Tips for maintaining good kidney health

Urological Health

How can one examine the condition of their kidneys? 

These are two straightforward exams.

The kidneys, along with the heart and brain, are essential to your survival. These two little organs in your lower back, about the size of a fist, are extremely important because they filter out excess fluid and waste. Additionally, they maintain a healthy blood pressure level. Most people are curious about their blood pressure and cholesterol levels. Individuals need to be aware of their kidney health and any signs of chronic renal disease.

Safeguard the kidneys

Chronic kidney disease (CKD) occurs 

•  The kidneys fail to sufficiently filter blood.
• The kidneys have incurred damage. 
• This condition is often attributed to diabetes. 

Diabetics in India often have this condition. According to research, about 20% of diabetics experience chronic kidney disease (CKD), which suggests that the condition is underdiagnosed in our nation. According to another estimation, the chronic illness affects around one-eighth of the population.

Why is understanding kidney health crucial?

• A diagnosis of chronic kidney disease (CKD) indicates 
• You have been experiencing renal problems for at least a few months. 
• Chronic renal disease can develop slowly and unnoticeably. 
• Dialysis and kidney transplants are common treatments for these patients.
• A gradual decline in kidney function could go undetected for a long time. 

When people learn they have chronic renal disease (CKD), it is usually after it has progressed to a stage when preventative treatment is no longer an option.  That's why it's crucial to be aware of your kidney stats.

Two key indicators for renal disease detection

* The estimated Glomerular Filtration Rate (eGFR) and the urine Albumin-Creatinine Ratio (uACR) are two important tests used to diagnose kidney disease. A blood test measures eGFR, while a urine test measures uACR. eGFR measures the efficiency of the kidneys in filtering blood, while uACR indicates the presence of albumin in the urine, which could indicate kidney impairment.

eGFR

* We compute eGFR using steady serum creatinine levels at least once a year, especially in all diabetic patients. Serum creatinine alone is not a reliable indicator of eGFR. Muscle mass and age, sex, and race are associated variables that influence serum creatinine. People whose creatinine levels fluctuate a lot, have very large or very little muscle, or have changed their eating habits should not use eGFR.

uACR

* Essentially, a uACR test tells the doctor or physician the amount of albumin that goes into your urine in 24 hours. Results of 30 or above for urine albumin indicate the possibility of kidney disease. You can repeat the test to confirm the results. To identify and track kidney impairment in individuals with type 1 diabetes who have had the disease for five years or longer or with type 2 diabetes, it is necessary to get urine albumin excretion tested annually. When a patient's clinical status changes or after therapeutic interventions, it may be necessary to monitor them more frequently.

* In addition to your kidney statistics, your doctor will take a picture of your urinary system and kidneys using imaging techniques, including CT scans and ultrasounds, as well as your medical history. This is how a thorough evaluation might help diagnose or rule out chronic kidney disease.

* Both patients and the healthcare system in India are feeling the effects of the increasing incidence of chronic renal disease. The increasing number of cases of chronic kidney disease (CKD) in the nation is putting a strain on healthcare systems, which must be addressed by increasing public awareness of the disease and encouraging screening for early detection. 

There is good news: People with chronic renal disease can have a very bright prognosis when the disease is detected early and treated appropriately.

Are there changes in skin tone, dryness, and edema? 

Quick action is required to treat your kidneys.

• You can damage your kidneys by drinking alcohol, eating processed foods, eating too many sweets, and not getting enough sleep. 
• Nevertheless, it is common to disregard the skin symptoms or other indicators of a kidney disease until the condition worsens.
• You must not disregard any of these skin-related symptoms that may indicate a sick kidney.

Severe Dehydration

Although changes in the weather can cause dry skin, this symptom, if it persists for an extended period of time, could indicate that your kidneys require immediate medical attention. Dialysis patients are at increased risk for developing skin dryness, scaliness, crackiness, and tightness, all of which are signs of end-stage kidney failure.

Also, read https://kidneyfailurerisk.com/.

Dermatitis and blisters

• Additionally, skin lesions like rashes and blisters can indicate a serious renal condition. When the bean-shaped organs in your body aren't working properly, it might cause certain rashes. Clusters of tiny, dome-shaped pimples that are exceedingly irritating develop into a rough patch on certain people.
• People with renal disease often experience blisters on their skin, which can spread to their hands, feet, and face. These blisters can become crusted and leave scars.

Increase in size

Swelling is an indication of slow kidney function. When your body is unable to eliminate toxins and retains excess fluids, including salt, you may see swelling in many parts of your body, including your feet, legs, hands, and perhaps even your face. Another symptom of kidney disease is a swollen appearance around the eyes.

Variations in Skin Tone

Your kidneys' inability to filter your blood properly as your disease progresses allows toxins to remain in your bloodstream, which eventually changes your skin tone. Consequently, a severe case of renal disease is characterized by a grayish or yellowish skin tone.

Ditch Pain

Maintaining healthy bones relies heavily on kidney function. When they aren't functioning correctly, they lead to subcutaneous calcium deposits, which primarily impact the fingers, knees, and elbows. When your kidneys aren't working right, you may notice an increase in the amounts of minerals like sodium and phosphate, which the body needs to keep in check.

Tips for maintaining good kidney health

In observance of World Kidney Day, doctors stated that screening is important since kidney disease often goes undiagnosed for longer periods, delaying treatment and potentially leading to life-threatening complications.

* A vital function of the body is that of the kidneys. It aids in regulating blood pressure, preserving bone health, and keeping hemoglobin normal (crucial for delivering oxygen in the blood from the lungs to the tissues), among other things. They also clean the blood of different metabolic waste products.

* Kidney disease is characterized by a wide range of symptoms, including but not limited to extreme weariness, irregularities in urine production, edema of the face and feet, and high blood pressure.

* In its early stages, kidney illness may not cause any symptoms at all. However, after the disease progresses, symptoms may become apparent. Indraprastha Apollo Hospital's Director and Head of Nephrology and Kidney Transplant, Dr. Amit Gupta, told IANS that patients often don't have symptoms until the disease has progressed.

* Because kidney disease often goes unnoticed for a longer period, the phrase "kidneys can be a silent killer" describes it well. Dr. P.N. Gupta, Director and Head of Nephrology at Paras Hospitals in Gurugram, noted that normal and regular investigations can discover kidney illness early on, allowing for management before it negatively impacts the patient's health.

* The main causes of chronic kidney disease (CKD), which is characterized by the gradual failure of the kidneys for months to years, are hypertension and diabetes. People who have a higher risk of developing chronic kidney disease (CKD), such as those with a family history of the disease, a history of diabetes or hypertension, or who use opioids often, should be "screened regularly."

Blood and urine tests should be done every 6 to 12 months for those at risk of renal problems, according to Gupta.

* "About half of the patients with diabetic retinopathy (DR), a complication of diabetes that impacts the eyes, also have chronic kidney disease (CKD)," says Dr. Parth Rana of Netralaya Hospital in Ahmedabad.

* Over 62% of chronic kidney disease (CKD) cases in India are attributable to diabetes, and among Indians with diabetes, 18% get diabetic retinopathy in urban areas.

* Disease duration is inversely related to the prevalence of chronic kidney disease and diabetic retinopathy. Additionally, Rana told IANS that diabetic retinopathy might happen before chronic kidney disease starts or gets worse because both conditions share similar risk factors like smoking, poor blood sugar control, high blood pressure, or unhealthy cholesterol levels.

* He elaborated by saying that damage to the body's small blood vessels caused by high sugar levels is a common thread between CKD and diabetic retinopathy.

* There is an increased incidence of age-related eye disorders in patients with CKD. The most common causes of blindness in middle-aged and older individuals are age-related eye illnesses, including glaucoma, cataracts, retinopathy, and age-related macular degeneration.

* In addition, COVID exacerbated renal disease in people who were already experiencing it. Kidney failure is associated with an increased incidence of severe COVID-19, according to multiple studies.

* Others demonstrated that dialysis patients are more likely to have less robust antibody responses following immunization.

* Dr. Salil Jain, director and head of the nephrology clinic at the Fortis Memorial Research Institute in Gurugram, said, "It is well known that patients with CKD are at higher risk of morbidity and mortality secondary to COVID-19 infection."

* "There was approximately a 30 percent mortality rate in patients on hemodialysis during the second wave as compared to a normal population where the mortality rate was 10 percent," according to him.

* Hemodialysis removes excess fluid, salt, and waste from the blood when the kidneys can no longer perform their filtration function properly.

Conclusion

Drinking lots of water, avoiding painkillers and traditional drugs, controlling blood pressure and diabetes, quitting smoking, reducing sodium intake, and maintaining physical activity are key preventive measures against kidney illness.

No need to panic if urine is pink or red

No need to panic if the urine is pink or red. 

