Kidney Failure

Unlike acute renal failure with its sudden (but reversible) failure of kidney function, chronic renal failure is slowly progressive. It most often results from some disease that causes gradual destruction of the kidneys and can range from mild dysfunction to severe kidney failure. Progression may continue to end-stage renal disease. Chronic renal failure usually occurs over a number of years as the internal structures of the kidney are slowly destroyed. In the early stages, there may be no symptoms. Progression may be so gradual that symptoms do not occur until kidney function is less than one-tenth of normal.

Chronic renal failure occurs in approximately 2 out of every 10,000 people. Causative diseases include glomerulonephritis of any type (one of the most common causes), polycystic kidney disease, hypertension, Alport syndrome, reflux nephropathy, obstruction, kidney stones, infection, and analgesic toxicity. Diabetes mellitus is a major cause of chronic renal failure.

Chronic renal failure results in the accumulation of fluid and waste products in the body, causing low urine output and waste accumulation. These may occur without symptoms. Most bodily systems are affected by chronic renal failure.

Treatment of the underlying disorders may help prevent or delay development of chronic renal failure. Treatment focuses on controlling the symptoms, minimizing complications, and slowing the progression of the disease.

Associated diseases that cause or result from chronic renal failure must be controlled. Hypertension, congestive heart failure, urinary tract infections, kidney stones, obstructions of the urinary tract, glomerulonephritis, and other disorders should be treated as appropriate. Blood transfusions or medications such as iron and erythropoietin supplements may be needed to control anemia.

Fluid intake may be restricted, often to an amount equal to the volume of urine produced. Dietary restrictions may slow the build-up of wastes in the bloodstream and control associated symptoms such as nausea and vomiting. Salt, potassium, phosphorus, and other electrolytes may be restricted.

There is no cure for chronic renal failure. Untreated, it usually progresses to end-stage renal disease. Lifelong treatment may control the symptoms of chronic renal failure. Dialysis or kidney transplant may eventually be required.

There are steps that can be taken, but must be taken early, to reduce the complications and symptoms as much as possible. Some ways to help prevent or slow down the onset of chronic renal failure include:-

  • monitoring blood pressure regularly
  • following recommended treatments for chronic diseases such as diabetes, lupus, and hypertension
  • not smoking – for people with diabetes, smoking can speed up the damage to the small blood vessels in the body
  • not abusing over-the-counter medications
  • getting treatment for urinary tract infections or any type of urinary problems as soon as possible
  • reducing autoimmunity activity

 


Signs, symptoms & indicators of Kidney Failure

Symptoms - Gas-Int - General  

Hiccups



 

Unexplained nausea



 

Unexplained vomiting



Symptoms - General  

Constant fatigue



Symptoms - Nails  

Nails turning white towards the ends

Leukonychia (partial or completely white nails) is a sign of renal failure.



Symptoms - Skin - General  

Itchy skin




Conditions that suggest Kidney Failure

Circulation  

Pericarditis

Sometimes pericarditis may be a secondary symptom of kidney failure.



 

Anemia (Iron deficiency)

Patients with CRF often suffer from complications such as anemia, which occurs when failing kidneys no longer produce sufficient erythropoietin, a hormone that stimulates the production of oxygen-carrying red blood cells (RBCs). In addition to decreased levels of RBCs, patients often begin to accumulate toxic metabolites, which shorten the lifespan of existing RBCs.



Environment / Toxicity  

Magnesium Toxicity

High levels of magnesium can develop in patients with kidney failure and in elderly people whose kidney functions are reduced. This is especially true with magnesium supplementation.



Hormones  


Lab Values  

Elevated Homocysteine Levels

Homocysteine levels in patients suffering from chronic renal failure are significantly elevated at an early stage. The kidney plays a very significant role in homocysteine metabolism but this does not occur during chronic renal failure. In addition, there is a decreased extra-renal catabolism, which contributes to the hyperhomocysteinemia state. [Hyperhomocysteinemia: A Role in The Accelerated Atherogenesis of Chronic Renal Failure?, Netherlands Journal of Medicine, 1995;46: pp.244-251]



 


Metabolic  


Musculo-Skeletal  

Gout / Hyperuricemia

Patients with impaired renal function filter and excrete less uric acid and therefore become hyperuricemic. Interestingly, patients with renal failure do not develop gout as frequently as expected, despite their high plasma urate levels. The explanation for this phenomenon may be that they have not incurred sustained hyperuricemia levels long enough to develop gout. Only 1% of renal failure patients develop gout but nearly 30% of patients with adult polycystic kidney disease do.



