Medications That Can Harm The Kidneys
No matter what kind of medicine you take, whether OTC or prescription, it is destined to take a trip through your kidneys. Taking a drug the wrong way or in excessive amounts can damage these vital, bean-shaped organs and lead to serious complications. In the worst-case scenario, it could necessitate a kidney transplant.
Compared with 30 years ago, patients todayhave a higher incidence of diabetes and cardiovascular disease, take multiple medications, and are exposed to more diagnostic and therapeutic procedures with the potential to harm kidney function, according to Cynthia A. Naughton, PharmD, senior associate dean and associate professor in the department of pharmacy practice at North Dakota State University. All of these factors are associated with an elevated risk of kidney damage.
An estimated 20% of cases of acute kidney failure are due to medications. The technical term for this scenario is nephrotoxicity, which is growing more common as the aging population grows, along with rates of various diseases.
The kidneys get rid of waste and extra fluid in the body by filtering the blood to produce urine. They also keep electrolyte levels balanced and make hormones that influence blood pressure, bone strength and the production of red blood cells. When something interferes with the kidneys, they cant do their job, so these functions can slow down or stop altogether.
Increased Risk Of Parkinson’s Disease In Patients With End
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Agent Orange & Kidney Disease
Even though kidney disease and renal failure arent on the VAs list of Agent Orange presumptive conditions, there is evidence that herbicides like Agent Orange can harm kidney function. In fact, a study at a VA Medical Center in Shreveport, LA found a potential link between Agent Orange and kidney cancer. Medical records that show this type of link can be critical in your appeal for VA disability benefits. Its also important to note that some veterans will experience kidney disease secondary to diabetes.
While the VA may deny an initial claim for disability benefits for kidney disease caused by agent orange exposure, they will still consider medical evidence in an appeal. To do so, its important to find a health care provider who will provide a diagnosis for renal disease and consider all potential environmental exposures when doing so. They will use this information to form a medical nexus in support of your claim.
Keep in mind that while it is possible to prove service connection for Agent Orange and kidney disease, you will likely need to fight your case all the way to the Board of Veterans Appeals. It can be difficult to win this type of veteran benefits case at the Regional Office, so you will likely need to continue fighting. Obtaining sufficient medical evidence, including a clear medical nexus from a doctor, will be key in supporting your disability claim.
Complications In Advanced Pd
While worsening of motor function and drug-induced motor complications represents a major challenge in patients with mid-stage to advanced disease, in the advanced stage of PD the most troublesome and distressful complications are usually nonmotor symptoms, including psychiatric and cognitive disorders, autonomic disturbances, and sleep disorders that significantly increase the need for supportive care. Unfortunately, these symptoms are frequently neglected in clinical practice due to limited consultation time, perception of the patient and caregivers that their symptoms are unrelated to the disease, or insufficient awareness of the clinicians, who generally focus on motor symptoms .
Proper supporting care becomes increasingly important in advanced PD. Rehabilitative and support services for patients and family become key interventions as the disease reaches its more debilitating stages and pharmacologic or surgical treatment becomes less relevant. Management of motor and nonmotor complications in advanced PD requires careful and ongoing assessment of whether symptoms are a side effect of medication or related to the progression of the disease .
End of Dose Wears Off Symptoms in Advanced PD
Progression of motor symptoms Dystonia
Fragmentation of Dosing
Dopamine Agonists Contraindicated
L-dopa and Dietary Proteins
Hallucinations, Delusions, Psychosis
Depression and Anxiety
Is Parkinsons Disease Fatal
Most doctors agree that Parkinsons disease is not fatal. In fact, the majority of Parkinsons patients live as long as others in their age group. According to the Michael J. Fox Foundation for Parkinsons Research, people with Parkinsons die WITH the condition, not from it. This means that, as the disease progresses, your risk factor for fatal injuries increases, but Parkinsons itself does not cause death.
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Parkinsons Disease And Your Bladder
Many diagnosed with Parkinsons disease experience urinary tract issues. A Michigan Medicine urologist discusses treatment options for patients to consider.
Anne Pelletier-Cameron, M.D., often jokes to her patients that shes a female plumber of the lower urinary tract. On a more professional note, however, shes a urologist in the Michigan Medicine Department of Urology.
In this role, Pelletier-Cameron treats patients with a variety of lower urinary tract symptoms. Some of her patients have been diagnosed with Parkinsons disease, a progressive nervous system disorder that impacts movement. But the breakdown of nerve cells that characterize Parkinsons disease can also cause non-movement symptoms, including bladder issues.
Half of all women and 17% of men will experience urinary incontinence, or the inability to hold urine, she says, noting that for Parkinsons disease patients, those numbers escalate.
