Dyad 6 guomanman and chenya

Staying Fit With Kidney Disease

Physical fitness is very important in today's world. Everyone is enjoying the benefits of greater strength and feeling better. Exercise keeps your body strong and healthy.

In the past, it was thought that people with kidney disease would not be able to join in vigorous activity. We know now that patients who decide to follow an exercise program are stronger and have more energy.

With exercise, it becomes easier to get around, do your necessary tasks and still have some energy left over for other activities you enjoy.

In addition to increased energy, other benefits from exercise may include:

* improved muscle physical functioning
* better blood pressure control
* improved muscle strength
* lowered level of blood fats (cholesterol and triglycerides)
* better sleep
* better control of body weight.

Choose continuous activity such as walking, swimming, bicycling (indoors or out), skiing, aerobic dancing or any other activities in which you need to move large muscle groups continuously.

Low-level strengthening exercises may also be beneficial as part of your program. Design your program to use low weights and high repetitions, and avoid heavy lifting.

Exercise at least three days a week. These should be non-consecutive days, for example, Monday, Wednesday and Friday. Three days a week is the minimum requirement to achieve the benefits of your exercise.

How Hard to Work While Exercising

This is the most difficult to talk about without knowing your own exercise capacity. Usually, the following ideas are helpful:

* Your breathing should not be so hard that you cannot talk with someone exercising with you. (Try to get an exercise partner such as a family member or a friend.)
* You should feel completely normal within one hour after exercising. (If not, slow down next time.) You should not feel so much muscle soreness that it keeps you from exercising the next session.
* The intensity should be a "comfortable push" level.
* Start out slowly each session to warm up, then pick up your pace, then slow down again when you are about to finish.

The most important thing is to start slowly and progress gradually, allowing your body to adapt to the increased levels of activity.

Try to schedule your exercise into your normal day. Here are some ideas about when to exercise:

* Wait one hour after a large meal.
* Avoid the very hot times of the day.
* Morning or evening seems to be the best time for exercising.
* Do not exercise less than an hour before bedtime.
Work toward 30 minutes a session. You should build up gradually to this level.

There is nothing magical about 30 minutes. If you feel like walking 45 to 60 minutes, go ahead.

When you feel these just stop:
* If you feel very tired
* If you are short of breath
* If you feel chest pain
* If you feel irregular or rapid heart beats
* If you feel sick to your stomach
* If you get leg cramps
* If you feel dizzy or light-headed.

You should not exercise without talking with your doctor if any of the following occurs:

* you have a fever.
* you have changed your dialysis schedule.
* you have changed your medicine schedule.
* your physical condition has changed.
* you have eaten too much.
* the weather is very hot and humid, unless you exercise in an air-conditioned place.
* you have joint or bone problems that become worse with exercise.
If you stop exercising for any of these reasons, speak to your doctor before beginning again.

reference

http://www.kidney.org/atoz/atozItem.cfm?id=112

RESPONSE: Kidney Stones-ACTIVITY
BY: Dyad2: Gil Legarda and Joanalyn Balino

Kidney stones removed safely by supine position
By: Jane Salodof MacNeil

MacNeil studied about the effectiveness and safety of supine position for patients undergoing percutaneous procedure. This study was carried out in quasi- experimental design. The standard in dong percutaneous nephrolithotomies is in prone position but the researchers compare the safety of prone position. This study was to prevent complications in the procedure. There were 350 patients undergone percutaneous nephrolithomies reviewed by Dr. Isabel Camargo et al. from the year 1993 to year 2004. All patients had kidney stones and will undergo percutaneous nephrolithotomies were enrolled in this study. This study was held in Galdakao Hospital in Spain. Interventions were used in this study specifically the supine position while doing the procedure. Operations lasts for about 70-180 minutes.

The most common and main complication of the procedure was bleeding in 2% of patients, these patients required nephrectomy to stop bleeding. There were no patients had damage to adjacent organs, and the sepsis rate is just 1 percent. All patients were stone free after the procedure except three of the patients included. According to Dr Camargo if patients will placed on their backs the colon is not pushed aginst the kidney and reducing the risk of colon perforation and damage to adjacent organs. Also Dr. Camargo said that patients were more comfortable and management of anesthesia is easier because the chest is not compressed.

Only few research were done regarding the safety of supine position over prone position while undergoing percutaneous nephrolithotomies. There should be an additional study of this intervention and also other nephrologist should comment or give statements regarding this intervention for the benefit of the patients and the easiness of the nephrologist while doing the procedure.

