Chronic Kidney Disease - Causes and Risk Factors

Drawing on over 30 years of medical experience, Dr. Rex Mahnensmith has served patients at the StayWell Health Center in Waterbury, Connecticut, since 2015. Dr. Rex Mahnensmith has experience treating a number of significant health conditions, including chronic kidney disease.

Chronic kidney disease, or chronic kidney failure, is the medical term used to describe the gradual loss of proper kidney function. Chronic kidney disease is a progressive condition that can culminate in a patient requiring life-saving kidney dialysis. While the effects of the disease can be mitigated and managed, particularly with early intervention, individuals should do everything in their power to maintain healthy kidney function.

Type 1 and type 2 diabetes represents one of the most common diseases that places excess stress on the kidneys. Other diseases that pose a similar threat include polycystic kidney disease, interstitial nephritis and glomerulonephritis, and vesicoureteral reflux. Physical injuries or conditions can also lead to chronic kidney disease, such as an extended blockage of the urinary tract.

Finally, a variety of risk factors can elevate a person’s chances of developing chronic kidney disease. In addition to diabetes, individuals living with cardiovascular disease are more likely to develop chronic kidney disease than those with regular blood pressure levels. Smoking, obesity, and advanced age are also risk factors.

Potential Symptoms of Chronic Kidney Disease

Dr. Rex Mahnensmith joined the StayWell Health Center in Waterbury, Connecticut, as an internal medicine physician in 2015. In this position, Dr. Rex Mahnensmith primarily diagnoses and treats patients living with chronic kidney disease.

Chronic kidney disease (CKD), sometimes referred to as chronic kidney failure, is the gradual and consistent loss of proper kidney functions, a condition that can lead to dangerous levels of fluid, electrolyte, and waste build up throughout the body. Treatment of CKD involves identifying the cause of kidney failure and taking the appropriate steps to mitigate further damage.

In the early stages, symptoms and signs of CKD can be hard to pinpoint. As the disease progresses, individuals may experience any number of non-specific symptoms, including changes in sleeping patterns, impaired mental acuity, nausea and vomiting, and hypertension. Fluid build ups in certain parts of the body can trigger additional symptoms. For example, build ups around the lining of the heart can result in chest pain, while shortness of breath may indicate fluid build-ups in the lungs.

Individuals who feel they may be living with symptoms of kidney disease should reach out to a trusted medical professional for further testing.

Researchers Create Nanoparticle for Treating Kidney Disease

Dr. Rex Mahnensmith serves as an internal medicine physician at the StayWell Health Center in Waterbury, Connecticut. Dr. Rex Mahnensmith comes to this position as the former clinical director of nephrology and the medical director of dialysis at the Yale Medical Group, where he cared for numerous patients with kidney disease.

Chronic kidney disease has traditionally been a difficult condition to treat. Conventional options have been limited to dialysis, kidney transplantation, or strong systemic medications, all of which are intensely demanding on the body. Recently, however, researchers at the University of Southern California have begun to explore the option of targeted drug delivery. 

The research team began by developing a nanoparticle known as a micelle. Created from a peptide chain that includes glutamic acids and lysine, it is 10 to 20 times smaller than the typical nanoparticle. Its size enables it to pass through the kidney filtration system, while the peptide component allows the kidneys to retain the particle instead of excreting it as waste. 

Retention of the nanoparticle by the kidneys is crucial, as it allows for the release of the drug at the site of the disease. This in turn minimizes side effects and may increase the likelihood that the drug will have its intended effects. 

In vivo testing has shown that when injected into mice, the nanoparticles concentrated in the kidneys and were safely expelled within a week. This promising result suggests that the method may be effective not only in treating disease but also in preserving other organs.

Five Life Habits That Make a Difference for Health and Survival

A graduate of Yale University School of Medicine, Dr. Rex Mahnensmith is a professor emeritus at the university, where he began teaching a clinical track more than 15 years ago. In addition, he leverages his training and experience to serve as internal medicine physician at StayWell Health Center in Waterbury, Connecticut. Also an author, Dr. Rex Mahnensmith has written a number of articles, including a piece titled Five Life Habits That Make A Difference for Health and Survival.