Organ Health  


Skin-Hair-Nails  


Symptoms - Urinary  

Kidney failure



Counter Indicators
Symptoms - Urinary  

Confirmed absence of kidney failure




Risk factors for Kidney Failure

Diet  

Dehydration

A mysterious epidemic is devastating the Pacific coast of Central America, killing more than 24,000 people in El Salvador and Nicaragua since 2000 and striking thousands of others with chronic kidney disease at rates unseen virtually anywhere else. Scientists say they have received reports of the phenomenon as far north as southern Mexico and as far south as Panama.

Last year it reached the point where El Salvador’s health minister, Dr. Maria Isabel Rodriguez, appealed for international help, saying the epidemic was undermining health systems.

Wilfredo Ordonez, who has harvested corn, sesame and rice for more than 30 years in the Bajo Lempa region of El Salvador, was hit by the chronic disease when he was 38. Ten years later, he depends on dialysis treatments he administers to himself four times a day. “This is a disease that comes with no warning, and when they find it, it’s too late,” Ordonez said as he lay on a hammock on his porch.

Many of the victims were manual laborers or worked in sugar cane fields that cover much of the coastal lowlands. Patients, local doctors and activists say they believe the culprit lurks among the agricultural chemicals workers have used for years with virtually none of the protections required in more developed countries. But a growing body of evidence supports a more complicated and counterintuitive hypothesis.

The roots of the epidemic, scientists say, appear to lie in the grueling nature of the work performed by its victims, including construction workers, miners and others who labor hour after hour without enough water in blazing temperatures, pushing their bodies through repeated bouts of extreme dehydration and heat stress for years on end. Many start as young as 10. The punishing routine appears to be a key part of some previously unknown trigger of chronic kidney disease, which is normally caused by diabetes and high-blood pressure, maladies absent in most of the patients in Central America.

“The thing that evidence most strongly points to is this idea of manual labor and not enough hydration,” said Daniel Brooks, a professor of epidemiology at Boston University’s School of Public Health, who has worked on a series of studies of the kidney disease epidemic.

Because hard work and intense heat alone are hardly a phenomenon unique to Central America, some researchers will not rule out manmade factors. But no strong evidence has turned up. “I think that everything points away from pesticides,” said Dr. Catharina Wesseling, an occupational and environmental epidemiologist who also is regional director of the Program on Work, Health and Environment in Central America. “It is too multinational; it is too spread out. I would place my bet on repeated dehydration, acute attacks everyday. That is my bet, my guess, but nothing is proved.” [Published February 12, 2012 Associated Press]



Environment / Toxicity  


Infections  

Malaria

Plasmodium falciparum, if not promptly treated, may cause kidney failure, seizures, mental confusion, coma, and death.



Lab Values - Chemistries  

Elevated creatinine

In true renal failure, the BUN is less than 10 times the creatinine. Serum creatinine’s relation to renal failure is exponential. A creatinine of 2 means that half of the kidney function is lost. If the creatinine is around 5, about 80 to 90% of their kidney function is lost.



 

Elevated serum K



 

Low CO2



 

Elevated BUN



 

Hypocalcemia



Counter Indicators
Lab Values - Chemistries  

Normal BUN or low BUN



 

Normal creatinine

In true renal failure, the BUN is less than 10 times the creatinine. Serum creatinine’s relation to renal failure is exponential. A creatinine of 2 means that half of the kidney function is lost. If the creatinine is around 5, about 80 to 90% of their kidney function is lost.



Metabolic  

Nephrotic Syndrome (NS)

Nephrotic syndrome is associated with renal failure. The disease that causes NS can damage the glomeruli and can interfere with their ability to clean the blood. The edema that is present in the legs may also be occurring in the kidney tissue itself and can interfere with the kidneys’ ability to clean the blood. Renal failure can either be gradual (CRF) or acute (ARF).

BUN and creatinine may or may not be elevated in NS. If bun and creatinine are elevated the patient has renal failure and the prognosis is worse.



 

Anorexia / Starvation Tendency

The common medical complications of being severely underweight include kidney damage.



