Immune checkpoint inhibitors are drugs used to treat cancer. They work by blocking the ability of cancer cells to hide from the immune system. In recent years, they are effective in treating other diseases such as multiple sclerosis, rheumatoid arthritis, and psoriasis.
However, these drugs may also cause kidney damage. This is because they prevent the immune system from attacking and killing cancer cells that are hiding in the kidneys.
What do immune checkpoint inhibitors do?
Immune checkpoint inhibitors are a class of drugs that work by targeting the immune system. They can be used to treat a wide range of conditions, including:
Rheumatoid arthritis (RA)
Chronic lymphocytic leukemia (CLL)
Melanoma and other cancers
Metastatic breast cancer
Immune checkpoint inhibitors are a type of cancer drug used to treat several types of cancer, including melanoma and lung cancer.
These types of drugs work by stopping the immune system from attacking your body’s tissues. This is great for people with trouble with their immune system because it means they don’t have to worry about their body attacking their cancerous tumors.
Unfortunately, these drugs also have some side effects that may cause problems. Here are some of the most common side effects:
Fatigue or weakness
Rash or itching
Hair loss or baldness
Nausea or vomiting (often severe)
Changes in vision
Immune checkpoint inhibitors and kidney disease.
Immune checkpoint inhibitors have been used to treat a variety of different cancers, but they are now also being tested for several other diseases. The most common use is for people with kidney disease who have failed to respond to conventional treatments.
If you have kidney disease and your doctor has recommended that you try an immune checkpoint inhibitor as part of your treatment, there are some things you should keep in mind:
You may need to take the drug for longer than expected—your doctor will monitor how well the drug works for you over time.
You will likely need to undergo additional blood tests before and after taking the drug so that the effects can be monitored carefully.
The side effects from these drugs can be severe—they include stomach ulcers, nausea/vomiting, low blood pressure, and fatal heart attacks.
Did you know that adult kidney transplant recipients with chronic rejection should limit protein intake to 0.73 ± 0.11 g/kg body weight as this may safely stabilize the glomerular filtration rate and slow the progression to kidney failure?
In a healthy individual, a protein intake of ~ 0.8 g/kg body weight per day is recommended for the general population for body weight maintenance. However, the average protein intake among patients with chronic kidney disease is 0.9 ± 0.4 g/kg body weight per day, which is higher than the guideline level. A previous study has shown that higher dietary protein levels are associated with accelerated renal function decline in dialysis patients. Therefore, further studies on the effects of dietary protein intake on the progression of chronic kidney disease and rheumatoid arthritis are needed.
The kidneys play a crucial role in maintaining normal body fluid homeostasis. The primary function of the kidney is to filter waste, excess water, and salt while retaining essential electrolytes such as sodium, potassium, and calcium. Kidney function deteriorates when there is an increase in glomerular filtration rate and the excretion of waste products increases in excess. This phenomenon is called glomerulosclerosis. Accumulation of corticosteroids (produced by autoregulatory mechanisms) inhibits the release of vasopressin from the anterior lobe of the pituitary gland
The current research on immunosuppressive protocols for kidney transplant recipients with chronic rejection does not support the restriction of dietary protein and interference with normal nutrition for patients. Researchers are working on finding a balance between recommendations mentioned in different studies.
Chronic kidney disease (CKD) is a condition in which the kidneys lose their ability to filter blood. The kidneys are two bean-shaped organs that are located just below the rib cage, on either side of the spine. They play a vital role in maintaining the body’s fluid balance and removing waste from the blood.
The most common cause of CKD is diabetes. Other causes include high blood pressure, glomerulonephritis, polycystic kidney disease, and a wide range of other diseases or conditions.
The Impact of Chronic Kidney Disease on the African American Community:
African Americans are disproportionately affected by chronic kidney disease. Black communities are more likely to suffer from chronic illness and have a lower life expectancy.
This is partly because African Americans tend to be more resistant to the progression of chronic kidney disease and thus live with it for a longer time.
Health Disparities Faced by (and Impacting) the African American Community:
The African American community faces several health disparities, with chronic illness being a major factor. This is a problem that affects not only the African American community but also the greater population. The prevalence of chronic illness in black communities has been linked to genetics and environmental factors and can be seen as a form of institutional racism.
In America, blacks are more likely to be diagnosed with heart disease, diabetes, hypertension, and stroke than whites. They are also more likely to die from these diseases than whites. In addition to this, black mothers are three times as likely to die from pregnancy-related complications than white mothers. These disparities have led many people to believe that there is an inherent bias in the health care system against people who are members of the African American community.
