Category: Medicine Hat News

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Kidney Failure

Dr. B, why do kidneys fail?

Kidneys fail because their functioning capacity to get rid of body’s toxic substances is compromised by different kinds of diseases and injuries. Some of these are: diabetes, high blood pressure, polycystic kidneys, blockage of the urinary tract and certain type of medications.

Kidney failure, also called renal failure, can be partial or complete; acute or chronic. In acute renal failure, kidneys do recover function in six weeks or so. In chronic renal failure the damage is permanent. Chronically diseased kidneys can sustain life until about 90 percent of their functioning capacity has been lost.

What do kidneys do?

Kidneys remove wastes and toxic substances. They regulate water and electrolyte balance, and produce hormones that regulate blood pressure, the making of red blood cells, and uptake of calcium from the intestine.

Kidneys are essential to life. We are lucky that we have two kidneys compared to other essential organs like the brain, heart, and liver.

What happens if kidneys fail?

The body is unable to get rid of toxic substances from the blood. It has difficulty maintaining fluid and electrolyte balance and acid base balance. The blood pressure goes up. Certain parts of the body become puffy from fluid retention. There is change in the urinary output and in its content.

What is the long-term prognosis of chronic renal failure?

Without kidney dialysis and kidney transplant the prognosis is bad. Dialysis is life-prolonging process for patients with end stage kidney disease. Dialysis removes toxic materials from a patient’s blood. It also helps in maintaining body’s fluid, electrolyte and acid-base balance. But kidney transplantation is the most effective treatment.

Statistics show that as of 1998, there were 3434 patients waiting for an organ transplant in Canada. This is 88 percent increase since 1991! Eighty-one percent of patients listed for an organ transplant in 1998 were waiting for a kidney.

John Boksteyn, President of the Southern Alberta Branch and member of the National Board of Directors of The Kidney Foundation of Canada says that the Foundation is a national volunteer organization dedicated to improving the health and quality of life of people living with kidney disease.

Boksteyn adds, “March is Kidney Month and the volunteers have been working hard to collect funds for research and education. They also actively promote awareness of, and commitment to organ donation”.

How can we take care of our kidneys?

Maintain adequate hydration by drinking enough water. Have your blood pressure checked and treated if it is high. If you suffer from diabetes then follow your doctor’s advice and keep your blood sugar level under control. Have your urine checked for sugar, blood and protein as part of your physical examination. When you take any medications on regular basis, especially off the counter, then check for its effect on kidneys. Chronic urinary infection and kidney stone problems should be treated.

We are blessed with two kidneys to keep us healthy. Let us take care of them for our family and ourselves – you never know when a family member may need to borrow one!

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Diet and Cancer

“Doc, one more column on nutrition and I will throw up!” says Dave.

“Dr. B, just ignore him. Tell me, how can good nutrition prevent cancer?” asks Susan.

Susan, this question has been bothering me too. So, let us see if there is any scientific literature to prove that good nutrition can prevent cancer.

Here are two articles. First one, a review article titled “Diet and the prevention of cancer” in the British Medical Journal. Second one, “Diet and cancer” in the Encyclopaedia Britannica. This is what they have to say.

There are three ways in which a person’s usual diet may lead to cancer: (1) A cancer producing substance, in food or drink, can come in contact with the lining of the mouth, throat, oesophagus, stomach, intestines, liver, or urinary bladder and trigger changes leading to cancer. (2) A person is little overfed or a little underfed may influence the incidence of hormone-dependent cancers in the breast, uterus or prostate by altering the hormone secretion or metabolism. (3) Some nutrients may influence the susceptibility of other sites to cancer producing substances.

It has been estimated that diet may be responsible for around 38 percent of cancer deaths. About 80 percent of cancers of the large bowel, breast and prostate may be related to diet. One of the articles says: While there is strong but indirect epidemiological evidence that most of the common cancers could be made less common by suitable modifications of food habits, there is still no precise and reliable evidence as to exactly what dietary changes would be of major importance.

For people like you and me this creates a significant dilemma. We need to know exactly what to eat and what to avoid to prevent cancer. Just like the “heart smart” diets where we know the type of foods that will keep our heart and blood vessels healthy.

Colon and rectal cancer is one for which the evidence that diet is involved is probably strongest. Constipation is known to be a risk factor because of the increased time the cancer inducing substances in the stool spend against the lining of the colon and rectum. Increased intake of fibre and vegetables can hasten the transit time and reduce the risk.

Red meat , processed meat, and canned meat increase the risk of colon and rectal cancer.

When it comes to breast cancer, overweight postmenopausal women have up to a twofold greater risk. In premenopausal women, the effect of weight is inconsistent. Meat and alcohol are associated with increased risk. Low intake of vegetables and fibre may have the same effect.

Other cancers where nutrition is important are: cancer of the prostate, stomach, oesophagus, pancreas, lung, and uterus. The common theme is – excessive use of cigarettes, alcohol, meat, and fat. Not enough intake of fruits, vegetables, fibre, and certain types of vitamins.

Role of vitamins in cancer is controversial. Some experts believe that caution should be used with high doses of purified supplements of vitamins and minerals. But all experts believe that vegetables and fruits have strong protective effect and red meat and processed meat is linked to high risk of many cancers.

So next time you buy a burger, don’t ask: Where is the beef?


This series of articles explore the health problems of Dave and his family. They are composite characters of a typical family with health problems.

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Cholesterol

Doc, what is cholesterol? Where does it come from? What does it do?