Urological Health

Hematuria ( Blood in urine)

Urine with red blood cells is called hematuria.

Bloody urine is common. It may not change your urine color, so you may not notice. pee tests can help your doctor identify minute amounts of blood in your pee.

Hematuria—pink or red urine—may suggest a more serious health issue. Consult a doctor.

Microscopic hematuria

Two primary types:

1. Gross hematuria: Pink, crimson, or cola-colored urine.
2. Microscopic hematuria: Blood only appears under a microscope.

Gross hematuria

Crimson blood cells make urine pink, crimson, or cola-colored. You can observe it with your naked eyes, and while it may be frightening, it is not unpleasant.

Key gross hematuria features:

• Urine may turn pink, crimson, or brown.
• Urination can be painful due to blood clots.
• Not always painful: Unless clots obstruct urine flow or there are stones or infections, it may not hurt.

The next step:

Contact a doctor if gross hematuria is present. They may suggest:

• Urine culture/analysis
• CT or ultrasound imaging
• cystoscopy (bladder inspection)

Hematuria causes

Blood in the urine has many causes, from mild to severe. An organized breakdown will help you understand

Common Hematuria Causes:

* Infections

• Urinary tract infections often affect women, leading to symptoms such as burning, urgency, and murky or bloody urine.
• Pyelonephritis-related fever, back discomfort, and malaise are common.
• Stones: Sharp crystals can irritate the urinary system lining, causing apparent or microscopic bleeding.

*Trauma or exercise is a common cause.

• Accidents or contact sports cause kidney or bladder injuries.
• In rare cases, long-distance running can produce transient hematuria (dubbed “runner’s hematuria”).

* Structure or function issues are also a common cause.

• Enlarged prostate (BPH): Common in older men; can block urine flow and bleed.
• The kidneys' filtering units are inflamed.
• Polycystic kidney disease causes cysts and bleeding and is hereditary.

* Cancer:

• Cancer can affect the bladder, kidney, or prostate, especially in individuals who are older or smokers. 
• Pee testing detects these cancers painlessly.

Medication and Substances

• Blood thinners (warfarin, aspirin)
• Antibiotics like penicillin
• Cyclophosphamide (chemo)

Other reasons

• Women's endometriosis can affect the bladder or ureters.
• Disease or trait: sickle cell
• Radiotherapy can irritate the bladder lining.

Note: Beets and phenazopyridine can cause crimson urine.

Hematuria therapy

Hematuria is a symptom, not a diagnosis; thus, its treatment depends on its etiology. This systematic overview will help.

• Treatment Options: Cause-Based Approach
• Infection of the urinary tract-Antibiotics to cure the illness
• Stones in the bladder or kidney-Management of pain, hydration, or lithotripsy to break up stones
• An enlarged prostate-Treatment with alpha-blockers or surgery if severe.
• Glomerulonephritis—In advanced cases, immunosuppressants, blood pressure management, or dialysis
• Bladder, kidney, prostate cancer-Stage- and type-specific surgery, chemotherapy, radiotherapy, or immunotherapy
• Injury or trauma-Observation or surgery, depending on severity
• Caused by exercise-Usually resolves with rest.
• Medication—Drug adjustment or cessation under medical supervision

Supportive Measures

• Fluid intake helps flush the urinary tract.
• Avoid irritants: Limit caffeine, alcohol, and spicy meals if symptoms worsen.
• Monitoring: Urine tests or imaging may be needed for resolution.

In Cases Without Cause

Sometimes the cause is unclear. In such cases:

• Regular monitoring is advised, especially for cancer risk factors.
• Periodic urine testing, imaging, or cystoscopy may be indicated.

Hematuria ICD-10

Hematuria is coded R31 in ICD-10, which encompasses different blood in urine. A breakdown:

• ICD-10 Codes for Hematuria: Code Description
• R31.0: Gross hematuria (blood in urine) R31.1: Benign essential microscopic hematuria
• R31.21: Asymptomatic microscopic hematuria R31.29: Other little hematuria
• R31.9 Unspecified hematuria

This documentation and the billing code assist in the diagnostic evaluation process. Acute cystitis with hematuria may require a distinct code, such as N30.01.

Microscopic hematuria

Microscopic hematuria is blood in the urine that can only be seen under a microscope or in a lab-tested urine dipstick test.

What It Means

• Defined as 3 or more RBCs per high-power urine microscopy field.
• Urine looks normal; therefore, it's typically found during routine checkups or unrelated tests.

Common Reasons

• Urinary tract infections
• Stones in the kidney or bladder
• Men's BPH
• Hard exercise (particularly long-distance running)
• Menstruation or external genitalia pollution
• NSAIDs, anticoagulants, and antibiotics
• Urethral strictures, glomerulonephritis, or chronic kidney disease
• Rare bladder, kidney, and prostate cancers, especially in younger persons

Strategy for Evaluation

• Urinalysis should be repeated if the initial test was during menstruation or illness.
• If you're over 35, smoke, or have other risk factors, imaging and cystoscopy may be required.
• No clear cause? Monitoring often follows.

What are the symptoms?

Usually asymptomatic, although pain, fever, or frequent urination may indicate a problem.

Does hematuria affect women?

Female hematuria can have many reasons, some of which are unique to female anatomy and others shared by all genders. Here's how it breaks down:

* Infections of the bladder

• Urethral shortening is the main cause in women.
• Symptoms: burning, urgency, murky, foul-smelling urine, and pelvic pain.
• Stones in the kidneys or bladder
• Crystals can irritate the bladder lining.
• Pain, frequent urination, and blood may occur.
• Either menstruation or vaginal bleeding
• Blood from the vagina, cervix, or uterus may mix with urine, simulating hematuria.
• It's crucial to distinguish urinary bleeding from contamination.
• Endometriosis is the growth of endometrial tissue in the bladder or ureters.
• Cyclic hematuria, pelvic discomfort, and urinary symptoms can result.

Hematuria from Exercise

• Hematuria often occurs after intense physical activity such as long-distance running or cycling.
• Usually, the condition self-corrects.

Sexual or Traumatic Experience

• Urethral or bladder irritation might cause bleeding.

* Medications

• Aspirin, warfarin, NSAIDs, and antibiotics can induce bleeding.
• Glomerulonephritis or Kidney Disease
• Microscopic or gross hematuria can result from the kidney filter.

*Cancer

• Although it is rare, bladder or kidney cancer can lead to painless hematuria in older women and smokers.

Also, read https://www.pvurology.org/hematuria.php

Diagnosis

Hematuria is diagnosed step-by-step to determine the reason for blood in the urine, whether visible or microscopic. How doctors usually do it:

(1) Urinalysis

Perform a dipstick test for blood, proteins, or infections.

Microscopy: Verifies red blood cells and casts, crystals, and microorganisms.

(2)  Medical History and Physical Exam

• Smoking, recent infections, trauma, drugs, and family histories of kidney disease or cancer are risk factors.
• Women use this test to distinguish between urinary bleeding and vaginal bleeding.

(3)  Imaging Tests 

• These tests visualize the urinary tract and inspect its structure.
• Ultrasound benefits the kidneys and bladder without radiation.
• CT scans are effective for spotting stones, malignancies, and bleeding.
• In certain circumstances, physicians utilize MRI for soft tissue detail. 

(4) Cystoscopy

• The urethra inserts a narrow camera tube into the bladder.
• It is used to detect bladder cancers, stones, and inflammation.

(5)  Urine Cytology

• Urine tests are conducted to detect abnormal or malignant cells.
• The test is particularly helpful in cases of suspected cancer.

In Cases Without Cause

• If all tests are normal, the cause of hematuria may be idiopathic. In such cases:
• Monitoring is advised, especially for cancer risk factors.
• Testing can occur every 6–12 months.

Would you like a diagram of how doctors prioritize tests?

Test and blood in the urine

Testing and treating hematuria—blood in the urine—requires precise diagnosis and treatment. A clear breakdown:

• Tests for Blood in Urine
• Urinalysis
• A dipstick test detects blood, protein, or illness.
• RBCs, crystals, bacteria, and casts are detected by microscopic investigation.

Health history and exam

• Doctors inquire about symptoms, infections, drugs, trauma, and kidney disease or cancer in the family.
• Imaging Tests
• Cystoscopy
• A narrow camera-equipped tube is introduced into the bladder to detect tumors, stones, and inflammation.
• Urine Cytology
• Urine tests for abnormal or malignant cells.

The treatment for blood in the urine varies based on its underlying cause.

• The treatment for UTI is antibiotics.
• Hydration, pain relief, or lithotripsy for kidney/bladder stones
• BPH: Enlarged prostate. Medications or surgery to reduce the prostate
• Blood pressure management, immunosuppressants, or dialysis for severe kidney disease
• Stage-based surgery, chemotherapy, radiation, or immunotherapy for bladder, kidney, or prostate cancer.
• Exercise-induced Hematuria usually fixes it.
• Medication-related: Drug adjustment or discontinuation under medical supervision
• If no reason is established and no risk factors exist, monitoring may be enough.
• Many advise monitoring.

