Young diseases

why Medifast works

2008-05-01T23:23:00.000-07:00

The Medifast plan is a healthy, low calorie diet that helps you lose weight quickly and safely. It is a natural weight loss program that uses great tasting, low calorie meals. The Medifast low calorie diet provides natural weight loss that is quick and safe.
Calorie Gap

The clinically proven results of Medifast are designed to create a healthy gap between the calories you take in and the amount your body burns, thus promoting natural weight loss. Medifast's high-protein, fortified meal replacements help you lose weight faster and more easily than ever before.
Nutritious

Each healthy, low calorie Medifast meal is formulated with a proven combination of carbohydrates and protein to allow you to successfully lose weight without losing muscle. Many times, dieters on other low calorie diets do not meet the minimum daily-recommended nutritional requirements. Medifast meals, however, provide the nutrients that the body needs to lose weight and get healthy.
Clinically Proven and Physician Recommended

Medifast has been proven in multiple clinical studies. Medifast programs have been recommended by over 15,000 physicians and used by over 1 million customers for 25 years.

What is Medifast?

2008-05-01T22:05:00.000-07:00

Medifast is a meal replacement program that helps most people lose weight faster than traditional food-based diet plans.

Medifast is a healthy diet that makes quick weight loss simple. With the 5 & 1 Plan, there is no calorie counting, no points system, no diet pills and no confusion. The Medifast low calorie diet consists of clinically proven meal replacements designed to help you lose 2-5 pounds per week.

Never Go Hungry!
Because Medifast is a healthy diet, you eat every 2-3 hours, which results in you never getting hungry or lacking energy. The convenient prepackaged meals of Medifast's low calorie diet allow you to be successful with quick weight loss.

Clinically Proven and Physician Recommended...
Medifast has been proven in in multiple clinical studies. Medifast programs have been recommended by over 15,000 physicians and used by over 1 million customers for 25 years!

Nephro

2007-11-11T02:15:00.001-08:00

Nephrologists treat a wide spectrum of diseases which result in chronic kidney disease (CKD) and renal failure as well as diseases which are influenced by damaged kidneys. To keep up with all the relevant publications which contain useful or potentially influential articles is a labour-intensive task. The "Expert Update" is intended to help in this task by selecting and screening on a regular basis publications which cover important new data in nephrology, as well as those which are relevant to nephrologists, but are not aimed directly at the field.

Every month, a European expert will analyse and summarise a publication with new data and will discuss the potential impact for nephrologists on their current or future practice. The "Expert Update" will cover a range of topics from highly scientific subjects to new information relevant to the daily practice of nephrologists.

Readers can also ask the expert for further comment about the article or review.

Pharmacokinetics and pharmacodynamics of epoetin delta in two studies in healthy volunteers and two studies in patients with chronic kidney disease.

2007-11-11T02:08:00.000-08:00

BACKGROUND: Epoetin delta, unlike recombinant erythropoietins, is produced in a human cell line and therefore has a human-type glycosylation profile. OBJECTIVES: The pharmacokinetics of epoetin delta were examined in 2 studies in healthy volunteers and 2 studies in patients with chronic kidney disease. METHODS: In study 1, 21 healthy men were randomized to receive epoetin delta 15, 40, or 100 IU/kg IV tiw or placebo for 4 weeks. In study 2, an open-label, cross-over study, 32 healthy volunteers were randomized to receive single doses of epoetin delta 75 IU/kg IV or SC. In study 3, 40 patients receiving hemodialysis were withdrawn from epoetin alfa and randomized to receive epoetin delta or epoetin alfa 50 or 100 IU/kg tiw for 4 weeks. Study 4 was a single-dose study comparing epoetin delta 150 and 300 IU/kg IV or SC in 28 hemodialysis patients. RESULTS: In study 1, after repeated dosing (day 24) in healthy men, mean C(max) values ranged from 219.9 to 1793.0 enzyme-linked immunosorbent assay units (EU)/L; AUC from 827 to 9318 h x EU/L; C1 from 0.014 to 0.024 L/h per kg; Vd from 0.067 to 0.076 L/kg; and t(1/2) from 2.23 to 3.35 hours. There was evidence of a dose-dependent effect of epoetin delta on hemoglobin levels and hematocrit, with doses of 40 and 100 IU/kg associated with significant increases compared with 15 IU/kg (P < 0.001 for dose trend). The only adverse event occurring in > or = 10% of healthy individuals in study 1 was headache (1 [20.0%] in the epoetin delta 15 IU-kg group, 3 [60.0%] in the epoetin delta 100-IU/kg group, 2 [33.3%] in the placebo group). In study 2 in healthy volunteers, mean values for epoetin delta 75 IU/kg IV were 1771 EU/L for C(max), 10,632 h x EU/L for AUC, 0.010 L/h per kg for Cl, 0.074 L/kg for Vd, and 5.12 hours for t(1/2); the corresponding values for epoetin delta 75 IU/kg SC were 113 EU/L, 3231 h x EU/L, 0.035 L/h per kg, 0.760 L/kg, and 14.90 hours. The serum epoetin delta concentration peaked after 10.9 hours with subcutaneous administration. The most common adverse event in study 2 was back pain (10 [31.3%] individuals). In study 3 in patients receiving hemodialysis, mean values for C(max) and AUC with a single dose of epoetin delta 50 IU/kg were 1103 EU/L and 10,896 h x EU/L, respectively, and with the corresponding dose of epoetin alfa were 1354 EU/L and 9957 h x EU/L. Values for the 100-IU/kg doses were approximately double those for the 50-IU/kg doses. Values for Cl, Vd, and t(1/2) were numerically similar for epoetin delta and epoietin alfa across doses. Epoetin delta 100 IU/kg was associated with a numerically greater rate of increase in hemoglobin compared with the 50-IU/kg dose (mean, 0.025 vs -0.004, respectively); the results were similar for epoetin alfa (0.029 vs -0.001). The difference between epoetin alfa and epoetin delta was not statistically significant. The most common adverse events were related to edema (peripheral edema: 60%/50% for epoetin delta 50/100 IU/kg and 60%/60% for epoetin alfa 50/100 IU/kg; facial edema: 30%/30% and 50%/70%, respectively; generalized edema: 50%/30% and 40%/40%). In study 4 in patients receiving hemodialysis, mean C(max) values with epoetin delta 150 and 300 IU/kg IV were 3257 and 4770 EU/L, respectively; the corresponding mean values were 36,208 and 77,736 h x EU/L for AUC, 0.007 and 0.005 L/h per kg for Cl; 0.097 L/kg for Vd in both groups; and 9.9 and 13.2 hours for t(1/2). With epoetin delta 150 and 300 IU/kg SC, the respective values were 162.2 and 467.7 EU/L, 9547 and 27,888 h x EU/L, 0.026 and 0.020 L/h per kg, 1.28 and 0.78 L/kg, and 33.1 and 27.8 hours. The only adverse event occurring in > or = 10% of subjects was headache (2 [40.0%] in the epoetin delta 150-IU/kg IV group, 3 [50.0%] in the epoetin delta 300-IU/kg SC group). No neutralizing anti-erythropoietin antibodies were detected in any individual. The bioavailability of subcutaneous epoetin delta is approximately 30%, and concentrations peak later and decline more slowly than with intravenous injection. Pharmacokinetic parameters in hemodialysis patients were similar to those in healthy individuals, although AUC and t(1/2) were numerically higher (by 49% and 34%, respectively). CONCLUSIONS: These studies in healthy volunteers and patients with chronic kidney disease indicate that the pharmacokinetics of epoetin delta are dose dependent but nonlinear, leading to dose-dependent increases in hemoglobin levels. The pharmacodynamic response to epoetin delta appeared to be as expected for an epoetin

You Are What You Eat

2007-11-09T19:57:00.000-08:00

Better food habits can help you reduce your risk for heart attack. A healthful eating plan means choosing the right foods to eat and preparing foods in a healthy way.

t's Not Just a Man's Disease
Heart disease is far and away the leading cause of death of American women, but you can do a lot to help protect yourself and women from it. Read this section for some important advice.

Exercise & Fitness
Swimming, cycling, jogging, skiing, dancing, walking and dozens of other activities can help your heart. Whether it is included in a structured exercise program or just part of your daily routine, all physical activity adds up to a healthier heart

Managing Your Weight
We can help you manage your lifestyle to better manage your weight and reduce your risk for heart attack.

Cholesterol Low Down
To urge Americans to reduce their risk for heart disease, the American Heart Association introduces "Taking It Personally," as part of the Cholesterol Low Down national education campaign.

Gandarusa

2007-11-09T19:54:00.000-08:00

Nama Tempatan: Gandarusa
Nama Saintifik: Justicia Gendarussa linn
Nama Lain: Daun rusa(melayu), bo gu dan(cina),gendarussa(english)
Famili: Acanthaceae
Lokasi dijumpai:
Asal:
keterangan:
Tumbuhan ini boleh dijumpai tumbuh liar dikawasan semak pada ketinggian 1-500 meter dari aras laut. Ia tumbuh tegak dan boleh mencapai ketinggian hingga 2 meter. Panjang daunnya lebih kura 5-20 cm dan daunnya dari jenis daun tunggal.Dua jenis gandarusa biasa dijumpai dan dibezakan oleh warna batangnya. Ada yang berwarna hitam dan ada yang berwarna hijau.Pokok berbatang hitam lebih popular sebagai ubat dari yang berbatang hijau
kegunaan:
Ia biasa digunakan untuk mengubat lebam akibat terpukul, tulang patah, rheumatik dan bisul.cara penggunaannya ,untuk tulang patah daunnya yang segar atau kering dikisar hingga lumat dan diampur cuka untuk ditampal pada bahagian yang luka dengan syarat tulang telah berada pada kedudukannya yang betul.Untuk rheumatik 15-30 g daunnya yang segar direbus hingga mendidih dan airnya diminum.Untuk lebam pula daunnya dilayurkan pada api hingga layu dan ditampal pada bahagian yang lebam.Ia juga boleh digunakan untuk menurunkan panas badan, menyembuhkan lumpuh otot muka (selalunya disebabkan oleh minor stroke),sakit kepala, mata dan telinga.

***Amaran: Tidak boleh digunakan oleh wanita hamil.
_____________________________________________________________________________________
Ulasan pembaca
Gandarusa hitam mempunyai batang hitan dengan daun hijau gelap.ada juga gandarusa yang mempunyai daun hijau putih dengan batang hitam. Jenis ini banyak ditanam sebagai tumbuhan hiasan. Nama saintifik gandarusa hitam ialah gandarusa vularis
~Admin
Knp tak leh guna utk wanita yg hamil??
~sweetgirl,penang
gandarusa hitam mempunyai khasiat besar yang kurang diketahui,antaranya untuk mengubati sengatan berbisa, mandi lepas bersalin,pulih tenaga.kami banyak menanamnya
~putrahero@hotmail.com
mcm mane nak guna kan ganda rusa for minor stroke bahagia muka
~nieya
daun gandarusa memang daun terpilih oleh orang tua-tua dulu gunakan sebagai bahan rebusan mandian, terutama kepada ibu-ibu bersalin..
http://livingnaturally.myblog.com

~kdier
tolongin dong carikan gambarnya! gue pengen ngliyat.
thanks
~Karman
e e ada pla,.. sorry ye lambat surf
~Karman
masalah PEKANG(angin dlm kepala/lebih kurang migrain).7 helai daun ini +sireh pinang sehelai seadatnya(di doakan terlebih dahulu)disemburkan pada kepala sebelum matahari terbenam.Insya-ALLAH mujarab...
~aurasyami_71@yahoo.com

Belimbing Tanah

2007-11-09T19:50:00.000-08:00

Nama Tempatan: Belimbing tanah
Nama Saintifik: tacca integrifolia
Nama Lain: Belimbing batu, white bat plant
Famili: taccaceae
Lokasi dijumpai:
Asal:
keterangan:
Tumbuhan berumpun ini agak sukar ditemui namun ia biasanya didapati tumbuh liar dikawasan yang agak redup terutamanya dikebun getah.Daunnya lebar dan panjang berukuran kira-kira 15 inci panjangnya. Ia membiak melalui rizom dan pokoknya jika dilihat sekali imbas menyerupai pokok kunyit.
kegunaan:
Digunakan untuk menurunkan tekanan darah tinggi. seluruh pokok ini termasuk akar dan buahnya direbus hingga mendidih dan airnya diminum dua kali sehari. selain dari itu tonik ini juga berupaya mengubati masalah buasir, kencing manis, lemah jantung dan buah pinggang
_____________________________________________________________________________________
Ulasan pembaca
Pokok ini kami cuba tanam secara komersil tapi gagal.Tahap kematian agak tinggi, tumbuhan ini tidak tahan kepada transplanting.
~
Betul tu, dah beberapa kali saya try to transplant pokok ni, baru kali ni macam nak berjaya sikit, tapi growth very slow, saya letakkan polybagnya bawah teduhan pohon lain dan potong semua daunnya hingga tinggal pucuk saja sebab dari pemerhatian saya sebelum ni, pokok ni mati akibat daun asalnya mengering.
~Melur
kalau ada sesiapa jumpa atau memiliki pokok ini sila beritau saya. Ujang 019-3562893. Kalau tak silap saya pokok ini perlukan daun getah reput utk tumbesaran(makanan) dan memerlukan cuma air hujan saja, bukan air paip.(ada klorin)
~ujang83s@yahoo.com
Kat kampung saya ada le jumpa sikit-sikit dalam dua tiga rumpun sekali.Mungkin betul jugak sebab tanah mak saya tu dulunya bekas kebun getah.Saya ada try tanah sepokok dalam pasu kat rumah saya sekarang ni tapi pokoknya tak besar sangat, berbunga minggu lepas, cantik, macam dalam gambar ni lah.
~Nor
Saya rasa ini
~
sesiapa yang berminat dgn pokok belimbing tanah sila hubungi 0139553694 putrahero@hotmail.com
~rusli
The genus Tacca consists of long-lived, short stemmed, rhizomatous or tuberous herbaceous plants that grow in the shade of Asian rain forests. Four species of Asian Tacca have attractive, entire leaves, vertical growth habit, and strange whisker-like (filiform) bracts below the flowers that can hang down for as much as 1 foot in length. It is these structures and their accompanying cluster of luridly colored flowers that has given rise to the sobriquet "batflower" for these marvelous tropical plants. Unlike its better known close relative, T. chantrieri, T. intergrifolia has white bracts hovering over the nodding flowers. The bracts are beautifully veined with purple. The rhizome of this species grows vertically and the crown of large, attractive leaves emerge from the top of the rhizome. The leaves superficially resemble those of some Peace lilies (Spathiphyllum), but the resemblance ends when the flowers begin to appear. The good news for foliage producers in Florida is that large plants of the white batflower can be finished in just over 1 year from seed. The white batflower fits into any foliage production scheme with ease. The plants thrive in 70-80% shade, high temperatures, and even moisture. White batflower is remarkably free of pest and disease problems. Caterpillars, snails and slugs may occasionally feed on the leaves, but the damage is minimal. Flowering seems to begin when the plants have produced 2-3 full-size leaves. The season lasts from May to November. Large, flowering-size plants of Tacca integrifolia were distributed to foliage nursery contributors to the University of Florida Foundation-SHARE program last year. Packets of seed will be available later this year. ref: http://flrec.ifas.ufl.edu/tropicline/Volume%209(1).html
~Nor
sesiapa yang ingin ubat buasir sila sms 0139553694,rusli
~rusli
Nor hang tulis apa, aku tak paham... kalau nak tulih biaq org kita jer yang tau jangan bocoqkan pada org putih....pikiq la sikit...
~Nazhrol
Rujukan dibawah adalah dari sebuah website mat saleh, saya copy paste je, sebab tu saya tulis rujukannya kat bawah sekali tu, ada url untuk websitenya. Ni kajian yang mat salleh lakukan pada pokok ni
~Nor
ubat buasir. ambil satu perdu pokok belimbing bukit@belimbing tanah(bukan belimbing buluh)rebuskannya sehingga mendidih. minumlah air tersebut 2 kali sehari, insya Allah dalam 2 hari akan segera sembuh.air tersebut juga boleh dibuat ubat penyakit darah tinggi atau kencing manis.
~fajarsiang@yahoo.com
kenapa pokok belimbing tanah ni lain daripada belimbing tanah yang biasa digunakan untuk ubati pokok belimbing tanah yang selalu digunakan untuk merawat penyakit darah tinggi tu?
~nana
Seluruh bahagian:Dikeringkan serta direbus lalu air rebusan ini diminum utk merawat kencing manis dan mengeluarkan batu karang
~niksuzanna@jma.gov.my
Sesuai ditanam sebagai tumbuhan hiasan. Bentuknya yg menarik dan agak luar biasa cukup diminati oleh pecinta flora
~niksuzanna@jma.gov.my
YA POKOPNYA AMAT SUSAH DI TEMUI KAWASAN TERDEDAH CAHAYA MATA HARI.DAN SUSAH HIDUP DI KAWASAN PANAS.KEBIASAAN TUMBUHAN INI BERADA DI TEMPAT SEJUK DAN REDUP.
~condee04@yahoo,com.sg
sesuai dijadika motif studio lanjutan kayu ....ceh....ceh
~pensyarah upsi
Tumbuh secara semulajadi dalam belukar kebun getah yang tanah jenis halus berpasir dan lembab. Kadar cahaya matahari mungkin 25 %, redup, sejuk. Tanahnya gembur dan tidak kering. Berjiran dengan pokok paku gajah.Saya temui pokok ini di Kg Sungai Ramal Dalam,Kjg tidak jauh dari Tol Sungai Ramal, kat rumah Pak Din. 10 kali cuba pindahkan,..gagal.
La ni semuanya dah habis, sebab kebun tu dah terang. Pak Din jual batang getah.
~Apak Nuar
issyyy, issyyy, issyyy tak sesuaiiii langsung nama dia belimbing tanah. tak menunjukkan ciri-ciri belimbing langsung.
apa kata kita tukar nama lain yang sepadan dengannya....
seumur idup tak penah jumpa....
~nz
saya pernah beli pokok ni di pasar tani shah alam stadium.dah cuba tanam tapi mati.Tapi menurut kawan saya setiap hari ahad ada dijual dipasar tani tu.cubalah cari
~shim04
Pokok Belimbing Tanah adalah sejenis pokok yang sifatnya suka kepada tanah-tanah yang agak berpasir,lembab,tanah dilering bukit,redup hidup secara kelompok-kelompok diantara satu pokok kesatu pokok,senang didapati dibukit-bukit yang kurang tingginya dari paras laut.

