Lupus Nephritis: what Exercise Is Ok ?

Proper exercise is beneficial to the recovery of Lupus Nephritis. The patients are often accompanied by arthritis, heart problem, lung problem etc. They should avoid violent exercise and contact sports . some aerobic and mild exercise can enhance the functions of heart and liver and strengthen bones and muscles, it can prevent or relieve the complications of Lupus Nephritis remarkably. Yoga, biking, jogging are ok for them.It can improve blood circulation and enhance immunity.

Besides taking proper exercise, the patients should also pay more attention to the following items.

1. Diet

Food is a common factor in triggering the onset and relapse of lupus. Therefore, the patients should avoid the foods that cause allergy such as mango, fish, shrimp etc.

2. Avoid exposure to sunlight

Ultraviolet light can trigger the relapse of lupus activity and aggravate renal function deterioration. Therefore, the patients should avoid exposing to sunlight in hot summer. They should prepare topee, sunblocking cream and wear longsleeved clothes when going out.

3. Be alert to infections

Patients with Lupus Nephritis have to use a large dosage of hormone and immunosuppressive agents to control the disease. Meanwhile, these medicines will also weaken the immunity. The external virus, germs and other outside stuffs are very likely to invade into body thus resulting in infections. Even if a mild infection may trigger the disease. Therefore, the patients with Lupus Nephritis should be alert to infections and do their best to avoid infections.

Lupus Nephritis Photosensitivity and How to Deal With

Lupus nephritis is inflammation of the kidney that is caused by systemic lupus erythematous (SLE). Also called lupus, SLE is an autoimmune disease. With lupus, the body's immune system targets its own body tissues. Lupus nephritis happens when lupus involves the kidneys.

Have lupus, you might be photosensitive -- meaning you have an unusually strong reaction to sunlight. In fact, more than half of all people with lupus are light sensitive. More importantly, 40% to 70% of people with lupus experience an increase in lupus symptoms after being exposed to ultraviolet (UV) rays, either from the sun or from artificial light.

Photosensitive people may develop a skin rash, known as a butterfly rash, which appears over the nose and cheeks after sun exposure. Other rashes might look like hives. Sunlight may cause also a lupus flare, resulting in fever, joint pain, or even organ inflammation.

Each person with lupus may have a different level of photosensitivity – just like in the general population. If photosensitivity is a problem for you, here are some ways to protect yourself from the sun:

People with lupus should not stay in the sun for extended periods and should make every effort to avoid UV rays outside, which are at their peak between 10 a.m. and 4 p.m. Don’t be fooled by an overcast day, because clouds don’t filter out all of the sun’s UV rays. Keep track of the time you spend in the sun. It often takes two to three weeks before skin abnormalities occur from sun exposure.

Apply sunscreen liberally: It takes at least 1 ounce of sunscreen to cover your entire body. Remember to reapply frequently. Sweat, water, contact, and clothing can all rub sunscreen off. People often forget to apply sunscreen to their necks, backs, and ears, all of which are commonly affected by photosensitivity related to lupus.

People with lupus who work or spend a lot of time outside should consider wearing clothing that has built-in sun protection or using an umbrella made with special fabric designed to block UV rays. If you are fair-skinned and have light eyes and light hair, you should be even more careful when exposed to UV rays, because people with those features are more sensitive to the sun and artificial light than people who have darker hair and skin.

Lupus Nephritis Clinical Presentation

Lupus nephritis is a serious complication of systemic lupus erythematosus (SLE; lupus) and is a major predictor of poor outcome. Most commonly, lupus nephritis develops early in the course of disease, but it can be a late complication as well (called delayed lupus nephritis [DLN]). Mortality is higher for lupus patients who develop nephritis than for those who do not.

Patients with active lupus nephritis often have other symptoms of active systemic lupus erythematosus (SLE), including fatigue, fever, rash, arthritis, serositis, or central nervous system (CNS) disease. These are more common with focal proliferative and diffuse proliferative lupus nephritis.