Strategies for Reducing Risk Factors that Contribute to Chronic Kidney Disease in the African American Population:
In the United States, African Americans have a greater risk of developing chronic kidney disease than other populations. The risk factors for CKD in minority populations are not well understood, but some studies have identified that they may include high blood pressure, diabetes, and obesity.
To reduce these risk factors, there needs to be an increase in education about the risks of CKD in minority populations. Additionally, there needs to be more research done on how these risk factors can be prevented and how this disease can be detected early on.
If you want to live a healthy life, then you must be aware of some of the habits that are damaging your kidneys.
Overusing Painkillers: Over-the-counter pain medicines, such as NSAIDs (nonsteroidal anti-inflammatory drugs) and Analgesics, may alleviate your aches and pains, but they can harm the kidneys, especially if you already have kidney disease. NSAIDs block pain signals from your brain to your body, which can damage small blood vessels in the kidneys.
Frequent use of excessive salts: Diets high in salt are high in sodium, which can increase blood pressure and, in turn, harm your kidneys.
Eating Processed Foods: Processed foods are significant sources of sodium and phosphorus. Many people who have kidney disease need to limit phosphorus in their diets.
Not Drinking Enough Water: Staying well hydrated helps your kidneys clear sodium and toxins from the body. Drinking plenty of water is also one of the best ways to avoid painful kidney stones. Those with kidney problems or kidney failure may need to restrict their fluid intake, but for most people, drinking 1.5 to 2 liters (3 to 4 pints) of water per day is a healthy target.
Missing Out on Sleep: A good night’s rest is extremely important to your overall well-being and, it turns out, your kidneys. Kidney function is regulated by the sleep-wake cycle which helps coordinate the kidneys’ workload over 24 hours.
Eating too much meat: Eating too much meat can damage your kidney too. Animal protein is known to produce high amounts of acid in the blood which can be detrimental to the kidneys and cause acidosis. Acidosis is a condition in which the kidneys cannot remove acid fast enough.
Smoking: Smoking is harmful to your health which includes your kidneys. People who smoke are more susceptible to having protein in their urine, which is a sign of kidney damage
Excessive alcohol consumption: High alcohol intake may raise uric acid generation and damage your kidneys hence it is mandatory to cut down on alcohol intake.
If you’re suffering from high blood pressure, one might wonder if you need to take medication to lower the readings. However, changing one’s lifestyle is crucial to managing high blood pressure. Maintaining blood pressure control through a healthy lifestyle may eliminate, postpone, or minimize the need for medication.
Things to do for controlling high blood pressure
Consume a balanced diet – A diet low in cholesterol and saturated fat and high in whole grains, fruit, vegetables, and low-fat dairy products can reduce high blood pressure by up to 11 mm Hg. The Mediterranean diet and the Dietary Strategy to Prevent Hypertension (DASH) diet are two examples of eating regimens that can reduce blood pressure.
Consume alcohol in moderation – It is possible to reduce blood pressure by roughly 4 mm Hg by limiting alcohol consumption to fewer than one drink per day for women and two drinks per day for males. 12 ounces of beer, 5 grams of wine, or 1 ounce of an 80-proof liquor constitute one drink. However, consuming far too much alcohol can cause a significant increase in blood pressure. Additionally, it can lessen the efficiency various drugs to lower blood pressure.
Give up smoking – Blood pressure goes up when you smoke. Smoking cessation lowers blood pressure. It may also lengthen life by lowering the probability of heart disease as well as enhancing general health.
Have a restful night’s sleep – Getting under six hours of rest each night for a few weeks might result in poor sleep quality, which can lead to hypertension. Numerous conditions, such as sleep apnea, restless legs syndrome, and general insomnia, can interfere with sleep (insomnia). If you frequently have difficulties sleeping, let your healthcare professional know. Sleep quality can be increased by identifying and treating the problem. To achieve more comfortable sleep, although, if you don’t suffer from sleep apnea and restless legs syndrome, try these easy suggestions.
If you have chronic kidney disease (CKD), you can take steps to protect your kidneys from more damage.
Maintain a healthy blood pressure level.
The most important thing you can do to treat kidney illness is to control your blood pressure. Hypertension can cause kidney injury. You can preserve your kidneys by maintaining the blood pressure at or below the level recommended by your doctor. Blood pressure will be less than 140/90 mm Hg for the majority of people.
If you have diabetes, achieve your blood glucose target.