Kegunaan Pokok Belimbing Tanah secara Perubatan:

1.Ubat darah Tinggi
2.Kencing Manis
3.Tambah Tenaga
4.Lancar perjalanan darah
5.Lancar saluran Hempedu lawas kencing

Cara-Cara Nya:

1.Ambil satu atau dua batang Pokok Belimbing Tanah kemudian dibersihkan dengan air bersih
2.Dipotong daun dan batang
3.Kemudian masukkan kedalam bekas periuk tanah direbuskan hingga mendidih
4.Biar ianya sejuk sedikit kemudian ambil air dalam satu cawan campur sedikit gula untuk tujuaan sedap minum sahaja buka manis sangat supaya senang hendak minum
5.Sedia untuk minum pada setiap hari pagi dan malam dengan secukup rasa sekadar yang sesuai dengan badan seorang itu.

SELAMAT MENCUBA DENGAN IZIN ALLAH BOLIH PULIH PENYAKIT TUAN-TUAN DAN PUAN-PUAN.

~Mohd Hadzri Abdullah,Pusat Pengajian Sains Kajihay
Pokok Belimbing Tanah adalah sejenis pokok yang sifatnya suka kepada tanah-tanah yang agak berpasir,lembab,tanah dilering bukit,redup hidup secara kelompok-kelompok diantara satu pokok kesatu pokok,senang didapati dibukit-bukit yang kurang tingginya dari paras laut.

Kegunaan Pokok Belimbing Tanah secara Perubatan:

1.Ubat darah Tinggi
2.Kencing Manis
3.Tambah Tenaga
4.Lancar perjalanan darah
5.Lancar saluran Hempedu lawas kencing

Cara-Cara Nya:

1.Ambil satu atau dua batang Pokok Belimbing Tanah kemudian dibersihkan dengan air bersih
2.Dipotong daun dan batang
3.Kemudian masukkan kedalam bekas periuk tanah direbuskan hingga mendidih
4.Biar ianya sejuk sedikit kemudian ambil air dalam satu cawan campur sedikit gula untuk tujuaan sedap minum sahaja buka manis sangat supaya senang hendak minum
5.Sedia untuk minum pada setiap hari pagi dan malam dengan secukup rasa sekadar yang sesuai dengan badan seorang itu.

SELAMAT MENCUBA DENGAN IZIN ALLAH BOLIH PULIH PENYAKIT TUAN-TUAN DAN PUAN-PUAN.

~Mohd Hadzri Abdullah,Pusat Pengajin Sains Kajihaya
ye juga, ini rupa keladi murai, boleh ubat buasir. blimbing tanah pokoknya kcil2, ada buah sebesar pangkal lidi, masam. ambil secekak, rebus utk drh tg. utk drh tg, boleh juga rendam kincam, 10-15 helai, dlm air panas, lepas 15 minit, tapis dan minum, sehari 2 kali. esok stop, selangkan sehari. kalau tiap hari, tknn drh jadi rendah pula. selangkan se hari. Saya dah cuba, trnkn tknn dp 206 kp 126 dlm sehari. insya Allah
~arbi, at arbipage@hotmail.com
ye juga, ini rupa keladi murai, boleh ubat buasir. blimbing tanah pokoknya kcil2, ada buah sebesar pangkal lidi, masam. ambil secekak, rebus utk drh tg. utk drh tg, boleh juga rendam kincam, 10-15 helai, dlm air panas, lepas 15 minit, tapis dan minum, sehari 2 kali. esok stop, selangkan sehari. kalau tiap hari, tknn drh jadi rendah pula. selangkan se hari. Saya dah cuba, trnkn tknn dp 206 kp 126 dlm sehari. insya Allah
~arbi, at arbipage@hotmail.com
di kenali jugak dgn nama belimbing bukit..kat kawasan - kawasan perkelahan banyak pokok nie.mujarab untuk darah tinggi.insya.dah cuba.
~az_2378@yahoo.com
tumbuhan ini banyak terdapat kawasan berhampiran sungai terutama kawasan berjeram(bagus untuk buasir)saya biasa jumpa di hutan simpan gading selangor dan hutan simpan batang kali.di hutan lenggor johor banyak tumbuh di kawasan permatang, jenis ini kecil tapi mujarab untuk merawat penyakit buah pinggang.sesiapa yg berminat sila hubungi saya 0136023073
~rusli forestry

Bunga Cina

2007-11-09T19:48:00.000-08:00

Nama Tempatan: Bunga Cina / Melur Cina
Nama Saintifik: Gardenia Augusta
Nama Lain: Kacapiring, gardenia
Famili: Rubiaceae
Lokasi dijumpai:
Asal:
keterangan:
Bunga cina atau nama saintifiknya Gardenia augusta, Merr dari famili Rubiaceae banyak ditanam sebagai tumbuhan hiasan atau sebagai pagar kerana daunnya yang rimbun dan mempunyai banyak cabang. Bunganya yang berwarna putih berbentuk seperti bunga mawar dan berbau harum. warna putih akan berubah menjadi kekuningan selepas bunga mekar sepenuhnya.Tumbuhan ini boleh tumbuh ditempat sejuk atau panas dan ia merupakan tumbuhan yang senang dijaga.Tempat yang paling sesuai untuk pertumbuhannya adalah ditempat yang beriklim agak sejuk seperti dikawasan pergunungan dengan ketinggian lebih kurang 400 meter dari paras laut.Pokok ini boleh mencapai ketinggian 1 - 2 meter.Ia membiak melalui keratan batang dan semaiannya boleh dilakukan dengan memilih ranting yang agak tua, buang semua daunnya dan tanamkan di dalam polybag berisi pasir. pastikan air mencukupi semasa pertumbuhan akarnya.Pokok ini mempunyai potensi untuk di komersialkan sebagai minyak wangi kerana bau bunganya yang harum
kegunaan:
ia boleh digunakan untuk mengubati penyakit seperti Kencing manis (diabetes mellitus), sariawan, demam dan sembelit. carnya untuk kencing manis 12 helai daun bunga cina direbus dengan 2 gelas air hingga tinggal satu gelas dan diminum sekali sehari. Untuk sariawan pula 7 helai daunnya diramas dengan secawan air,tapis dan campurkan air itu dengan 2 sudu makan madu dan seketul gula batu.minum 2 kali sehari. Manakala untuk demam pula, ramas 7 helai daunnya dengan secawan air, tapi , capur dengan gula batu dan minum 2 kali sehari.Untuk sembelit pula ambil 3 biji buahnya, rebus dengan 2 gelas air hingga mendidih dan tinggal satu gelas, minum airnya.

Senduduk Putih

2007-11-09T19:46:00.000-08:00

Ulasan Produk
macam mana nak dapatkan pokok ni..nak beli tak tahu caranya..puas mencuba tak jadi
~m_mizall@ukyahoo
Saya pernah beli pokok senduduk putih di Nurseri tapi ia tak tahan lama lebih kurang dalam 3 bulan saja mati... Cuba biakkan menerusi tut juga tak jadi... Ada petua ke menjaga pokok ini supaya ia tahan lama?
~aedin

~siti
pokok ni senang je jaganya.minggu lepas masa saya balik Kelantan, tkejut jgk saya tgok pokok ni dah besar, sihat malah bebunga lebat.ia dtanam dtempat kering dan tak bbaja.ayah saya tu bukan suka jaga tp sihat bunganya.nak tanya ayah saya ke macam mana dia jaga??nanti bgtau.apa salahnya bkongsi pandangan ye
~sitizalehah@gmail.com
sepertinya tanaman ini dikampung aku banyak
tapi pada dipotongin karena dibilang tanaman pengganggu. kata kakek dikampung cuma rumput biasa. emang itu manfaatnya apa? sapa tau kalau itu percis sama mungkin aku bisa jadi pensupplay tanaman herbal tersebut.
aku bisa minta keterangan yang lebih spesifik
~ari_indigo@yahoo.com
senduduk ada 2 warna:

Purple & putih. Kata mak2 bidan, senduduk bunga putih lebih bagus khasiatnya pada kewanitaan berbanding dengan senduduk bunga purple tapi kalu takde yang putih, purple pun boleh!!
~sarina

Anemia

2007-11-04T00:25:00.000-07:00

Anemia, one of the more common blood disorders, occurs when the level of healthy red blood cells (RBCs) in the body becomes too low. This can lead to health problems because RBCs contain hemoglobin, which carries oxygen to the body's tissues. anemia can cause a variety of complications, including fatigue and stress on bodily organs.

Anemia can be caused by many things, but the three main bodily mechanisms that produce it are:

* excessive destruction of RBCs
* blood loss
* inadequate production of RBCs

Among many other causes, anemia can result from inherited disorders, nutritional problems (such as an iron or vitamin deficiency), infections, some kinds of cancer, or exposure to a drug or toxin.
Anemia Caused by Destruction of RBCs

Hemolytic ("hemo" means blood, "lytic" means destroying) anemia occurs when red blood cells are being destroyed prematurely. (Normally, the lifespan of RBCs is 120 days. In hemolytic anemia, they have a much shorter lifespan.) And the bone marrow (the soft, spongy tissue inside bones that makes new blood cells) simply can't keep up with the body's demand for new cells. This can happen for a variety of reasons. Sometimes, infections or certain medications - such as antibiotics or antiseizure medicines - are to blame.

In a condition known as autoimmune hemolytic anemia, the immune system mistakes RBCs for foreign invaders and begins destroying them. Other children inherit defects in the red blood cells that lead to anemia. Common forms of inherited hemolytic anemia include sickle cell anemia, thalassemia, and glucose-6-phosphate dehydrogenase deficiency.

* Sickle cell anemia is a severe form of anemia found most commonly in people of African heritage, although it can affect those of Caucasian, Saudi Arabian, Indian, and Mediterranean descent. In this condition, the hemoglobin forms long rods when it gives up its oxygen, stretching red blood cells into abnormal sickle shapes. This leads to premature destruction of RBCs, chronically low levels of hemoglobin, and recurring episodes of pain, as well as problems that can affect virtually every other organ system in the body. About 1 out of every 625 African-American children is born with this form of anemia.
* Thalassemia, which usually affects people of Mediterranean, African, and Southeast Asian descent, is marked by abnormal and short-lived RBCs. Thalassemia major, also called Cooley's anemia, is a severe form of anemia in which RBCs are rapidly destroyed and iron is deposited in the skin and vital organs. Thalassemia minor involves only mild anemia and minimal red blood cell changes.
* Glucose-6-phosphate dehydrogenase (G6PD) deficiency most commonly affects men of African heritage, although it has been found in many other groups of people. With this condition the RBCs either do not make enough of the enzyme G6PD or the enzyme that is produced is abnormal and doesn't work well. When someone born with this deficiency has an infection, takes certain medicines, or is exposed to specific substances, the body's RBCs suffer extra stress. Without adequate G6PD to protect them, many red blood cells are destroyed prematurely.

Anemia Caused by Blood Loss

Blood loss can also cause anemia - whether it's because of excessive bleeding due to injury, surgery, or a problem with the blood's clotting ability. Slower, long-term blood loss, such as intestinal bleeding from inflammatory bowel disease (IBD), can also cause anemia. Anemia sometimes results from heavy menstrual periods in teen girls and women. Any of these factors will also increase the body's need for iron because iron is needed to make new RBCs.
Anemia Caused by Inadequate Production of RBCs

Aplastic anemia occurs when the bone marrow can't make enough RBCs. This can be due to a viral infection, or exposure to certain toxic chemicals, radiation, or medications (such as antibiotics, antiseizure drugs, or cancer treatments). Some childhood cancers can also cause aplastic anemia, as can certain chronic diseases that affect the ability of the bone marrow to make blood cells.

High levels of hemoglobin and RBCs help fetal blood carry enough oxygen to developing babies in the relatively oxygen-poor environment in utero. Thus, infants are born with some protection from iron deficiency. After the child is born, more oxygen is available and the baby's hemoglobin level normally drops to a low point at about 2 months of age, a condition known as physiologic anemia of infancy. This temporary and expected drop in the blood count is considered normal and no treatment is required because the infant's body soon starts making red blood cells on its own.

Anemia also occurs when the body isn't able to produce enough healthy RBCs because of an iron deficiency. Iron is essential to hemoglobin production. Poor dietary iron intake (or excessive loss of iron from the body) can lead to iron deficiency anemia, the most common cause of anemia in children. Iron deficiency anemia can affect children at any age, but is most commonly seen in those younger than 2 years old.

Girls going through puberty also have a particularly high risk for iron deficiency anemia because of the onset of menstruation; the monthly blood loss increases the amount of iron they need to consume in their diets.
Signs and Symptoms of Anemia

If your child has anemia, the first symptoms might be mild skin paleness, and decreased pinkness of the lips and nailbeds. These changes happen gradually, though, so they may be difficult to notice. Other common signs of anemia include:

* irritability
* fatigue
* dizziness, lightheadedness, and a rapid heartbeat

Depending on what's causing the anemia, symptoms may also include jaundice (yellow-tinged skin), a yellowing of the whites of the eyes, an enlarged spleen, and dark tea-colored urine. In infants and preschool children, iron deficiency anemia can result in developmental delays and behavioral disturbances, such as decreased motor activity and problems with social interaction and attention to tasks. Recent research indicates that developmental problems may persist into and beyond school age if the iron deficiency is not properly treated.
Diagnosing Anemia

In many cases, doctors don't diagnose anemia until they run blood tests as part of a routine physical examination. A complete blood count (CBC) may indicate that there are fewer red blood cells than normal. Other diagnostic tests may include:

* Blood smear examination: Blood is smeared on a glass slide for microscopic examination of RBCs, which can sometimes indicate the cause of the anemia.
* Iron tests: These include total serum iron and ferritin tests, which can help to determine whether anemia is due to iron deficiency.
* Hemoglobin electrophoresis: Used to identify various abnormal hemoglobins in the blood and to diagnose sickle cell anemia, the thalassemias, and other inherited forms of anemia.
* Bone marrow aspiration and biopsy: This test can help determine whether cell production is happening normally in the bone marrow. It's the only way to diagnose aplastic anemia definitively and is also used if a disease affecting the bone marrow (such as leukemia) is a suspected cause of the anemia.
* Reticulocyte count: A measure of young RBCs, this helps to determine if production of red blood cells is at normal levels.

