properly. I usually get into the -- -- reflux or you're back and up to execute it used to -- -- we're preparing them outside. -- that multiple. Infections. And so far he let me announce that broke about two per couple years and that what ability good it is removed. But my question is that doctor. Right in that same area being very familiar with the pain that that reflux. But the urine caused -- I mean continuously. I'm a real commitment at saint. I'm still getting that -- from time to time and that same area. And my question is is there a chance that when they did the surgery. Can at seizures -- up and then. With a kidney used to be connected to ensure whatever. That would cause muscle contractions does that mean it does. At times it -- as well as still a bit kidney so anything you could land him in that direction. How I would truly appreciate it. Sure. It's. Tough situation. I'm -- frolic just by training. In the question. Is really more of -- Euro logic issues these. Repeated infections and requiring removal mean. Any time you have any kind of abdominal surgeries the risk for occasions and all that can be fair but. You know whether or not that can continue. To cause discomfort is. That unfortunately. I don't know -- -- and you've told your doctor you're still suffering these pains. Or get them that any number of doctors and health and well you know they just threw it -- -- much -- anything you know. And somewhat sub industry that became an -- or something that it happened it is little. -- shooters in the and in economy. One publisher heart. I'm good for your son by -- hit. It's good to have one in the house. One thing that I would ask is because I am occupying the minds of similar things like that with the reflux. Maybe it -- on that will be at some your listeners because. I think some people may be having that and not know what it's that would call thing -- whatever because it. I got a few friends that -- now I have that same things so maybe if you could touch and a little bit for the others and I'll gladly give up ninety. -- no thank you for calling term and be happy it's. To try so. You know these these kind of reflect situations -- anatomical. Issues usually arising from the Blatter from the your editors sort of the outflow of the kidney. Can cause reflex but also things like kidney stones for example can cause. I'm a lot of pain and discomfort. In that area in the back in in the kidneys. Down into the growing and so it can be number of those things really again this is one of those things where. You have symptoms but not really otherwise unknown so imaging you know with something as simple as an ultrasound may be able to tell you if you have that kind of -- Process going on so just asks who moon volunteer doctor about it absolutely. You know and that the more we learn the more complicated everything seems hidden and this is a very complicated issue. We have another caller. Mitch from applause. -- Mitch was there are you here. -- want to give -- called back. That he wants an info from the doctor. Not we we were talking about the transplant. Is the list just endless. It seems that way especially for our dialysis patients. The wait time. In this region were probably looking at about five years for -- dishonest -- transplant. It is regionally dependence on depending on what part of -- the country you're in the list maybe longer or shorter. And there are different types of transplants. There is what we call living donor transplant which is. Either family member or friend who's looking to donate. And then there's also the deceased donors which are. Pete Pace people who have passed away from various issues and are. Donor. Listed as donors and then those kidneys can be allocated based on time on the list. And so the longer you're on that transplant list. The more likely wanted to get that kidney that. The importance is really making it to that point and in some of these patients are pretty sick to begin with and getting them that far is really important. Mitch has called that -- that you had a question for the doctor. They're. Europe and Asia remember in the the back. Into and so. However it is but. -- bulging. -- About what Katrina. Clinic for regular. But it kind of -- -- want public. -- -- Out of one. Of -- oh. And did what we. Here are apart. They could be quite serious actually I'm and you know I'm. I'm glad to hear that you you know you kept up with that has some effect but. I think it's important to follow up with someone for this now like he said and we've talked about there really no symptoms associated with these disease process is so. You can be spilling. Graham's thing grams of protein in the urine and not even know it whatsoever. And did did the high amounts of protein in the urine are directly. Because direct damage to those two deals in those filters in the kidney and so you could be progressing down with worsening kidney function not even know it in again. Until it's too late so routine testing is important that trying to get in with a kidney doctor again. Are your what do you when was the last time you were checked mansion. Well. -- thought about what. It will. -- Well. That would bet they'd get it back to vote at all -- well. That one but does. That they're sort of radio. Didn't read it there does that. Have a big problem. Here. And that's what I think a lot of patience think about it you don't feel sick from it you feel fine and so. It's important to keep up with him -- -- staying on top -- your heart. You are. Okay and next thing on how you will take another break will be right back and we're gonna continue this talk on kidney disease right after this. Doctor bill -- is our special guest along with Thomas Anderson who has been on dialysis patient and I wanted to go back to mr. Anderson. You know listening to that other caller who realizes he has some issues but isn't feeling any symptoms. Kind of need to be motivated to keep on top when it. What would you say to friends of yours that are having issues I'm no longer. Doctor. Hook until he invented that it's go to -- -- And CNN and especially -- -- that if he had. Have blood pressure. And show well it's you know. He should stay out of go to the doctor. You're absolutely right -- -- that that is that the if you have certain things the right there are