I discovered that I had chronic kidney disease by chance when I was called in for a flu vaccine. I’m 64 years old. The GP informed me that I was eligible for the vaccine due to my kidney problem, which he referred to as CKD 3a. This condition had been detected in routine blood tests a year earlier. I asked why I hadn’t been informed earlier, and the GP explained that he didn’t want to worry me. A nurse also gave the same explanation, but it has been bothering me. Is there anything I should be doing?
There are likely many people who are unaware that they have been diagnosed with chronic kidney disease (CKD).
It’s important to understand that despite the alarming name, CKD is not always a significant condition. Doctors often view it as a risk factor for other health issues rather than a disease in itself.
However, your GP should have definitely informed you about the diagnosis.
CKD is essentially a decline in the kidneys’ ability to filter blood, which tends to occur with age. It is often associated with conditions such as high blood pressure, type 2 diabetes, heart disease, and obesity.
It is important to be aware of CKD as it can worsen and increase the risk of heart disease.
CKD 3a is the earliest stage, indicating a consistently mild reduction in kidney function. Stage 4 is severe, while stage 5 indicates kidney failure.
Treatment for CKD 3a involves monitoring the kidneys to ensure they are not deteriorating and regularly checking blood pressure to prevent damage from other conditions.
This can be achieved through annual urine tests, monitoring for diabetes, treating underlying high blood pressure, and possibly considering a cholesterol-lowering statin due to the risk to the heart.The importance of a healthy lifestyle cannot be overstated. It is crucial to avoid smoking, maintain a balanced diet, limit salt intake (less than 6g per day according to the NHS), and engage in regular exercise.
Individuals with chronic kidney disease (CKD) must also be cautious about certain medications and supplements. Anti-inflammatories like ibuprofen should be avoided, as well as protein supplements and herbal remedies, as they can potentially harm the kidneys.
People with CKD are at a higher risk for flu and Covid, so it is essential for them to stay up to date with vaccinations.
A concerned individual asks about the safety of taking the antidepressant citalopram while trying to conceive. The advice given is that the risks and benefits of medication must always be considered, especially for pregnant women. Citalopram, an SSRI, is generally safe to take during pregnancy and does not pose a significant risk to the developing child. While some studies have linked SSRIs to premature and low-birth weight babies, it is unclear whether this is directly caused by the medication.
The individual also inquires about the appropriateness of prescribing antibiotics to their late mother, who ultimately passed away from C. diff. C. diff is a bacterial infection that causes diarrhea. The use of antibiotics in this case may not have been appropriate, as they can disrupt the natural balance of bacteria in the gut and potentially worsen the infection. However, it is impossible to say for certain whether withholding antibiotics would have saved the individual’s mother’s life.Dr Cannon’s replies should be understood in a general context and she does not engage in personal correspondence.
For elderly and frail individuals, gut problems like this can have serious consequences, leading to dehydration and kidney damage. This is more likely to occur in patients who have been on strong antibiotics, as these drugs not only kill bacteria but also deplete the healthy ones in the gut, allowing C. diff to take hold. Outbreaks of C. diff are often seen in old people’s homes and hospital wards.
The NHS has made significant efforts to prevent C. diff through careful antibiotic prescribing and strict hygiene and isolation measures in hospitals.
Unfortunately, recent statistics show that over 13% of people with C. diff die, with the highest mortality rates observed in those over 85.
Treating C. diff involves the use of specific antibiotics provided by a hospital microbiology team. It is also important to consume plenty of fluids and discontinue other medications that can affect the gut or hydration levels. This may include stopping certain high blood pressure treatments and stomach acid suppressants like omeprazole.
It is advised not to use any anti-diarrhea medications, including over-the-counter options like loperamide (Imodium).
Drug regulators have approved the use of anastrozole, a medicine that lowers estrogen hormone levels, for women with a high genetic risk of developing breast cancer.
While this may seem like good news, anastrozole does have significant side effects. Due to my family history, I am one of the 250,000 women in the UK who could benefit from this decision. However, I am hesitant to take a tablet that could induce early menopause and increase the risk of osteoporosis, among other side effects.
I would like to hear your thoughts. Would you take anastrozole to prevent breast cancer? Have you taken it and experienced any adverse effects? Please email me at the address below.
Physiotherapy sessions can be prescribed for various ailments.Physios assist with recovery from injuries, joint replacements, and stroke rehabilitation. Some specialize in working with disabled individuals, while others address incontinence and pelvic problems. Although not universally agreed upon, I view this as a positive development. On social media, I have observed doctors debating the measurable benefits of physiotherapy and the conflicting advice provided by physios regarding treatment. I am curious about your personal experiences. Did physiotherapy prove helpful or merely pointless? Please email me at the address provided on the right.
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