If risk factors like smoking or age are present, urine testing or imaging may be repeated.

Conclusion

Hematuria is a symptom, not a disease, indicating a urinary tract or kidney issue. 

While infections, exercise, and minor trauma can be cured or may resolve on their own. Kidney disease and cancer necessitate further investigation and personalized treatment. The managerial secret is identifying the cause through urinalysis, imaging, and maybe cystoscopy. Treatment can be customized, ranging from antibiotics and water to surgery or long-term monitoring.  A timely review can transform a red warning into a manageable or even curable issue. 

Chronic kidney disease needs immediate attention.

Urological Health

How is chronic kidney disease defined? 

In chronic kidney disease (CKD), the kidneys lose their ability to filter waste and excess fluids from the bloodstream. Kidney function gradually declines over months or years and is usually permanent. 

Chronic kidney disease

Clearer breakdown:

• Medical Definition

The definition of CKD is

• Reduced kidney function, as shown by a GFR below 60 mL/min/1.73 m.
• Signs of kidney disease include proteinuria and structural problems.

For 3 months or more

• This is important because when kidney function declines:
• Body waste builds up
• It causes a fluid and electrolyte imbalance.
• It can cause high blood pressure, anemia, bone disease, and cardiovascular difficulties.

The five stages of CKD are based on GFR, with Stage 1 being moderate and Stage 5 indicating kidney failure (end-stage renal disease).

What is stage 4 renal disease? 🧬 

Stage 4 Chronic Kidney Disease (CKD) severely damages the kidneys, causing them to function at 15–29% of normal. This final stage before renal failure (Stage 5) involves close medical monitoring and lifestyle changes to limit progression.

🔍 Key Features: eGFR: 15-29 mL/min/1.73 m²; Duration: 3 months minimum. Severity: Significant renal function loss

Common Symptoms

• Fatigue and weakness
• Leg, ankle, or hand swelling
• Nausea, vomiting
• Appetite loss
• Concentration issues
• Urination changes (frequency)
• Shortness of breath or chest pain
• Dry, itchy skin
• Anemia (low red blood cell count) is a potential complication.
• High blood pressure
• Mineral and bone issues
• High potassium, for example)
• Heart disease risk rises dramatically.

Strategies for Management

• Nephrology visits (quarterly or more)
• Reduced sodium, potassium, and phosphorus diet
• Medication for blood pressure, anemia, and other issues
• Dialysis or transplant preparation, if needed
• Proactive care can avoid renal failure in stage 4.

Chronic renal disease signs

Early-stage chronic kidney disease (CKD) generally develops silently. Many people fail to notice symptoms until the condition progresses. What to look for:

• Common CKD symptoms include fatigue and weakness from anemia or toxins.
• Swelling—especially in legs, ankles, feet, or eyes
• More frequent, less frequent, frothy, or dark urine
• Shortness of breath—from lung fluid or anemia
• Chronic itching—from blood waste buildup
• Later-stage nausea or vomiting
• Loss of appetite—often with weight loss
• Electrolyte abnormalities cause muscle cramping.
• Lack of focus—linked to toxin accumulation and anemia
• Hypertension—a cause and sign of CKD

Why Symptoms Are Often Ignored

Early symptoms (1–2) may be minor or nonexistent. This is why CKD is known as the "silent" disease. Regular screening is necessary for those with diabetes, hypertension, or a family history of renal disease.

What is the first sign of renal disease?

Early identification of renal issues is difficult because the initial clue is typically mild and easily disregarded. However, one of the first and most obvious indicators is

• Urine that is foamy or bubbly

Proteinuria occurs when compromised kidney filters leak protein into the urine. The foam from shaking a beverage bottle may stay and require numerous flushes to eliminate.

Additional early signs may include

• Frequent nighttime urination
• Edema—ankle, foot, or eye swelling
• Fatigue or weakness from toxicity or anemia
• Dry, itchy skin from mineral imbalances
• Concentration issues or brain fog

Regular screening, such as urine protein and blood eGFR tests, is essential for early-stage kidney disease, which often has no symptoms. This is especially important for those with risk factors, including diabetes, high blood pressure, or a family history of renal disease.

Chronic renal disease therapy

Treating chronic kidney disease (CKD) involves slowing progression, managing symptoms, and decreasing consequences. Early and persistent treatment can help, but there's no cure.

🛠• Key Treatment Methods

The video explains the treatment options for chronic kidney disease

1. Lifestyle changes

• Modified diet: Low sodium, potassium, and phosphorus; moderate protein.
• Limit booze and quit smoking
• Get 150 minutes of exercise per week.
• Control your weight, blood pressure, and sugar levels.
• Don't use ibuprofen unless prescribed.

2. Medications

• Common blood pressure medications include ACE inhibitors like ramipril and ARBs like losartan.
• Diabetes management: SGLT2 inhibitors like dapagliflozin protect the kidneys.
• Statins cut cholesterol and cardiovascular risk.
• Iron supplementation or erythropoiesis-stimulating medications for anemia
• Bone health: Vitamin D analogs, phosphate binders

3. Regular Testing of eGFR and uACR: Monitor renal function and protein loss.

• Blood pressure, electrolytes, and hemoglobin levels are important for making therapy adjustments.

4. Advanced Stage 5/ESRD Therapies

• Dialysis: Hemodialysis or peritoneal waste filtering
• Kidney transplant: Best long-term outcome for qualified individuals.

Personalised Care

• Treatment strategies depend on CKD stage, cause (e.g., diabetes, hypertension), and health. Regular nephrologist visits are essential.

Also, read https://renaldosage.com/blog/chronic-kidney-disease

What is the latest chronic renal disease treatment?

Chronic kidney disease (CKD) treatment is making progress in both slowing its progression and discovering new therapies. The following list highlights the most promising developments for 2025:

1. SGLT2 Inhibitors: Game-Changer

Non-diabetics are using SGLT2 inhibitors like empagliflozin, dapagliflozin, and canagliflozin, designed for diabetes, to slow the progression of CKD. They:

• Decrease proteinuria
• Lower kidney failure risk
• Provide heart protection
• These are many CKD patients' first-line treatments.

2. REACT Trial: Regenerative Cell Therapy

REACT is testing Renal Autologous Cell Therapy, which uses a patient's kidney cells to rebuild tissue. Early results are promising:

• Restoring renal function
• Dialysis delay or avoidance
• Highly effective in diabetic CKD

3. Combining Therapies and Precision Medicine

• CAPTIVATE is testing combinations of
• SGLT2 inhibitors
• Mineralocorticoid receptor antagonists
• GLP-1 agonists
• This personalized approach may reduce renal decline better than single-drug regimens.

4. Artificial Organs and Bioengineered Kidneys

• The Kidney Project uses silicon nanopore membranes and human cells to create an implantable bioreactor that mimics kidney function. 
• It passed animal testing and may shortly enter human trials.

5: Stem Cell Therapies for Transplant Tolerance

Reprogramming the immune system with ImmunoFree could reduce the requirement for lifetime immunosuppressants after a kidney donation.

6. Recent FDA Approvals:

• In 2023, the FDA approved Empagliflozin (Jardiance) for chronic kidney disease (CKD).
• The FDA approved RNAi therapy, known as Nedosiran (Rivfloza), for the treatment of an uncommon kidney stone disease.
• Tenapanor (XPHOZAH) is prescribed for dialysis patients with excessive phosphorus.
• Budesonide (TARPEYO) is a treatment for IgA nephropathy.

What is renal failure death?

On the verge of death, kidney failure (ESRD) causes the body to shut down due to poisons and fluids. Physical and emotional symptoms grow gradually.

Physical Signs

As kidney function diminishes, the following symptoms may worsen:

• Low or no urine production
• Fluid retention causes leg, foot, hand, and face swelling.
• Fatigue and weakness that persist after rest
• Vomiting, nausea, or appetite loss
• Fluid in the lungs causes breathlessness.
• Skin dryness, itching, or color changes
• Joint stiffness, muscle cramping
• Headaches, backaches, or discomfort
• Confusion or focus issues
• Smelly breath or a metallic taste
• Sleep disturbances
• Bloody stools or nosebleeds
• Signs of Emotion and Neurology

As poisons influence the brain:

• Family apathy or withdrawal
• Trouble, anxiety, or sadness
• Delirium, hallucinations, paranoia
• Disorientation, memory loss
• Nighttime uneasiness or restlessness

Last days or hours

You may notice the following symptoms in the latter stages:

• Breathing difficulties or extended pauses
• Cool, mottled skin, especially hands and feet
• Low awareness or unresponsiveness
• Lack of bowel/bladder control
• Lower blood pressure, heart rate
• Caring Support
• Palliative care manages pain, breathing, and emotional well-being if dialysis or transplant is not possible.