Many of my PD patients end up having other bladder problems, including issues with urgency and frequency, says Pelletier-Cameron. Nocturia, or the need to urinate many times during the night, is also common, along with difficulty in emptying the bladder.
Pelletier-Cameron says the impact of bladder symptoms cant be ignored.
How Is Neurogenic Bladder Diagnosed
A doctor will do an exam and may order several tests of the nervous system and the bladder to diagnose neurogenic bladder: These include:
- Urodynamic studies: These bladder function tests measure how much urine the bladder can hold, the pressure within the bladder, how well urine flows, and how well the bladder empties when it is full. Special sensors may be placed on the skin near the urethra or rectum to see if the muscles and nerves in those parts of the body are working properly.
- Cystoscopy: The doctor may perform this procedure to examine the inside of the bladder and urethra with the use of a small telescope .
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Agent Orange & Kidney Disease: What Vietnam Veterans Should Know
Veterans who served in the Vietnam War are likely aware of the health effects of Agent Orange. Agent Orange Exposure has been connected to a number of conditions. However, the United States Department of Veterans Affairs hasnt formally recognized all of these diseases.
Chronic kidney disease is an example of a condition that is likely linked to Agent Orange herbicide exposure, yet veterans may not be automatically entitled to service connection for it. This can require more work on the veterans part, but the extra effort can often earn the veteran the appropriate benefits. This guide will break down how to obtain service connection for kidney disease based on Agent Orange exposure.
Causes Of Parkinsons Disease
At present, we do not know the cause of Parkinsons disease. In most people there is no family history of Parkinsons Researchers worldwide are investigating possible causes, including:
- environmental triggers, pesticides, toxins, chemicals
- genetic factors
- combinations of environment and genetic factors
- head trauma.
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New Approaches For Control Of Renal Failure
Control of diabetes and early treatment for the risk factors of diabetes are very important in preventing or delaying nephropathy. Control of hypertension with medications that modulate the renin-angiotensin system has been shown to decrease the incidence as well as progression of diabetic kidney disease. The consumption of angiotensin-converting enzyme inhibitors or angiotensin II receptor antagonists reduces the incidence of ESRD in patients with type II DM. Interestingly, the effects of angiotensin II receptor antagonists and ACEIs are independent of any antihypertensive property, which suggests a direct renal effect.
Furthermore, several new approaches, including the consumption of antifibrotic agents, endothelin receptor antagonists, inhibitors of advanced glycation end-products , receptor antagonists of advanced glycation end-products growth factors and protein kinase C oxidase inhibitors NADPH and glycosaminoglycans has shown promising results in preventing the progression of diabetic nephropathy.
Role Of Antioxidants In Control Of Diabetes And Kidney Disease
Buffering the generation of ROS or consumption of these compounds might be a promising therapeutic approach to ameliorate diabetes and/or renal damage.
Antioxidants have been shown to be effective in a lot of ROS-induced diseases. The role of antioxidant therapy in diabetes and/or renal failure in humans is not clear, but there are a number of preclinical reports showing the effectiveness of antioxidants in the prevention and treatment of diabetes as well as renal failure.
Antioxidants with plant origins have been shown to be a better choice for this purpose and a lot of plants exhibit antioxidant activity. In this regard, it is better that we try using plants that have shown good results for controlling both DM and kidney disease.
Stage Two: Symptoms Begin Affecting Movement On Both Sides Of Your Body
Once the motor symptoms of Parkinsons disease are affecting both sides of the body, you have progressed to Stage Two. You may begin having trouble walking and maintaining your balance while standing. You may also begin noticing increasing difficulty with performing once-easy physical tasks, such as cleaning, dressing, or bathing. Still, most patients in this stage lead normal lives with little interference from the disease.
During this stage of the disease, you may begin taking medication. The most common first treatment for Parkinsons disease is dopamine agonists. This medication activates dopamine receptors, which make the neurotransmitters move more easily.
Parkinsons Disease Late Stages: What Will Happen To Me
With advanced Parkinsons disease, stage 5 life expectancy can be months or years depending on how your condition presents. You are likely to need round-the-clock care at this stage, and you may not be able to move around independently. Patients with late-stage Parkinsons disease are more susceptible to pneumonia, sepsis, pyelonephritis and decubitus ulcers. Late-stage Parkinsons also leads to Parkinsons disease dementia in 50% of cases. For all of these reasons, many late-stage Parkinsons patients are cared for by loved ones or in a hospice.
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Symptoms Of Parkinsons Disease
The type, number, severity and progression of Parkinsons disease symptoms vary greatly. Every person is affected differently they may not get every symptom.