Organ Health  

Alport Syndrome

Alport Syndrome causes progressive kidney damage. This means that the glomeruli undergo a gradual but persistent process of destruction, leading to kidney failure in many cases. Boys with Alport Syndrome inevitably develop kidney failure, but kidney failure in girls is unusual. The age at which boys with Alport Syndrome develop kidney failure varies from family to family. It may occur as early as 15-20 years of age, but in some families, kidney failure does not develop until the men are 40-50 years of age.



 


 

Diabetes Type II

Type II diabetes mellitus is the leading cause of chronic kidney failure, accounting for 35% of the new cases each year and 25% of all cases in the U.S.. People with diabetes are at risk for developing anemia because this specific type of kidney damage, known as diabetic nephropathy, can result in a slow but progressive loss of kidney function and a related decrease in red blood cell production.

Of the almost 16 million Americans with diabetes, 10 percent to 21 percent, or, between 1.6 to 3.2 million Americans develop diabetic kidney disease (diabetic nephropathy), with the risk of developing kidney disease increasing with time. What many of these people may not know, is that anemia may be an important warning of this devastating complication.



 


Symptoms - Glandular  

Poorly controlled diabetes



 

Reasonably controlled diabetes

Diabetes mellitus is a major cause of chronic renal failure. In Singapore, statistics have shown that out of the 500 newly diagnosed kidney failure patients each year, 50% were caused by diabetes and 9% were caused by hypertension. When sugar levels rise enough to spill into the urine, as in diabetes, blood vessels in the kidneys are damaged. This condition is known as diabetic nephropathy. Symptoms related to kidney failure usually occur only in late stages of the disease, when kidney function has diminished to less than 25% of normal capacity. For many years before that point, kidney disease of diabetes exists as a silent process.



Symptoms - Metabolic  

Recent unexplained weight loss




Kidney Failure suggests the following may be present

Diet  

Dehydration

A mysterious epidemic is devastating the Pacific coast of Central America, killing more than 24,000 people in El Salvador and Nicaragua since 2000 and striking thousands of others with chronic kidney disease at rates unseen virtually anywhere else. Scientists say they have received reports of the phenomenon as far north as southern Mexico and as far south as Panama.

Last year it reached the point where El Salvador’s health minister, Dr. Maria Isabel Rodriguez, appealed for international help, saying the epidemic was undermining health systems.

Wilfredo Ordonez, who has harvested corn, sesame and rice for more than 30 years in the Bajo Lempa region of El Salvador, was hit by the chronic disease when he was 38. Ten years later, he depends on dialysis treatments he administers to himself four times a day. “This is a disease that comes with no warning, and when they find it, it’s too late,” Ordonez said as he lay on a hammock on his porch.

Many of the victims were manual laborers or worked in sugar cane fields that cover much of the coastal lowlands. Patients, local doctors and activists say they believe the culprit lurks among the agricultural chemicals workers have used for years with virtually none of the protections required in more developed countries. But a growing body of evidence supports a more complicated and counterintuitive hypothesis.

The roots of the epidemic, scientists say, appear to lie in the grueling nature of the work performed by its victims, including construction workers, miners and others who labor hour after hour without enough water in blazing temperatures, pushing their bodies through repeated bouts of extreme dehydration and heat stress for years on end. Many start as young as 10. The punishing routine appears to be a key part of some previously unknown trigger of chronic kidney disease, which is normally caused by diabetes and high-blood pressure, maladies absent in most of the patients in Central America.

“The thing that evidence most strongly points to is this idea of manual labor and not enough hydration,” said Daniel Brooks, a professor of epidemiology at Boston University’s School of Public Health, who has worked on a series of studies of the kidney disease epidemic.

Because hard work and intense heat alone are hardly a phenomenon unique to Central America, some researchers will not rule out manmade factors. But no strong evidence has turned up. “I think that everything points away from pesticides,” said Dr. Catharina Wesseling, an occupational and environmental epidemiologist who also is regional director of the Program on Work, Health and Environment in Central America. “It is too multinational; it is too spread out. I would place my bet on repeated dehydration, acute attacks everyday. That is my bet, my guess, but nothing is proved.” [Published February 12, 2012 Associated Press]



Counter Indicators
Diet  


Mental  

Schizophrenia

Patients who undergo dialysis regularly may be exposed to high levels of aluminum in dialysis fluids and medicines. A reaction called dialysis encephalopathy can occur. What follows is a progressive mental degeneration manifested by tremors, convulsions, psychosis and other changes in speech and behavior. Reduction of aluminum levels significantly reduces the incidence of this problem.