Some patients have asymptomatic lupus nephritis; however, during regular follow-up, laboratory abnormalities such as elevated serum creatinine levels, low albumin levels, or urinary protein or sediment suggests active lupus nephritis. This is more typical of mesangial or membranous lupus nephritis.

Symptoms related to active nephritis may include peripheral edema secondary to hypertension or hypoalbuminemia. Extreme peripheral edema is more common in persons with diffuse or membranous lupus nephritis, as these renal lesions are commonly associated with heavy proteinuria.

Other symptoms directly related to hypertension that are commonly associated with diffuse lupus nephritis include headache, dizziness, visual disturbances, and signs of cardiac decompensation.

High Blood Pressure and High Creatinine

High blood pressure (hypertension) is designated as either essential (primary) hypertension or secondary hypertension and is defined as a consistently elevated blood pressure exceeding 140/90 mm Hg.

High blood pressure is called "the silent killer" because it often causes no symptoms for many years, even decades, until it finally damages certain critical organs.

Poorly controlled high blood pressure ultimately can cause damage to blood vessels in the eye, thickening of the heart muscle and heart attacks, hardening of the arteries (arteriosclerosis),hypertensive nephropathy, kidney failure, and strokes.

How to lower high creatinine effectively?

Serum creatinine is an effective measure for kidney functions. In the treatment of kidney disease, the patients are very concerned as to how to lower their elevated creatinine and stop further damage on their kidneys. The complexity of kidney diseases means that a comprehensive treatment system is required so as to control the illness condition. The people need to know the severity of high creatinine and treat their disease positively.

Work with your doctor to develop a personalized diet that is low in protein. The amount of protein you eat on this diet depends on how much you weigh, so do not attempt this diet on your own. You will also need to test frequently to be sure that the creatinine levels in your urine are increasing and the levels in your blood are decreasing. This indicates that the creatinine is being excreted properly. Doctors will prescribe Lasix, a strong diuretic, to promote urination. This is another reason a person with high creatinine levels must drink plenty of water.

We need to know why creatinine increases. Creatinine as a wasteful product should normally be discharged out of the body by the kidneys. The medicines played good role in reducing the excessive toxins such as creatinine, urea nitrogen, uric acid, etc. However, this will not help for improving or injuring the lesioned renal tissues. In long-term developing course, with scarring on the kidneys worsening and kidney condition deteriorating, serum creatinine keeps on rising and efficacy of the medicines will get reduced. Such risk factors as inflammations, cold, infections can cause rapid deterioration of kidney function and worsen the illness condition.

High Blood Pressure and Kidney Disease

How does high blood pressure hurt the kidneys?

High blood pressure makes the heart work harder and, over time, can damage blood vessels throughout the body. If the blood vessels in the kidneys are damaged, they may stop removing wastes and extra fluid from the body. The extra fluid in the blood vessels may then raise blood pressure even more. It's a dangerous cycle.

High blood pressure is one of the leading causes of kidney failure, also called end-stage renal disease (ESRD). People with kidney failure must either receive a kidney transplant or have regular blood-cleansing treatments called dialysis. Every year, high blood pressure causes more than 25,000 new cases of kidney failure.

How can blood pressure be controlled?

People with prehypertension or high blood pressure should :

• maintain their weight at a level close to normal.
• eat fresh fruits and vegetables, grains, and low-fat dairy foods.
• limit their daily salt, or sodium, intake to 2,000 milligrams. They should limit frozen foods and trips to fast food restaurants. They should read nutritionlabels on packaged foods to learn how much sodium is in one serving. Keeping a sodium diary can help monitor sodium intake.
• get plenty of exercise—at least 30 minutes of moderate activity, such aswalking, cycling, or swimming, most days of the week.
• avoid consuming too much alcohol. Men should have no more than two drinks—two 12-ounce servings of beer or two 5-ounce servings of wine or two 1.5-ounce servings of hard liquor—a day. Women should have no more than a single serving a day because differences in the way foods are broken down in the body make women more sensitive to the effects of alcohol.

http://www.kidneyabc.com/hypertensive-nephropathy/

Secondary Chronic Kidney Disease--Hypertensive Nephropathy

Even if people have had high blood pressure, they usually do not know what complications would happen in a few years. Heart disease may be the most concerned for them, but they always ignore the most fatal one—kidney disease (Hypertensive Nephropathy ). High blood pressure will narrow and harden main artery and the blood capillary. In kidneys, a large number of tiny blood vessel balls are in charge of blood filtration. Little tiny blood vessels cannot bear the high pressure, so they will become narrow in order to reduce the blood infusion. As a result, it will directly lead to the lack of blood and oxygen. Renal inflammation would occur to hurt kidney tissues.