In addition to running these tests, your child's doctor may ask about a family history of anemia and your child's symptoms and medications. This may lead the doctor to perform other tests to look for specific diseases that might be causing the anemia.
Treating Anemia

Treatment for anemia depends on its cause. It's important not to assume that any symptoms your child may be having are due to iron deficiency. Be sure to have your child checked by a doctor.

If your child does have iron deficiency anemia, the doctor may prescribe medication as drops (for infants) or as a liquid or tablet (for older children), and also may recommend adding certain iron-rich foods to your child's diet.

If your teenage daughter is anemic and has heavy or irregular menstrual periods, in some cases her doctor may prescribe a birth control pill to help regulate the bleeding.

Folic acid and vitamin B12 supplements may be prescribed if the anemia is traced to a deficiency of these nutrients, although this is rare in children.

If a certain medication appears to be the cause, your child's doctor may discontinue it or replace it with something else - unless the benefit of the drug outweighs this side effect.

Anemia caused by an infection will usually improve when the infection passes or is treated.

Depending on the cause, treatment for more severe or chronic forms of anemia may include:

* transfusions of normal red blood cells taken from a donor
* removal of the spleen or treatment with medications to prevent blood cells from being removed from circulation or destroyed too rapidly
* medications to fight infection or stimulate the bone marrow to make more blood cells

Bone marrow transplantation may be considered in some cases of sickle cell anemia, thalassemia, and aplastic anemia. This procedure involves taking bone marrow cells from a donor and injecting them into the child's vein; the donated cells then travel through the bloodstream to the child's bone marrow, where they begin producing new blood cells.
Caring for a Child With Anemia

The type, cause, and severity of your child's anemia will determine what kind of care is needed. Rest assured, though, that children often tolerate anemia much better than adults.

In general, a child with significant anemia may tire more easily than other children and therefore need to limit activity levels. Make sure that your child's teachers and other caregivers are aware of the condition. If iron deficiency is the cause, follow the doctor's directions about dietary changes and taking any iron supplements.

If the spleen is enlarged, your child may be prohibited from playing contact sports because of the risk that the spleen could rupture or hemorrhage if your child is hurt. Certain forms of anemia, such as sickle cell anemia, require other more specific kinds of care and treatment.
Preventing Anemia

Whether anemia can be prevented depends on its cause. Currently, there is no way to prevent anemia due to genetic defects affecting the production of RBCs or hemoglobin.

However, you can take steps to help prevent iron deficiency, the most common form of anemia. Before following any of these suggestions, be sure to talk them over with your child's doctor.

* Cow's milk consumption. During the first 6 months of life, babies are usually protected against developing iron deficiency by the stores of iron built up in their bodies pre-birth. But after month 6, as infants continue to grow, they often don't get enough iron through breast milk alone or regular cow's milk (which contains less iron than fortified infant formula). Regular cow's milk can also cause some infants to lose iron from their intestines, and drinking lots of it can make an infant less interested in eating other foods that are better sources of iron. For these reasons, regular cow's milk is not recommended for children until they reach 1 year of age and are eating an iron-rich diet. In addition, your child should not drink more than 24-32 ounces (709-946 ml) of milk each day. If you can't get your child to eat more iron-rich foods, speak with your child's doctor about giving your child an iron supplement.
* Iron-fortified cereal and formula. These products can help ensure that your baby is getting enough iron, especially during the transition from breast milk or formula to solid foods.
* Well-balanced diet. Make sure that your child or teen regularly eats foods that contain iron. Good choices include iron-fortified grains and cereals, red meat, egg yolks, leafy green vegetables, yellow vegetables and fruits, potato skins, tomatoes, molasses, and raisins. If your child is a vegetarian, you'll need to make an extra effort to ensure sufficient iron sources because iron found in meat, poultry, and fish is more easily absorbed than iron found in plant-based and iron-fortified foods. Also, be aware that certain food combinations can inhibit or promote absorption of iron. For example, drinking coffee or tea (including iced tea) with a meal can significantly lower the amount of iron absorbed. On the other hand, vitamin C helps the body absorb iron.

If you have any questions about anemia, or you think your child might have the condition, talk with your child's doctor.

Your Kidneys and How They Work

2007-11-04T00:14:00.000-07:00

Your Kidneys and How They Work

On this page:

* What do my kidneys do?
* What is renal function?
* Why do kidneys fail?
* How do kidneys fail?
* What are the signs of kidney disease?
* What medical tests will my doctor use to detect kidney disease?
* What are the stages of kidney disease?
* What can I do about kidney disease?
* What happens if my kidneys fail completely?
* Hope Through Research
* Points to Remember
* For More Information

Your two kidneys are vital organs that perform many functions to keep your blood clean and chemically balanced. Understanding how your kidneys work can help you to keep them healthy.
What do my kidneys do?
Image of the parts of the urinary tract, with labels pointing to the kidneys, ureters, and bladder.
The kidneys remove wastes and extra water from the blood to form urine. Urine flows from the kidneys to the bladder through the ureters.

Your kidneys are bean-shaped organs, each about the size of your fist. They are located near the middle of your back, just below the rib cage. The kidneys are sophisticated reprocessing machines. Every day, your kidneys process about 200 quarts of blood to sift out about 2 quarts of waste products and extra water. The waste and extra water become urine, which flows to your bladder through tubes called ureters. Your bladder stores urine until you go to the bathroom.

The wastes in your blood come from the normal breakdown of active tissues and from the food you eat. Your body uses the food for energy and self-repair. After your body has taken what it needs from the food, waste is sent to the blood. If your kidneys did not remove these wastes, the wastes would build up in the blood and damage your body.

The actual filtering occurs in tiny units inside your kidneys called nephrons. Every kidney has about a million nephrons. In the nephron, a glomerulus—which is a tiny blood vessel, or capillary—intertwines with a tiny urine-collecting tube called a tubule. A complicated chemical exchange takes place, as waste materials and water leave your blood and enter your urinary system.

At first, the tubules receive a combination of waste materials and chemicals that your body can still use. Your kidneys measure out chemicals like sodium, phosphorus, and potassium and release them back to the blood to return to the body. In this way, your kidneys regulate the body’s level of these substances. The right balance is necessary for life, but excess levels can be harmful.
Illustration of a kidney and an enlargement of the nephron.
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In the nephron (left), tiny blood vessels intertwine with urine-collecting tubes. Each kidney contains about 1 million nephrons.

In addition to removing wastes, your kidneys release three important hormones:

* erythropoietin (eh-RITH-ro-POY-eh-tin), or EPO, which stimulates the bone marrow to make red blood cells

* renin (REE-nin), which regulates blood pressure

* calcitriol (kal-suh-TRY-ul), the active form of vitamin D, which helps maintain calcium for bones and for normal chemical balance in the body

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What is renal function?

Your health care team may talk about the work your kidneys do as renal function. If you have two healthy kidneys, you have 100 percent of your renal function. This is more renal function than you really need. Some people are born with only one kidney, and these people are able to lead normal, healthy lives. Many people donate a kidney for transplantation to a family member or friend. Small declines in renal function may not cause a problem.

But many people with reduced renal function have a kidney disease that will get worse. You will have serious health problems if you have less than 25 percent of your renal function. If your renal function drops below 10 to 15 percent, you cannot live long without some form of renal replacement therapy—either dialysis or transplantation.

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Why do kidneys fail?

Most kidney diseases attack the nephrons, causing them to lose their filtering capacity. Damage to the nephrons may happen quickly, often as the result of injury or poisoning. But most kidney diseases destroy the nephrons slowly and silently. Only after years or even decades will the damage become apparent. Most kidney diseases attack both kidneys simultaneously.

The two most common causes of kidney disease are diabetes and high blood pressure. If your family has a history of any kind of kidney problems, you may be at risk for kidney disease.
Diabetic Nephropathy

Diabetes is a disease that keeps the body from using glucose (sugar) as it should. If glucose stays in your blood instead of breaking down, it can act like a poison. Damage to the nephrons from unused glucose in the blood is called diabetic nephropathy. If you keep your blood glucose levels down, you can delay or prevent diabetic nephropathy.
High Blood Pressure

High blood pressure can damage the small blood vessels in your kidneys. The damaged vessels cannot filter wastes from your blood as they are supposed to.

Your doctor may prescribe blood pressure medication. Blood pressure medicines called angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) have been found to protect the kidneys even more than other medicines that lower blood pressure to similar levels. The National Heart, Lung, and Blood Institute (NHLBI), one of the National Institutes of Health, recommends that people with diabetes or reduced kidney function should keep their blood pressure below 130/80 mm Hg.
Glomerular Diseases

Several different types of kidney disease are grouped together under this category, including autoimmune diseases, infection-related diseases, and sclerotic diseases. As the name indicates, glomerular diseases attack the tiny blood vessels (glomeruli) within the kidney. The most common primary glomerular diseases include membranous nephropathy, IgA nephropathy, and focal segmental glomerulosclerosis. Protein, blood, or both in the urine are often the first signs of these diseases. They can slowly destroy kidney function. Blood pressure control is important with any kidney disease. Treatments for glomerular diseases may include immunosuppressive drugs or steroids to reduce inflammation and proteinuria, depending on the specific disease.
Inherited and Congenital Kidney Diseases

Some kidney diseases result from hereditary factors. Polycystic kidney disease (PKD), for example, is a genetic disorder in which many cysts grow in the kidneys. PKD cysts can slowly replace much of the mass of the kidneys, reducing kidney function and leading to kidney failure.

Some kidney problems may show up when a child is still developing in the womb. Examples include autosomal recessive PKD, a rare form of PKD, and other developmental problems that interfere with the normal formation of the nephrons. The signs of kidney disease in children vary. A child may grow unusually slowly, may vomit often, or may have back or side pain. Some kidney diseases may be “silent” for months or even years.

If your child has a kidney disease, your child’s doctor should find it during a regular checkup. Be sure your child sees a doctor regularly. The first sign of a kidney problem may be high blood pressure, a low number of red blood cells (anemia), or blood or protein in the child’s urine. If the doctor finds any of these problems, further tests may be necessary, including additional blood and urine tests or radiology studies. In some cases, the doctor may need to perform a biopsy—removing a tiny piece of the kidney to examine under a microscope.

Some hereditary kidney diseases may not be detected until adulthood. The most common form of PKD was once called "adult PKD" because the symptoms of high blood pressure and renal failure usually do not occur until patients are in their twenties or thirties. But with advances in diagnostic imaging technology, doctors have found cysts in children and adolescents before any symptoms appear.
Other Causes of Kidney Disease

Poisons and trauma, for example a direct and forceful blow to your kidneys, can lead to kidney disease.

Some over-the-counter medicines can be poisonous to your kidneys if taken regularly over a long period of time. Products that combine aspirin, acetaminophen, and other medicines such as ibuprofen have been found to be the most dangerous to the kidneys. If you take painkillers regularly, check with your doctor to make sure you are not putting your kidneys at risk.
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How do kidneys fail?

Many factors that influence the speed of kidney failure are not completely understood. Researchers are still studying how protein in the diet and cholesterol levels in the blood affect kidney function.
Acute Renal Failure

Some kidney problems happen quickly, like an accident that injures the kidneys. Losing a lot of blood can cause sudden kidney failure. Some drugs or poisons can make your kidneys stop working. These sudden drops in kidney function are called acute renal failure (ARF).

ARF may lead to permanent loss of kidney function. But if your kidneys are not seriously damaged, acute renal failure may be reversed.
Chronic Kidney Disease

Most kidney problems, however, happen slowly. You may have “silent” kidney disease for years. Gradual loss of kidney function is called chronic kidney disease (CKD) or chronic renal insufficiency. People with CKD may go on to permanent kidney failure. They also have a high risk of dying from a stroke or heart attack.
End-Stage Renal Disease

Total or nearly total and permanent kidney failure is called end-stage renal disease (ESRD). People with ESRD must undergo dialysis or transplantation to stay alive.
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What are the signs of kidney disease?

People in the early stages of kidney disease usually do not feel sick at all.

If your kidney disease gets worse, you may need to urinate more often or less often. You may feel tired or itchy. You may lose your appetite or experience nausea and vomiting. Your hands or feet may swell or feel numb. You may get drowsy or have trouble concentrating. Your skin may darken. You may have muscle cramps.

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What medical tests will my doctor use to detect kidney disease?

Since you can have kidney disease without any symptoms, your doctor may first detect the condition through routine blood and urine tests. The National Kidney Foundation recommends three simple tests to screen for kidney disease: a blood pressure measurement, a spot check for protein or albumin in the urine (proteinuria), and a calculation of glomerular filtration rate (GFR) based on a serum creatinine measurement. Measuring urea nitrogen in the blood provides additional information.
Blood Pressure Measurement

High blood pressure can lead to kidney disease. It can also be a sign that your kidneys are already impaired. The only way to know whether your blood pressure is high is to have a health professional measure it with a blood pressure cuff. The result is expressed as two numbers. The top number, which is called the systolic pressure, represents the pressure when your heart is beating. The bottom number, which is called the diastolic pressure, shows the pressure when your heart is resting between beats. Your blood pressure is considered normal if it stays below 120/80 (expressed as “120 over 80”). The NHLBI recommends that people with kidney disease use whatever therapy is necessary, including lifestyle changes and medicines, to keep their blood pressure below 130/80.
Microalbuminuria and Proteinuria

Healthy kidneys take wastes out of the blood but leave protein. Impaired kidneys may fail to separate a blood protein called albumin from the wastes. At first, only small amounts of albumin may leak into the urine, a condition known as microalbuminuria, a sign of deteriorating kidney function. As kidney function worsens, the amount of albumin and other proteins in the urine increases, and the condition is called proteinuria. Your doctor may test for protein using a dipstick in a small sample of your urine taken in the doctor’s office. The color of the dipstick indicates the presence or absence of proteinuria.

A more sensitive test for protein or albumin in the urine involves laboratory measurement and calculation of the protein-to-creatinine or albumin-to-creatinine ratio. This test should be used to detect kidney disease in people at high risk, especially those with diabetes. If your first laboratory test shows high levels of protein, another test should be done 1 to 2 weeks later. If the second test also shows high levels of protein, you have persistent proteinuria and should have additional tests to evaluate your kidney function.
Glomerular Filtration Rate (GFR) Based on Creatinine Measurement

GFR is a calculation of how efficiently the kidneys are filtering wastes from the blood. A traditional GFR calculation requires an injection into the bloodstream of a substance that is later measured in a 24-hour urine collection. Recently, scientists found they could calculate GFR without an injection or urine collection. The new calculation requires only a measurement of the creatinine in a blood sample.

Creatinine is a waste product in the blood created by the normal breakdown of muscle cells during activity. Healthy kidneys take creatinine out of the blood and put it into the urine to leave the body. When kidneys are not working well, creatinine builds up in the blood.

In the lab, your blood will be tested to see how many milligrams of creatinine are in one deciliter of blood (mg/dL). Creatinine levels in the blood can vary, and each laboratory has its own normal range, usually 0.6 to 1.2 mg/dL. If your creatinine level is only slightly above this range, you probably will not feel sick, but the elevation is a sign that your kidneys are not working at full strength. One formula for estimating kidney function equates a creatinine level of 1.7 mg/dL for most men and 1.4 mg/dL for most women to 50 percent of normal kidney function. But because creatinine values are so variable and can be affected by diet, a GFR calculation is more accurate for determining whether a person has reduced kidney function.