Your specialist would also check your A1C.. The A1C complete blood count ( cbc determines your normal blood sugar level over the last three months. This test is distinct from the routine blood glucose tests you perform. The higher your A1C score, the larger your blood sugar over the last three months. Maintain a close eye on your daily blood glucose levels to help you reach your A1C target.
Assess your kidney health with the help of your medical team.
The tests used by doctors to diagnose kidney illness could also be used to detect changes in kidney function and damage. Kidney disease deteriorates with time. Ask your healthcare provider how well the test findings compare to the previous ones every time you are examined.
Take medicines exactly as directed.
Take your medicines as per your doctor’s advice.
Create a food plan with the help of a dietician.
Include physical activity in your daily routine.
Strive towards a healthy weight.
Get adequate rest.
Discover healthy coping mechanisms for stress and despair.
If you are facing these 10 Things, Get Kidney Treatment at our San Dimas, Covina, Pasadena, Upland & Ontario Clinics. Please call to make an appointment: California Kidney Specialists
Fact: Most kidney diseases are curable with timely treatment. Some kidney diseases are irreversible and progressive (progress towards end-stage renal failure), but this progression can be slowed down if the disease is detected and treated early and appropriately.
Myth: There’s nothing you can do about getting Kidney Disease
Fact: Most cases of kidney disease could be prevented.
Diabetes & High Blood Pressure cause nearly three-fourths of all cases of kidney failure. Keeping those conditions under control can help you prevent Kidney Disease
1 in 10 people will have a kidney stone, yet the great majority will never develop kidney disease. Kidney stones are rarely left untreated because they are so painful. Help prevent kidney stones by drinking plenty of water every day.
Myth: I feel fine, so I don’t need to continue with treatment
Fact: Many patients with Chronic Kidney Disease (CKD) feel very well with proper therapy, and so they may discontinue medications/treatment. Discontinuation of therapy in CKD can be dangerous., as it can lead to rapid worsening of kidney function leading to an earlier requirement for initiation of dialysis/kidney transplantation.
Myth: Kidney Transplant cannot happen before dialysis
Fact: Pre-emptive transplantation refers to kidney transplantation before a patient needs to start dialysis therapy. Patients who get a pre-emptive transplant receive their kidney when their health is generally good, which can improve new kidney function and enhance overall health and life expectancy.
Myth: No one knows what causes kidney disease.
Fact: The two most common causes of kidney disease are diabetes and high blood pressure. Both can harm your kidneys by causing damage to the tiny blood vessels in your kidneys. Many other conditions can harm the kidneys.
If you have high blood pressure, your doctor might recommend getting more exercise. While medication can help manage your blood pressure, exercise is an excellent way to help lower your blood pressure by making your heart stronger and maintaining a healthy weight.
Aerobic classes. Sign up for classes like aqua aerobics, Zumba, and a functional fitness class. When in doubt, ask your gym or rec center what classes they offer that fit your needs.
Hiking: The muscle power needed to climb a road on an incline, a hill or a mountain can help you achieve a greater level of fitness. Physical activity such as hiking can lower blood pressure up to 10 points.
Riding your bike does count if it’s done for at least 10 minutes and you’re actively pedaling. A beginner cycling class could also be a great way to get a workout scheduled into your routine.
Swimming: This form of exercise can be beneficial in controlling blood pressure in adults 60 and older, another study found. Over a period of 12 weeks, swimmer participants gradually worked their way up to 45 minutes of continuous swimming at a time. By the end of the study, the swimmers had reduced their systolic blood pressure by an average of nine points.
Brisk walking. You’ll have to walk faster than you normally walk to elevate your heart and break
All CKS Nephrologists have expertise in treating and preventing Primary/Essential and Secondary Hypertension. Our Nephrologists will work with our patients and their families to create a comprehensive plan of treatment that will include dietary counseling, exercise, and medications to optimize blood pressure control.
Hypertension, or High Blood Pressure, which if left untreated, increases the risk of your having a heart attack Get treated at our San Dimas, Covina, Pesadana, Upland & Ontario Clinics
Dietary restrictions vary depending on the stage of kidney disease.
For instance, people with early stages of chronic kidney disease will have different dietary restrictions than those with end-stage renal disease, or kidney failure.
Those with end-stage renal disease who require dialysis will also have varying dietary restrictions. Dialysis is a type of treatment that removes extra water and filters waste.
The majority of those with late or end-stage kidney disease will need to follow a kidney-friendly diet to avoid a buildup of certain chemicals or nutrients in the blood.