This damaged process would last for a long time and gradually hurt kidneys. So in most time, people would have no consciousness for no obvious symptoms present in the body. "I have a strong urination at night. In the beginning, I though it may be caused more water input. Now I know it is a sign of hypertensive nephropathy."

What are the specific physical performance of hypertensive nephropathy? Specific performance:

Early nocturia increased, followed by proteinuria, individual cases have occurred hematuria, usually without low back pain. Often associated with atherosclerotic retinopathy, left ventricular hypertrophy, coronary heart disease, heart failure, cerebral arteriosclerosis, cerebral vascular accident. Malignant hypertension is associated with cardiovascular complications, the rapid development of the disease, proteinuria and hematuria, renal function rapidly diminished, and even uremia.

High blood pressure can cause complications of the heart, brain, kidney and other organs, can lead to high morbidity and mortality, 10% of the hypertensive patients died of renal failure. Therefore, high blood pressure and kidney disease is one pair of real "loser".

Hypertensive nephropathy to patients is a very serious, so in order to reduce such damage, must be timely treatment.

Could Folic Acid Cause Hypertensive Nephropathy?

What is Hypertensive Nephropathy

Hypertensive Nephropathy is a medical condition in which chronic high blood pressure causes kidney damages. As the name suggests, hypertensive nephropathy is caused by high blood pressure. Why hypertension harms kidneys? Blood pressure means the force of blood against the walls of the blood vessels. Extra fluid in the body or the narrowed blood vessel will raise the blood pressure.


What is Folic acid

Folic acid has active ingredients of folic acid. It is used in therapeutic drug levels, heart injury, folate deficiency, rheumatoid arthritis, anemia. Common side effects of Folic acid include nausea, fatigue, weakness, fever, breathing difficulty.

On Oct, 18, 2012: 80,246 people reported to have side effects when taking Folic acid. Among them, 12 people (0.01%) have Hypertensive Nephropathy.Gender of people who have Hypertensive nephropathy when taking Folic acid :

Age of people who have Hypertensive nephropathy when taking Folic acid :

Top conditions involved for these people:

• Wheezing
• Paroxysmal nocturnal haemoglobinuria
• Haemoglobin abnormal
• Diabetes mellitus non-insulin-dependent
• Thyroidectomy

High Blood Pressure (Hypertensive Nephropathy)

Hypertension is a condition when your blood pressure is recorded consistently at the level of 140/90 mmHg or higher. Most of the time, hypertension does not show any symptoms. The problem is that Hypertension is not just a cause of kidney disease, but it's also a result of damage created by the kidney disease. High blood pressure makes your heart work harder and damages your blood vessels. As the blood vessels in your heart become damaged, they lose their effectiveness in screening the wastes from your body. This increases the fluids in your body and increases your blood pressure even more.

The damage of the blood vessels in your kidneys due to high blood pressure is what is known as Hypertensive Nephropathy.

What are the symptoms of Hypertensive Nephropathy?

If high blood pressure runs in your family, the presence of the disease seems to increase chances of developing kidney disease. Symptoms of kidney disease due to high blood pressure include:

• A need to urinate more often, especially at night
• Decrease in amount of urine or difficulty urinating
• Edema (fluid retention), especially in the lower legs

What are the Types of Hypertensive Nephropathy?

There are 2 types of hypertensive nephropathy, namely benign nephrosclerosis and malignant nephrosclerosis. Benign nephrosclerosis is most present in people over 60 years old while the rare malignant nephrosclerosis occurs only in 1 to 5 percent of people with hypertension.