The new GFR calculation uses the patient’s creatinine measurement along with weight, age, and values assigned for sex and race. Some medical laboratories may make the GFR calculation when a creatinine value is measured and include it on their lab report.
Blood Urea Nitrogen (BUN)

Blood carries protein to cells throughout the body. After the cells use the protein, the remaining waste product is returned to the blood as urea, a compound that contains nitrogen. Healthy kidneys take urea out of the blood and put it in the urine. If your kidneys are not working well, the urea will stay in the blood.

A deciliter of normal blood contains 7 to 20 milligrams of urea. If your BUN is more than 20 mg/dL, your kidneys may not be working at full strength. Other possible causes of an elevated BUN include dehydration and heart failure.
Additional Tests for Kidney Disease

If blood and urine tests indicate reduced kidney function, your doctor may recommend additional tests to help identify the cause of the problem.

Renal imaging. Methods of renal imaging (taking pictures of the kidneys) include ultrasound, computed tomography (CT scan), and magnetic resonance imaging (MRI). These tools are most helpful in finding unusual growths or blockages to the flow of urine.

Renal biopsy. Your doctor may want to see a tiny piece of your kidney tissue under a microscope. To obtain this tissue sample, the doctor will perform a renal biopsy—a hospital procedure in which the doctor inserts a needle through your skin into the back of the kidney. The needle retrieves a strand of tissue about 1/2 to 3/4 of an inch long. For the procedure, you will lie on your stomach on a table and receive local anesthetic to numb the skin. The sample tissue will help the doctor identify problems at the cellular level.

For more information, see the fact sheet on Kidney Biopsy from the National Kidney and Urologic Diseases Information Clearinghouse.

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What are the stages of kidney disease?

Your GFR is the best indicator of how well your kidneys are working. In 2002, the National Kidney Foundation published treatment guidelines that identified five stages of CKD based on declining GFR measurements. The guidelines recommend different actions based on the stage of kidney disease.

* Increased risk of CKD. A GFR of 90 or above is considered normal. Even with a normal GFR, you may be at increased risk for developing CKD if you have diabetes, high blood pressure, or a family history of kidney disease. The risk increases with age: People over 65 are more than twice as likely to develop CKD as people between the ages of 45 and 65. African Americans also have a higher risk of developing CKD.

* Stage 1: Kidney damage with normal GFR (90 or above). Kidney damage may be detected before the GFR begins to decline. In this first stage of kidney disease, the goals of treatment are to slow the progression of CKD and reduce the risk of heart and blood vessel disease.

* Stage 2: Kidney damage with mild decrease in GFR (60 to 89). When kidney function starts to decline, your health care provider will estimate the progression of your CKD and continue treatment to reduce the risk of other health problems.

* Stage 3: Moderate decrease in GFR (30 to 59). When CKD has advanced to this stage, anemia and bone problems become more common. Work with your health care provider to prevent or treat these complications.

* Stage 4: Severe reduction in GFR (15 to 29). Continue following the treatment for complications of CKD and learn as much as you can about the treatments for kidney failure. Each treatment requires preparation. If you choose hemodialysis, you will need to have a procedure to make a vein in your arm larger and stronger for repeated needle insertions. For peritoneal dialysis, you will need to have a catheter placed in your abdomen. Or you may want to ask family or friends to consider donating a kidney for transplantation.

* Stage 5: Kidney failure (GFR less than 15). When the kidneys do not work well enough to maintain life, you will need dialysis or a kidney transplant.

In addition to tracking your GFR, blood tests can show when substances in your blood are out of balance. If phosphorus or potassium levels start to climb, a blood test will prompt your health care provider to address these issues before they permanently affect your health.

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What can I do about kidney disease?

Unfortunately, chronic kidney disease often cannot be cured. But if you are in the early stages of a kidney disease, you may be able to make your kidneys last longer by taking certain steps. You will also want to be sure that risks for heart attack and stroke are minimized, since CKD patients are susceptible to these problems.

* If you have diabetes, watch your blood glucose closely to keep it under control. Consult your doctor for the latest in treatment.

* Avoid pain pills that may make your kidney disease worse. Check with your doctor before taking any medicine.

Blood Pressure

People with reduced kidney function (a high creatinine level in the blood or a low creatinine clearance) should have their blood pressure controlled, and an ACE inhibitor or an ARB should be one of their medications. Many people will require two or more types of medication to keep their blood pressure below 130/80 mm Hg. A diuretic is an important addition to the ACE inhibitor or ARB.
Diet

People with reduced kidney function need to be aware that some parts of a normal diet may speed their kidney failure.

Protein. Protein is important to your body. It helps your body repair muscles and fight disease. Protein comes mostly from meat. As discussed in an earlier section, healthy kidneys take wastes out of the blood but leave protein. Impaired kidneys may fail to separate the protein from the wastes.

Some doctors tell their kidney patients to limit the amount of protein they eat so that the kidneys have less work to do. But you cannot avoid protein entirely. You may need to work with a dietitian to find the right food plan.

Cholesterol. Another problem that may be associated with kidney failure is too much cholesterol (koh-LES-tuh-rawl) in your blood. High levels of cholesterol may result from a high-fat diet.

Cholesterol can build up on the inside walls of your blood vessels. The buildup makes pumping blood through the vessels harder for your heart and can cause heart attacks and strokes.

Smoking. Smoking not only increases the risk of kidney disease, it contributes to deaths from strokes and heart attacks in people with CKD. You should try your best to stop smoking.

Sodium. Sodium is a chemical found in salt and other foods. Sodium in your diet may raise your blood pressure, so you should limit foods that contain high levels of sodium. High-sodium foods include canned or processed foods like frozen dinners and hot dogs.

Potassium. Potassium is a mineral found naturally in many fruits and vegetables, like oranges, potatoes, bananas, dried fruits, dried beans and peas, and nuts. Healthy kidneys measure potassium in your blood and remove excess amounts. Diseased kidneys may fail to remove excess potassium, and with very poor kidney function, high potassium levels can affect the heart rhythm.
Treating Anemia

Anemia is a condition in which the blood does not contain enough red blood cells. These cells are important because they carry oxygen throughout the body. If you are anemic, you will feel tired and look pale. Healthy kidneys make the hormone EPO, which stimulates the bones to make red blood cells. Diseased kidneys may not make enough EPO. You may need to take injections of a man-made form of EPO.
Preparing for End-Stage Renal Disease

As your kidney disease progresses, you will need to make several decisions. You will need to learn about your options for treating ESRD so that you can make an informed choice between hemodialysis, peritoneal dialysis, and transplantation.

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What happens if my kidneys fail completely?

Complete and irreversible kidney failure is sometimes called end-stage renal disease, or ESRD. If your kidneys stop working completely, your body fills with extra water and waste products. This condition is called uremia. Your hands or feet may swell. You will feel tired and weak because your body needs clean blood to function properly.

Untreated uremia may lead to seizures or coma and will ultimately result in death. If your kidneys stop working completely, you will need to undergo dialysis or kidney transplantation.
Dialysis

The two major forms of dialysis are hemodialysis and peritoneal dialysis. In hemodialysis, your blood is sent through a filter that removes waste products. The clean blood is returned to your body. Hemodialysis is usually performed at a dialysis center three times per week for 3 to 4 hours.
Illustration of a man being treated with hemodialysis.
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Hemodialysis

In peritoneal dialysis, a fluid is put into your abdomen. This fluid captures the waste products from your blood. After a few hours, the fluid containing your body’s wastes is drained away. Then, a fresh bag of fluid is dripped into the abdomen. Patients can perform peritoneal dialysis themselves. Patients using continuous ambulatory peritoneal dialysis (CAPD) change fluid four times a day. Another form of peritoneal dialysis, called continuous cycling peritoneal dialysis (CCPD), can be performed at night with a machine that drains and refills the abdomen automatically.
Illustration of a person being treated with peritoneal dialysis.
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Peritoneal dialysis
Transplantation
Illustration of a transplanted kidney.
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Kidney transplantation

A donated kidney may come from an anonymous donor who has recently died or from a living person, usually a relative. The kidney that you receive must be a good match for your body. The more the new kidney is like you, the less likely your immune system is to reject it. Your immune system protects you from disease by attacking anything that is not recognized as a normal part of your body. So your immune system will attack a kidney that appears too “foreign.” You will take special drugs to help trick your immune system so it does not reject the transplanted kidney.

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Hope Through Research

As our understanding of the causes of kidney failure increases, so will our ability to predict and prevent these diseases. Recent studies have shown that intensive control of diabetes and high blood pressure can prevent or delay the onset of kidney disease.

In the area of genetics, researchers supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) have located two genes that cause the most common form of PKD and learned that a person must have two defective copies of the PKD1 gene to develop PKD. Researchers have also found a gene in the roundworm that is identical to the PKD1 gene. This new knowledge will be used in the search for effective therapies to prevent or treat PKD.

In the area of transplantation, new drugs to help the body accept foreign tissue increase the likelihood that a transplanted kidney will survive and function properly. Scientists at NIDDK are also developing new techniques to induce tolerance for foreign tissue in patients before they receive transplanted organs. This technique will eliminate or reduce the need for immunosuppressive drugs and thereby reduce expense and complications. In the future, scientists may develop an artificial kidney for implantation.

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Points to Remember

* Your kidneys are vital organs that keep your blood clean and chemically balanced.

* The progression of kidney disease can be slowed, but it cannot always be reversed.

* End-stage renal disease (ESRD) is the total loss of kidney function.

* Dialysis and transplantation can extend the lives of people with ESRD.

* Diabetes and high blood pressure are the two leading causes of kidney failure.

* You should see a nephrologist regularly if you have renal disease.

* Chronic kidney disease (CKD) increases the risk of heart attacks and strokes.

* If you are in the early stages of renal disease, you may be able to save your remaining renal function for many years by

o controlling your blood glucose
o controlling your blood pressure
o following a low-protein diet
o maintaining healthy levels of cholesterol in your blood
o taking an ACE inhibitor or an ARB
o quitting smoking

How does Diabetes affect how I respond to a cold or flu?

2007-11-02T19:34:00.000-07:00

How does Diabetes affect how I respond to a cold or flu?
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Being sick by itself can raise your blood glucose. Moreover, illness can prevent you from eating properly, which further affects blood glucose.

In addition, diabetes can make the immune system more vulnerable to severe cases of flu. People with diabetes who come down with flu may become very sick and may even have to go to a hospital. You can help keep yourself from getting flu by getting a flu shot every year. Everyone with diabetes, even pregnant women, should get a yearly flu shot.

What should I do when I am sick?
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Be sure to continue taking your anti-diabetic medications or insulin. Don’t stop taking the medications even if you can’t eat.

Your health care provider may even advise you to inject more insulin during sickness.

Test your blood glucose every four hours, and keep track of the results.

Drink extra (calorie-free) liquids, and try to eat as you normally would. If you can’t, try to have soft foods and liquids containing the equivalent amount of carbohydrates that you usually consume.

Weigh yourself every day. Losing weight without engaging on a weight loss programme is a sign of high blood glucose.

Check your temperature every morning and evening. A fever may be a sign of infection.

Call your health care provider or go to an emergency room if any of the following happens to you:

* You feel too sick to eat normally and are unable to consume any food for more than 6 hours.
* You're having severe diarrhea.
* Excess weight loss within a short period of time.
* Your temperature is over 38 degrees Celsius.
* Your blood glucose is lower than 4.0mmol/L or remains over 15mmol/L.
* You have moderate or large amounts of ketones in your urine.
* You're having trouble breathing.
* You feel sleepy or can't think clearly.

Why is it important for Diabetics to be physically active?
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Physical activity can help you control your blood glucose, weight, and blood pressure, as well as raise your “good” cholesterol and lower your “bad” cholesterol. It can also help prevent heart and blood flow problems, reducing your risk of heart disease and nerve damage, which are often problems for people with diabetes.

How much and how often should Diabetics exercise?
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Experts recommend moderate intensity physical activity for 30 minutes for at least 3 times a week. Some examples of moderate intensity physical activities are walking briskly, mowing the lawn, dancing, swimming, or bicycling.

If you are not accustomed to physical activity, you may want to start with a little exercise, and work your way up. As you become stronger, you can add a few extra minutes to your physical activity. Do some physical activities every day. It’s better to walk 10 or 20 minutes each day than one hour once a week.

Talk to your health care provider about a safe exercise plan. He or she may check your heart and your feet to be sure you have no special problems. If you have high blood pressure, eye, or foot problems, you may need to avoid some kinds of exercise.

What are some good types of physical activities for Diabetics?
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Walking vigorously, hiking, climbing stairs, swimming, aerobics, dancing, bicycling, tennis, basketball, volleyball, or other sports are just some examples of physical activities that will work your large muscles, increase your heart rate, and make you breathe harder – important goals for fitness.

In addition, strength training exercises with hand weights, elastic bands, or weight machines can help you build muscle. Stretching helps to make you flexible and prevent soreness after other types of exercise.

Do physical activities you really like. The more fun you have, the more likely you will do it each day. It can be helpful to exercise with a family member or friend.

Are there any safety considerations for Diabetics when they exercise?
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Exercise is very important for diabetics to stay healthy, but there are a few things to watch out for.

You should avoid some kinds of physical activities if you have certain diabetic complications. Exercise involving heavy weights may be bad for people with blood pressure, blood vessel, or eye problems. Diabetes-related nerve damage can make it hard to tell if you’ve injured your feet during exercise, which can lead to more serious problems. If you do have diabetic complications, your health care provider can tell you which kinds of physical activities would be best for you. Fortunately, there are many different ways to get exercise.

Physical activity can lower your blood glucose too much, causing hypoglycemia (low blood glucose), especially in people who take insulin or certain oral medications. Hypoglycemia can happen at the time you’re exercising, just afterward, or even up to a day later. You can get shaky, weak, confused, irritable, anxious, hungry, tired, or sweaty. You can get a headache, or even lose consciousness.

To help prevent hypoglycemia during physical activity, check your blood glucose before you exercise. If it's below 5.6mmol/L, have a small snack. In addition, bring food or glucose tablets with you when you exercise just in case. It is not good for people with diabetes to skip meals at all, but especially not prior to exercise.

After you exercise, check to see how it has affected your blood glucose level. If you take insulin, ask your health care provider if there is a preferable time of day for you to exercise, or whether you should change your dosage before physical activity, before beginning an exercise regimen.

When you exercise, wear cotton socks and athletic shoes that fit well and are comfortable. After you exercise, check your feet for sores, blisters, irritation, cuts, or other injuries.

Drink plenty of fluids during physical activity, since your blood glucose can be affected by dehydration.

How can Diabetes affect nerve endings?

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Having high blood glucose for many years can damage the blood vessels that bring oxygen to some nerves, as well as the nerve coverings. Damaged nerves may stop sending messages, or send messages too slowly or at the wrong times. Numbness, pain, and weakness in the hands, arms, feet, and legs may develop. Problems may also occur in various organs, including the digestive tract, heart, and sex organs.

Diabetic Neuropathy is the medical term for damage to the nervous system from diabetes. The most common type is peripheral neuropathy, which affects the arms and legs. An estimated 50% of those with diabetes have some form of neuropathy, but not all with neuropathy have symptoms. People with diabetes can develop nerve problems at any time, but the longer a person has diabetes, the greater the risk. The highest rates of neuropathy are among people who have had the disease for at least 25 years. Diabetic Neuropathy also appears to be more common in people who have had problems controlling their blood glucose levels, in those with high levels of blood fat and blood pressure, in overweight people, and in people over the age of 40.

How can I prevent nerve damage if I have Diabetes?
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You can help keep your nervous system healthy by keeping your blood glucose as close to normal as possible, getting regular physical activity, not smoking, taking good care of your feet each day (see below), having your health care provider examine your feet at least 4 times a year, and getting your feet tested for nerve damage at least once a year.

Why is it especially important to take care of my feet if I have Diabetes?
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Nerve damage, circulation problems, and infections can cause serious foot problems for people with diabetes. Sometimes nerve damage can deform or misshape your feet, causing pressure points that can turn into blisters, sores, or ulcers. Poor circulation can make these wounds slow to heal. Sometimes this can lead to amputation of a toe, foot, or leg.