other issues -- our current career. And what the doctor was saying in the commercial news. Is that not only if you have kidney disease you may have other issues such as bones -- can't talk about that. Sure. So. You know what we think of kidney disease you just think about you know typically. The kidneys themselves failing in but they kidneys do so much and are an integral part of any of your total body systems so for example. Kidneys clear toxins from the blood and it helps maintain fluid status so. If you're not doing that you're gonna develop fluid in the the lay eggs the hands potentially in the lungs. Thumb potentially around the heart. The kidneys also produce a hormone that's involved in here and Nina so your red blood cell production and so as your kidneys begin to fail. You end up becoming more and more anemic. You also don't. Manager iron as as well as a normal person would -- you'd become iron deficient despite you know just a regular diets lead need to have more I hear a new meaning to take. Medicine to help that that hormone basically taking -- that to increase or red blood cell count. It effects of bones you get brutal brittle bone disease the primary problem there is. It's phosphorus which is found in so many of the foods that you eat some dairy meats. Even things like beans for example have higher phosphorous well he kidney. Gets rid of phosphorous but when it's not working correctly that phosphorus builds up and we know phosphorus is -- on the blood vessels with -- on the hard increases terrorists are. Heart disease and stroke in. And heart failure. Kidney disease. Has. Has been shown to be associated with depression has been shown to be associated with decreased immune functions of your higher risk for infection. So all these things essentially. Com are our. Part of the kidney disease process and so will we see a patient we don't just look at their kidney function we're looking at their. Red blood cells -- phosphorous there there bone metabolism. You know we we discuss. Just how are they feeling that you're malnourished are -- eating do we need to help them supplement an additional protein in their -- these -- the things that we're looking. Four in a perfect world if you could look at a person who is a kidney health group and say this is what you need to do the rest of your life to keep them healthy. What would you -- While. The things that for example we do in our clinic -- we we sort of take a multi. Multifaceted approach with not just the doctors but it's it's a team effort and that patients the center of this so. We we have classes on their diet for example so what kind of food should they not be eating pleasure should be beating so things that are -- I -- protein is good things that are high -- phosphorus is bad things that are high in salt is bad things that are high in sugars that so these kind of things. We do. We managed there iron in there Anemia and meat of the medicines if they need to do that we have social workers available you know we make referrals for. Depression -- management of that. We manage their diabetes and high blood pressure along with the primary care doctor so it it's. It's it's not just the kidney -- here it's -- there's so many members of this team and the patient is sort of them middle person in the primary person has to be involved and all those steps. How long can one being on dialysis. That's a great question. You know. We in our practice them with our with our group of physicians that policy we've we have. We one of my colleagues at the pace has been on thousands for over thirty years so it can be many many years. So I think the key is each patient is different analysis and so it's. It's how they manage their -- how they managed influence how we helped them with Anemia and all these things and so. It's it's a two way street you know and that's what we try to work with our patients to get. As healthy as possible mister -- said that he goes three times a week is that pretty normal that's the typical so. Three times a week four hours each treatment that's the average what we call. Outpatient -- dialysis but there are other -- those modalities out there we were talking about earlier compared to -- dialysis. -- this is a type of thousands that's done every night in the home with a catheter in the belly it's it's very safe. And done around the world and patients do it themselves you don't have to go to a center you don't have to sit somewhere for hours and doing a do yourself there is. Nocturnal him or night he -- dialysis -- you go to a century do it at home there's home he would analysis. There's lots of different ways to do doubts of some different. Prescriptions and -- key is trying to fit it with the patient's lifestyle what works best for the patient. And you know if they wanna -- spend time at home you know than some of the other ones might be better option than in center team analysis -- elements. Mr. Anderson's doing. -- that's incredible and that's a commitment for hours three times we absolutely. But you know and I'm hopeful with everybody. Understanding the connection between the other diseases. That if you have diabetes you really need to be on top of this -- if you have high blood pressure etc. I think that's the message we all need to hear. And that in some cases and on all of and in some cases we really do have control movement on my golly. We can look at Epsilon for some -- that I've got sugar in my purse and I thought we we have to make decisions I think that's that's really what it's about. I want everyone to stay with this because. Coming up we'll have our cash contest code word right after this. It's the 1000 dollar cash contest the code word this hour is purchase PURCH. A SE. Entered the code word at WWL dot com slash cache or click on the contest link on our website for your chance to win 1000 dollars nationwide. And it's just the simple underwear the -- office computer surfing at home or on your Smartphone or tablet you can win anywhere listened for the next code word -- -- the top our news. At 6 PM good luck from Smart radio and a common data WL and thank you to both. Thomas Anderson and doctor than John Allen. This has been a real lesson for us and I think all of us are paying attention and we're gonna take better care of ourselves thank you so much.