Tips to Manage Chronic Kidney Disease

1. Split up your plate
2. Don't eat too much salt
3. Pay attention to protein
4. Pick complex carbs over simple carbs
5. Cut down on saturated fats and stay away from trans fats.
6. Watch how much alcohol you drink.
7. Talk to your doctor about lowering your potassium and phosphorus levels.
8. Get the help of a dietitian. 

Conclusion,

Chronic Kidney Disease causes kidney function to decline over time. Early stages can go unreported, but thorough screening and management impede its progression. Modern medicines, including SGLT2 inhibitors, regenerative cell research, and personalized care regimens, help patients delay kidney failure and maintain quality of life.

Education, regular monitoring, and compassionate support help with early identification and end-stage symptoms. 

Blood disorders are rare and life-threatening

Describe the blood disorder

Any ailment that affects red, white, platelet, or plasma blood cells is a blood disorder. When something goes wrong with these components, it can affect the entire body since they carry oxygen, fight infections, coagulate blood, and maintain immunological function.

Blood disorder symptoms

A brief summary by type:

• Red blood cell disorders: Anemia and sickle cell disease are examples.
• White blood cell disorders: Leukemia and leukopenia damage the immune system by lowering white blood cell numbers.
• Thrombocytopenia—low platelet count—can cause excessive bleeding, while thrombocythemia—high count—can lead to clots.
• Plasma disorders: Hemophilia and hypercoagulability are examples.

Fatigue, frequent infections, unexplained bruising or bleeding, and pale skin are common symptoms.

Listing hereditary blood diseases

Genetic blood disorders influence blood cell formation and clotting factors and are handed down from parents to offspring. Here are some common inherited blood disorders, classified by type:

1. RBC Disorders

• Sickle Cell Disease—Unusual hemoglobin makes red cells stiff and sickle-shaped.
• Thalassemia—Hemoglobin decreased, causing anemia.
• Hereditary Spherocytosis—Sphere-shaped red cells break down.
• An enzyme deficiency that can cause hemolytic anemia under stress is G6PD.

2. White Blood Cell Disorders

• CGD affects the immune system's ability to fight infections.
• A leukocyte adhesion deficit prevents white blood cells from migrating to infection sites.
• Wiskott-Aldrich Syndrome is a rare condition affecting the immune system and platelets.

3. Platelet/Clotting Disorders

• Deficiency of clotting factors VIII or IX causes prolonged bleeding in hemophilia A and B.
• A deficiency or malfunction of the von Willebrand factor affects clotting.
• A mutation in Factor V Leiden increases blood clot risk.
• Protein S or C Deficiency—Impaired anticoagulant function increases thrombosis risk.

4. Metabolic and Plasma Disorders

• Paroxysmal Nocturnal Hemoglobinuria (PNH)—A genetic mutation affects red cell viability.
• Rare illnesses that disrupt nutrition processing and blood cell activity are called inborn metabolic errors (IEM).

5. Bone Marrow/Stem Cell Disorders: Aplastic Anemia

• Myelofibrosis
• Essential Thrombocythemia

Infections, autoimmune diseases, or environmental exposures can cause, inherit, or acquire the aforementioned disorder. These illnesses can range from minor to life-threatening and require lifelong treatment.

Also, read https://www.thehealthsite.com/diseases-conditions/blood-diseases/.

Which three blood problems are most common?

The top three blood diseases by prevalence and clinical significance are

Anemia:  Worldwide, this is the most common blood condition. It occurs when your body lacks healthy red blood cells or hemoglobin to transport oxygen. The most frequent variety is iron-deficiency anemia, caused by poor diet, blood loss, or chronic disease.

Hemophilia: A hereditary bleeding condition that causes persistent bleeding due to insufficient clotting factors. The most prevalent inherited blood disorders are hemophilia A and B, which are rarer than anemia.

Leukemia: A white blood cell malignancy. It causes weariness, infections, and easy bruising by disrupting normal blood cell synthesis. Some of the most prevalent blood malignancies can affect children and adults.

Blood issues

Blood problems can affect red cells, white cells, platelets, or plasma; however, there are certain common symptoms:

Symptoms of Many Blood Disorders

• Fatigue and weakness
• White or yellow skin
• Shortness of breath
• Unsteadiness
• Unexpected bleeding or bruises
• Frequent infections
• Swollen spleen or lymph nodes
• Joint or bone pain

Blood Disorder Causes and Risks

Blood diseases can be inherited or acquired. This systematic overview will help you understand

• 1. Genetic/Hereditary cause
• 2. Environment, lifestyle
• 3. Medical Conditions, Infections
• 4. Medicines and Procedures
• 5. Age/Sex

Explain anemia.

Anemia occurs when your body lacks healthy red blood cells or hemoglobin to transport oxygen to tissues. When oxygen flow drops, organs and muscles lack fuel, causing weariness, weakness, and more.

Types of Anemia

• Each type of blood disorder has its own specific cause and treatment.
• Iron-Deficiency Anemia: Vitamin-Deficiency Aplastic, hemolytic, sickle cell, and thalassemia are types of anemia.

Anemia requires a specific diet.

Eating to manage anemia—especially iron-deficiency anemia—is beneficial and empowering. Increase the formation of red blood cells and the absorption of iron. 

1. Choose Iron-Rich Foods

• Dietary iron comes in two forms.
• Red meat, poultry, and seafood provide easily absorbed heme iron.
• Lentils, beans, tofu, spinach, and fortified cereals contain non-heme iron, which is poorly absorbed.

2. Add vitamin C to iron.

• Vitamin C improves non-heme iron absorption. Try mixing.

3. Add B12 and Folate

• These nutrients are necessary for red blood cell formation:

4. Avoid Mealtime Iron Blockers

• Tea and coffee (tannins), calcium-rich foods or supplements (milk, cheese)

5. Use cast iron

• Cooking acidic foods like tomato sauce in cast iron pans can increase your natural iron intake.

How do we diagnose blood disorders?

Medical history, physical examination, and specific laboratory tests diagnose blood diseases by identifying the affected cells—red, white, platelets, or plasma. 

In the medical history and physical exam, 

• Review the symptoms, including exhaustion, bruises, infections, and bleeding.
• Family history can detect hemophilia or thalassemia.
• Pale skin, enlarged spleen or liver, swollen lymph nodes.

2. Blood tests

These are diagnostic fundamentals:

• CBC: Checks red, white, hemoglobin, hematocrit, and platelets.
• A peripheral blood smear examines blood cell shape and appearance under a microscope.
• The CBC measures immature red cells to assess bone marrow function.
• Iron Studies: Serum iron, ferritin, and transferrin saturation—key anemia tests.
• Test B12 and Folate for dietary deficits.
• PT, aPTT, and INR tests examine clotting function.
• A bone marrow biopsy is used to diagnose leukemia or aplastic anemia.

3. Genetic and Specialized Testing

• Sickle cell and thalassemia are identified by hemoglobin electrophoresis.
• Leukemia and lymphoma: Flow Cytometry detects aberrant white blood cells.
• Molecular and Genetic Tests: Find blood cancer or hereditary illness mutations.

4. Imaging and Extra Tests

• Ultrasound or CT scans are used to detect organ enlargement or lymph node involvement.
• If lymphoma is suspected, biopsy the lymph nodes.

How does one go about treating a blood disorder?

Surgery, medicine, infusion therapy, blood transfusions, and other treatments are available. You may feel less sick and have more energy after using them. Bone marrow transplants are occasionally an option for patients with benign blood diseases. Healthy stem cells replace sick blood cells in a bone marrow transplant.

How to avoid blood disorders?

Not all blood problems can be prevented, especially inherited ones; however, there are measures to lower your risk and improve your blood health:

1. Eating Nutrient-Rich

• Red meat, lentils, spinach, and fortified cereals contain iron.
• Red blood cell synthesis requires vitamin B12 and folate, which are found in eggs, dairy, leafy greens, and legumes.
• Vitamin K: Broccoli, kale, and Brussels sprouts support coagulation.

2. Avoid hazardous substances

• Reduce benzene exposure in industrial environments.
• Stop smoking and drink less—both can damage blood cells and raise clotting risk.

3. Be Active and Maintain a Healthy Weight

• Regular exercise increases circulation and lowers blood clot risk.
• DVT and metabolic blood problems are less likely with a healthy weight.

4. Handle Chronic Conditions

• Control diabetes, renal disease, and autoimmune illnesses to maintain blood cell production and function.

5. Hydrate and avoid immobility

• Long durations of sitting (like traveling) and dehydration can increase clotting risk. Stay active and hydrated.

