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Affects of Diabetes and Hypertension On Your Kidneys
Dr. Slamat Ali discusses the affect of diabetes and hypertension on your kidneys.
Featured Speaker:
Dr. Ali is American Board certified in Nephrology and Internal medicine. He had comprehensive training in the field of adult renal diseases and hypertension. After completing his residency in internal medicine, he worked as an internist and then chose nephrology as passion and career. His medical knowledge and clinical research background allow him to handle chronic conditions efficiently. He has extensive clinical experience and has participated in volunteer projects.
Dr. Ali is relatively new to the Bakersfield community and enjoys traveling, music, community involvement and spending time with his family. He loves the people of Bakersfield and enjoys helping them to keep their kidneys healthy. He is looking forward to providing comprehensive kidney care to people of Bakersfield
Slamat Ali, MD
Slamat Ali, MD is a dedicated nephrologist in Bakersfield. He earned his medical degree from Allama Iqbal Medical College Lahore, Pakistan. He completed his Internal Medicine training at New York Medical College/Montefiore Medical Center and Nephrology Fellowship at Brookdale University Hospital and Medical Center New York.Dr. Ali is American Board certified in Nephrology and Internal medicine. He had comprehensive training in the field of adult renal diseases and hypertension. After completing his residency in internal medicine, he worked as an internist and then chose nephrology as passion and career. His medical knowledge and clinical research background allow him to handle chronic conditions efficiently. He has extensive clinical experience and has participated in volunteer projects.
Dr. Ali is relatively new to the Bakersfield community and enjoys traveling, music, community involvement and spending time with his family. He loves the people of Bakersfield and enjoys helping them to keep their kidneys healthy. He is looking forward to providing comprehensive kidney care to people of Bakersfield
Transcription:
Affects of Diabetes and Hypertension On Your Kidneys
Bill Klaproth (Host): So, diabetes and hypertension, if poorly controlled over time, can damage your kidneys leading to a host of other complications. You don’t even want to go there. So, let’s learn more with Dr. Slamat Ali, a Nephrologist with Bakersfield Memorial Hospital. Dr. Ali, thanks so much for your time. So, first off, can you explain the difference between a urologist and a nephrologist?
Slamat Ali, MD (Guest): Thank you Bill. Actually you start with a very good question. Many times patients ask me, so nephrologist is primarily a physician who deals with the kidney diseases if the patient has any functional problem with the kidneys. But a urologist is a surgeon and they usually take care of urogenital system of males and only urinal system of the females. And they primarily are a surgeon and if the patient has any tumor or bigger stone that needs to be removed surgically; the urologists take care of that. But if the patient has any issues related to the function of the kidney, nephrologist primarily take care the kidney disease.
Host: All right very well. Good to know the difference between a urologist and a nephrologist. So, being a nephrologist, you are an expert on the kidneys. So, can you tell us what is the role or the function of our kidneys?
Dr. Ali: Primarily the function of the kidneys is to get rid of the waste products which we produce in our body after the consumption of food. And also the electrolyte balance and the acid-base balance which we produce also as the result of consumption of food.
Host: So, our kidneys play a vital role in ridding our body of waste from the food that we eat and then you also mentioned the electrolyte balance and the acid-base balance. So, how would we know this? what are the symptoms and consequences of poor kidney health?
Dr. Ali: If the patient develops really advanced kidney disease and the patient started having symptoms, so patient will develop nausea, vomiting, poor appetite, forgetfulness, lightheadedness, dizziness. The patient also will start retaining fluid, will develop swelling in the legs, become short of breath is the patient has a fluid collection into the lungs and patient may also develop abnormal heart rhythm because of the electrolyte imbalance.
Host: So, those are really important symptoms to remember. So, we’ve all heard the term, know your numbers. So, when it comes to understanding what’s happening with your kidneys, you need to know your numbers when you go to the physician. So, you are going to have a blood test and a urinalysis. So, this is how you understand what’s happening with your kidneys. So, what is the number we really need to understand and look out for? So, tell us about the numbers.
Dr. Ali: Yes, so every patient – I would advise that every patient once they go see their primary doctor and if they have their blood test done to check their kidneys, that they should look at that and they should pay attention on the GFR. GFR means the glomerular filtration rate. That’s how we assess how is your kidney function. So, in your recording it will be mentioned that the GFR is 57 and so you need to pay attention to the numbers.