Public health researchers have published five habits that correlate to poor health: cigarette smoking, excessive alcohol consumption, inadequate exercise, obesity, and inadequate sleep. When it comes to the first habit, doctors recommend complete abstinence from tobacco, as toxic chemicals irritate respiratory tissues and can lead to various forms of cancer. Physicians also recommend abstinence from alcohol or consuming only moderately on occasion to avoid damage to the liver and other organs.

In terms of exercise, five days of rigorous exercise per week can help burn calories and strengthen the heart, in addition to improving circulation and reducing stress. Finally, doctors recommend maintaining a body mass index of less than 25 kg. of weight per square meter of height and getting at least seven hours of sleep per night.

Kidney Disease Causes and Risk Factors

Dr. Rex Mahnensmith stands out as the former clinical director of nephrology and medical director of dialysis for Yale Medical Group, which he served for more than 20 years. Now an internal medicine physician at the StayWell Health Center in Connecticut, Dr. Rex Mahnensmith brings an in-depth knowledge of kidney disease and its risks.

Approximately 33 percent of adults in the United States have an elevated risk of kidney disease. Patients with this condition experience a gradual decrease in the kidney's ability to filter excess fluid and waste products from the blood. As kidney function becomes severely impaired, the level of waste, fluid, and electrolytes can build up in the body to dangerous levels.

This condition typically develops in response to other conditions. Diabetes and high blood pressure are the most common root causes, but recurring kidney infections can also cause the kidneys to fail. Other causes include extended obstruction of the urinary tract, inflammation of the kidney's internal structures, and the presence of polycystic kidney disease.

Patients who have a family history of kidney disease are at higher risk of developing kidney disease. The condition is also more common in individuals of Hispanic, African-American, Asian, and Native American heritage.

Stages of Chronic Kidney Disease

As a physician and chief medical officer at the StayWell Health Center in Waterbury, Connecticut, Dr. Rex Mahnensmith draws on more than 40 years of clinical practice experience. Dr. Rex Mahnensmith served for 20 years as medical director of dialysis and clinical director of nephrology at the Yale Medical Group, through which he treated numerous patients with kidney disease.

The course of chronic kidney disease involves five stages, which differ based on the kidneys' level of function and the amount of protein in the urine. Clinicians determine the former by testing the glomerular filtration rate, or GFR, which is defined by the amount of blood that the nephrons of the kidney can filter per minute.

A person with mild symptoms of kidney disease but normal or better GFR (90 percent or greater kidney function) receives a classification of Stage 1, which suggests potential kidney damage but normal levels of kidney function. Stage 2 correlates with a reduced GFR and 89 to 60 percent kidney function.

As GFR drops and kidney function decreases, the patient progresses through Stages 3a, 3b, and 4. A patient with Stage 5 chronic kidney disease, also known as end-stage kidney disease, has complete or near-complete loss of function, to the degree that there is a dangerous accumulation of water and waste in the blood. This causes a variety of symptoms including headache, cognitive disturbances, digestive distress, and changes in skin color.

Patients who reach Stage 5 chronic kidney disease typically need intensive treatment in order to survive. This may take the form of dialysis or a kidney transplant.

Challenges to Post-Acute Care

Dr. Rex Mahnensmith is an internal medicine physician at StayWell Health Center in Waterbury, Connecticut. Over the course of his long career, Dr. Rex Mahnensmith has also served in emergency, outpatient, nephrology, and geriatric settings. While employed in skilled nursing facilities, Dr. Mahnensmith participated in post-acute rehab care. Skilled nursing facilities face several challenges in providing post-acute care to patients recently released from a hospital setting.

Many patients, upon release from the hospital, need post-acute care in a skilled nursing facility before they are able to return home. In these types of situations, additional care and rehab services are necessary. While an important part of a patient’s healing process, skilled nursing facilities face several challenges that revolve around coordination of care and conflicting orders and documentation.

In facing these difficulties, medical professionals are seeking greater coordination between general practitioners, hospitals, specialists, and other involved parties. Utilizing electronic health records can help with essential communication. In addition, emerging technologies such as tracking devices that can detect decline and medication adherence can help. 

By embracing solutions to the challenges of care coordination, the medical community at large will be able to reduce preventable readmissions, strengthen partnerships, and increase the quality of care that post-acute patients receive.