In those with chronic kidney disease, the kidneys cannot adequately remove excess sodium, potassium, or phosphorus. As a result, they’re at a higher risk of elevated blood levels of these minerals.
A kidney-friendly diet, or renal diet, usually limits sodium to under 2,300 mg per day, as well as your potassium and phosphorus intake.
The National Kidney Foundation’s most recent Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines don’t set specific limits on potassium or phosphorus
Potassium and phosphorus are still a concern for people with kidney disease, but they should work closely with their doctor or dietitian to determine their limits for these nutrients, which are usually based on lab results.
Damaged kidneys may also have trouble filtering the waste products of protein metabolism. Therefore, individuals with chronic kidney disease of all stages especially stage 3–5, should limit the amount of protein in their diets unless they’re on dialysis
However, those with end-stage renal disease undergoing dialysis have an increased protein requirement
Here are 17 foods that you should likely avoid on a renal diet.
Whole wheat bread
Oranges and orange juice
Pickles, olives, and relish
Potatoes and sweet potatoes
Packaged, instant, and premade meals
Swiss chard, spinach, and beet greens
Dates, raisins, and prunes
Pretzels, chips, and crackers
If you have kidney disease, reducing your potassium, phosphorus, and sodium intake can be an important aspect of managing the disease.
The high sodium, high potassium, and high phosphorus foods listed above are likely best limited or avoided.
You’re more tired, have less energy, or are having trouble concentrating. A severe decrease in kidney function can lead to a buildup of toxins and impurities in the blood. This can cause people to feel tired, and weak and can make it hard to concentrate. Another complication of kidney disease is anemia, which can cause weakness and fatigue.
You’re having trouble sleeping. When the kidneys aren’t filtering properly, toxins stay in the blood rather than leaving the body through the urine. This can make it difficult to sleep. There is also a link between obesity and chronic kidney disease, and sleep apnea is more common in those with chronic kidney disease, compared with the general population.
You have dry and itchy skin. Healthy kidneys do many important jobs. They remove wastes and extra fluid from your body, help make red blood cells, help keep bones strong and work to maintain the right amount of minerals in your blood.Dry and itchy skin can be a sign of the mineral and bone disease that often accompanies advanced kidney disease when the kidneys are no longer able to keep the right balance of minerals and nutrients in your blood.
You feel the need to urinate more often. If you feel the need to urinate more often, especially at night, this can be a sign of kidney disease. When the kidney filters are damaged, it can cause an increase in the urge to urinate. Sometimes this can also be a sign of a urinary infection or enlarged prostate in men.
You see blood in your urine. Healthy kidneys typically keep the blood cells in the body when filtering wastes from the blood to create urine, but when the kidney’s filters have been damaged, these blood cells can start to “leak” out into the urine. In addition to signaling kidney disease, blood in the urine can be indicative of tumors, kidney stones, or an infection.
Your urine is foamy. Excessive bubbles in the urine – especially those that require you to flush several times before they go away—indicate protein in the urine. This foam may look like the foam you see when scrambling eggs, as the common protein found in urine, albumin, is the same protein that is found in eggs.
You’re experiencing persistent puffiness around your eyes. Protein in the urine is an early sign that the kidneys’ filters have been damaged, allowing the protein to leak into the urine. This puffiness around your eyes can be because your kidneys are leaking a large amount of protein in the urine, rather than keeping it in the body.
Your ankles and feet are swollen. Decreased kidney function can lead to sodium retention, causing swelling in your feet and ankles. Swelling in the lower extremities can also be a sign of heart disease, liver disease, and chronic leg vein problems.
You have a poor appetite. This is a very general symptom, but a buildup of toxins resulting from reduced kidney function can be one of the causes.
Your muscles are cramping. Electrolyte imbalances can result from impaired kidney function. For example, low calcium levels and poorly controlled phosphorus may contribute to muscle cramping
If you have Some Signs of Kidney Disease then contact us. Our goal at California Kidney Specialists is to prevent Chronic Kidney Disease and slow its progression to avoid the initiation of dialysis.
Part of prevention and treatment is a specific CKD diet. We work with our patients and their families to create a comprehensive plan.
Call and make an appointment today to meet one of our Nephrologists
Our Services Office Locations: Kidney treatment in San Dimas, Kidney treatment in Covina, Kidney treatment in Upland, Kidney Treatment in Pasadena
California Kidney Specialists is one of the largest kidney care groups In Southern California with over 35 years of dedicated service & has a team of experienced nephrologists, kidney transplant specialists and kidney transplant surgeons in California.