What should I do on a regular basis to take care of my feet?
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* If you have corns and calluses, ask your doctor or podiatrist (specialist deals with disorder of lower limbs) about the best way to care for them.
* Wash your feet in warm (not hot) water and dry them well
* Cut your toenails once a week or when needed. Cut toenails when they are soft from washing. Cut them to the shape of the toe and not too short. File the edges with an emery board.
* Rub lotion on the tops and bottoms of feet (but not between the toes) to prevent cracking and drying.
* Wear shoes that fit well. Break in new shoes slowly, by wearing them 1 to 2 hours each day for the first 1 to 2 weeks.
* Wear stockings or socks to avoid blisters and sores.
* Wear clean, lightly padded socks that fit well; seamless socks are best.
* Always wear shoes or slippers, because when you are barefoot it is easy to step on something and hurt your feet.
* Protect your feet from extreme heat and cold.
* When sitting, keep the blood flowing to your lower limbs by propping your feet up and moving your toes and ankles for a few minutes at a time.
* Avoid smoking, which reduces blood flow to the feet.
* Keep your blood sugar, blood pressure, and cholesterol under control by eating healthy foods, staying active, and taking your anti-diabetic medicines.

How can Diabetes affect the digestion?
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Gastroparesis, otherwise known as delayed gastric emptying, is a disorder where, due to nerve damage, the stomach takes too long to empty itself. It frequently occurs in people with either Type 1 or Type 2 Diabetes.

Symptoms of gastroparesis include heartburn, nausea, vomiting of undigested food, an early feeling of fullness when eating, weight loss, abdominal bloating, erratic blood glucose levels, lack of appetite, gastroesophageal reflux, and spasms of the stomach wall.

How can Diabetes affect my sexual performance?
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Many people with diabetic nerve damage have trouble having sex. For example, men can have trouble maintaining an erection and ejaculating. Women can have trouble with sexual response and vaginal lubrication. Both men and women with diabetes can get urinary tract infections and bladder problems more often than average.

How can Diabetes affect my mood?
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Several studies suggest that diabetes doubles the risk of depression, although it’s still unclear why. The psychological stress of having diabetes may contribute to depression, but the metabolic effect of diabetes on brain function may also play a role. At the same time, people with depression may be more likely to develop diabetes.

The risk of depression increases as more diabetic complications develop. When you are depressed, you do not function as well, physically or mentally; this makes you less likely to eat properly, exercise, and take your medication regularly.

Psychotherapy, medication, or a combination of both can treat depression effectively. In addition, studies show that successful treatment for depression also helps improve blood glucose control.

How can I keep my kidneys healthy if I have Diabetes?

2007-11-02T19:29:00.000-07:00

There’s a lot you can do to prevent kidney problems. A recent study shows that controlling your blood glucose can prevent or delay the onset of kidney disease. Keeping your blood pressure under control is also important. Diabetic kidney disease happens slowly and silently, so you might not feel that anything is wrong until severe problems have developed.

Therefore, it is important to get your blood and urine checked for kidney problems each year. Your doctor can learn how well your kidneys are working by testing every year for micro-albumin (a protein) in the urine. Micro-albumin in the urine is an early sign of diabetic kidney disease. Your doctor can also do a yearly blood test to measure your kidney function. Go to the doctor if you develop a bladder or kidney infection; symptoms include cloudy or bloody urine, pain or burning when you urinate, an urgent need to urinate often, back pain, chills, or fever.

What are the early signs of kidney disease in Diabetes?
The finding of excess amounts of protein in the urine is an early sign of diabetic kidney disease.

This usually occurs after 10 to 15 years of diabetes. If the protein loss should become heavy, the amount of protein in the blood decreases. This low blood protein level results in fluid retention causing swelling of the legs.

High blood pressure usually develops or worsens as the disease progresses. People with diabetes should have their blood, urine and blood pressure checked regularly by their doctor. This will lead to better control of the disease and early treatment of high blood pressure, if present.

What are the late signs of kidney disease in Diabetes?
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As the kidney's function declines (this is shown by the results of progressive blood tests), non-specific symptoms may develop such as nausea, vomiting, loss of appetite, weakness, tiredness, itchiness, muscle cramps and anaemia.

The need for insulin may decrease. If any of these symptoms occur you should consult your doctor.

What happens if the kidneys fail completely?
If the kidneys become so damaged that only about 10% of overall kidney function remains, it is called End-Stage Kidney Failure.

The average time between the onset of diabetic kidney damage and End-Stage Kidney Failure is about 5 to 7 years, but it can vary from person to person.

For diabetics in a reasonable state of health, End-Stage Kidney Failure can be treated by dialysis or transplantation.

Can a person with Diabetes have a kidney transplant?
Yes, a kidney transplant can come from a deceased person (cadaver transplant) or from a close blood relative (living related transplant). However, it is important for the recipient not to have other organ damage due to diabetes, for example, to the heart, brains and eyes. If these are already present, a transplant may not be suitable.

Important points about Diabetes and the kidney
* Severe kidney failure is much more common in Type 1 (juvenile-onset) than Type 2 (adult-onset) Diabetes;
* Diabetes may affect small blood vessels in the kidney and cause permanent kidney damage (Diabetic Nephropathy) and kidney failure;
* Early diabetic kidney damage (Diabetic Nephropathy) can be detected by a urine test. The most practical way to follow the condition of the kidneys is with blood tests;
* Genetic manipulation (fat or muscle cells that don’t normally make insulin have a human insulin gene inserted — then these "pseudo" islet cells are transplanted into people with Type 1 Diabetes)
* Maintaining normal blood pressure is the most effective method for slowing the rate at which kidney function is lost;
* End-Stage Kidney Failure can be treated by kidney transplantation, haemodialysis or peritoneal dialysis.

Monitoring of kidney in Diabetic Patients

2007-11-02T19:25:00.000-07:00

It is very important for kidney function to be monitored in diabetic patients. This is done both by monitoring blood pressure and a special test for protein in the urine. It should be done at least once a year.

How can Diabetes affect cardiovascular health?
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Cardiovascular disease is the leading cause of early death among people with diabetes. Adults with diabetes are two to four times more likely than people without diabetes to have heart disease or experience a stroke. At least 65% of people with diabetes die from heart disease or stroke. About 70% of people with diabetes also have high blood pressure.

How are cholesterol, triglyceride, weight, and blood pressure problems related to Diabetes?
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People with Type 2 Diabetes have high rates of cholesterol and triglyceride abnormalities, obesity, and high blood pressure, all of which are major contributors to higher rates of cardiovascular disease. Many people with diabetes have several of these conditions at the same time. This combination of problems is often called metabolic syndrome. The metabolic syndrome is often defined as the presence of any three of the following conditions:

* excess weight around the waist
* high levels of triglycerides
* low levels of HDL, or "good" cholesterol
* high blood pressure
* high fasting blood glucose levels

If you have one or more of these conditions, you are at an increased risk for having one or more of the others. The more conditions you have, the greater the risk to your health.

How can I be “heart healthy” and avoid cardiovascular disease if I have Diabetes?
To protect your heart and blood vessels, eat right, get physical activity, don’t smoke, and maintain healthy blood glucose, blood pressure, and cholesterol levels.

* Choose a healthy diet, low in salt. Work with a dietitian to plan healthy meals.
* If you’re overweight, talk about how to safely lose weight. Ask about a physical activity or exercise programme.
* Quit smoking if you currently do.
* Get a hemoglobin A1C test (HbA1c) at least twice a year to determine what your average blood glucose level was for the past 2 to 3 months.
* Get your blood pressure checked at every doctor’s visit, and get your cholesterol checked at least once a year. Take medications if prescribed by your doctor.

Each of these approaches still has a lot of challenges, such as preventing immune rejection; finding an adequate number of insulin cells; keeping cells alive; and others. But progress is being made in all areas.

How can Diabetes affect the eyes?
In diabetic eye disease, high blood glucose and high blood pressure cause small blood vessels to swell and leak liquid into the retina of the eye, blurring the vision and sometimes leading to blindness. People with diabetes are also more likely to develop cataracts – a clouding of the eye’s lens, and glaucoma – optic nerve damage. Laser surgery can help these conditions.

How can I keep my eyes healthy if I have Diabetes?
There’s a lot you can do to prevent eye problems. A recent study shows that keeping your blood glucose level closer to normal can prevent or delay the onset of diabetic eye disease. Keeping your blood pressure under control is also important. Finding and treating eye problems early can help save sight. It is best to have an eye doctor give you a dilated eye examination at least once a year. The doctor will use eye drops to enlarge (dilate) your pupils to examination the back of your eyes. Your eyes will be checked for signs of cataracts or glaucoma, problems that people with diabetes are more likely to get.

Because diabetic eye disease may develop without symptoms, regular eye examinations are important for finding problems early. Some people may notice signs of vision changes. If you’re having trouble reading, if your vision is blurred, or if you’re seeing rings around lights, dark spots, or flashing lights, you may have eye problems. Be sure to tell your health care provider or eye doctor about any eye problems you may have

How can Diabetes affect the kidneys?

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Over many years diabetes affects the small blood vessels throughout the body. Damage may be caused to the kidneys as well as the eyes, skin, nerves, muscles, intestine and heart.

The kidneys contain tiny filters made up of small blood vessels and as these become damaged, protein leaks into the urine and the kidneys are less able to filter (purify) the blood properly.

The normal removal of excess salt and water from the body is reduced and toxic substances build up in the blood. Kidney failure caused by diabetes is called “diabetic nephropathy”.

If the nerves in the body are damaged by diabetes, it is called neuropathy, and this can affect bladder control, resulting in difficulty in emptying the bladder.

Urine can remain in the bladder and the pressure that builds up can back-up and damage the kidneys. In addition, if urine stays in the bladder for long periods of time, infection may develop because of the rapid growth of bacteria in urine that has high sugar content. In diabetic kidney disease (also called diabetic nephropathy); cells and blood vessels in the kidneys are damaged, affecting the organs’ ability to filter out wastes. Wastes build up in your blood instead of being excreted. In some cases this can lead to kidney failure. When the kidneys fail, a person has to have his or her blood filtered through a machine (a treatment called dialysis) several times a week, or has to get a kidney transplant.

Can Diabetes be prevented?

2007-11-02T19:22:00.000-07:00

A number of studies have shown that regular physical activity and moderate weight loss can significantly reduce the risk of developing Type 2 Diabetes. Type 2 Diabetes also appears to be associated with obesity.

Researchers are making progress in identifying the exact genetics and "triggers" that predispose some individuals to develop Type 1 Diabetes, but prevention remains elusive.

When should I be tested for Diabetes?
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Anyone aged 45 years and above should consider getting tested for diabetes, especially if you are overweight. If you are younger than 45, but are overweight and have one or more additional risk factors (see below), you should consider testing.

What are the risk factors which increase the likelihood of developing Diabetes?
* Being overweight or obese (ref:Nutriweb)
* A parent, brother, or sister with diabetes
* Prior history of gestational diabetes or giving birth of at least one baby weighing more than 9 pounds
* High blood pressure measuring 140/90 or higher
* Physical inactivity, exercise less than three times a week

How does body weight affect the likelihood of developing Diabetes?
Being overweight or obese (ref:Nutriweb) is a leading risk factor for Type 2 Diabetes. Being overweight can keep your body from making and using insulin properly, and can also cause high blood pressure.

What is Pre-diabetes?
People with blood glucose levels that are higher than normal but not yet in the diabetic range have "pre-diabetes." Doctors sometimes call this condition impaired fasting glucose (IFG) or impaired glucose tolerance (IGT), depending on the test used to diagnose it.

IFG is a condition in which the blood sugar level is high (6.1 to 7.0mmol/L) after an overnight fast but not high enough to be classified as diabetes. IGT is a condition in which the blood sugar level is high (7.8 to 11.1mmol/L) after a two-hour oral glucose tolerance test, but is not high enough to be classified as diabetes. Insulin resistance and pre-diabetes usually have no symptoms. You may have one or both conditions for several years without noticing anything.

If you have pre-diabetes, you have a higher risk of developing Type 2 Diabetes. Studies have shown that most people with pre-diabetes go on to develop Type 2 Diabetes within 10 years, unless they lose weight through modest changes in diet and physical activity. People with pre-diabetes also have a higher risk of heart disease.

Effects of Diabetes
Diabetes can affect any part of your body. The good news is that you can prevent most of these problems by keeping your blood glucose (blood sugar) under control, eating healthily, being more physically active, and working with your health care provider to keep your blood pressure and cholesterol under control and getting necessary screening tests.

Diabetes & Kidney Disease

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Your body converts carbohydrates to glucose. Glucose is the simple sugar that is the main source of energy for the body's cells. To enter cells, glucose needs the help of insulin. Insulin is a hormone produced by the pancreas. When a person does not make enough insulin, the body can’t utilise glucose. The glucose builds up in the blood. High levels of glucose in the blood or urine lead to a finding of diabetes.

Diabetes mellitus is a disorder where the pancreas does not make enough insulin or the insulin is not effective. This insulin imbalance causes the body’s blood sugar level to rise, and eventually many unhealthy changes can occur in different body organs.

The normal and target blood glucose ranges are:
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Ref: American Diabetes Association Guidelines & The Malaysia Clinical Practice Guidelines 2005

There are more than 1 million people in Malaysia have diabetes. Many times the disease can lead to kidney damage and even kidney failure. Diabetes is the most common cause of kidney failure in Malaysia.

Latest statistics indicated that 57% of kidney failure was due to diabetes. Most people’s diabetes does not damage the kidneys enough to cause kidney failure. Proper control of diabetes and blood pressure, together with certain medications may prevent the onset of kidney complications or reduce further kidney damage if that has already occurred.

What are the symptoms of Diabetes?
People who think they might have diabetes must visit a physician for diagnosis. They might have SOME or NONE of the following symptoms:

* Frequent urination
* Excessive thirst
* Unexplained weight loss
* Extreme hunger
* Sudden vision changes
* Tingling or numbness in hands or feet
* Feeling very tired much of the time
* Very dry skin
* Sores that are slow to heal
* More infections than usual

Nausea, vomiting, or stomach pains may accompany some of these symptoms in the abrupt onset of insulin-dependent diabetes, namely Type1 Diabetes.

What are the types of Diabetes?
Type 1 Diabetes, also called insulin-dependent diabetes mellitus (IDDM) or juvenile-onset diabetes, accounts for 5% to 10% of all diagnosed cases of diabetes. Occurs mainly in young people below 30 years and is caused by an inability of the pancreas to produce enough insulin. These people need insulin injections.

Type 2 Diabetes, also called non-insulin-dependent diabetes mellitus (NIDDM) or adult-onset diabetes usually develops in people older than 40 years, accounts for about 90% to 95% of all diagnosed cases of diabetes. The abnormal blood sugar in these people is usually controlled with diet and / or medications.

Gestational diabetes is a type of diabetes that only pregnant women get. If not treated, it can cause problems for mothers and babies. Gestational diabetes develops in 2% to 5% of all pregnancies but usually disappears when a pregnancy is over.

What are the risk factors for Diabetes?
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Risk factors for Type 2 Diabetes include old age, obesity, a family history of diabetes, prior history of gestational diabetes, impaired glucose tolerance, physical inactivity, and race/ethnicity.

Risk factors are less well defined for Type 1 Diabetes than for Type 2 Diabetes, but autoimmune, genetic, and environmental factors are involved in developing this type of diabetes.

Gestational diabetes occurs more frequently in people with a family history of diabetes than in other groups. Obesity is also associated with higher risk. Women who have had gestational diabetes are at increased risk for developing Type 2 Diabetes in the later part of their life.

Studies have shown that nearly 40% of women with a history of gestational diabetes developed diabetes later. Other specific types of diabetes, which may account for 1% to 2% of all diagnosed cases, result from specific genetic syndromes, surgery, drugs, malnutrition, infections, and other illnesses.

What is the treatment for Diabetes?
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Healthy eating, physical activity, and insulin injections are the basic therapies for Type 1 Diabetes. The amount of insulin taken must be balanced with food intake and daily activities. Blood glucose levels must be closely monitored through frequent blood glucose testing.