Reference:
Jane Salodof MacNeil (2006). Kidney stones removed safely by supine position Internal Medicine News, Sept 15, 2006. Retrieved July 3,2009 from

Brazilian Journal of Medical and Biological Research (2005) 38: 577-582Effect of a rehydration sports drink on urolithiasis
ISSN 0100-879X

Effect of an isotonic rehydration sports drink and exercise on urolithiasis in rats
. Bergamaschi2, 2Disciplina de Fisiologia Cardiovascular e Respiratória,
G.S. di Marco1, Departamento de Farmacologia,
C.V. Razvickas1, Universidade Federal de São Paulo, São Paulo, SP, Brasil
and N. Schor1
The objective of the present study was to evaluate the role of physical
exercise as well as the influence of hydration with an isotonic sports
drink on renal function in male Wistar rats. Four groups were studied
over a period of 42 days: 1) control (N = 9); 2) physical exercise (Exe,
N = 7); 3) isotonic drink (Drink, N = ; 4) physical exercise + isotonic
drink (Exe + Drink, N = . Physical exercise consisted of running on
a motor-driven treadmill for 1 h/day, at 20 m/min, 5 days a week. The
isotonic sports drink was a commercial solution used by athletes
for rehydration after physical activity, 2 ml administered by
gavage twice a day. Urine cultures were performed in all animals.
Twenty-four-hour urine samples were collected in metabolic cages
at the beginning and at the end of the protocol period. Urinary
and plasma parameters (sodium, potassium, urea, creatinine, calcium)
did not differ among groups. However, an amorphous material was
observed in the bladders of animals in the Exe + Drink and Drink
groups. Characterization of the material by Western blot revealed the
presence of Tamm-Horsfall protein and angiotensin converting en-
zyme. Physical exercise and the isotonic drink did not change the
plasma or urinary parameters measured. However, the isotonic drink
induced the formation of intravesical matrix, suggesting a potential
lithogenic risk.

References
1. Burke LM & Read RS (1993). Dietary supplements in sport. Sports
Medicine, 15: 43-65.
2. Colussi G, Ferrari ME, Brunati C & Civati G (2000). Medical preven-
tion and treatment of urinary stones. Journal of Nephrology, 13
(Suppl 3): S65-S70.
3. Balaji KC & Menon M (1997). Mechanism of stone formation. Uro-
logic Clinics of North America, 24: 1-11.
4. Hruska K, Seltzer J & Grieff M (1997). Nephrolithiasis. In: Schirier
RW & Gottschalk CW (Editors), Diseases of the Kidney. 6th edn.
Vol. I. Little Brown and Company, Boston, MA, USA, 739-764.
5. Bihl G & Meyers A (2001). Recurrent renal stone disease - advances
in pathogenesis and clinical management. Lancet, 25: 651-656.
6. Rodgers A, Greylihg K & Noakes T (1991). Crystalluria in marathon
runners. Urological Research, 19: 189-192.
7. Pak CY, Smith LH, Reisnick MI & Weinerth JL (1984). Dietary
management of idiopathic calcium urolithiasis. Journal of Urology,
131: 850-852.

The metabolic syndrome and uric acid nephrolithiasis:
Novel features of renal manifestation of insulin resistance
NICOLA ABATE, MANISHA CHANDALIA, ALBERTO V. CABO-CHAN, JR., ORSON W. MOE,
and KHASHAYAR SAKHAEE (2004)

The percentage of the world’s population affected by obesity is increased. This may be due to inadequate physical activity and decrease in the metabolic rate of certain individuals. This may result to an increase in insulin resistance subsequent to depression of the pancreas to release insulin for energy use. The metabolic syndrome experienced is consistently related to uric kidney stone formation and metabolic abnormalities. The study was designed to evaluate whether the insulin resistance associated with low urine pH in healthy individuals (non-stone formers) and whether the resistance in insulin may lead to uric acid nephrolithiasis. A total of 55 healthy volunteers, non-stone formers were included in the study. Most of the participants do have a large range of body mass index and 13 of the participant’s experiences recurrent uric acid nephrolithiasis. All of the participants did undergo 24-hour urine studies, and anthropometric measurement of adipose tissue component. Student t test was used for comparison of study groups. Spearman correlation coefficients were used to assess the association between continuous variables. Paired t test was used to compare means of urinary variables at baseline and during hyperinsulinemic phase of the clamps. Results are presented as mean standard deviation (SD).

A total of 3 salient findings were identified in the study. First, patients who do have low urine pH as a result of insulin resistance among obese may predispose clients to form uric acid stone. The second, there is a significant relationship among obesity-related insulin resistance to the urinary acidity of urine. Lastly, the degree of insulin resistance affects the renal acidification in non-stone former individuals.

An increasing percentage of the world’s population has characteristics of insulin resistance, as indicated by recent epidemiologic, the course in the population at risk and incidence for kidney stones may further amplify. Through this study, insulin resistance has already been identified as a predisposing factor and major potential target of intervention to either reduce risk for kidney stone formation in high-risk patients. This can also improve the clinical outcome of patients who already have kidney stones.

References:
ABATE N, GARG A, PESHOCK RM, et al: Relationship of generalized and regional adiposity to insulin sensitivity in men with NIDDM.
Diabetes 45:1684–1693, 1996

Authors and Disclosures:
NICOLA ABATE, MANISHA CHANDALIA, ALBERTO V. CABO-CHAN, JR., ORSON W. MOE,
and KHASHAYAR SAKHAEE
Department of Internal Medicine, The Center for Human Nutrition, The Center for Mineral Metabolism and Clinical Research, Division of Endocrinology and Metabolism and Division of Nephrology, University of Texas Southwestern Medical Center at Dallas, Texas
Copyright 2004 by the International Society of Nephrology