These are not uncommon questions. Most adults, who have a regular physical examination, undergo routine blood tests to check for cholesterol level. Some are normal. Others are abnormal. Some have to go on a diet. Some have to take pills. Is this necessary?

Cholesterol is normally present in blood and all animal tissues. It is odourless and tasteless. It is essential to life. It is an important component of the membrane that surrounds each cell. Cholesterol is required when body synthesises substances like bile acids, steroid hormones, and vitamin D.

Where does it come from?

The liver and many other organs synthesize cholesterol. We also consume considerable amount of it in our diet.

How does it do the damage?

Cholesterol is not soluble in the blood. In order for it to be transported to different sites in the body, it has to attach itself to certain type of protein called lipoprotein. This transportation occurs through the bloodstream.

LDL (low density lipoprotein), also known as bad cholesterol, picks up the cholesterol from the liver and transports it to various tissues and body cells. Here the cholesterol gets separated from the lipoprotein and is used by the cells. This includes the deposition of cholesterol and other fatty substances circulating in the blood stream in the interior walls of the blood vessels. These deposits (atherosclerosis) narrow the blood vessels causing heart attacks and strokes. Higher levels of blood cholesterol cause more damage and increased narrowing of the blood vessels.

HDL (high density lipoprotein), also known as good cholesterol, transports excess or unused cholesterol from the tissues back to the liver, where it is broken down to bile acids and then removed from the body.

How can we avoid high cholesterol levels in the blood?

Mainly by improved nutrition (remember March is nutrition month!). Susan White, Clinical Dietician at the Medicine Hat Regional Hospital has a very informative hand out for the Cardiac Rehab Program patients. It is called: Nutrition – For Your Heart. It has five titles: 1.Eat more fibre 2. Meats and Alternatives 3. Choose lower fat Milk Products 4. Reduce all sources of dietary fat 5. Reduce salt, caffeine and alcohol intake.

Avoid lard, butter, cheese, whole milk, red meat, candy and baked goods containing shortening. Egg-yolks and shrimps are high in cholesterol. If you love cheese then eat in small amounts. Pick varieties with less than 20 percent M.F. (milk fat), and products made with skim milk or partly skim milk.

Chips, deep-fried items (who does not love French fries?), and commercially baked goods should be avoided. Same goes for ice cream, whipping or cereal cream, coffee whitener or regular puddings.

So, it is not easy. Careful thinking and strong motivation helps.

Those who fail to control their cholesterol level by diet and exercise end up on pills. There are several in the market and your doctor should be well versed in this area as it is such a common problem. Heart disease is the number one killer.

In the last few days you have had your plate full with items on nutrition. Hopefully, it has not given you indigestion. If you decide to make changes in how and what you eat then do it slowly. Sometimes it is the smallest changes that can pretty well change your life.

Good luck and happy eating!

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Healthy Eating

One morning, I am sitting in my office sipping hot chocolate with whipping cream. Next to it is a chocolate chip muffin and butter. A dietician drops by for some business. She looks at my hot chocolate and muffin. Her eyes almost pop out. “Dr. B., do you know March is a nutrition month?”

No I didn’t know. Anyway, so what?

“Dr. B., do you know what David Suzuki wrote recently in the Medicine Hat News? He says that the number of overfed people on earth is now equal to those who are hungry. About 55 percent of our population is overweight. Food today is more about convenience, brand recognition and entertainment than it is about nourishment.”

Food processing companies spend more on advertising than any other industry. Half of that is for candy, sweetened breakfast cereal and fast food – a large portion of which targets children.

“Dr. B., in your millennium column you said we should take care of ELMOS (exercise, laughter, meditation, organic healthy food, stress relief)! Don’t you follow your own advice?”

Well, here is an outspoken dietician. But she is right. Our good intentions do not always translate into compliance. Here are some examples.

I wish I could do everything that will keep me healthy. I wish my family and my co-workers will eat and do everything that is right and healthy. I wish every restaurant I go to have the right kind of healthy food that tastes just right and fill me up, so I don’t have to order more or eat my children’s leftovers.

I wish I could stop telling the waiter that dessert is not good for me but it is all right for my children. After all they haven’t been out for a meal with their dad for sometime. And when the dessert comes then why do I stretch my arm with a spoon and ask, “Can I try some, son?”

I wish each morning I don’t have to stand in front of the mirror in my birthday suite, pinch my waistline and then step on a scale which never tells the truth anyway! “Waiting for a miracle, eh?” asks my wife.

Enough of this. So I call Marian Ho, Manager, Dietetics at the Medicine Hat Regional Hospital. Marian gives me a newsletter from the Dieticians of Canada. It says that taste, health, convenience and food as entertainment score as the top four nutrition trends in Canada.

Ninety-three per cent of Canadians say taste is an important factor. Eighty-nine percent rank nutrition and health as the next most important factor when choosing foods. Upto 58 percent of women decide what they will be serving for dinner the same day or at the last minute, usually on their way home from work.

Such trends are hard to change. Recognizing this, Dieticians of Canada has chosen “Great Food Fast” as the theme for the “March 2000 National Nutrition Month Campaign”. Their newest cookbook, “Great Food Fast” has over 125 recipes to help us follow the food guide and plan balanced meals. The book costs $19.95 and can be purchased from a bookstore after March 1st 2000.

Well, I better order my copy. But buying a book is not enough unless I do something about it. Only then the mirror and the scale will tell the truth!

Start reading the preview of my book A Doctor's Journey for free on Amazon. Available on Kindle for $2.99!