Host: So, you just said your GFR is 57. What are the numbers we need to know? What is normal, what is not normal?
Dr. Ali: Yes, so the normal GFR is more than 120. And if it is between 90 to 120, this is called stage one kidney disease. If it is between 60 to 90, this is stage two kidney disease. If it is between 30 to 60, it is stage three kidney disease. And if it is between 15 to 30, it is stage four kidney disease. If it is less than 15, it is called stage five kidney disease.
Host: Okay, that’s a really easy way to remember that. So, we’re looking for our GFR number to be over 120 to be normal.
Dr. Ali: Yes. But that also, the numbers depend on the age of the patient. In any age, because of the aging after the age of 40; the kidney numbers decrease one by one every year. But it means that it depends on the age also.
Host: Got it.
Dr. Ali: But in any age, the number should be more than 60. If it is less than 60, that’s the most important. In any case it should be more than 60 in any age. If it is less than 60; you should be concerned and ask your doctor to refer to a nephrologist.
Host: Okay, very important point. So, now let’s talk about diabetes and hypertension. So, how does diabetes affect the function of our kidneys? Could you tell us in kind of basic laymen terms?
Dr. Ali: It decreases the numbers, as we mentioned that, the numbers.
Host: Yeah, we were just talking about that.
Dr. Ali: So, if the patient has diabetes uncontrolled, from five years or ten years; it causes the decrease in the kidney numbers which we just mentioned. All right easy to understand. So, uncontrolled diabetes are going to cause those GFR numbers to go down.
Dr. Ali: Yes.
Host: And then does high blood pressure have the same effect on the function of our kidneys?
Dr. Ali: With the time, if the blood pressure is uncontrolled; and it remains uncontrolled over a period of time, if it’s more than five years; it starts affecting the kidney and it will decrease the kidney numbers.
Host: So, that’s why it’s good to know your numbers. And that GFR number through a blood test. So, then what about the urinalysis? What does the urinalysis show usually when we go to the physician, we have to pee in the cup. What does the urinalysis show?
Dr. Ali: The urine test will tell us only if the patient is leaking protein in the urine.
Host: Right so when protein is being leaked into the urine, that is another sign that there’s something wrong with the kidneys.
Dr. Ali: Because sometimes the patients say that oh when I make urine, my urine becomes foamy. Any patient who has diabetes over a period of time, ten years not controlled and now the patient is complaining now I notice that my urine is foamy when I make urine. It means that the patient is leaking protein in the urine.
Host: And is that the same between damage from diabetes and or high blood pressure in both scenarios? Would the kidneys start leaking protein into the urine?
Dr. Ali: That’s a difference between the high blood pressure and diabetes. In diabetes, most of the time, the patient has a decrease in the kidney number and leaking of the protein in the urine. But in high blood pressure, usually the leaking of the protein is normal, but the patient has a decrease in the number.
Host: So, with diabetes damage to the kidney you are going to have the lower GFR number and you are going to potentially have the leaking of protein into the urine.
Dr. Ali: Yes.
Host: And the telltale sign of that then is the foaming when you go to the bathroom.
Dr. Ali: Yes.
Host: Whereas with hypertension, you are not going to have the foaming. Meaning hypertension might be a little more dangerous because you are missing one telltale sign, there’s no foaming when you go to the bathroom. Is that right?
Dr. Ali: Yes.
Host: So, let’s talk about prevention for people with diabetes or high blood pressure. What should they do to help prevent poor kidney health?
Dr. Ali: So, if any patient primarily because our focus is mainly on these two topics, so, primarily if any patient who has high blood pressure, the patient should check his blood pressure regularly and control the blood pressure. They should be on the right medication and should get the dietary restrictions and do regular exercise. And control the blood pressure.
Host: So, paying attention to lifestyle modifications is very important. Of course, watching what you eat, dietary restrictions, getting enough exercise and things like that. So, what about treatment? What can you tell us about that?
Dr. Ali: We should focus on the prevention of the kidney disease. Because the treatment options are different. If the patient already developed the kidney disease; then we have a different options but primarily our focus should be to prevent the kidney disease. And how we prevent is to control the blood pressure with the lifestyle modifications and the medications, control diabetes with the medications and lifestyle modifications so that we have the minimum affect of the high blood pressure and diabetes on the kidneys. So, our main focus should be for general public the main focus should be to control these two conditions so that it has a minimum side effect or minimum effects on the kidneys.