Organ Health  

Alport Syndrome

Alport Syndrome causes progressive kidney damage. This means that the glomeruli undergo a gradual but persistent process of destruction, leading to kidney failure in many cases. Boys with Alport Syndrome inevitably develop kidney failure, but kidney failure in girls is unusual. The age at which boys with Alport Syndrome develop kidney failure varies from family to family. It may occur as early as 15-20 years of age, but in some families, kidney failure does not develop until the men are 40-50 years of age.




Kidney Failure can lead to

Circulation  

Anemia (Iron deficiency)

Patients with CRF often suffer from complications such as anemia, which occurs when failing kidneys no longer produce sufficient erythropoietin, a hormone that stimulates the production of oxygen-carrying red blood cells (RBCs). In addition to decreased levels of RBCs, patients often begin to accumulate toxic metabolites, which shorten the lifespan of existing RBCs.



Lab Values  

Elevated Homocysteine Levels

Homocysteine levels in patients suffering from chronic renal failure are significantly elevated at an early stage. The kidney plays a very significant role in homocysteine metabolism but this does not occur during chronic renal failure. In addition, there is a decreased extra-renal catabolism, which contributes to the hyperhomocysteinemia state. [Hyperhomocysteinemia: A Role in The Accelerated Atherogenesis of Chronic Renal Failure?, Netherlands Journal of Medicine, 1995;46: pp.244-251]



Metabolic  


Musculo-Skeletal  

Gout / Hyperuricemia

Patients with impaired renal function filter and excrete less uric acid and therefore become hyperuricemic. Interestingly, patients with renal failure do not develop gout as frequently as expected, despite their high plasma urate levels. The explanation for this phenomenon may be that they have not incurred sustained hyperuricemia levels long enough to develop gout. Only 1% of renal failure patients develop gout but nearly 30% of patients with adult polycystic kidney disease do.



 

Restless Leg Syndrome (RLS) / Periodic Limb Movement Disorder (PLMD)

Secondary causes of RLS are associated with dopamine receptor blockers, end-stage renal disease, fibromyalgia, iron deficiency, discontinuation of opiates, pregnancy, use of spinal anesthesia, and uremia.



Skin-Hair-Nails  



Recommendations for Kidney Failure

Amino Acid / Protein  

Cysteine / N-acetyl-cysteine (NAC)

Oral treatment with acetylcysteine (400mg twice daily) reduced serum creatinine concentrations in a controlled study of 121 patients with chronic renal insufficiency. [J Am Coll Cardiol 2002;40(8): pp.1383-8]



Animal-based  

Chitosan

In a study of patients with chronic renal failure undergoing long-term hemodialysis 450 mg of chitosan 3 times a day for 12 weeks produced multiple benefits. Mean serum cholesterol went down 43% and mean serum hemoglobin increased from 5.8 to 6.8 g/dl in those patients who received the chitosan. Mean urea (from 75 to 45 mM) and creatinine (from 1. 001 to 0.875 mM) levels in serum showed significant reductions after 12 weeks of chitosan treatment. Compared with the control group, the treatment group reported significantly improved appetite, sleep and feeling of physical strength. No significant side effects were seen. (Jing SB. et al. J Pharm Pharmacol 1997;49:72 1-723.)



Botanical  

Herbal Combinations

The use of Liu Wei Di Huang Wan or Six Flavor Tea Pill has shown a decrease of fatalities due to kidney disease.



Detoxification  

Heavy Metal Detoxification / Avoidance

A study evaluated 272 men and women with chronic renal failure and found that there was a significantly increased risk from exposure to lead, copper, chromium, tin, mercury, welding fumes, silicon containing compounds, grain dust and oxygenated hydrocarbons. Occupational exposures were high amongst patients with diabetic nephropathy.



 


Diet  


 

Vegetarian/Vegan Diet

A low protein diet is important in reducing the processing responsibilities of compromised kidneys.