Malignant nephrosclerosis only occurs in a case of hypertension with diastolic blood pressure exceeding 130mm Hg. This is present in patients that already have an existing kidney disease that developed into malignant hypertension.

How is Hypertensive Nephropathy prevented?

• To prevent hypertension-related kidney damage:
• Keep your blood pressure below 130/80
• Have your blood pressure checked regularly
• Maintain a proper diet
• Take any medications prescribed by your doctor

Stage 4 Chronic Kidney Disease (CKD)

A person with stage 4 chronic kidney disease (CKD) has advanced kidney damage with a severe decrease in theglomerular filtration rate (GFR) to 15-30 ml/min. It is likely someone with stage 4 CKD will need dialysis or a kidney transplant in the near future.

As kidney function declines waste products build up in the blood causing a condition known as “uremia.” In stage 4 a person is likely to develop complications of kidney disease such as high blood pressure, anemia (a shortage of red blood cells), bone disease, heart disease and other cardiovascular diseases.

Symptoms that are experienced in stage 4 include:

Fatigue: Feeling tired is common for people with CKD and is often caused by anemia.

Too much fluid: The kidneys may lose their ability to control how much fluid stays in the body. A person may notice swelling (edema) in their lower legs, hands or face around the eyes. With too much fluid someone, could even feel short of breath.

Urination changes: Urine may be foamy if there is protein in it, or dark orange, brown, tea colored or red if it contains blood. A person may urinate more or less than normal, or get up at night to go to the bathroom.

Kidney pain: Most people with CKD do not have kidney pain, but with some kinds of kidney problems, such aspolycystic kidney disease (PKD) or infections, they may have pain in their back where the kidneys are located.

Sleep problems: Some people have trouble falling asleep or staying asleep. Itching, muscle cramps or restless legs can keep them awake.

Nausea: Vomiting or feeling nauseated may occur with CKD.

Taste changes: Food may not taste like it usually does, or may have a metallic taste.

Uremic breath: As urea builds up in the blood, it may be detected in the breathing causing bad breath.

Loss of appetite: People in this stage may not feel like eating, and some people report having a metallic taste in their mouth or bad breath.

Difficulty in concentrating: Having trouble balancing a checkbook or focusing on reading the newspaper can happen with CKD.

Nerve problems: Numbness or tingling in your toes or fingers is a symptom of CKD.

Chronic kidney disease (CKD) happens if your kidneys have been damaged. Kidneys can become damaged from a physical injury or a disease like diabetes or high blood pressure. Once your kidneys are damaged, they are not able to filter blood or do their other jobs well enough to keep you healthy. Some of the important jobs kidneys do:

• Filter blood
• Balance your body's fluids
• Regulate hormones
• Help keep blood pressure under control
• Keep bones healthy
• Help make red blood cells

Even if you get treatment in stage 4 and are careful about your health, your kidneys may still fail. Kidney failure happens when:

• 85-90% of kidney function is gone
• GFR falls below 15
• Kidneys don't work well enough to keep you alive

There is no cure for kidney failure, but with treatment it is possible to live a long, fulfilling life. Having kidney failure is not a death sentence. People with kidney failure live active lives and continue to do the things they love.


Is Kidney Failure in Your Chronic Kidney Disease(CKD) Future? Make An Estimation of Your Current CKD. http://www.kidneyabc.com/CKDQuestionnaire.html

Stage 3 Chronic Kidney Disease(CKD) Diet

In Stage 3 CKD,GFR is approximately 30-60%: GFR 45-59 (3A) or 30-44 (3B). Rememember that GFR is an estimate and may require a correction for (black) race.Developing a healthy lifestyle may be able to help prevent some long-term complications of kidney disease like bone disease or heart problems and maintain the kidney function for as long as possible.

Stage 3 chronic kidney disease is defined as having moderate kidney damage that limits some of the filtering ability of the kidneys, but doesn't necessitate dialysis. Decreasing the level of waste by making diet modifications preserves the remaining function and staves off further damage.