Host: Okay so focus on prevention and then make sure you pay attention to those lifestyle modifications.
Dr. Ali: Right.
Host: And any final thoughts Dr. Ali?
Dr. Ali: So, any patient who has diabetes and high blood pressure should have a regular check up to find out that your kidney number is stable or if it is getting worse and then how we can improve it.
Host: Well Dr. Ali, this has been really fascinating. Thank you for talking to us about how diabetes and hypertension affect the function of our kidneys. Thank you so much for your time.
Dr. Ali: All right. Thank you very much.
Host: That’s Dr. Slamat Ali, a Nephrologist with Bakersfield Memorial Hospital. And for more information please visit www.dignityhealth.org/bakersfield. And if you liked what you’ve heard, please share it on your social channels and be sure to check out the full podcast library for topics of interest to you. This is Hello Healthy, a Dignity Health podcast. I’m Bill Klaproth. Thanks for listening.
Affects of Diabetes and Hypertension On Your Kidneys
Bill Klaproth (Host): So, diabetes and hypertension, if poorly controlled over time, can damage your kidneys leading to a host of other complications. You don’t even want to go there. So, let’s learn more with Dr. Slamat Ali, a Nephrologist with Bakersfield Memorial Hospital. Dr. Ali, thanks so much for your time. So, first off, can you explain the difference between a urologist and a nephrologist?
Slamat Ali, MD (Guest): Thank you Bill. Actually you start with a very good question. Many times patients ask me, so nephrologist is primarily a physician who deals with the kidney diseases if the patient has any functional problem with the kidneys. But a urologist is a surgeon and they usually take care of urogenital system of males and only urinal system of the females. And they primarily are a surgeon and if the patient has any tumor or bigger stone that needs to be removed surgically; the urologists take care of that. But if the patient has any issues related to the function of the kidney, nephrologist primarily take care the kidney disease.
Host: All right very well. Good to know the difference between a urologist and a nephrologist. So, being a nephrologist, you are an expert on the kidneys. So, can you tell us what is the role or the function of our kidneys?
Dr. Ali: Primarily the function of the kidneys is to get rid of the waste products which we produce in our body after the consumption of food. And also the electrolyte balance and the acid-base balance which we produce also as the result of consumption of food.
Host: So, our kidneys play a vital role in ridding our body of waste from the food that we eat and then you also mentioned the electrolyte balance and the acid-base balance. So, how would we know this? what are the symptoms and consequences of poor kidney health?
Dr. Ali: If the patient develops really advanced kidney disease and the patient started having symptoms, so patient will develop nausea, vomiting, poor appetite, forgetfulness, lightheadedness, dizziness. The patient also will start retaining fluid, will develop swelling in the legs, become short of breath is the patient has a fluid collection into the lungs and patient may also develop abnormal heart rhythm because of the electrolyte imbalance.
Host: So, those are really important symptoms to remember. So, we’ve all heard the term, know your numbers. So, when it comes to understanding what’s happening with your kidneys, you need to know your numbers when you go to the physician. So, you are going to have a blood test and a urinalysis. So, this is how you understand what’s happening with your kidneys. So, what is the number we really need to understand and look out for? So, tell us about the numbers.
Dr. Ali: Yes, so every patient – I would advise that every patient once they go see their primary doctor and if they have their blood test done to check their kidneys, that they should look at that and they should pay attention on the GFR. GFR means the glomerular filtration rate. That’s how we assess how is your kidney function. So, in your recording it will be mentioned that the GFR is 57 and so you need to pay attention to the numbers.
Host: So, you just said your GFR is 57. What are the numbers we need to know? What is normal, what is not normal?
Dr. Ali: Yes, so the normal GFR is more than 120. And if it is between 90 to 120, this is called stage one kidney disease. If it is between 60 to 90, this is stage two kidney disease. If it is between 30 to 60, it is stage three kidney disease. And if it is between 15 to 30, it is stage four kidney disease. If it is less than 15, it is called stage five kidney disease.
Host: Okay, that’s a really easy way to remember that. So, we’re looking for our GFR number to be over 120 to be normal.
Dr. Ali: Yes. But that also, the numbers depend on the age of the patient. In any age, because of the aging after the age of 40; the kidney numbers decrease one by one every year. But it means that it depends on the age also.
Host: Got it.
Dr. Ali: But in any age, the number should be more than 60. If it is less than 60, that’s the most important. In any case it should be more than 60 in any age. If it is less than 60; you should be concerned and ask your doctor to refer to a nephrologist.