Some of the more common symptoms are:
- resting tremor
- blood pressure fluctuation
People living with Parkinsons for some time may experience hallucinations , paranoia and delusions . These symptoms are able to be treated so have a talk with your doctor.
Treatment Of Rls In Pd
Regardless of the above discussion, it is clear that many people with PD have difficulty falling asleep because of annoying sensations in the legs accompanied by a sometimes unbearable sense of restlessness in the legs. For these people, taking dopamine agonists before bed can be helpful. Caution is in order, of course, because in some patients with PD, especially older or more advanced patients, these medications can cause confusion and hallucinations and are thus not well-tolerated. A long-acting levodopa formulation or medications such as gabapentin, gabapentin enacarbil and pregabalin can also be effective. Trying to address sleep issues such as RLS in patients who have sleep complaints can be an important aspect of maximizing therapy for PD.
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Nighttime Hallucinations Psychosis & Confusion
Nighttime hallucinations and confusion may result from any combination of cognitive impairment, dopaminergic medications, age and PD-related vision changes and lack of sleep. Psychosis may first appear after infection, trauma, surgery or prolonged hospitalization. Symptoms may range from a sensation that someone or something is standing at the side of or behind the person, to very detailed and often frightening visions. Delusions may occur as well.
Treating Parkinsons Psychosis
The first-line approach to treatment of PD psychosis involves simplification of the anti-PD medication regimen and adjusting dose timing , treating other sleep disturbances, providing a consistent and familiar sleep environment , and in more severe cases, the use of atypical antipsychotic drugs.
Most of the available anti-psychotics are always avoided in PD psychosis because they block dopamine receptors and can cause significant problems with movement. However, two anti-psychotic medications, quetiapine and clozapine, are sometimes used as they have less of an ability to worsen motor symptoms. However, data for the use of quetiapine is limited and clozapine requires the patient to undergo frequent blood draws to monitor blood counts. A newer medication pimavanserin, was approved by the FDA to treat PD psychosis. It has a different mechanism of action, and does not block the dopamine system, but rather the serotonin system, and therefore does not increase motor symptoms.
Managing Advanced Parkinsons Disease
Advanced Parkinsons disease, stage 4 or 5 of the Hoehn and Yahr Scale, is characterized by very limited mobility without assistance, severe motor deficits, risk of falls, and cognitive and psychotic problems. With the advent of L-dopa and other dopaminergic treatments, the progression of PD has become markedly slower however, over the years treatment loses its efficacy, while a number of complicationssuch as motor fluctuations and dyskinesiadevelop, probably due to the progressive loss of dopaminergic neurons and their striatal and cortical connections. These complications are observed in 50% of patients after 5 years of disease and in 80% of patients after 10 years of treatment .
Treatment of the advanced stages of PD is entirely different from earlier stages. Early treatment is geared towards symptom relief and prevention of motor symptoms. During the later stages, the palliative care model is introduced to provide the patient with comfort and support. In the advanced stages, the focus of treatment shifts to treating nonmotor symptoms using a more supportive and palliative approach .
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Kidney Disease Kidney Failure And Palliative Care
Kidney disease includes conditions that damage your kidneys and decrease their ability to keep you healthy. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia , weak bones, poor nutritional health and nerve damage.
Kidney disease also increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long period of time. Diabetes, high blood pressure and other disorders can cause Kidney disease. Early detection and treatment can often keep chronic kidney disease from getting worse. Kidney disease may lead to kidney failure which requires dialysis or a kidney transplant.
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Journaling Can Help Those With Parkinsons Build A Legacy
Mitochondria are the so-called powerhouses of the cell. These sub-cellular structures are critical for generating energy, among many other essential roles. A large body of evidence has indicated that dopamine-producing neurons in Parkinsons disease tend to have dysfunctional mitochondria. However, it has not been clear whether this is a cause or a consequence of the disease.
To gain insight, a team of researchers in the U.S. and Spain engineered mice whose dopaminergic neurons lacked a specific gene called Ndufs2, which is important for mitochondrial function. The scientists conducted a battery of assessments analyzing the mices behaviors as they grew, and detailing the accompanying changes in their brain biology.
Through weaning, Ndufs2-null mice were indistinguishable from littermates with functional mitochondria, the researchers reported. However, as the mice aged, abnormalities became evident. The mice exhibited difficulty with fine motor coordination and memory. At the same time, analyses in the mices brains suggested increasing dysfunction of dopaminergic neurons.
Notably, treatment with levodopa a standard Parkinsons treatment that basically works by giving the brain more material with which to make dopamine eased some of these abnormalities.
Analyses of the mices brains over time showed that dopaminergic neuron dysfunction occurred in stages. First, the axons were impaired, and the impairment then slowly spread up to the soma.