We Are Here To Serve You
Our experienced physicians are specialists in kidneys and kidney related diseases. This includes Chronic Kidney Disease (CKD), End Stage Renal Disease (ESRD), Hypertension, Anemia, Kidney Transplantation and more. Below are more details on of some of the common conditions managed by Snohomish Kidney Institute.
Chronic kidney disease (CKD) refers to a gradual and progressive decline in kidney function over time. As the body ages the kidneys age and lose function. This is a slow process that typically does not result in significant impairment. However, some patients have an accelerated decline in kidney function. Diabetes, hypertension, and diseases that attack the internal structure of the kidney are the most common reasons for accelerated decline in kidney function. CKD, when advanced, allows waste products to accumulate in the body and a multitude of symptoms can potentially develop. Symptoms include weight loss or excess weight gain, fatigue, decrease in urine output, loss of appetite, swelling of the body, increased tendency to bruise or bleed, paleness, seizures, confusion or even coma. The role of the nephrologist is to help preserve kidney function as best possible and to prepare or start renal replacement therapy (dialysis or kidney transplant) when symptoms develop.
Please consider calling us for a nephrology consultation if you or your patient has any of the following conditions:
- Elevated Creatinine (Creatinine > 1.5 mg/dL or GFR < 45 ml/min)
- Hypertensive Urgency
- Proteinuria or Hematuria
- Severe edema or volume overload
- Recurrent kidney stones
Dialysis is a form of renal replacement therapy. Unfortunately, many patients will lose kidney function (either acutely or chronically) and need a modality to replace the functions of the human kidney. Dialysis can be done in two ways:
- Hemodialysis – Blood is taken from the patient’s body to a machine that will act as an artificial kidney. The machine can remove excess fluid, correct electrolytes, remove waste products, buffer acid production, and return the blood to the patient’s body.
- Peritoneal Dialysis – Fluid is entered into the abdominal cavity of the patient. It will help remove water, correct electrolytes, remove waste products, and buffer acids to then be drained out of the abdomen.
While many patients receive hemodialysis in an outpatient dialysis facility, both hemodialysis and peritoneal dialysis can be performed at home. Home dialysis focuses on training patients to perform the task of hemodialysis or peritoneal dialysis independently, in the comfort of their own homes, and on their own schedules. If you need to go on dialysis your nephrologist will work with you to determine which option is best for you and your lifestyle.
Hypertension (HTN) = a fancy medical term for high blood pressure.
- Normal blood pressure: systolic or <120/80 mmHg
- Prehypertension: >120/80 mmHg
- Hypertension: >140/90 mmHg
Essential (primary) HTN – The exact cause of this is poorly understood. It may be a combination of genetic background, race, diet, weight gain, and other environmental factors.
Secondary HTN – High blood pressure that may have a specific underlying cause that is different from “essential HTN.” Your doctor will determine if you need to be screened for this.
Causes: Sleep apnea, Chronic Kidney Disease, disorders of the adrenal gland, narrowing of kidney arteries, birth control pills, and Non-steroidal anti-inflammatory medications (ie. Ibuprofen, naproxen).
Resistant HTN – Blood pressure that is not at goal despite being treated with 3 medications; one of these has to be a diuretic.
For many patients with advanced kidney disease, a kidney transplant is often the best option. A kidney transplant can provide a better quality of life than dialysis. Patients who receive a kidney transplant typically have more energy, more freedom and a less strict diet. Our team is experienced in helping guide patients through the kidney transplant process.
Anemia is very common in people with Chronic Kidney Disease (CKD). Anemia is a result of not enough red blood cells in your body. Red blood cells are very important as they carry oxygen through your bloodstream, helping your bones, muscles, and organs work properly. Your kidneys help your body make red blood cells with signals from a hormone called erythropoietin (EPO). If you have kidney disease you will lack the EPO to create sufficient red blood cells. Your nephrologist and healthcare team can work with you to manage your anemia to help you feel better.