Host: Okay, very important point. So, now let’s talk about diabetes and hypertension. So, how does diabetes affect the function of our kidneys? Could you tell us in kind of basic laymen terms?
Dr. Ali: It decreases the numbers, as we mentioned that, the numbers.
Host: Yeah, we were just talking about that.
Dr. Ali: So, if the patient has diabetes uncontrolled, from five years or ten years; it causes the decrease in the kidney numbers which we just mentioned. All right easy to understand. So, uncontrolled diabetes are going to cause those GFR numbers to go down.
Dr. Ali: Yes.
Host: And then does high blood pressure have the same effect on the function of our kidneys?
Dr. Ali: With the time, if the blood pressure is uncontrolled; and it remains uncontrolled over a period of time, if it’s more than five years; it starts affecting the kidney and it will decrease the kidney numbers.
Host: So, that’s why it’s good to know your numbers. And that GFR number through a blood test. So, then what about the urinalysis? What does the urinalysis show usually when we go to the physician, we have to pee in the cup. What does the urinalysis show?
Dr. Ali: The urine test will tell us only if the patient is leaking protein in the urine.
Host: Right so when protein is being leaked into the urine, that is another sign that there’s something wrong with the kidneys.
Dr. Ali: Because sometimes the patients say that oh when I make urine, my urine becomes foamy. Any patient who has diabetes over a period of time, ten years not controlled and now the patient is complaining now I notice that my urine is foamy when I make urine. It means that the patient is leaking protein in the urine.
Host: And is that the same between damage from diabetes and or high blood pressure in both scenarios? Would the kidneys start leaking protein into the urine?
Dr. Ali: That’s a difference between the high blood pressure and diabetes. In diabetes, most of the time, the patient has a decrease in the kidney number and leaking of the protein in the urine. But in high blood pressure, usually the leaking of the protein is normal, but the patient has a decrease in the number.
Host: So, with diabetes damage to the kidney you are going to have the lower GFR number and you are going to potentially have the leaking of protein into the urine.
Dr. Ali: Yes.
Host: And the telltale sign of that then is the foaming when you go to the bathroom.
Dr. Ali: Yes.
Host: Whereas with hypertension, you are not going to have the foaming. Meaning hypertension might be a little more dangerous because you are missing one telltale sign, there’s no foaming when you go to the bathroom. Is that right?
Dr. Ali: Yes.
Host: So, let’s talk about prevention for people with diabetes or high blood pressure. What should they do to help prevent poor kidney health?
Dr. Ali: So, if any patient primarily because our focus is mainly on these two topics, so, primarily if any patient who has high blood pressure, the patient should check his blood pressure regularly and control the blood pressure. They should be on the right medication and should get the dietary restrictions and do regular exercise. And control the blood pressure.
Host: So, paying attention to lifestyle modifications is very important. Of course, watching what you eat, dietary restrictions, getting enough exercise and things like that. So, what about treatment? What can you tell us about that?
Dr. Ali: We should focus on the prevention of the kidney disease. Because the treatment options are different. If the patient already developed the kidney disease; then we have a different options but primarily our focus should be to prevent the kidney disease. And how we prevent is to control the blood pressure with the lifestyle modifications and the medications, control diabetes with the medications and lifestyle modifications so that we have the minimum affect of the high blood pressure and diabetes on the kidneys. So, our main focus should be for general public the main focus should be to control these two conditions so that it has a minimum side effect or minimum effects on the kidneys.
Host: Okay so focus on prevention and then make sure you pay attention to those lifestyle modifications.
Dr. Ali: Right.
Host: And any final thoughts Dr. Ali?
Dr. Ali: So, any patient who has diabetes and high blood pressure should have a regular check up to find out that your kidney number is stable or if it is getting worse and then how we can improve it.
Host: Well Dr. Ali, this has been really fascinating. Thank you for talking to us about how diabetes and hypertension affect the function of our kidneys. Thank you so much for your time.
Dr. Ali: All right. Thank you very much.
Host: That’s Dr. Slamat Ali, a Nephrologist with Bakersfield Memorial Hospital. And for more information please visit www.dignityhealth.org/bakersfield. And if you liked what you’ve heard, please share it on your social channels and be sure to check out the full podcast library for topics of interest to you. This is Hello Healthy, a Dignity Health podcast. I’m Bill Klaproth. Thanks for listening.