Healthy eating, physical activity, and blood glucose monitoring are the basic therapies for Type 2 Diabetes. Most people will require oral medications and eventually will require a combination of oral medications and insulin or a switch to insulin to control their blood glucose levels. People with diabetes must take responsibility for their day-to-day care, and keep blood glucose levels from going too low or too high.

People with diabetes should see a health care provider who will monitor their diabetes control and help them learn to manage their diabetes. In addition, people with diabetes may see endocrinologists (specialist deals with diseases that affect organs that make hormones), who may specialize in diabetes care; ophthalmologists for eye examinations; podiatrists (specialist deals with disorders of lower limbs) for routine foot care; and dietitians and diabetes educators who teach the skills needed for daily diabetes management.

Is there a cure for Diabetes?
In response to the growing health burden of diabetes, the diabetes community has three choices: prevent diabetes; cure diabetes; and improve the quality of care of people with diabetes to prevent devastating complications. All three approaches are actively being pursued by the Ministry of Health Malaysia.

Several approaches to "cure" diabetes are being pursued overseas:

* Pancreas transplantation
* Islet cell transplantation (Islet cells produce insulin)
* Artificial pancreas development
* Genetic manipulation (fat or muscle cells that don’t normally make insulin have a human insulin gene inserted — then these "pseudo" islet cells are transplanted into people with Type 1 Diabetes)

Each of these approaches still has a lot of challenges, such as preventing immune rejection; finding an adequate number of insulin cells; keeping cells alive; and others. But progress is being made in all areas.

What causes Type 1 Diabetes?
The causes of Type 1 Diabetes appear to be much different than those for Type 2 Diabetes, though the exact mechanisms for developing both diseases are unknown. The appearance of Type 1 Diabetes is suspected to follow exposure to an "environmental trigger," such as an unidentified virus, stimulating an immune attack against the beta cells of the pancreas (that produce insulin) in some genetically predisposed people.

Tips for Parents having Children with Kidney Disease

2007-11-02T19:12:00.000-07:00

If your child has been diagnosed with kidney disease, you are no doubt feeling distressed and bewildered. These feelings are normal. And once you realize that your child's illness is a reality the family must accept, you can develop some practical ways to cope with the day-to-day aspects of it. Here are some guidelines others have found helpful:

* Learn about the disease and its treatments.
* Learn as much about your child's disease and its treatment as you possibly can. And pass this information on to your child. You'd be surprised at how much even very young children can understand. And many times they will accept information more easily than an adult.
* Encourage your child to ask questions. Many times, your child will ask questions you had not thought about or were afraid to ask because you thought they sounded "dumb".
* Don't try to explain more than your child can understand, but don't lie and don't apologize for any treatments or procedures that have to be followed.
* Help your child understand that the doctors, nurses, social workers, dietitians, laboratory personnel and everyone else is on his or her side. They all want to help your child feel better, even if that means they have to do things that will cause some temporary pain or discomfort.
* Actively participate in your child's care.
* Develop a spirit of mutual respect and cooperation with health professionals.
* Write out all the details of your child's medical history, including dates. This will make it easier for you each time you come in contact with a new doctor.
* Try to be with your child as much as possible during treatments and any hospitalization that might be necessary. If you cannot be there, arrange for someone else to be presents i.e. a grandparent, other relative, or close family friend. And make sure a favorite book, stuffed animal or special blanket is taken along.
* Help your child take control of the illness.
* Try to maintain a normal daily routine, even during hospitalization.
* Help your child understand about doctor's offices, hospitals, dialysis centres and laboratories and how they are used. By helping your child understand the places that are filled with strange and frightening instruments and machines, you can help eliminate a lot of your child's fear.
* Be creative in finding ways for your child to participate in his or her own care. Your child will feel much more in control if you provide as many opportunities to do so as you can.
* Help your child to understand and accept diet restrictions. Even a child as young as 2 or 3 can understand about "diet" if it is explained simply. Often, the child will be more compliant with dietary restrictions than an adult will. Have your child make a list of favorite foods and take him or her with you when you talk to the dietitian to see if these foods can be incorporated into the diet plan. Whatever you do, don't ever use bribes or force your child to eat. These tactics rarely work and more often turn mealtime into a very unpleasant experience.
* Don't let medicine time ruin your day. A matter-of-fact attitude is your best weapon in getting your child to take medication. Your child has no choice about whether or not to take prescribed medication, but you can offer a choice of when and where. And once the choice is made, make a schedule and stick to it. Unpleasantness is a lot easier to cope with if you know exactly when it is coming and don't procrastinate. Sometimes medication must be given with meals, but don't give it at the table where your child eats. Find a place not associated with food and eating, such as the living or family room while your child is distracted by a favorite TV show.
* Another weapon you have at medicine time is plain, ordinary water. If your child is on a fluid-restricted diet, water may be one of the things he or she would like to have most, so reserve part of the day's fluid intake for a couple of swallows after medicine time.
* Share your experience with others. Don't let yourself become isolated. Talk with the kidney staff and with other families of children with kidney disease.
* Don't hesitate to ask relatives and friends for help. Chances are they want to, but don't know how, and are just waiting for you to ask. Sharing your experience will help you find ways to grow with it.

Treatment for Kidney Disease

2007-11-02T18:27:00.000-07:00

Since another medical ailment usually causes chronic kidney disease, the most effective way to treat kidney disease is to treat and manage the disease that originally caused your kidney damage, for instance diabetes and hypertension.

In Malaysia, some 57% of kidney failure patients are diabetics and 6% hypertensive. Hence, your doctor will use blood and urine tests to regularly monitor your kidney’s condition. These tests will determine how your kidneys are functioning and whether any changes to your treatment plan is required.

Chronic Kidney Disease (CKD)
CKD is often progressive, and if this happens, your symptoms may occur more frequently or become severe.

Depending on your stage of CKD, you may need to make dietary changes to help slow its progression. You may be asked to limit your use of salt or watch how much potassium or phosphorus is in your diet.

In the early stages of this disease, only a small part of the kidney is involved. Some people have destruction of the glomerulus or renal tubules. Early kidney disease can cause scarring, which interferes with the blood flow to a portion of the kidney.

In many cases, early detection and treatment may keep CKD from getting worse.

Over time, if CKD is not treated, End Stage Kidney Failure occurs, one will require immediate and ongoing dialysis treatment or a kidney transplant.

In most patients, medication is used in addition to dietary restrictions to prevent further damage to the kidneys. This is done to try and delay the progression to End Stage Kidney Failure.

Kidney Failure
The treatment of End Stage Kidney Failure involves haemodialysis (using a kidney machine), peritoneal dialysis or kidney transplantation.

The type of treatment chosen is determined by the general health and medical condition of the person, by its impact on the person's lifestyle and by the person's personal preference.

Many people may receive each one of these three forms of treatment at various times. What may be the best treatment for one person at one time might not be the best for another or for the same person at a different time.

Dialysis is a life-saving process that artificially replaces part of the functions of the kidney.

There are two types of dialysis: haemodialysis and peritoneal dialysis.

Haemodialysis involves removing blood from the body and filtering it in an artificial kidney

(dialysis machine). The patient is connected by a tube to the dialysis machine, which continuously draws blood out, cleans it and removes excess fluid and then returns the blood back to the patient. Haemodialysis must be performed for 3 to 4 hours at least three times a week. It is usually performed at a dialysis centre, though home dialysis is also possible.

Peritoneal Dialysis is internal or in-body dialysis. Peritoneal dialysis entails use of a blood-cleansing solution called "dialysate" that is introduced into the peritoneal cavity, the region of the abdomen that is lined by the peritoneum. While in the peritoneal cavity, the dialysate works to extract toxins and excess fluids from the blood. After a period of time, the solution is then drained from the body cavity.

Three types of peritoneal dialysis are available.
1. Continuous Ambulatory Peritoneal Dialysis (CAPD).
CAPD requires no machine and can be done in any clean, well-lit place. With CAPD, your blood is always being cleaned. The dialysis solution passes from a plastic bag through the catheter and into your abdomen, where it stays for several hours with the catheter sealed. The time period that dialysis solution is in your abdomen is called the dwell time. Next, you drain the dialysis solution into an empty bag for disposal. You then refill your abdomen with fresh dialysis solution so the cleaning process can begin again. With CAPD, the dialysis solution stays in your abdomen for a dwell time of 4 to 6 hours, or more. The process of draining the used dialysis solution and replacing it with fresh solution takes about 30 to 40 minutes. Most people change the dialysis solution at least four times a day and sleep with solution in their abdomens at night. With CAPD, it’s not necessary to wake up and perform dialysis tasks during the night.

2. Continuous Cycler-Assisted Peritoneal Dialysis (CCPD)
CCPD uses a machine called a cycler to fill and empty your abdomen three to five times during the night while you sleep. In the morning, you begin one exchange with a dwell time that lasts the entire day. You may do an additional exchange in the middle of the afternoon without the cycler to increase the amount of waste removed and to reduce the amount of fluid left behind in your body.

3. Combination of CAPD and CCPD
If you weigh more than 175 pounds or if your peritoneum filters wastes slowly, you may need a combination of CAPD and CCPD to get the right dialysis dose. For example, some people use a cycler at night but also perform one exchange during the day. Others do four exchanges during the day and use a minicycler to perform one or more exchanges during the night. You’ll work with your health care team to determine the best schedule for you.

6.4. Kidney Transplantation
A kidney transplant involves the taking of a kidney from the body of a healthy person or cadaver and implanting it surgically into the body of someone who has lost kidney function. The transplanted kidney can then perform the function of that person's own kidneys. A successful kidney transplant will allow you to have a better quality of life, improves lifestyle and will free you from dialysis treatments.

Whilst a transplant is not a cure for kidney failure, it does allow patients to live a more "normal" life than that experienced on dialysis. Patients with a well-functioning transplant have a greater sense of well-being and are able to enjoy a lifestyle free of dependence on dialysis treatments, although they must continue with their transplant drug treatment.

A transplant can mean improvement in anaemia, bone disease and in children, body growth. It also offers freedom from previous dietary and/or fluid restrictions and from restrictions on time and mobility.

It is the treatment of choice for chronic kidney failure for those who are considered suitable candidates for a transplant. To find out if you are a candidate, your health care team will perform a series of tests as part of a complete medical assessment.

Many ESRD patients benefit greatly from a kidney transplant. After successful transplantation, patients no longer require dialysis. Today there are many patients on waiting list to receive a kidney transplant. The development of effective anti-rejection drugs means that the prognosis for five-year survival for most of these patients is high.

To avoid rejection, the best possible source of kidney donation is a close relative whose blood and tissue type match the patient's. Donated organs from cadavers also have high success rates. A growing source of kidneys for transplantation comes from living donors who are not blood relatives, but with whom the patient has an emotional tie, such as a spouse, friend or co-worker.

High Risk Group

2007-11-02T18:26:00.000-07:00

#
One belongs to the high risk group if he has the following or he is:
o Diabetes
o High blood pressure
o Family history of kidney disease, diabetes or high blood pressure
o Obesity
o Kidney stone
o Above 50 years old

Patients with diabetes, high blood pressure or individuals with a family history of kidney disease, diabetes or high blood pressure should have checkups on blood pressure, blood sugar and urine tests for at least once a year to check on the status of their kidneys. It is important that patients with established kidney disease must monitor their condition by visiting their doctors regularly.

Practice a Balanced Diet
o Lower the fat, salt and sugar content in your diet and add more fiber, fresh fruits and vegetables. A low salt diet is especially important if you have high blood pressure.

Overcome Obesity
o The best way is with regular exercise and a well balanced diet. Exercise for 30 minutes for at least 3 times a week if possible.

Quit Smoking
o There is no 'safe' level of smoking and smoking is damaging to blood vessel walls. Damaged blood vessel walls can lead to atherosclerosis (hardening of blood vessels) and ischemia of the kidneys.

Avoid Unnecessary Medications
o Certain medications are toxic to the kidneys in susceptible individuals, especially if taken in large amounts over long periods. Your doctor can give you specific advice on what medications to avoid.

Screening Is Vital!
Annual Health Screening is vital to check whether your kidneys are healthy. Your checkup should include:

* Blood pressure
* Blood test for glucose and creatinine
o A kidney profile includes measurement of various chemicals and waste products in the blood. This test would be able to tell you if you have moderate to severe kidney failure. It is important to note that this test is usually normal in early kidney disease.
* Urine test
o The urine test is important in screening for kidney disease. Specialized urine test will be able to confirm early kidney disease thereby allowing appropriate treatment to prevent further kidney damage.

Ultrasound may be required for certain individuals. It is a form of scanning which looks at the kidneys and urinary tract. Certain diseases such as kidney stone, tumor, cyst or blockage of the urinary tract can be detected by an ultrasound scan.

Prevention of Kidney Disease

2007-11-02T18:25:00.001-07:00

he two major contributors to Chronic Kidney Failure in Malaysia are diabetes and high blood pressure. Hence, the sooner these illnesses are treated, the better the chance of preventing Chronic Kidney Failure.

Those suffering from these ailments should be medically supervised, because careful control of blood pressure, blood sugar level, taking a low protein diet and weight reduction can significantly slow down or even prevent the development of chronic kidney diseases.

In the case of acute kidney diseases, it is also important to seek medical attention early, so that effective therapy can be started promptly. Early treatment of acute kidney disease can prevent permanent damage, whereas delay in diagnosis and treatment may result in permanent kidney failure.

Even in the case of irreversible kidney failure, dialysis and kidney transplantation have made remarkable progress in recent years, enabling patients with End Stage Kidney Failure to lead active lives.

Signs & Symptoms of Kidney Disease

2007-11-02T18:24:00.000-07:00

Signs & Symptoms of Kidney Disease

When kidney disease develops over a short period of time it’s called Acute Kidney Failure. This is usually caused by an acute 'insult' (damage) to the kidneys. Unlike Chronic Kidney Failure, this can usually be treated and cured. Acute kidney diseases often cause symptoms that are quite obvious, the most prominent being:
# blood in the urine
# swelling of the face, feet, ankles and legs
# new onset of high blood pressure
# shortness of breath

The above symptoms are more likely to occur in children because they are more likely to suffer acute kidney diseases. However, that does not mean adults are free of them, so if you note any combination of these symptoms, immediately seek medical attention.

Note that other diseases can also cause similar symptoms, but a simple urine test can indicate if they are due to kidney diseases. For instance, the urine test will indicate if albumin (protein) and blood are present in the urine, as they imply the presence of kidney diseases. A blood test can also show how well your kidneys are performing their main function of eliminating waste products.

In contrast, many chronic kidney diseases do not manifest clear warning signals in their early stages. There may be loss of appetite, mild swelling in the legs, and tiredness. It is not uncommon for these symptoms to be so mild or non-specific that they are ignored over long periods of time.

In fact, some people with chronic kidney disease do not have any symptoms in the initial stages. But as kidney function declines, symptoms may include:
# fatigue
# frequent headaches
# loss of appetite (anorexia)
# sleep problems (insomnia)
# itchy skin
# frequent urination or urinary retention
# nausea or vomiting
# swelling or numbness of the hands and feet
# darkening of the skin
# muscle cramps

Chronic kidney disease

2007-11-02T18:19:00.000-07:00

Chronic Kidney Disease (CKD) means a condition that damages one’s kidneys. It decreases kidneys’ ability to keep one healthy by doing their functions.

CKD is a common, life-threatening illness that often goes undetected until very advanced.
CKD may progress slowly over a long time. A lot of people are not aware that they have
kidney disease until it’s severe. If it’s found and treated early, CKD may often be slowed down or stopped.

The risk factors for CKD include:
– Diabetes
– High blood pressure
– A family history of kidney disease, diabetes or high blood pressure
– Obesity
– Kidney stone
– Above 50 years old

Annual Health Screening is vital to check whether your kidneys are healthy.

