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Friday, December 6, 2013

Stage 3 Chronic Kidney Failure (CRF)

Stage 3 Chronic Kidney Failure (CRF) is moderate decline of kidney function with Glomerular Filtration Rate of 30 to 59ml/min. In most cases, symptoms of kidney diseases start to become present in this stage. This is a crucial stage for treatment. Active treatment and lifestyle changes could help to preserve renal functions and delay the progress, but in poorly treated or controlled cases, it may deteriorate into Stage 4 Chronic Kidney Failure.
The symptoms of stage 3 Chronic Kidney Failure may differ from case to case, but generally include the follows:
Weakness/fatigue: Feeling fatigued is a common symptom caused by anemia, because the kidneys are not functioning properly to produce erythropoietin thus causing reduction of red blood cells.
High blood pressure: The kidneys play a key role in regulating blood pressure, and in turn, hypertension can damage the kidneys. It is common that stage 3 kidney failure patients have high blood pressure.
Fluid retention: The kidneys may fail to discharge unneeded fluid into urine. This can cause swelling in eyelids, ankles, legs, etc. Too much fluid accumulation can make a person short of breath.
Urination changes. Protein loss in urine can make the urine foamy. If there is blood in urine, people could notice dark orange, brown, tea colored or red. A person may have reduced or increased urine output, or visit the toilets more often at night.
Kidney pains: Most types of kidney diseases don’t cause kidney pains. But for some special types, such as Polycystic Kidney Disease (PKD) and infections, people may complain of pains where the kidneys are.
Sleep problems: some patients may have difficulty in falling asleep due to such problems as itching, muscle cramps and restless legs.
It is necessary that patients at stage 3 Chronic Kidney Failure see a nephrologist. The doctor will examine kidney patients and perform lab tests so that they can gather information to offer the best treatment advice. The goal is to keep the kidneys function as long as possible.
Because dietary management is so important, patients will be referred to a registered dietitian who will give a suitable dietary plan based on the lab tests and individualized illness condition. The patients will be advised for daily protein intake for 0.8 grams per kilogram per day. The intake of phosphorus needs to be restricted to keep healthy range of serum phosphorus and maintain bone health. The patients at stage 3 Chronic Kidney Failure usually don’t need to restrict their intake of potassium unless its blood levels is high. People with Diabetes will need to limit carbohydrates from their diet. Sodium intake should be limited for management of hypertension and fluid retention. The patient will also need to avoid over the counter dietary supplements unless approved by the doctor. Working with a renal dietitian will be helpful because the diet will change as the illness condition changes.
People with stage 3 Chronic Kidney Failure will need to adhere to dietary goals which include the management of blood pressure, blood glucose, lipids, weight, vitamins, hormones and minerals. The dietary tips for stage 3 Chronic Kidney Failure mainly include the follows:
Balance the intake of calories. Firstly it is necessary to weigh yourself and make sure if you are in healthy weight, over weight or underweight. A proper diet helps to provide additional calories if you are underweight or avoid extra weight gain if you are overweight. Find the diet to lose weight if you are overweight, and keep track to see if any change is needed.
Fats and cholesterol. It is advised that people with stage 3 chronic kidney failure replace saturated fats and trans fats by poly- and monounsaturated fats from vegetable oil, canola oil and olive oil. High blood cholesterol levels could increase a person’s risk of cardiovascular diseases.
Protein supplements. The recommendation for protein intake in stage 3 Chronic Kidney Failure is the same as healthy individuals, that is, 0.6 to 0.8g per day. This equals 55g protein for a person weighing 68kg. While on a low-protein diet, at least half of proteins should come from high quality animal proteins that contain all the essential amino acids and produce the least blood urea nitrogen (BUN), and this includes egg white, milk, fish, lean meat, etc.
Sodium consumption. Limiting the intake of sodium and water will help the management of blood pressure for patients with stage 3 Chronic Kidney Failure. The sodium intake recommendation for stage 3 CRF is 1,000 to 4,000mg/d based on a person’s blood pressure, fluid balance and the presence of other diseases that will affect the sodium requirements. A good level to start in stage 3 kidney failure is 1,500-2,500mg/d or as is prescribed by your doctor.
Many people with Chronic Kidney Failure have high blood pressure and Diabetes. Management of those two medical conditions will be of help to at least delay the progression of the kidney condition and make the kidneys live longer. Stage 3 Chronic Kidney Failure is irreversible, but by eating right and having the medicines prescribed by doctors carefully, the patients can expect to keep better kidney health.
There is currently no cure for kidney disease, the deterioration of the illness condition over a gradual course could make the patients develop into a more advanced stage. Thereby, the patients need to note that in addition to daily care management, proper treatment that helps improve the kidney condition is a wise choice. It will be advised to visit doctors every 3-6 months, and regularly keep your condition at check and consult the doctor if there is any need for improvement of the treatment plan.

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