6. Get Regular Checks

• Anemia, coagulation difficulties, and aberrant cell counts can be detected by routine blood testing.
• Consider genetic counseling if blood diseases run in your family.

7. Use Medication Carefully

• Always consult your doctor and report unexpected symptoms. Some medicines can influence blood cell counts or coagulation.

Conclusion

Blood problems range from genetic sickle cell anemia and hemophilia to acquired iron-deficiency anemia and leukemia. Symptoms like weariness, infections, and bleeding may have several causes: genetics, nutrition, environment, or immune reactions.

Early detection by blood testing helps control many blood problems. Prevention often requires a healthy lifestyle, nutrient-rich food, and risk factor awareness, especially if there is a family history.

How to fix restless legs syndrome

Neurological Disorders

Info

RLS, also known as Willis-Ekbom Disease, is a neurological and sleep-related condition that produces an irresistible impulse to move the legs and painful sensations like crawling, itching, throbbing, or pulling.

Restless legs syndrome.

Symptoms

• Start or worsen while sitting or lying down,
• Are momentarily eased by walking or stretching,
• Nighttime intensity increases.
• It can interrupt sleep and cause daytime weariness, mood swings, and concentration issues.

RLS can affect everyone; however, it appears more in women and worsens with age. Primary RLS can occur alone or in conjunction with iron deficiency, kidney illness, or pregnancy.

No cure, however, lifestyle modifications, addressing causes, and symptom-management drugs are available.

Restless Legs Syndrome types

Based on the onset of symptoms and the identification of a specific cause, we categorize Restless Legs Syndrome (RLS) into two primary forms:

Idiopathic RLS

• It typically occurs before the age of 45.
• The cause of idiopathic RLS is unknown, but it often runs in families, indicating a genetic component.
• Slow progression: Symptoms may intensify over time.

Secondary RLS

• It typically manifests after the age of 45.
• Iron deficiency, kidney illness, diabetes, Parkinson's disease, and pregnancy can cause it.
• Treatment for the underlying cause may lead to unexpected symptom onset and improvement.

Some publications also identify two subtypes of RLS: early-onset and late-onset.

• Early-onset: Genetic and modestly progressing.
• Late-onset: Secondary and faster-progressing.

RLS Signs and Symptoms

RLS causes sensory and motor problems that interrupt sleep and rest. The hallmark symptoms are

Main Symptoms

• The urge to move the legs usually causes discomfort.
• Sitting or lying down worsens symptoms.
• Walking, stretching, or jiggling the legs provides temporary alleviation.
• During the night, it becomes more difficult to fall asleep.

Sensation descriptions

The sensations are often described as

• To crawl
• Tugging
• Burning or itching
• Aching or throbbing
• Buzzing or electric emotions

These sensations frequently occur deep in the legs on both sides. Sometimes the arms are involved.

Sleep-Related Issues

• Trouble falling or staying asleep
• Twitching or jerking legs at night (frequently associated with PMD)
• Poor sleep causes daytime weariness, irritation, and concentration issues.

Cognitive and emotional effects

• Depressive or anxious moods
• Trouble focusing or remembering
• Lower productivity and living quality
• Symptom strength and duration vary. 
• Some people have remissions, especially early on.

Also, read https://rls.bio/.

Restless Legs Syndrome Causes and Risks

Restless Legs Syndrome (RLS) has genetic, neurological, and systemic causes. Below is a list of key causes and risk factors.

The main causes

• Families often experience RLS, particularly when symptoms first manifest before the age of 40. Multiple gene variations are associated with the disorder.
• Dopamine Dysfunction: Like Parkinson's disease, brain dopamine circuits can alter muscle control and cause RLS symptoms.
• Iron deficiency in the brain, such as in the substantia nigra, can decrease dopamine production and cause RLS even with normal blood iron levels.

Secondary causes (underlying conditions)

• Iron loss, inflammation, and metabolic abnormalities cause RLS in chronic kidney disease (CKD) patients, especially dialysis patients.
• Changes in hormones, especially in the third trimester, might cause transient RLS symptoms.
• Diabetes and other diseases can damage peripheral nerves, increasing RLS risk.
• Others: RLS is linked to Parkinson's, rheumatoid arthritis, and fibromyalgia.

Risk factors

• Risk increases with age, especially after 45.
• Females are more likely to have RLS, probably due to hormones.
• Low Iron Stores: Low ferritin or transferrin saturation causes worry even without anemia.
• Antihistamines, antidepressants, and antipsychotics may aggravate symptoms.
• Lifestyle factors: Nighttime caffeine, alcohol, and tobacco usage might worsen RLS.

Diagnostics of Restless Legs Syndrome

Clinical diagnosis of Restless Legs Syndrome (RLS) relies on symptoms and medical history. Healthcare providers usually approach it:

Diagnostic Criteria (International RLS Study Group)

To certify a diagnosis of RLS, all of the following criteria must be present:

The patient must experience an uncomfortable urge to move their legs.

• Resting causes or worsens symptoms.
• Relaxation by walking or stretching.
• Nighttime deterioration.
• Arthritis or leg cramps do not cause the symptoms.

Tests to support

• No lab test can prove RLS; however, doctors may prescribe
• Doctors recommend blood tests due to the correlation between RLS and low brain iron (ferritin).
• Neurological exam: To rule out neuropathy.
• Polysomnography: Although it is rarely necessary, doctors may perform it if they suspect sleep apnea.

A Differential Diagnosis

• Doctors will also evaluate and rule out:
• Neuropathy peripheral
• Leg cramps at night
• Arthritis
• Movement or anxiety problems

Restless Legs Syndrome Treatment and Medication

Treatment for Restless Legs Syndrome (RLS) involves lifestyle changes, addressing its causes, and using medications. The overview follows a structured format:

Home remedies and lifestyle

The video about natural treatment for RLS.

These are usually the first steps for mild symptoms:

• Exercise regularly (but not before bed)
• Pre-bedtime massage or stretching
• Heated baths or pads
• Avoiding caffeine, alcohol, and nicotine at night
• Good sleep hygiene: regular bedtime, cool/dark room, no screens.

Medication

For moderate-to-severe symptoms or sleep disturbances, doctors may prescribe:

1. First-line Calcium Channel Alpha-2-Delta Ligands

• Pregabalin, Gabapentin enacarbil,
• Reduce nerve pain
• Side effects: dizziness, fatigue, weight gain.

2. Dopamine agonists

• Pramipexole, Ropinirole, Rotigotine patch
• Reduce symptoms by mimicking dopamine
• Risk: symptom worsening, impulse control issues

3. Iron Supplement

• To people with low ferritin or iron stores, even without anemia
• Ferric carboxymaltose can be taken orally or intravenously.

4. Other Choices

• Opioids, such as tramadol and oxycodone, are prescribed for patients with severe symptoms who do not respond to other treatments.
• Clonazepam may aid sleep, but not fundamental symptoms.

Treatment of underlying conditions

Addressing the etiology of RLS, such as iron deficiency, kidney disease, or pregnancy, can improve symptoms.

Alternative and Complementary Medicine

Several alternative and complementary therapies have shown potential in treating Restless Legs Syndrome (RLS) and increasing sleep quality:

Physical and Sensory Therapies

• Acupuncture: Stimulating body points may lessen leg pain and nighttime movements.
• Massage works well before bedtime to improve circulation, relax muscles, and release dopamine.
• Near-infrared light treatment (NIR): Low-energy light may relieve nerve pain in neuropathy patients.
• Warm baths and cold packs help relieve leg pain and flare-ups.

Approaches based on nutrition and supplements

Iron supplementation: Essential for low ferritin levels, even without anemia. Never supplement without testing.

• Natural muscle relaxant magnesium may reduce twitching and promote sleep.
• Some people with B12 and D deficiencies have worsening symptoms.
• Folic acid may relieve symptoms, although data is limited.
• Use Mind-Body Techniques
• Yoga and stretching: Gentle exercises reduce muscle stress and improve sleep.
• Meditation and deep breathing alleviate stress, a proven RLS trigger.
• Progressive muscular relaxation: A guided method to quiet the nervous system and relax muscles.

Other emerging options

• Electrical stimulation or vibration therapy, such as foot and leg stimulators, may be beneficial when used before bedtime.
• Foot wraps and pneumatic compression devices may help some people.
• In mild situations, these therapies can serve as a supplement to traditional treatments or stand alone.

Restless Legs Syndrome Prevention

Restless Legs Syndrome (RLS) prevention involves reducing risk factors and adopting nerve- and brain-healthy routines. Although genetic RLS cannot be prevented, several methods may help lessen its symptoms:

Take care of root causes.

• Low ferritin is a primary cause. Treatment of iron deficiency early can prevent symptoms.
• Controlling chronic illnesses like diabetes, renal disease, and peripheral neuropathy can prevent subsequent RLS.
• Medication review. Antihistamines, antidepressants, and antipsychotics may aggravate RLS. If a new drug causes symptoms, consult your doctor.

