Friday, February 3, 2023

Stage 5 Kidney Disease And Congestive Heart Failure Prognosis

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Echocardiographic Findings In Relation To Cause Of Chronic Kidney Disease

No More Dialysis! Dr Michael’s Journey of Recovery From Stage 5 Kidney Failure | #EWSuccessStory

To explore any differences between different causes of ESKD, we compared patients with an aetiology of hypertension, diabetes, glomerulonephritis and polycystic kidney disease . Left atrial volume was significantly larger in patients with hypertensive nephropathy compared to the other groups. We found no difference in the number of patients with LVEF< 50%, LVEF40%, or valve disease between groups.

Table 3 Echocardiographic findings by cause of kidney disease

Heart Disease And Chronic Kidney Disease

Having chronic kidney disease means you are more likely to get heart disease. CKD can cause heart disease, and heart disease can cause CKD. In fact, heart disease is the most common cause of death among people on dialysis.

The best way to prevent heart disease is to prevent or treat the problems that can cause it, such as diabetes, high blood pressure and anemia.

Who Will Be On My Health Care Team

Youll have a whole team of trained health care providers to help you live well with kidney failure. The following people may be part of your health care team:

Nephrologist. A doctor who specializes in kidney health and oversees your treatment.

Dialysis nurse. A dialysis nurse will monitor your in-center dialysis and will see you monthly if youre doing home or peritoneal dialysis. The nurse will make sure youre taking your medicines correctly and help you find ways to lessen the side effects of dialysis. If you do home hemodialysis or peritoneal dialysis, your dialysis nurse will teach you how to set up your treatment, take care of the equipment, and watch for infections or other problems.

Transplant coordinator. A specially trained nurse who will be your point of contact, arrange your appointments, and teach you what to do before and after the transplant.

Renal dietitian. A renal dietitian is trained to help people with kidney failure. Your dietitian will help you make choices about what to eat and drink to help your treatment work better so youll feel better.

Social worker. Dialysis clinics and transplant centers have a social worker who works with people who have ESRD. Your renal social worker can help you find answers to problems such as

  • keeping a job or changing jobs
  • getting help paying for treatments
  • finding services to help with transportation or chores around the house
  • finding counseling services to deal with family problems

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Prognosis By Ejection Fraction

Ejection fraction is a measure of how much blood is pumped out of your heart each time it contracts. A healthy heart has an EF of between about 55 percent to 75 percent.

Some people with CHF have a reduced EF. This means their heart is pumping less blood out to the rest of their body than a healthy heart. Studies have shown that people who have CHF and a reduced EF have a more challenging outlook than people with CHF who do not have a reduced EF.

The exact survival rates varied among studies, but have shown that EF has an impact on prognosis. Your doctor will have the best information about how your ejection fraction can affect your prognosis.

What You Can Do

Congestive Heart Failure (CHF): Symptoms, Stages, Life Expectancy ...

Some risk factors of heart failure, like age, cant be modified. Still, people with CHF can take steps to improve the long-term prognosis. The first thing to do is to be familiar with any family history of heart disease. You’ll also want to learn about all the possible symptoms. Don’t ignore any symptom that you think is cause for concern. Tell your healthcare provider about them right away.

Regular exercise, along with managing any other health issues you may have, can also help to keep CHF under control.

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Clinical Consequence Of Findings At Echocardiographic Screening

Echocardiographic screening could potentially have an impact on management for 31 of the participating patients. Only one of the 19 patients who were found to have an LVEF40% without previously having been diagnosed with a heart failure, received both beta-blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers . Thus, 7% of the screened population would potentially benefit from early detection of systolic dysfunction and initiation of evidence- based heart failure therapy. With regards to valve disease, none of the patients who were found with previously unrecognized aortic or mitral stenosis or regurgitation in our study would qualify for valve replacement based on severity and symptoms combined. However, the findings in 13 patients who were previously unrecognized suggest that they should undergo careful clinical and echocardiographic reevaluation at regular or intensified intervals. It was not evident if and why the two patients with symptomatic, severe aortic stenosis had not been evaluated for valve replacement.

Fig. 2

Prevalence of evidence based heart failure treatment in haemodialysis patients with LVEF40%. ACE-I denotes angiotensin converting enzyme inhibitor ARB, angiotensin receptor blocker MRA mineralocorticoid/aldosterone receptor antagonist LVEF, left ventricular ejection fraction

How Long Can You Live With Stage 5 Ckd

The average length of time spent on a kidney transplant waiting list for a deceased donor kidney is three to five years.

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What Steps Can I Take To Manage Stage 5 Ckd

At Stage 5 CKD, there is usually no cure and you cannot reverse the damage to kidney function. There are treatment options for kidney failure that can help you live life.