Protein Restrictions

Protein serves to maintain muscle mass and support your immune system. Urea is a by-product of protein breakdown by the liver. Your kidneys take the urea and produce urine for excretion of waste products. Reducing your protein intake reduces the amount of urea produced and, thus, the workload of the kidneys. However, according to DaVita, a dialysis facility for kidney failure, for stage 3, a dietitian will usually recommend eating a healthy diet with protein at the level of 0.8 grams of protein per kilogram of body weight, the same level recommended for all healthy people. One kilogram of body weight is equivalent to 2.2 lb.

Phosphorus and Calcium

Phosphorus is a mineral that works with calcium to support bone health. As your kidney function worsens, phosphorus can build up in the blood causing itchy skin and your bones to lose calcium. This stage of the diet restricts the amount of phosphorus in your diet by limiting beans, legumes, beer and dark colored carbonated beverages. Phosphorus binders can be used to remove excess phosphorus from your ingested food. These binders are usually concentrated calcium supplements because phosphorus and calcium compete for absorption in your intestines. Providing high amounts of calcium with your meals decreases the amount of phosphorus your body absorbs, thereby preventing kidney associated bone disease.

Fat-Soluble Vitamins

Fat-soluble vitamins A, D, E and K may have to be taken in water-soluble form, according to DaVita. Switching to water-soluble forms prevents buildup of these fat-soluble vitamins. Increasing the availability of vitamin D in water-soluble form is helpful as your kidneys may not be able to convert UV light into the active form of vitamin D.

Fluid Restrictions

Fluid isn't restricted on the stage 3 diet for chronic kidney disease. Your kidneys are still filtering your blood with some limitations. Stage 3 chronic kidney disease doesn't warrant a change in how much fluid and water you drink per day. If the filtration rate of your kidneys decreases, your physician may restrict how much fluid you can have per day to delay dialysis.



Is Kidney Failure in Your Chronic Kidney Disease(CKD) Future? Make An Estimation of Your Current CKD:http://www.kidneyabc.com/CKDQuestionnaire.html

CKD and Low-Potassium

Chronic kidney disease is a serious condition that occurs when your kidneys cannot filter the way they are supposed to. There are many situations that can cause kidney disease and there are various stages of this condition. Making dietary changes such as watching your potassium intake is an important step in managing CKD. Given the serious nature of CKD, check with your doctor on how much potassium you need.
Potassium and the Kidneys
Along with regulating fluid balance and removing wastes, your kidneys also regulate the amount of potassium circulating in the blood by removing excess. If the kidneys lose their ability to filter properly, potassium levels may get too high and in the later stages of kidney disease, high potassium levels can cause complications, notes the National Kidney and Urologic Diseases Information Clearinghouse. Hyperkalemia or too much potassium in the blood can lead to irregular heart rhythms, nausea, muscle weakness, numbness and tingling in various areas of your body and in severe cases it can contribute to a heart attack.
Low-Potassium Diet
Many foods contain potassium, so you will need to work closely with your doctor or registered dietitian to find the right plan. Avoid high-potassium foods such as apricots, dates, melons, oranges, artichokes, beets, potatoes and spinach, suggests the University of Michigan. Soy milk, yogurt, dried peas, beans and bran are also high in potassium. Instead, choose apples, berries, cranberries, grapes, cauliflower, corn, eggplant, lettuce and mushrooms. You can also leach foods to help remove some of the potassium from them. Because each person is different, it may take some trial and error to find the right diet to keep your potassium levels in check.

Is Kidney Failure in Your Chronic Kidney Disease(CKD) Future?

Make An Estimation of Your Current CKD. This health checker estimates the risk to develop Kidney Failure and provide some guidance for CKD patients:http://www.kidneyabc.com/CKDQuestionnaire.html

Chronic Kidney Disease and Stages

About Chronic Kidney Disease

Chronic kidney disease (CKD) is a disease whereby the kidneys have trouble removing waste products and fluid from the body. Usual causes of CKD include Diabetes Mellitus, high blood pressure and chronic glomerulonephritis. People with CKD often have no symptoms although the kidney function is severely affected.