You should visit your doctor or clinic and get tested. Your checkup should include:
o Urine test for protein
- Protein is an important building block in your body. Any filtered protein
is normally reabsorbed and kept in your body. When your kidney are
damaged, however, protein leaks into your urine.
- There are different tests to check for protein in your urine. If you have two
positive tests over several weeks, you are said to have persistent protein
in your urine. This is a sign of CKD.
o Blood pressure
o Blood test for glucose
o Blood test for creatinine
- Creatinine is a waste product that comes from muscle activity.
- Your kidneys normally remove creatinine from your blood. When your
kidneys are damaged, however, your blood creatinine may build to a high
level.
- The results of your test should be used to estimate your Glomerular
Filtration Rate, or GFR. Your GFR tells how much kidney function
you have.

Test results show CKD
Your doctor will want to pinpoint your diagnosis and check your kidney function to help plan your treatment. The doctor may do the following:

* Calculate your GFR, which is the best way to tell how much kidney function you have. You do not need to have another test to know your GFR. Your doctor can calculate it from your blood creatinine, your age, race and gender. Your GFR tells your doctor your stage of kidney disease and helps the doctor plan your treatment. (See the chart below on “5 Stages of Chronic Kidney Disease”)
* Perform an ultrasound or CT scan to get a picture of your kidneys and urinary tract. This tells your doctor whether your kidneys are too large or too small, whether you have a problem like a kidney stone or tumor and whether there are any problems in the structure of your kidneys and urinary tract.
* Perform a kidney biopsy, which is done in some cases to check for a specific type of kidney disease, see how much kidney damage has occurred and help plan treatment. To do a biopsy, the doctor removes small pieces of kidney tissue and looks at them under a microscope.

Stage Description GFR Level mL/ min
1 Kidney damage with normal or higher GFR 90 or more
2 Kidney damage and mild decrease in GFR 60 to 89
3 Moderate decrease in GFR 30 to 59
4 Severe decrease in GFR 15 to 29
5 Kidney failure
(dialysis or kidney transplant needed) Less than 15

To prevent CKD progression
Early detection and treatment can often slow or stop CKD. How well your treatment can achieve this goal depends on:

* Your stage of CKD when you start treatment. The earlier you start, the better you are likely to do.
* How carefully you follow your treatment plan. Learn all you can about CKD and its treatment, and make sure to follow all the steps of your treatment faithfully.
* The cause of your kidney disease. Some kidney diseases are more difficult to control..

Your Kidney

2007-11-02T18:13:00.000-07:00

Do you know that your Kidneys…?

1. Weigh less than 1% of your body weight?
2. Receive 20% of the blood that is pumped by your heart?
3. Filter 180 litres of fluids per day to produce 2 litres of urine?
4. Maintain your body’s internal environment constant?
5. Remove harmful wastes from your body via urine?
6. Produce certain essential hormones?
- Erythropoietin which stimulates the bone marrow to produce red blood cells
- Renin to regulate blood pressure
- Activate Vitamin D to produce calcitriol which helps maintain calcium balance in
the bones.

Blood Pressure

2007-08-15T20:59:00.000-07:00

The heart, a muscle about the size of a fist, is one of the hardest working organs in our bodies. Over the course of an average life span, it beats about two and a half billion times without ever taking a break. The daily choices we make about how we live our lives determine our hearts' ability to function optimally.

According to the American Heart Association, cardiovascular disease is the number one killer in the United States. More than 2,600 people die of heart disease every day, which translates into one cardiovascular death every 33 seconds.

Despite the seriousness and prevalence of heart disease, cardiovascular problems aren't inevitable. There are steps you can take -- eating a healthy, low-fat diet and getting plenty of exercise -- to reduce your risk. On the other hand, bad habits such as smoking and drinking too much alcohol overburden our already busy hearts and cause them to break down.

"Cardiovascular disease is a real problem in the United States," said Elijah Saunders, M.D., Head of the Hypertension Section of the University of Maryland School of Medicine's Division of Cardiology. "The average American diet is high in fat, cholesterol, calories and salt, and our lifestyles are far too sedentary."

Elevated Blood Pressure: The Silent Killer
High Blood Pressure Risk Factors
It is important to keep your blood pressure under 140/90 mm Hg. Blood pressure higher than that is considered dangerous. Below is a list of high blood pressure risk factors. People with any of these risk factors should have their blood pressure checked every time they visit their doctor. For those who fall into several risk categories, experts recommend purchasing a blood pressure cuff and a stethoscope and taking your own pressure reading every week.

Cigarette smoking or being exposed to secondhand smoke on a daily basis
Diabetes (a fasting glucose higher than 125 mg/dL)
Kidney disease
Family history of hypertension
Being obese or overweight
Leading a physically inactive, sedentary lifestyle
Men over the age of 45
Women over the age of 55
Taking oral contraceptives
Elevated cholesterol levels
Frequently consuming alcoholic beverages
Being African American
Hypertension or high blood pressure is often a precursor to heart disease. High blood pressure that goes undetected or isn't properly controlled can lead to heart attack, heart failure, kidney failure, stroke or premature death. Because hypertension has few early symptoms, many people aren't aware they have it.

"Only about half of the people in this country who have high blood pressure know they have it," said Saunders. "Of those who know they have it, only about half are being treated for it. And of those being treated for it, only about half actually have their blood pressure under control. Nationwide, that translates into about 25 percent of hypertensive patients who are controlling their blood pressure."

According to Saunders, many people shy away from taking the medications that could help them manage their blood pressure because they are concerned about their side effects. Treatment methods, however, have improved over the years, and some of the old fears are unfounded.

"The way drugs are being used to control high blood pressure today is much more effective than in the past," Saunders said. "Doctors are using ACE inhibitors, Calcium channel blockers, Beta-blockers, Angiotensin-receptor blockers (ARBs), Alpha-blockers and low-dose diuretics in ways that don't cause the sexual complications and other side effects of older therapies. Also, these new drugs only need to be taken once a day, instead of two or three times a day. This is a lot easier for patients."

Saunders, who has served on the Advisory Council of the National Heart, Lung and Blood Institute, has lectured extensively on hypertension. Throughout his career, he has focused on hypertension among the elderly and African American populations.

Statistics show that African Americans are 50 to 100 percent more likely to develop high blood pressure than their white counterparts. African Americans also develop hypertension at younger ages than whites, have a harder time keeping it under control and die from it at much higher rates.

Saunders is currently working with the National Institutes of Health to understand any possible genetic factors that increase hypertension in African Americans.

"Unlike sickle cell, I doubt that we're going to discover a single gene that predisposes African Americans to hypertension," Saunders said. "More than likely, it is a combination of environmental factors such as diet, obesity, physical inactivity and stress that contribute to the increased rates of high blood pressure we see in the African American community."

Control Your Pressure
The average adult has about five liters of blood flowing through the body via an intricate network of blood vessels called arteries, veins and capillaries. Blood is essential to life for it delivers oxygen from our lungs to our body tissues, and carries harmful waste to the kidneys to be removed. Blood also transports hormones from our glands to various parts of our bodies, as well as vitamins and nutrients from our digestive tracts.

When our blood vessels become clogged due to a plaque buildup of cholesterol and fat, our hearts must work twice as hard to pump enough blood to our vital organs. This is what causes our blood pressure to surge.

As the pressure increases inside of our arteries, veins and capillaries, our hearts become even more overworked. Over time, our hearts grow larger in an effort to compensate for the extra workload and eventually they become weaker.

When you add obesity, smoking, or diabetes to the mix, the risk of heart attack, stroke or kidney disease for those with high blood pressure increases dramatically. This is why it is important to know what your blood pressure is.

Experts recommend that you maintain a blood pressure lower than 140/90 mm Hg at rest. The higher number represents the maximum pressure exerted when the heart contracts (systole). It reflects the stiffness of the large arteries near the heart, and the volume of blood pumped into them. The lower number represents the pressure exerted when the heart begins to relax between beats (diastole), just before the next contraction. It measures the amount of constriction of the body's smaller arteries or arterioles.

Good Reasons to Exercise
A great way to lower your blood pressure and combat the corrosive effects of plaque buildup is to exercise. Studies have shown that sedentary lifestyles tend to elevate blood pressure, while regular exercise can reduce it.

According to Saunders, exercise is so effective at controlling blood pressure because it stimulates a substance within our bodies called nitric oxide. Nitric oxide is produced by our endothelial cells, which live on the inside layer of our blood vessels.

"Nitric oxide is a substance that helps to keep our blood vessels open," said Saunders. "During the early stages of plaque buildup or arteriosclerosis, one of the first things we see is a reduction in the amount of nitric oxide in the blood vessels. When we exercise, the accelerated pumping of our hearts forces more blood to flow through our vessels. As this blood pushes its way along the lining of our vessels, the endothelial cells release more nitric oxide."

You don't have to spend hours in the gym to reap the healthy benefits of exercise. Walking the dog, taking the stairs instead of the elevator, even vacuuming briskly can increase the blood flow from your heart and through blood vessels.

In addition to regular exercise, a heart-friendly diet is also important, said Saunders. Broiling foods instead of frying them and trimming the skin and fat off of meat all add up to less artery-clogging plaque in your blood vessels.

Shake That Salt Habit
So, you avoid foods high in fat and cholesterol and are exercising on a regular basis, what else can you do to stay healthy? Saunders suggests staying away from foods that contain a lot of sodium.

Sodium plays an essential role in regulating fluids in the body. Studies of diverse populations have shown that a high sodium intake is associated with higher blood pressures.

Although the human body requires only about 500 mg of sodium a day, the average American ingests between 6,900 mg and 9,000 mg of sodium a day. For people sensitive to sodium, such as those with a family history of hypertension, African Americans, diabetics and the elderly, the accumulation of too much salt in the body can be particularly risky.

Saunders recommends doing away with your salt shakers. Adding extra salt to most foods is unnecessary since many of the prepackaged, prepared foods that you buy in the grocery store already contain a lot of sodium.

"A good rule of thumb is that if you can taste the salt in your food, then there is too much of it," said Saunders. "Canned foods, snack foods, fast foods and other prepared foods are loaded with sodium. It is much better to prepare your own low-sodium meals. You may also consider using some salt substitutes (with approval by your doctor) or various condiments and seasonings that may add to the taste without excess salt. When eating out, insist that the food be prepared without sodium and you can then control the amount consumed."

If you don't have time to cook your meals from scratch, Saunders advises that you pay close attention to the amount of sodium listed on food labels. Since 1986, the Food and Drug Administration has required manufacturers to list sodium content on their products.

Say No to Smoking, Excessive Drinking

Another way to improve your overall cardiovascular health is to quit smoking and drinking a lot of alcohol.

While drinking in moderation doesn't seem to have much of an impact on your heart, having more than three drinks a day may contribute to high blood pressure. Alcohol has been shown to raise blood pressure by interfering with the flow of blood to and from the heart. When alcohol courses through your bloodstream, it pushes blood rich in nutrients away from your heart.

Studies have shown that it is much more difficult to control blood pressure if you drink heavily. Conversely, a reduction in alcohol consumption can help lower blood pressure.

Smoking also takes a heavy toll on the heart. According to the American Lung Association, over 400,000 Americans die of smoking-related illnesses each year. This figure includes those affected by secondhand smoke and babies born prematurely due to prenatal, maternal smoking.

Nicotine, one of thousands of chemicals found in cigarettes, causes the blood vessels to constrict. This narrowing of the vessels increases blood pressure.

Nicotine is an extremely addictive chemical. Studies show that nicotine activates the circuits in the brain that regulate pleasurable feelings. It does this by increasing the levels of a chemical found in our brains called dopamine. The U.S. Surgeon General warns that nicotine addiction is similar to heroine and morphine addiction. In fact, when smokers inhale, the nicotine reaches the brain faster than drugs that enter the body intravenously.

Kicking a smoking habit may not be easy, but it is worthwhile. About 1.3 million people quit smoking each year. The benefits of quitting are numerous. They include improved tolerance for exercise, and a reduction in the risk of developing lung cancer, bladder cancer and heart disease.

Three years after giving up nicotine, Saunders said that ex-smokers have a 65 percent reduction in deaths from heart disease relative to those who continue to smoke.

Make Heart-Healthy Changes
Experts urge the public to break those habits that threaten cardiovascular health. Adopting a more heart-healthy approach to life now can have a positive influence on future generations.

"We are all getting too fat in our society and we need to turn things around," said Saunders. "Physical inactivity among our youth is a real problem. We need to make sure that we eat eight servings of fruits and vegetables a day, and get more exercise. We need to get ourselves and our children away from the television sets and the computers, and start them exercising early in their lives."

Drugs

2007-08-15T20:04:00.000-07:00

drugs is good when you know how to handle it, but it will be killer if you use it in wrong way. any drugs can be friend and can be murderer! think yourself.

in medic instituition, drugs is an important elements, whether to save a life or to prevent diseases to keep grow very easy and fast. i dont know how you would feel if one of your family members died caused of drugs? but do you think drugs is killer?

some said yes, and some said no.

thats the answer if you poll out this question, whatever, let see current situation in malaysia, why i said malaysia? because i live there and know their people well. this is not a fact to keep down on malaysia reputation or name in the world, but it just a study case which i had go through.

now, we can see many cases of drugs, many teenagers involved in this case, even in university or college, they are addicted to drugs i.e.:syabu,heroin,pil kuda,daun ketum,etc.

many criminary cases are caused by them, when they already out of mind after taking drugs, they would be able to kill even their parents or members.

i dont know what will happen to our young generation? should we leave this matter behind? or should we forward to prevent it to parliament? think your self? or you have child, but you dont care what they want to do? or you did not put islamic education in your family spirit?

now! i ask you to check yourself first, then think did you care of your family? then think whether did you care of your race? then think what did you do to take care off your nations?.

from my opinion, malaysia would be malaysia as today if we have no chinese in our country. why? because most of chinese are businessman and successful in their business. but malay did not take initiative to success, but most of them are not care of this. how could malay success if right now malay teenagers involved with moral problems?

who should we accused? government?father?mother?encestor? think! think!. i feel sad to many youngers today. they did not care how to improve. most involved with "REMPIT" "DADAH" "ROGOL" "MAKSIAT".

Smoking

2007-05-08T04:33:00.000-07:00

Welcome back to my readers...

This time, i will expose about the student life in campus health style...firstly..my question to you all..are you student right now?...or...you are ex-student?..doesn't matter...but the important is...how you take care of your healthy..

for this article...i will expand into a fews scope that i shall discuss with you all...first is about the smoking, drugs, not enough sleep, inactive in the sport and pressure.

smoking, nowadays it not a big problem when we saw a student from the high school do smoking. even in the primary school still have the kids who have tried cigarette. but do you know the effect? by starting with smoking for fun..then they will involve their self by taking drugs and so on. and might be involved in black metal and so on.. we should think 5 years later or more about our generation, what they would become in future? if the situation is bad like now.

In malaysia, smoking are prohibited for person under age 18 years old, but, through my experience in primary and high school in early 1990's, the trend of student who is smoke is quite big, a few later..the trend of skin head came out...then the moral of our students is low on that time.

Can you imagine, about 16 to 17 years later? which is in this year, 2007 what was happened? ok, our ministry of health was come out with the solution of TAK NAK! campaign in order to combat smoking among young generation. but, it still not effective. still have person under 18 smoking.

And according to the health ministry, the increasing of new diseases are caused by smoke of ciggerate. we know that thousand of diseases are caused from smoking. so, how we can protect our young generation to stay good health?

From my opinion, the range of life of human in the future will be more short, because of the diseases. right now we can see, even 20 years old man might be able to get diabetes. in this early young? maybe they like to drink coke and other soft drink which is they don't know how to consume wisely and practicing inactive life style.

Wahh!.. its too long when i discuss about the smoking!.. for later..I'll discuss about drugs, not enough sleep, inactive in the sport and pressure. hopefully i will able to finish in one article...

Young Versus Healthy

2007-03-02T09:03:00.000-08:00

What do you think abaout recently desiases that accoured among teenagers and young people??

According to the situation right now, people life are not safe more!, why? because most of our activity and our items consumed everyday contribute to the diseases.

for the example, smoking..even you are not the smoker, you might be able to get the effect because the environment among you is not health.

other than that, the platic container, or plastic holder or anything that botol or product from plastic used to store our foods actually will contribute to the disease. example, when we eaten a foods that packed in plastic botols, the sintetic of botol will plus with the foods then insert into our body after we eat that foods.

the problem occured when there is too much inorganic or unextract things in our blood that contributed to the kidney problems and also blood pressure.

so, think and eat!