Your doctor will recommend that you:

  • Have visits with a nephrologist to check your blood levels and overall health.
  • Meet with a dietitian to help you create and follow a kidney-friendly eating plan. Your eating plan may involve limiting certain things to prevent them from building up in your body, such as fluids, potassium, salt or phosphorus. Learn more about a kidney-friendly diet for CKD.
  • Keep your blood pressure at a healthy level. They may prescribe blood pressure medicines like ACE inhibitor and ARBs.
  • Keep your blood sugar at a healthy level if you have diabetes.
  • Be active for at least 30 minutes on most days of the week. This can be anything from walking or riding a bike to swimming or dancing.
  • Quit smoking or using tobacco.

Stage B Treatment Options

Kidney Disease Reversal: Reverse Stage 5 KIDNEY FAILURE & regain kidney function to AVOID DIALYSIS

While stage A CHF is managed with lifestyle changes, the treatment plan for stage B typically includes taking medications regularly. People at this stage should still make the same lifestyle changes as those appropriate for stage A. However, your doctor may also prescribe additional treatments such as:

  • Angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers, if you arent taking any as part of your stage A treatment plan
  • Beta blockers if youve had a heart attack and your EF is 40% or lower, if you arent taking any as part of your stage A treatment plan
  • Possible surgery or intervention as a treatment for coronary artery blockage, heart attack, valve disease, or congenital heart disease

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What Causes Heart Failure

Although the risk of heart failure doesnt change as you get older, youre more likely to have heart failure when youre older.

Many medical conditions that damage the heart muscle can cause heart failure. Common conditions include:

  • Tobacco and recreational drug use.
  • Medications. Some drugs used to fight cancer can lead to heart failure.

Effective Heart Failure And Kidney Failure Prognosis

As we had discussed the interconnection between kidney failure and heart failure, it is important to know about effective treatment for both the conditions. Ayurvedic treatment for kidney failure provided by Karma Ayurveda is working as the effective heart failure and kidney failure prognosis.

The herbal medication prescribed by Dr. Puneet Dhawan eliminates the risk of heart failure by treating kidney diseases naturally. This is the ayurvedic kidney care institution which is providing the risk-free treatment to all the kidney patients since 1937. More than 35000 kidney patients found Karma Ayurveda the optimum destination to get treated. Kidney Disease Treatment In Ayurveda

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What Is The Importance Of Ejection Fraction

Your ejection fraction is one way to measure the severity of your condition. If its below normal, it can mean that you have heart failure. Your ejection fraction tells your healthcare provider how good of a job your left or right ventricle is doing at pumping blood. Usually, your EF number is talking about how much blood your left ventricle is pumping out because its your heart’s main pumping chamber.

Several non-invasive tests can measure your EF. With this information, your healthcare provider can decide how to treat you or find out if a treatment is working as it should.

A normal left ventricular ejection fraction is 53% to 70%. An LVEF of 65%, for example, means that 65% of the total amount of blood in your left ventricle is pumped out with each heartbeat. Your EF can go up and down, based on your heart condition and how well your treatment works.

Can You Get Better After A Diagnosis Of Heart Failure

Clinical aspects of chronic kidney disease

Heart failure is a chronic, progressive condition, which means it gets worse with time. But even though it doesnt necessarily get better, managing heart failure the right way can help reduce symptoms and slow down the progression of the condition.

I try to get patients to understand that this is not a death sentence, Mountis says.

Depending on the stage and severity of condition, some individuals may need more aggressive treatment, Mountis adds. But it is very possible to live a very good life with a diagnosis of heart failure.

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What Is Heart Disease

Heart disease includes any heart or blood vessel problem that keeps your heart from pumping blood as well as it should. It is also called cardiovascular disease .

Heart disease can include:

  • Pain, numbness, weakness or coldness in your legs or arms
  • Pain in your neck, jaw, throat, upper belly area or back
  • Swelling of your legs, ankles and feet
  • Irregular heartbeats that feel fast, pounding or fluttering
  • Feeling dizzy or lightheaded or fainting

Tell your doctor if you feel symptoms because heart disease is easier to treat when it is caught early.

Kidney Disease Prognosis And Life Expectancy

Chronic kidney disease, or CKD, is diagnosed in stages ranging from 1 to 5, measured by levels of a waste product in the blood called creatine. Doctors make a prognosis by evaluating the stage of the disease along with an individuals general health and age. Stage 1 and 2 kidney disease indicates mild damage, when your kidneys are mostly healthy and still working well. Stages 3, 4 and 5 reflect a more serious progression of CKD, with different life expectancies. Kidney disease is a serious health matter, but there are effective treatments and lifestyle practices that can slow its progression. Kidney transplant can give some people a normal life expectancy.

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Congestive Heart Failure Life Expectancy

review highlights that many physicians do not feel they can confidently predict a patients clinical trajectory in a 6-month time frame.

A 2019 metaanalysis estimates that the 1-, 2-, 5-, and 10year survival rates of all-type heart failure are 87%, 73%, 57%, and 35% , respectively. However, life expectancy for a person with CHF has substantially improved over time.