CKD stages


The stages of CKD (Chronic Kidney Disease) are mainly based on measured or estimated GFR (Glomerular Filtration Rate). There are five stages but kidney function is normal in Stage 1, and minimally reduced in Stage 2.

The table below shows CKD and GFR for each stage:

Stage GFR* Description 1 With normal or high GFR 90+ Normal kidney function but tests show early signs of kidney damage 2 Mild CKD 60-89 Mildly reduced kidney function, test results point to some signs of kidney damage 3 Moderate CKD 30-59 Moderately reduced kidney function 4 Severe CKD 15-29 Severely reduced kidney function 5 End-stage CKD <15 or on dialysis Established kidney failure, kidney dialysis or transplant may be needed

Chronic Kidney Disease And Anemia

Usually anemia begins in the early stages of chronic kidney disease and gets worse as kidney function, also known as renal function, decreases. Anemia, when untreated, can be the cause of a poor quality of life. In some cases, people with severe anemia don’t have the energy to even get out of bed. In addition, anemia may cause heart disease, increased hospitalizations, even death. To help people with chronic kidney disease and anemia have more energy to live a better life, anemia management is part of their kidney disease treatment.


Symptoms of anemia

Most people with anemia will have one or more of the following symptoms:

• Feeling weak
• Feeling tired or fatigued
• Shortness of breath
• Dizziness
• Rapid heartbeat
• Pale skin and gums
• Inability to think clearly

If someone with these symptoms talks to his or her doctor, the doctor will perform tests to determine the level and cause of anemia.


Anemia management is an important part of improving the quality of life and health of chronic kidney disease and dialysis patients. Treating anemia in people with kidney disease helps prevent fatigue and other symptoms, improves heart health and decreases hospitalizations. Talk to your doctor or members of your health care team to learn more about anemia management.



Make An Estimation of Your Current CKD. This health checker estimates the risk to develop Kidney Failure and provide some guidance for CKD patients : http://www.kidneyabc.com/CKDQuestionnaire.html

Chronic Kidney Disease Causes Symptoms and Stages

What causes CKD?

The two main causes of chronic kidney disease are diabetes and high blood pressure, which are responsible for up to two-thirds of the cases. Diabetes happens when your blood sugar is too high, causing damage to many organs in your body, including the kidneys and heart, as well as blood vessels, nerves and eyes. High blood pressure, or hypertension, occurs when the pressure of your blood against the walls of your blood vessels increases. If uncontrolled, or poorly controlled, high blood pressure can be a leading cause of heart attacks, strokes and chronic kidney disease. Also, chronic kidney disease can cause high blood pressure.

Other conditions that affect the kidneys are:

Glomerulonephritis, a group of diseases that cause inflammation and damage to the kidney's filtering units. These disorders are the third most common type of kidney disease.

Inherited diseases, such as polycystic kidney disease, which causes large cysts to form in the kidneys and damage the surrounding tissue.

Malformations that occur as a baby develops in its mother's womb. For example, a narrowing may occur that prevents normal outflow of urine and causes urine to flow back up to the kidney. This causes infections and may damage the kidneys.
Lupus and other diseases that affect the body's immune system.

Obstructions caused by problems like kidney stones, tumors or an enlarged prostate gland in men.

Repeated urinary infections.

What are the symptoms of CKD?

Most people may not have any severe symptoms until their kidney disease is advanced. However, you may notice that you:

• feel more tired and have less energy
• have trouble concentrating
• have a poor appetite
• have trouble sleeping
• have muscle cramping at night
• have swollen feet and ankles
• have puffiness around your eyes, especially in the morning
• have dry, itchy skin
• need to urinate more often, especially at night.

Anyone can get chronic kidney disease at any age. However, some people are more likely than others to develop kidney disease. You may have an increased risk for kidney disease if you:

• have diabetes
• have high blood pressure
• have a family history of chronic kidney disease
• are older
• belong to a population group that has a high rate of diabetes or high blood pressure, such as African Americans, Hispanic Americans, Asian, Pacific Islanders, and American Indians.