Adjustments to lifestyle

• Stay active: Moderate exercise boosts circulation and lowers symptoms. Avoid hard workouts before bed.
• Maintain a healthy weight: RLS risk increases with obesity. Even small weight loss helps.
• In the evening, limit caffeine, alcohol, and nicotine, which can worsen symptoms and interrupt sleep.

💤 Sleep hygiene

• Maintain a sleep schedule: Consistent bedtime and waketime support the circadian rhythm.
• Relax with warm baths, mild stretching, or reading before bed.
• Maintain a cool, dark, and quiet bedroom for better sleep.

Reduced stress

• Reduce nervous system overactivity by meditation, deep breathing, or progressive muscle relaxation.
• Treat anxiety and depression: They might aggravate RLS and sleep. 

These strategies can help if you're at higher risk owing to family history or pregnancy. 

Restless Legs Syndrome lifestyle changes

When symptoms are mild to moderate, lifestyle adjustments might help manage Restless Legs Syndrome (RLS).

• Physical activity and movement
• Regular activity like walking, yoga, or swimming might lessen discomfort. Avoid strenuous workouts before bedtime.
• Try calf, hamstring, or ankle stretches before bed to relieve nighttime pain.
• Massage therapy: Regular leg rubs or massage guns can relax muscles and mask pain.

💤 Sleep hygiene

• Daily sleep schedule: Go to bed and wake up at the same time.
• Set a nightly routine: Warm baths, reading, or mild stretching will help you relax.
• Optimize sleep: Keep your bedroom cold, dark, and quiet. A weighted blanket may help you feel grounded.

• Diet and supplements

• Caffeine and alcohol, especially at night, might aggravate symptoms and interrupt sleep.
• If ferritin levels are low, consume spinach, lentils, and lean meats, and take supplements.
• Consult your doctor before adding magnesium and B vitamins for nerve health.

Be aware of stress and medication.

• Relax the nervous system using meditation, deep breathing, or progressive muscle relaxation.
• Medication review. Antihistamines, antidepressants, and antipsychotics can worsen RLS. Consult your doctor for options.

Restless Legs Syndrome complications

• Restless Legs Syndrome (RLS) may seem harmless, but, untreated, especially in moderate to severe cases, it can cause various physical and emotional issues:

Sleep disturbance

• One of the most prevalent effects is chronic sleeplessness. Leg movement can make it difficult to fall or remain asleep.
• This causes daytime weariness, low attentiveness, and poor attention.

🧠 Mental and emotional impacts

Chronic sleep loss can cause:

• Memory issues
• Trouble focusing
• Depressive and anxiety disorders
• Work performance, relationships, and quality of life might suffer over time.
• A worsening of underlying conditions

Secondary RLS symptoms, if untreated, can worsen:

• Chronic Kidney Disease (CKD) is particularly prevalent among dialysis patients, who often experience Restless Legs Syndrome (RLS) and are frequently associated with iron deficiency.
• Diabetic peripheral neuropathy can increase nerve pain.

🔁 Supplement

Dopamine agonist medication can cause amplification when symptoms start earlier, intensify, or spread to additional body areas.

• This can complicate long-term management.
• Impairment in social and functional areas
• Due to sitting pain, severe RLS sufferers may avoid extended flights, movies, and meetings.
• The condition might cause social isolation and decreased daily activity.
• Early diagnosis and customized therapy can prevent many consequences. You can choose to do so.

Exercise Optimization for Restless Legs Syndrome: 8 Tips

Exercise helps manage RLS, so here's how to do it safely and successfully.

1. Maintain Routine

2. Avoid strenuous exercise before bed.

3. While exercising, wear compression stockings

4. Select Moderate Exercises

5. Use Lower-Body Stretches in Exercise

6. Do Exercise Daily

7. Listen to Your Body

8. Get Massaged

Conclusion

Effective management combines Physical activity, sleep hygiene, caffeine/alcohol avoidance, and fixing concerns like low iron. Pharmaceuticals or alternative therapies such as massage, yoga, or acupuncture can be used when necessary. RLS can cause insomnia, emotional difficulties, and social disengagement if untreated. However, with the appropriate techniques, most individuals can experience significant relief.

Diabetic Neuropathy latest treatment 

Neurological Disorders

Neuropathy: An Overview

Neuropathy damages or malfunctions nerves in the peripheral nervous system, which includes all nerves outside the brain and spinal cord. Neuropathy may affect neurons that control sensation, muscle movement, and autonomic functions, including heart rate and digestion.

Symptoms of neuropathy

Symptoms in common

• Tingling, numbness, or “pins and needles”
• Burning or stabbing pain in hands or feet
• Poor coordination or muscle weakness
• Touch or temperature sensitivity
• Autonomic nerve disorders can include digestive issues, disorientation, and excessive sweating.

What Are Common Neuropathic Pain Symptoms?

Neuropathy feels distinct from injury or inflammatory pain. The symptoms generally result from nerve signal misfiring caused by nervous system damage or dysfunction. Here are some popular ones:

Main Symptoms

• Burning or shooting pain: Electric shock or stabbing.
• Hands, feet, or limbs tingling or “pins and needles”
• A sense of “deadness” or lack of touch
• Allodynia: Pain from harmless stimuli like gentle touch or clothes brushiness
• Hyperalgesia: Exaggerated pain response—what should feel little hurts much.
• Dysesthesia: Abnormal crawling, itching, or buzzing sensations

Perhaps Other Signs

• Poor coordination or muscle weakness
• Nighttime pain gets worse
• Temperature sensitivity
• Poor sleep due to discomfort

These symptoms can be chronic or intermittent and follow a “stocking-glove” pattern, starting in the toes and fingers and rising. If you see any of these indicators, especially with diabetes, chemotherapy, or nerve injury, investigate.

Types of Neuropathy

• Peripheral neuropathy affects the arms, legs, feet, and hands.
• Internal organs are affected by autonomic neuropathy.
• The brain nerves affected by cranial neuropathy
• Focal neuropathy affects one or more nerves.

Treatment varies based on the underlying reason and may include:

• Controlling blood sugar in diabetes can help manage the root cause.
• Gabapentin or duloxetine for pain
• Physical treatment
• Nutrition (particularly B vitamins)
• Eliminating alcohol or enhancing ergonomics

What causes neuropathy?

Many factors can cause neuropathy. Here are the most prevalent causes, categorized for clarity:

First, metabolic and endocrine causes

• Diabetes is the most prevalent cause, as high blood sugar destroys nerves over time.
• Thyroid disorders, especially hypothyroidism
• Vitamin deficiencies: B1, B6, B12, E, niacin

2. Infections

• The shingles
• HIV/AIDS
• Hep C
• Lyme illness
• Leprosy

3. Inflammatory and Autoimmune Conditions

• Lupus
• Rheumatoid arthritis
• GBS
• Syndrome Sjögren. 
• In these settings, the immune system may assault neural tissues.

4. Toxins

• Direct nerve damage and nutritional deficits result from alcohol misuse.
• Lead, mercury, arsenic
• Drugs used in chemotherapy
• Certain antivirals/antibiotics

5. Genetic/Hereditary illnesses

• CMT disease
• Ataxia Friedreich. These are rare yet crucial in early-onset or familial instances.

6. Physical Injuries and Nerve Compression Trauma: vehicle accidents, falls, fractures

• Repeated stress: carpal tunnel or sciatica
• Nerve damage after surgery

7. Paraneoplastic and Cancer

• Tumors and cancer immune responses can damage neurons.

8. Blood and Vascular Diseases

• Reduced blood flow caused by vasculitis or diabetes leads to nerve ischemia.

9. Neuropathy

• Testing sometimes fails to identify a reason, especially in elderly individuals.

How does diabetes cause neuropathy?

Long-term high blood sugar damages nerves and small blood vessels, causing neuropathy in diabetes. How it goes:

1. Glucosetoxicity

• Chronic hyperglycemia impairs neuronal metabolism. Too much sugar:
• Disrupt nerve signals.
• Increase oxidative stress, damaging nerve cells with free radicals.
• Sorbitol and fructose build up in nerves, causing swelling and malfunction.

2. Vascular Damage

High blood sugar damages nerve-nourishing capillaries. The condition deprives nerves of oxygen and nutrients, limiting their function.

3. Immune dysfunction, inflammation

Low-grade inflammation and immunological responses from diabetes harm nerve tissue over time.

4: Lipid Imbalance

Diabetes's high triglycerides and other blood fats cause inflammation and oxidative stress, which can damage nerves.

Up to 50% of diabetics develop diabetic neuropathy due to metabolic, vascular, and inflammatory damage. Starting in the feet and legs, it may proceed silently before numbness, tingling, or pain appears.