A persons age at diagnosis may impact prognosis. The authors report that the 5-year survival rate for people under 65 years of age was around 79%, while the rate was about 50% for those 75 and over.

Additionally, how much blood a persons heart pumps out per beat, known as the ejection fraction , may affect life expectancy. Doctors will note a patients EF as a percentage, with a normal output falling between

40% may be at a greater risk of dying from CHF. However, a 2017 study reports that the 5-year life expectancy is poor among all patients admitted to the hospital with heart failure regardless of their EF, with the estimated 5-year mortality at 75.4%. The above 2019 meta-analysis also found no significant difference in the survival rate between patients with an EF below 40% and those with one above.

Risk factors, such as obesity, hypertension, and a poor diet may also negatively impact a persons outlook.

CHF is not curable, but early detection and treatment may help improve a persons life expectancy. Following a treatment plan that includes lifestyle changes may help improve their quality of life.

Heart Contractions And Diastolic Heart Failure

Stages of Congestive Heart Failure – Stage D (End-Stage)

When the heart muscles contract, known as the systole phase, the heart twists and closes slightly like a wringing motion.

Then, in the diastole phase, the muscle fibers relax, unwind, and stretch.

Each of these motions is essential for allowing the heart to expand and draw blood into the ventricles.

With diastolic heart failure, the second phase of a heartbeat is challenged by its

There are signs of severe cardiovascular disease.The person feels severe limitations.The person notices symptoms even when they are resting.

A doctor may use both of these methods together to classify a persons stage of heart failure.

For example, if a person is experiencing no symptoms but their ejection fraction is 45%, they are NYHA Class I, Stage B.

Several factors may lead to a person being more likely to develop diastolic heart failure.

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Help Keep Your Kidney Disease From Getting Worse

Good self-management will help you to live a long, fulfilling life and continue to do the things you love. It can also help to slow or even stop kidney disease from getting worse – and it may even stop or delay kidney failure. Good self-management starts with:

  • Controlling other health problems you may have
  • Treating complications of kidney disease
  • Managing or preventing heart disease

What Is The Life Expectancy For Stage 5 Kidney Failure Without Dialysis

Supportive, or palliative, care is the choice to not pursue treatmentin this instance, specifically dialysis. This course of action, however, will only allow you to maintain your quality of life. It will not help with nor extend your life expectancy.

Without dialysis, the life expectancy for stage 5 kidney failure is not a hard and fast answer, as it varies depending on each kidney patients unique medical history. Generally, life expectancy without dialysis can be anywhere from days to weeks, which depends on:

  • Amount of kidney function

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Nausea Or Lack Of Appetite

Nausea or lack of appetite can result from the accumulation of fluids in your abdomen.

Several of the signs and symptoms of congestive heart failure can also be associated with other diseases and medical conditions. Therefore, it is important that you see your doctor when any of them present themselves and persist.

If you are being treated for congestive heart failure and any of these signs and symptoms get worse, or if you begin to experience additional signs and symptoms, you should inform your doctor immediately. This can indicate that your heart failure is progressing and that your treatment is not working.

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Is There A Role For A Heart Transplant Or A Simultaneous Heart And Kidney Transplant

Kidney Dialysis Congestive Heart Failure

Our patient was considered for a heart transplant but because an eGFR< 2530 ml/min per 1.73 m2 or a creatinine level> 2.5 mg/dl are relative contraindications to heart transplant alone, the question arose as to whether he should receive a kidney transplant at the same time. There remains no standardized guidelines for when to perform simultaneous heart and kidney transplants, even though as many as 30% of heart transplant recipients have an eGFR< 45 ml/min per 1.73 m2 before their transplant .

Lower eGFR is a risk factor for death after heart transplant . Five years after a heart transplant alone, 11% of recipients will require RRT or have an eGFR< 30 ml/min per 1.73 m2 . The decrease in kidney function is likely multifactorial, but the kidney toxicity of calcineurin inhibitors probably plays a role. If nonreversible CKD precedes the heart transplant, it is reasonable to assume that kidney function will be more likely to progress in the setting of calcineurin inhibitor use.

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What Is An Ejection Fraction

An ejection fraction is a measurement of the blood pumped out of your heart with each beat, expressed in a percentage. It can be measured using an echocardiogram , multigated acquisition scan, nuclear stress test, magnetic resonance imaging , or during a cardiac catheterization. A normal ejection fraction is between 50% and 70%.

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End Stages Of Heart Failure: What To Expect

Congestive heart failure is one of the most common reasons for hospital admissions for senior citizens. In fact, over 5 million adults in the United States experience heart failure.

Heart failure occurs when the heart muscle becomes damaged and can no longer pump blood effectively. Although symptoms can be managed, this is a chronic condition with no cure. In time, patients will reach the final stages of congestive heart failure.

Patients in the end stages of heart failure want to know what to expect. The symptoms of end-stage congestive heart failure include dyspnea, chronic cough or wheezing, edema, nausea or lack of appetite, a high heart rate, and confusion or impaired thinking.

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