Five stages of chronic kidney disease


Below shows the five stages of CKD and GFR for each stage:

• Stage 1 with normal or high GFR (GFR > 90 ml/min)
• Stage 2 Mild CKD (GFR = 60-89 ml/min)
• Stage 3 Moderate CKD (GFR = 30-59 ml/min)
• Stage 4 Severe CKD (GFR = 15-29 ml/min)
• Stage 5 End Stage CKD (GFR <15 ml/min)

Focal Segmental Glomerulosclerosis (FSGS)

Focal Segmental Glomerulosclerosis (FSGS) is a disease that affects the kidney’s filtering system (glomeruli) causing scarring and loss of large amounts of protein in the urine. FSGS is a common cause of nephrotic syndrome.

What causes FSGS?

There is no single cause of FSGS. When the cause is not known it is called idiopathic or primary FSGS. In some patients FSGS may be the result of a genetic or inherited disease, an infection such as parvovirus or HIV/AIDS, or other kidney diseases that lead to scarring.

What are the symptoms?

Many people with FSGS have no symptoms at all. The most common complaint is edema, or swelling, especially in the legs. Often patients find that their shoes no longer fit, or that they have suddenly put on weight. High blood pressure, or hypertension, is also a very common finding. The hypertension in people with FSGS can often be very difficult to treat.

FSGS can also cause abnormal results in two different routine laboratory tests ordered by your doctor. The first is a test of kidney function called “creatinine." It is measured by taking a blood sample. Everyone has a certain amount of a substance called creatinine floating in his or her blood. This substance is always being produced by healthy muscles, but since the kidneys constantly filter it out the level of creatinine stays low. When the filters become damaged, the level of creatinine left in the blood goes up. A higher level of creatinine alerts the doctor that the kidneys aren’t filtering as well as they should.

The second test is for protein in your urine. Urine normally contains only a very small amount of protein. It is just too big to pass through the filters. But when the filters become scarred or damaged, they can “leak” protein into the urine. If a doctor finds too much protein in your urine, it usually means something is wrong with the filters. Some people with a large amount of protein in their urine say that their urine looks “foamy”, like bubbles built up in dishwater.

None of the above symptoms, or even all of them together, is specific for FSGS. If you or your doctor are concerned about FSGS, the only way to know for sure is to have a kidney biopsy.

How is FSGS diagnosed?

With information obtained from blood tests, urine tests and a kidney biopsy, a physician can determine if a person has FSGS.

Autosomal dominant PKD (inherited)

Polycystic kidney disease (PKD) is a genetic disorder characterized by the growth of numerous cysts filled with fluid in the kidneys. These cysts can reduce the kidney's ability to function, leading to kidney failure.

There are three major types of PKD:

• autosomal dominant PKD (inherited)
• autosomal recessive PKD (inherited)
• acquired cystic kidney disease, or ACKD (non-inherited)

Autosomal dominant PKD (inherited)

This is the most common inherited form of polycystic kidney disease, accounting for about 90 percent of all PKD cases.

"Autosomal dominant" means that if one parent has the disease, there is a 50 percent change that the disease will pass to your child, and that both girls and boys are equally affected.

In 25 percent of cases, there is no family history of PKD. You would not be at increased risk of having additional children with PKD, but your child with PKD would have a 50/50 chance to pass the gene on to her children.

Autosomal dominant PKD is often called the adult polycystic kidney disease.

What are the symptoms of autosomal dominant PKD?

• Symptoms usually develop between the ages of 30 and 40 (but they can begin as early as childhood), and may include:
• abdominal pain
• detectable abdominal mass
• pale color to skin
• bruise easily
• high blood pressure
• kidney stones
• aneurysms (bulging of the walls of blood vessels) in the brain
• diverticulosis (pouches in the intestines)
• urinary tract infections
• hematuria (blood in the urine)
• liver and pancreatic cysts
• abnormal heart valves

Autosomal dominant PKD may occur with other conditions including:

• Tuberous sclerosis - a genetic syndrome involving seizures, intellectual disabilities, benign tumors, and skin lesions
• Liver disease
• Severe eye problems (cataracts or blindness)