Neuropathy diagnosis:

Neuropathy is diagnosed step-by-step using clinical evaluation and focused testing to determine nerve damage type, etiology, and extent. It usually goes like this:

1. Medical History Detail

• Doctors inquire about:
• Symptom onset, duration, and pattern (numbness, tingling, pain)
• Diabetes, autoimmune disorders, and infections
• Medication, alcohol, and toxins
• Neurological disease family history
• This helps identify causes and direct tests.

2. Physical/Neurological Exam

• The exam may assess:
• Strength and tone
• Neuropathy reduces reflexes
• Touch, vibration, temperature, and pain
• Balance and coordination
• These data assist in identifying damaged nerves—sensory, motor, or autonomic.

3. Blood Tests

• To find root causes like
• Blood glucose (HbA1c) diabetes or prediabetes
• Lack of vitamins (B12, B6, E)
• Misfunctioning thyroid
• HIV, hepatitis C, or autoimmune markers

4. NCS and EMG

• Important tests:
• NCS measures nerve signal speed and strength.
• EMG measures muscular response to nerve stimulation.
• Together, they confirm neuropathy and identify nerve and muscle problems.

5. Select skin or nerve biopsy

• A skin biopsy can detect small fiber neuropathy by measuring nerve fiber density.
• Occasionally, nerve biopsy is needed for vasculitis or amyloidosis.

6. Imaging (if needed)

• MRI or ultrasound can rule out nerve compression or spinal problems.
• Preventing nerve damage and tailoring treatment requires early diagnosis. Those who are inquisitive are welcome.

What works to prevent diabetic neuropathy?

Preventing diabetic neuropathy requires maintaining healthy blood sugar levels. It goes beyond glucose management. Well-rounded strategy:

1. Tight Blood Sugar Control

This process is the foundation. Track daily levels using a glucose meter or CGM and undergo regular A1C testing to assess long-term control.

2. Regular Exercise

Try 150 minutes of moderate exercise like brisk walking, swimming, or cycling every week. It enhances circulation and insulin sensitivity and promotes nerve health.

3. Healthy Eating

Eat veggies, fruits, whole grains, lean proteins, and healthy fats. Cut back on sweets, processed meals, and alcohol.

4. Foot Care

Examine your feet every day for cuts, blisters, and infection. Apply moisturizer (not between toes), wear comfortable shoes, and never walk barefoot.

5. Stop smoking

Smoking impairs nerve oxygenation and circulation. Quitting dramatically lowers neuropathy progression risk.

6. Control BP, cholesterol

High blood pressure and cholesterol harm nerve-supplying blood vessels. You may need to modify your lifestyle and medication.

7. Weight Control

Obesity causes insulin resistance and inflammation. Slimming down even slightly improves metabolic health and nerve stress.

8. Supplement Well

Maintain vitamin B12 and D levels for nerve function. Lacks can aggravate or resemble neuropathy.

9. Early Symptom Reporting

Report early tingling, numbness, or burning. Treatment can halt or reverse nerve deterioration.

What are the new diabetic neuropathy treatments?

The video explains the new treatments to neuropathy

Beyond painkillers, diabetic neuropathy treatment is improving with targeted and regenerative methods. New medicines with high potential include

1. Neuromodulation Tech

The FDA-approved spinal cord stimulation (SCS) can treat the discomfort associated with diabetic neuropathy. The treatment modifies spinal cord pain signals before they reach the brain by using modest electrical pulses. Patients who don't respond to drugs benefit most.

2. Qutenza Capsaicin 8% Patch

Researchers are studying this EU/UK-approved high-concentration topical patch for diabetic neuropathy. This investigational medication desensitizes skin pain receptors, providing relief without systemic adverse effects.

3. Chemokine Receptor Inhibitor DF2755A

Neuroinflammation-related CXCR1/2 receptors are targeted by this investigational medication. Calming hyperactive sensory neurons may reverse peripheral neuropathy.

4. Nonopioid Designer Molecules

Researchers are discovering new chemicals to calm overactive pain-sensing neurons without causing damage to the heart or brain. One HCN ion channel-targeting drug has shown substantial pain alleviation in preclinical tests without sedation or addiction.

5. TENS devices with high frequency

Researchers are refining advanced TENS devices for home use. Non-invasive technologies control nerve activity and alleviate pain.

6. Sodium Channel Blockers

Researchers are exploring lacosamide and cenobamate, two newer nerve hyperexcitability blockers, as alternatives to gabapentin and duloxetine.

What lifestyle changes assist diabetic neuropathy?

Lifestyle adjustments can alleviate symptoms, decrease progression, and enhance quality of life for diabetic neuropathy. Well-rounded approach:

1. Improve Blood Sugar Management

Keeping blood glucose levels within the goal is most important. Work with your doctor to alter drugs or insulin using a CGM or regular testing.

2. Eat Nerve-Friendly.

Eat whole grains, leafy greens, berries, lean meats, and omega-3s from fish or flaxseed.

Limit refined carbs, sugary snacks, and processed foods to avoid glucose rises.

To maintain nerve health, consume enough B vitamins (particularly B12), vitamin D, and antioxidants.

3. Exercise regularly

Use walking, swimming, or cycling to get 30 minutes of moderate activity most days. Circulation, inflammation, and insulin sensitivity improve with exercise.

4. Quit smoking

Smoking decreases nerve blood flow and worsens neuropathy. Quitting improves circulation and nerve function greatly.

5. Drink less

Alcohol can harm nerves and affect blood sugar. Drink moderately or quit.

6. Take Foot Care Daily

Check your feet for wounds, blisters, and infection. Clean and moisturize them, wear well-fitting shoes, and avoid barefoot walking to avoid injury.

7. Control BP, cholesterol

High blood pressure and cholesterol damage nerve-nourishing blood vessels. Lifestyle and pharmaceutical adjustments may be needed to control them.

8. Weight Control

Even a slight weight loss reduces inflammation and blood sugar, relieving nerve strain.

9. Dealing with Stress

Pain and blood sugar control can deteriorate with chronic stress. Both can be regulated by mindfulness, yoga, or breathing.

Neuropathy symptoms after chemotherapy may last or not.

Chemotherapy-induced peripheral neuropathy (CIPN) might be transitory or permanent depending on numerous circumstances.

• CIPN starts in the hands or feet and may include:
• Stinging, burning, or “pins and needles”
• Absence of sensation
• Electric shock-like or stabbing discomfort
• Poor coordination or muscle weakness
• Touch or temperature sensitivity
• Trouble buttoning or writing

Also, read https://www.footcaremd.org/foot-and-ankle-conditions/the-diabetic-foot/neuropathy

Why It Happens

Taxanes, platinum-based medicines, and proteasome inhibitors can harm peripheral neurons. This damage might develop during therapy or months afterward.

Outlook and Duration

Some symptoms improve weeks or months following treatment.

Others may suffer long-term or irreversible nerve damage if treatment continues despite early neuropathy symptoms.

Helpful medications:

Duloxetine is a rare medicine that alleviates CIPN pain.

Vitamin B12, glutathione, and alpha-lipoic acid may help, but see your doctor first.

Physical therapy boosts balance, strength, and coordination.

Lifestyle: Gentle exercise, foot care, and no drinking or smoking may help improve symptoms.

Neuropathy Complications and Treatment

If you don't address the source of neuropathy early, it can lead to modest or life-altering problems. Here is a list of common problems and their respective treatments:

1. Cuts, wounds, ulcers

• Lack of sensation, especially in the feet, can make minor injuries like blisters or cuts go undiagnosed and worsen. This is prevalent in diabetic neuropathy.
• Treatment: Regular foot inspections, wound treatment, debridement, antibiotics, and unloading pressure with specific shoes or mobility aids.

2. Infection/gangrene

• Untreated wounds can cause cellulitis, osteomyelitis, or gangrene.
• Treatment: Antibiotics, surgery, and amputation in severe cases. Healing can also be achieved using hyperbaric oxygen therapy.

3. Amputations

• Prolonged infections or non-healing wounds may require partial or whole limb amputation, especially in diabetic neuropathy.
• Preventing this outcome requires early identification, foot care, and blood sugar control.

4. Mobility, Balance Issues

• Falls and fractures can result from muscle weakening and proprioception loss.
• We provide physical treatment, balance training, assistive equipment, and home safety adaptations.

5. Digestion, Bladder Issues

• Autonomic neuropathy can cause bladder control and digestion issues like constipation and diarrhea.
• Nutrition, motility medicines, bladder training, and catheterization may be used.

6. Joint and Bone Deformities

• Repeated, unrecognized traumas might damage foot joints (Charcot joint).
• Orthotics, immobilization, and surgery may be needed.