What You Need to Know about Kidney Cancer

2007-02-16T14:02:00.000-08:00

Introduction

Each year, more than 28,000 people in the United States learn that they have kidney cancer. The National Cancer Institute (NCI) has written this booklet to help people with kidney cancer and their families and friends better understand this disease. We hope others will read it as well to learn more about kidney cancer.

Definitions of words that may be new to readers and other terms related to kidney cancer can be found in the Glossary. For some words, a "sounds-like" spelling is also given.

This booklet discusses symptoms, diagnosis, treatment, and followup care. It also has information to help patients cope with kidney cancer.

Our knowledge about kidney cancer keeps increasing. For up-to-date information or to order this publication, call the NCI-supported Cancer Information Service (CIS) toll free at 1-800-4-CANCER (1-800-422-6237).

The CIS staff uses a National Cancer Institute cancer information database called PDQ and other NCI resources to answer callers' questions. Cancer information specialists can send callers information from PDQ and other NCI materials about cancer, its treatment, and living with the disease.

The Kidneys

The kidneys are two reddish-brown, bean-shaped organs located just above the waist, one on each side of the spine. They are part of the urinary system. Their main function is to filter blood and produce urine to rid the body of waste. As blood flows through the kidneys, they remove waste products and unneeded water. The resulting liquid, urine, collects in the middle of each kidney in an area called the renal pelvis. Urine drains from each kidney through a long tube, the ureter, into the bladder, where it is stored. Urine leaves the body through another tube, called the urethra.

The kidneys also produce substances that help control blood pressure and regulate the formation of red blood cells.

What Is Cancer?

Cancer is a group of many different diseases that have some important things in common. They all affect cells, the body's basic unit of life. To understand cancer, it is helpful to know about normal cells and about what happens when cells become cancerous.

The body is made up of many types of cells. Normally, cells grow and divide to produce more cells only when the body needs them. This orderly process helps keep the body healthy. Sometimes cells keep dividing when new cells are not needed. A mass of extra tissue forms, and this mass is called a growth or tumor. Tumors can be benign or malignant.

* Benign tumors are not cancer. They often can be removed and, in most cases, they do not come back. Cells in benign tumors do not spread to other parts of the body. Most important, benign tumors are rarely a threat to life.
* Malignant tumors are cancer. Cells in malignant tumors are abnormal and divide without control or order. These cancer cells can invade and destroy the tissue around them. Also, cancer cells can break away from a malignant tumor and enter the bloodstream or lymphatic system. This process is how cancer spreads from the original (primary) tumor to form new tumors in other parts of the body. The spread of cancer is called metastasis.

Kidney Cancer

Several types of cancer can develop in the kidney. This booklet discusses renal cell cancer, the most common form of kidney cancer in adults. Transitional cell cancer (carcinoma), which affects the renal pelvis, is a less common form of kidney cancer. It is similar to cancer that occurs in the bladder and is often treated like bladder cancer. Wilms' tumor, the most common type of childhood kidney cancer, is different from kidney cancer in adults. The Cancer Information Service can provide information about transitional cell cancer and Wilms' tumor.

As kidney cancer grows, it may invade organs near the kidney, such as the liver, colon, or pancreas. Kidney cancer cells may also break away from the original tumor and spread (metastasize) to other parts of the body. When kidney cancer spreads, cancer cells may appear in the lymph nodes. For this reason, lymph nodes near the kidney may be removed during surgery. If the pathologist finds cancer cells in the lymph nodes, it may mean that the disease has spread to other parts of the body. Kidney cancer may spread and form new tumors, most often in the bones or lungs. The new tumors have the same kind of abnormal cells and the same name as the original (primary) tumor in the kidney. For example, if kidney cancer spreads to the lungs, the cancer cells in the lungs are kidney cancer cells. The disease is metastatic kidney cancer; it is not lung cancer.

Symptoms

In its early stages, kidney cancer usually causes no obvious signs or troublesome symptoms. However, as a kidney tumor grows, symptoms may occur. These may include:

* Blood in the urine. Blood may be present one day and not the next. In some cases, a person can actually see the blood, or traces of it may be found in urinalysis, a lab test often performed as part of a regular medical checkup.
* A lump or mass in the kidney area.

Other less common symptoms may include:

* Fatigue;
* Loss of appetite;
* Weight loss;
* Recurrent fevers;
* A pain in the side that doesn't go away; and/or
* A general feeling of poor health.

High blood pressure or a lower than normal number of red cells in the blood (anemia ) may also signal a kidney tumor; however, these symptoms occur less often.

These symptoms may be caused by cancer or by other, less serious problems such as an infection or a cyst. Only a doctor can make a diagnoses. People with any of these symptoms may see their family doctor or a urologist, a doctor who specializes in diseases of the urinary system. Usually, early cancer does not cause pain; it is important not to wait to feel pain before seeing a doctor.

In most cases, the earlier cancer is diagnosed and treated, the better a person's chance for a full recovery.

Preparing Healthy Meals

2007-02-10T09:58:00.000-08:00

What if I don't have time to cook?

Eating healthy doesn't have to take a lot of time. You can prepare a healthy meal just as quickly as an unhealthy one. It's just a matter of planning ahead, having the right foods on hand, and learning how to cook quick, healthy meals.

Ask friends or coworkers who eat healthfully how they manage to find time. Get family members involved and ask them to help prepare meals or do other tasks. Find a cookbook or collect recipes that feature time-saving ideas.

To make preparing meals more fun, take a cooking class with a friend or loved one. Learn to prepare healthy ethnic dishes, such as Mediterranean, Indian, and Japanese foods, that you can share with your family and friends.

Try following these tips for making fast, healthy meals and snacks:

* Buy packaged, prewashed, ready-to-eat fresh vegetables, such as baby carrots, salad mixes, and chopped or shredded broccoli and cauliflower.
* Buy packaged, presliced fruits, such as melon or pineapple.
* Find recipes using foods that don't require a lot of cleaning and preparation, such as baby carrots, cherry tomatoes, or grapes.
* Drink 100% fruit or vegetable juice as a snack.
* Blend low-fat yogurt, fruit juice, and canned or frozen fruit to make a smoothie for breakfast or a snack.
* Use frozen vegetables to make a stir fry with skinless chicken. Serve on top of a quick brown rice or whole-wheat pasta.
* Add frozen vegetables to a jar of marinara spaghetti sauce and serve on whole-wheat pasta.
* Cook potatoes or other vegetables in a microwave.
* Cook vegetables and fruits over the grill. Drizzle them with olive oil and wrap in aluminum foil. Or put them on a skewer and cook directly on the grill.
* Make a fast fruit salad with sliced bananas, apples, blueberries, and a can of mandarin oranges.

Healthy Eating

2007-02-10T09:47:00.000-08:00

How can I start eating a healthier diet?

A healthy diet includes eating a variety of foods from the basic food groups: protein, such as meat, eggs, and legumes; dairy; fruits and vegetables; grains, such as breads and pasta; and fats and sweets. As simple as this sounds, it’s not always easy to get the nutrition you need. You may eat more of your favorite foods from only one food group, and as a result, avoid others. Or perhaps you opt for convenience over quality when you are hungry.

A healthy diet requires some planning and purpose and an effort to include a variety of foods in your meals. If you look closely at how you eat, you might find you aren't getting enough nutrients because you don't get the recommended number of servings from each food groupClick here to see an illustration..

So, not only is it important to pay attention to what you eat but also to what you are missing from your diet. To accomplish this, keep a food diary of everything you eat and drink for 1 week. Pay attention to serving sizes, and check to see if you are eating a variety of foods from each of the food groups. You don't need to meet the minimum number every day, but try to get the recommended intake on average over a week. You might find that making a few small changes will ensure that you're eating a healthy, balanced diet. Or, you may find that you are missing many important nutrients.

Learn to Manage Anger

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Managing anger may be more important for younger men than older men, says Charles Spielberger, PhD, professor of psychology at the University of South Florida in Tampa. "I don't know of studies that look only at men under age 35, but a young man is dealing with a lifelong habit of anger," he tells WebMD.

He says anger involves feelings ranging from annoyance to rage and causes psychological and biological changes. Spielberger developed the widely used STAXI (State Trait Anger Expression Inventory) to assess anger and has studied the role of anger in hypertension. "Research shows it is people who are boiling inside but don't show it who are more likely to develop hypertension."

Anger can also be a personality trait. "Some people feel anger more often across a wider variety of situations. People who do this and hold it in, they're the ones in danger of hypertension."

Spielberger tells WebMD that a good anger management program can help someone lower or normalize blood pressure. It's a three-step process.

First, learn to recognize the anger and the situations that cause it. "A lot of people who feel anger frequently might not recognize it, especially low to moderate levels."

Second, analyze the situation. "If your supervisor frequently makes you and other employees angry, tell yourself 'It's not me. This person is supercritical. I'll listen to what he says, but I'm not going to blame myself for his bad disposition.'"

Third, reduce the anger. "Counting to 10 will distract you, or try muscle relaxation. If possible, avoid the situation."

What About 'White Coat Hypertension?'

If you have a physical exam that shows elevated blood pressure, your doctor might say it could be "white coat hypertension," meaning the stress of seeing the doctor caused the high reading.

White coat hypertension was once thought to be benign, but that may not be the case, says Ulrich Broeckel, who is assistant professor of medicine at the Medical College of Wisconsin in Milwaukee. He co-authored a study of 1,677 patients aged 25 to 74. The study, reported in the British Medical Journal, measured structural changes in the heart, which Broeckel says were probably related to stress and the response to stress. "We found a significant difference between people who had white coat hypertension and those who didn't. It suggests that if people have these increases in blood pressure when they see a doctor, they have them in other stressful situations," says Broeckel.

Don't Wait 5 Years

"The longer you have untreated hypertension, the more complications you get," says Broeckel. "We also know patients who had early onset hypertension and developed diabetes at an early age. It makes early diagnosis and treatment very important."

Another Complication Worth Considering

2007-02-07T18:35:00.001-08:00

If the threat of premature death from complications of untreated high blood pressure doesn't get your attention, perhaps this will: A recent study showed that men with high blood pressure were 2.5 times as likely as men with normal pressure to develop erectile dysfunction (ED). Men with prehypertension also had a higher incidence of ED than did men with normal pressure.

Michael Doumas, MD, of the University of Athens in Greece, presented the study at the American Society of Hypertension 20th Annual Scientific Meeting and Exposition. In order to assess the link between hypertension and erectile dysfunction, researchers excluded men who had a history of diabetes, heart disease, renal failure, or liver and vascular disease, which are associated with ED.

While the study of men aged 31 to 65 didn't compare younger vs. older men, the fact that more than one-third of the participants with high blood pressure had erectile dysfunction should be seen as another very good reason to seek treatment and follow doctor's orders.

Risk Factors

Young men with hypertension often have what's called "metabolic syndrome," which is known to contribute to heart disease and diabetes. It includes a cluster of risk factors found in an individual and include excess body fat (especially around the waist and chest), high cholesterol, and insulin resistance. Studies have also shown that early vertex baldness can be associated with HBP. In addition, obstructive sleep apnea and snoring are linked to HBP in men in general.

Family history plays a role, but whether its importance varies with age of onset is unknown. "From epidemiological and twin studies, estimates range from 10% to 40%," says Ulrich Broeckel, MD, who is researching the role of genetics in hypertension. The goal of research is to subcategorize hypertension in order to improve diagnosis and treatment. "We're not ready for a diagnostic test, but ultimately we'll treat patients better based on their genetic makeup."

Younger vs. Older Men With High Blood Pressure

2007-02-06T06:52:00.000-08:00

Younger men with high blood pressure typically have high diastolic pressure while older men have high systolic pressure. "In young men, the diastolic pressure rises because the heart is pumping harder," says Lackland. "In older men, the systolic pressure rises and stiffens arteries.

"Part of the problem with young men is increased body mass. Ten years ago we wouldn't have seen hypertension in the teens and 20s, but now it's increasing along with rising obesity rates. We're seeing the increase in particular in African-American men, but it affects men of all races."

Lackland, who is professor of epidemiology and medicine at the Medical University of South Carolina in Charleston, says that as with older men, treatment for younger men follows JNC 7 guidelines for lifestyle changes and medications.

The JNC 7 recommends the following lifestyle modifications for people with prehypertension as well as hypertension:

Weight reduction. Maintain a normal weight with a target body mass index (BMI) of 18.5 to 24.9.

This can result in an approximate reduction in systolic blood pressure of 5-20 points per 10 kilograms of weight loss, according to the JNC 7.

DASH (Dietary Approaches to Stop Hypertension) eating plan. Adopt a diet rich in fruits, vegetables, and low-fat dairy products. Reduce saturated and total fat. This can be expected to drop systolic blood pressure by 8-14 points.

Lower salt intake. Reduce dietary sodium to less than 2,400 milligrams or about 1 teaspoon a day. According to the JNC 7, a 1,600-milligram sodium DASH eating plan has effects similar to a single drug therapy. The approximate reduction in systolic blood pressure would be 2-8 points.

Aerobic physical activity. Engage in regular physical activity, such as brisk walking, at least 30 minutes per day most days of the week. This can decrease systolic blood pressure by 4-9 points.

Moderation of alcohol consumption. Men should limit alcohol to no more than two drinks per day. A standard drink is defined by the type of alcohol. For example, a standard drink, such as a 12-ounce bottle of beer, a 5-ounce glass of wine, or 1.5-ounce shot of 80-proof distilled spirits, has between 11 and 14 grams of alcohol. Limiting the amount of alcohol to this quantity is expected to result in a reduction in systolic blood pressure by 2-4 points.

When medications are indicated for younger men, one question is what will be the long-term effect? "We've had medications around since the 1970s, but with newer ARBs (angiotensin receptor blockers), we don't know," says Lackland. "But the benefit of keeping blood pressure to goal is so great. Without treatment, a man at [age] 30 could be facing end-stage renal disease, stroke, or heart attack."

Hypertension Serious in Young Men

2007-02-05T09:15:00.000-08:00

High blood pressure is more common in younger men, and should be taken just as serious as in their older counterparts.

You're under 35 and feel fine, yet the doctor says your blood pressure is high and you'd better come back to have it checked again. Being a red-blooded male, you figure five years will be soon enough. After all, isn't high blood pressure an old man's disease?

"Young men are less likely than older men to believe they have hypertension and less likely to go back to the doctor," says Daniel Lackland, DrPH, spokesman for the American Society of Hypertension. "Often these are patients whose blood pressure would respond to weight management and other lifestyle changes, but they're less likely to seek treatment."

Untreated hypertension damages the heart and other organs and can lead to life-threatening conditions that include heart disease, stroke, and kidney disease. It's called "the silent killer" because symptoms generally appear only after the disease has caused damage to vital organs.

"With treatment, we can truly prolong life,"

Understanding High Blood Pressure

If your blood pressure is 120/80, 120 represents systolic pressure, or the pressure of blood against artery walls when the heart beats. Eighty represents diastolic pressure, or the pressure between beats.

The Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC 7) guidelines categorize hypertension as follows:

* Normal. Less than 120/80
* Prehypertension. 120-139/80-89
* Hypertension. 140/90 (130/80 for patients with diabetes or chronic kidney disease)
* Stage 2 hypertension. 160/100

Hypertension, or high blood pressure (HBP), exists when either the systolic measurement is 140 or higher or the diastolic measurement is 90 or higher. However, in the majority of people, controlling systolic hypertension is a more important heart disease risk factor than diastolic blood pressure (except in young people under the age of 50).

There are two types of hypertension: essential, which accounts for 90% to 95% of cases, and secondary. The cause of essential hypertension is unknown, although lifestyle factors such as obesity, sedentary lifestyle, and excessive alcohol or salt intake contribute to the condition. In secondary hypertension, the cause may be kidney disease; hormonal imbalance; or drugs, including cocaine or alcohol.

According to the JNC 7, half the adult population is prehypertensive or hypertensive, and because blood pressure increases with age, most people will become hypertensive if they live long enough.