Conclusion

Effective care includes:

Controlling diabetic blood sugar is one example of root cause treatment. Relieving symptoms using drugs, physical therapy, and neuromodulation. Weight loss, exercise, foot care, and smoking cessation. 

We are actively monitoring and preventing ulcers, falls, and digestive disorders. New treatments give hope for chronic or treatment-resistant cases. 

Best way to recover from concussion

 The best way to recover from a concussion

Neurological Disorders

A concussion overview

A concussion is a mild traumatic brain injury (mTBI) that briefly affects normal brain function. It is caused by a blow to the head or chest, whiplash, or other violent shaking of the head and body. It can occur with or without the loss of consciousness and may lead to temporary cognitive problems.  The brain rapidly oscillates inside the skull due to a blow to the head or a sharp jolt to the body. 

Concussion 

Key features

• Falls (particularly in kids and seniors)
• Football, soccer, and cycling injuries
• Bicycle or car accidents
• Physical assaults or blasts

Symptoms:

They may manifest instantly or develop over hours or days. Among them:

• Headache, dizziness, “seeing stars”
• Confusion or daze
• Nausea, vomiting
• Memory loss, especially event-related
• Light or noise sensitivity
• Sleep issues
• Changes in mood, like aggression or sorrow
• Young children may cry excessively. 
• lose interest in toys or change their eating/sleeping routines.

Most people recover fully, but repeated concussions can lead to long-term concerns like chronic headaches or cognitive difficulties.

When to see a doctor for emergencies

After a concussion, seek medical attention if you or someone else experiences any of the following emergency symptoms:

• A short loss of awareness
• Multiple vomiting episodes
• An aggravating headache
• Speech impediment
• Fits or seizures
• One pupil is bigger.
• Numbness or weakness in the arms or legs
• Struggling to walk, balance, or coordinate
• Unusual behavior, disorientation, or agitation
• Sleepiness or trouble awakening
• Vision changes (such as double vision or fuzzy sight)
• Lack of bladder/bowel control

Children 

• Continuous sobbing, 
• Unwillingness to eat 
• Immediately evaluate individuals who struggle to find comfort after a brain injury.

Even modest symptoms can worsen over hours or days. It's best to monitor a suspected concussion for 24 hours.

What causes a concussion?

A quick hit or jolt that accelerates brain movement produces a concussion. Even without obvious damage, this movement can strain and destroy brain cells, alter chemical impulses, and temporarily impede brain function.

The diagnosis of concussion

Although there is no single test for concussion, we use clinical examination, symptom assessment, and imaging to diagnose it.

Diagnostics of Concussion

1. Symptom review/history Healthcare providers inquire:

• How and when the damage occurred
• Instant symptoms (confusion, memory loss, headache)
• Any unconsciousness or amnesia

2. Neurological Exam This entails checking:

• Coordination and reflexes
• Balance, gait
• Vision and hearing
• Strength and feeling

3. Cognitive Tests: Brain function testing may assess:

• Concentration and memory
• Concentration span
• Memory for recent events

4. Standard Tools Sports use tools like the SCAT-6 (Sport Concussion Assessment Tool).

•  Assessments include symptoms, orientation, memory, and balance.

5. Imaging (if needed)

• To rule out bleeding or edema, CT scans are utilized for severe headaches, vomiting, or seizures.
• If symptoms continue or problems are suspected, an MRI may be performed.

6. Observation 

• To prevent symptoms from worsening, a person may be watched for 24 hours in a hospital or at home.

Athletic concussions

The high-impact nature of many sports makes concussions common in athletes. Mismanagement can cause long-term symptoms or repercussions, but most recover.

Why Athletes Risk

• Football, rugby, hockey, and boxing are collision sports.
• Speed activities like cycling and skiing enhance fall and head trauma risk.
• Many athletes underreport symptoms to stay competitive.

Main Concerns

• Second Impact Syndrome: Rapid brain swelling after a second concussion can be fatal.
• Recurrent head injuries, particularly in professional sports, can lead to Chronic Traumatic Encephalopathy (CTE), which is associated with memory loss, emotional issues, and cognitive decline.
• Delayed Recovery: Early returners may have longer post-concussion symptoms.

Management Best Practices

• Concussion-related immediate withdrawal from play—“When in doubt, sit them out.”
• Medical evaluation by a concussion specialist.
• Gradual return-to-play, depending on symptom remission, over days or weeks.
• Education and SCAT-6 baseline testing to better identify and manage concussions.
• Concussions are recognized and treated by athletes, coaches, and parents.

Concussion therapy

• Concussion treatment involves providing the brain with adequate time and appropriate conditions to heal. Conservative care can treat most concussions, but rest and cautious activity are crucial.

Main Treatment Methods

1. First 24–48 Hour Rest:

• Physical rest: Avoid sports, strenuous activity, and head injuries.
• Cognitive rest: Reduce symptom-causing screen time, reading, work, and school.

2. Gradually Resume Activity:

• As tolerated, mild physical and mental activity can resume after repose.
• Reduce activity if it worsens symptoms, then try again later.
• For athletes and students, a gradual return-to-play or return-to-learn protocol is implemented.

3. Managing Symptoms:

• Headaches: Acetaminophen (Tylenol) is best; avoid NSAIDs like ibuprofen early due to bleeding risk.
• Sleep problems: Plan your sleep and avoid caffeine and screens before bed.
• Consume balanced meals and stay hydrated to recuperate.

4. Tracking and Following:

• Note worsening symptoms like confusion, vomiting, or severe headache.
• Consult a doctor if symptoms last 10–14 days.

5. Avoid:

• Alcohol, recreational drugs, and injury-risky activities.
• “Pushing through” symptoms might delay or aggravate healing.
• Many recover within weeks, but some develop post-concussion syndrome.

Also, read https://www.physiotattva.com/conditions/concussion

Other concussion issues

Most concussions heal within weeks, but some can cause difficulties if symptoms are ignored or repeated traumas occur.

Common Concussion Problems

1. Post-Concussion Syndrome (PCS): Headache, dizziness, weariness, irritability, and concentration problems can last weeks or months. Some people endure these symptoms for a year or longer.

2. Post-Traumatic Vertigo: Head movements cause dizziness or spinning. Post-traumatic Ménière's illness or benign paroxysmal positional vertigo (BPPV) may cause it.

3. Cognitive and Emotional Changes: Some experience memory loss, difficulty, mood swings, anxiety, and depression. These can affect daily living subtly or severely.

4. Sleep Disturbances: Insomnia, disturbed sleep, and sleepiness can increase symptoms.

5. Chronic Traumatic Encephalopathy (CTE): Repeated concussions, especially in sports, cause CTE, a degenerative brain disease that causes memory loss, aggressiveness, and dementia-like symptoms.

6. Increased Risk of Future Concussions: Once you've had one concussion, you're more susceptible to another, and recovery may take longer with each future incident.

Prevention of concussions

Smart practices, correct equipment, and awareness can limit concussion risk in sports, at home, and on the road.

General Prevention Methods

1. Wear safety gear

• Biking, skateboarding, skiing, and contact sports require well-fitted helmets.
• Check helmets for safety and replace them after major impacts.

2. Build Neck Muscles

• Strong neck muscles can help absorb shock and reduce head movement during a collision.
• Exercises that focus on neck flexion, extension, and lateral movement may minimize concussion risk.

3. Use Sports Safety

• Learn and utilize proper tackling, heading, or falling methods.
• Avoid danger and play by the rules.

4. Safeguard Environment

• Home: Install stair gates, window guards, and non-slip mats.
• On playgrounds, use mulch or rubber instead of concrete or grass.

5 Vehicle Safety

• Always buckle up.
• Children should use age-appropriate car seats or booster seats.
• Avoid distractions while driving.

6. Teach and Communicate

• Educate players, parents, and coaches on concussion symptoms.
• Avoid overexerting yourself. Encourage reporting and management.

7. Manage Risks

• Fix vision or balance issues that increase fall risk.
• Exercise caution when prescribing dizziness medications, particularly for seniors.

Consultant for concussion

Neurologists are the best concussion specialists. Neurologists are qualified to assess the severity of a concussion, manage symptoms, and monitor for sequelae like post-concussion syndrome or cognitive abnormalities.

In difficult or lengthy situations, you may be referred to

• Neuropsychologists assess cognition and emotion, notably memory and mood.
• Athletic concussions: Sports medicine experts can advise on return-to-play protocols.
• Physiotherapists or vestibular therapists handle chronic balance issues or dizziness.
• ENT experts treat vertigo and tinnitus.

Conclusion

Emergency signals like persistent vomiting or confusion require immediate medical intervention. Repeated concussions can cause chronic traumatic encephalopathy, so athletes must be careful. Wear protective clothing, practice safe procedures, and strengthen neck muscles to prevent it. Neurologists, neuropsychologists, and vestibular therapists may help in difficult instances.