 

Reduced Water Consumption

If the kidneys are not allowing the body to get rid of excess fluid, fluid intake may need to be restricted so that the kidneys don’t have to work as hard. One day’s allotment is often based on the amount of urine produced the day before. For example, someone who produces 500ml of urine in one day might be allowed to drink 500ml of fluid over the following 24 hours, and so on. Fluid restrictions are usually only used in severe cases or if the renal failure has developed into end-stage renal failure.



 

High/Increased Protein Diet

You may need to have less protein in your diet to prevent further damage to your kidneys. With the right diet you can reduce the work your kidneys must do.



 

Increased Water Consumption

The amounts of liquids you drink must be balanced against how much you urinate. This will require your doctor’s help.



 

Therapeutic Fasting

Lengthy fasting should generally be avoided by people with renal failure. Short-term fasts may be helpful, but must be done under an experienced doctor’s supervision.



Homeopathy  

Homeopathic Remedies / Vaccines

Reports by doctors using homeopathy say that patient response is better in those who have not yet started with dialysis. Long-term constitutional therapy as well as therapy aimed at improving kidney function helps to keep the patient relatively free of symptoms and complications. Remedies such as Serum Anguillar Ichthyotoxin, Solidago and Urea have been found useful in dealing with chronic renal failure and its complications. Hipuric acid has been found to be useful for the itching of skin arising from chronic renal failure.



Mineral  

Potassium

You may need to limit the potassium in your diet because it may be hard for your kidneys to get rid of any extra potassium.



 

Magnesium

If you have kidney problems, taking magnesium supplements may cause you to accumulate the mineral too quickly, which could be toxic. As kidneys fail, they lose their ability to remove excess magnesium. If you have kidney problems, you should check with your doctor before taking magnesium supplements.



Nutrient  

CoQ10 (Ubiquin-one/ol)

In a randomized, double-blind, placebo-controlled trial, researchers found that CoQ10 treatment decreased progression and reversed renal dysfunction in a majority of patients with end-stage disease, many of whom were able to discontinue dialysis over the course of the 12-week trial.

Dr. Singh and his colleagues documented significantly lower levels of serum creatinine and blood urea nitrogen in the CoQ10 treated patients, with increases in creatinine clearance and urine output regardless of patient dialysis or baseline status. More significantly, only half the number of CoQ10 patients required dialysis at the end of the study when compared to subjects receiving placebo.

The researchers also reported considerable increases in the antioxidant vitamins E and C and beta-carotene in treated subjects, while plasma levels of oxidative stress such as thiobarbituric acid reactive substances, diene conjugates, and malondialdehyde all fell dramatically.

Although one in five patients did not respond, the researchers concluded that CoQ10 supplementation improves renal function in end-stage patients regardless of dialysis status, and can delay or avert the need for dialysis. They suggested that higher doses than those used in their study (180mg per day) might result in even greater improvement and response in others. [J Nutr Environ Med. 2003;13(1): pp.13-22]



 

Essential Fatty Acids

There have been a variety of trials of omega-3 fatty acid supplementation in patients with a variety of renal disorders. These trials suggest that such therapy may be of use in the treatment of IgA nephropathy and chronic renal failure. Dietary polyunsaturated fatty acid manipulation results in an anti-inflammatory. [Polyunsaturated Fatty Acids and Renal Disease, Proceedings of the Society For Experimental Biology and Medicine, 1996;213: pp.13-23.]

Fish oil supplementation is promising and does not produce the risks associated with corticosteroid and immunosuppressive drug use.



Vitamins  

Vitamin Folic Acid

Patients with chronic renal failure have homocysteine levels that are significantly elevated at an early stage. Taking 5mg of folic acid daily can significantly lower these homocysteine levels. [Hyperhomocysteinemia: A Role in The Accelerated Atherogenesis of Chronic Renal Failure?, Netherlands Journal of Medicine, 1995;46: pp.244-251]



 

Vitamin E

Vitamin E levels, independent of dietary intake, have been found to be lower in patients with chronic renal failure. This reflects increased oxidative activity and suggests the need for antioxidants such as vitamin E. [Dietary Intake and Plasma Levels of Antioxidant Vitamins in Health and Disease: A Hospital-Based, Case-Control Study, Singh, Ram, B., M.D., et al, Journal of Nutritional & Environmental Medicine, 1995;5: pp.235-242]



 

Vitamin C (Ascorbic Acid)

The authors of the following study believe it shows that vitamin C supplementation leads to a significant increase in serum oxalate levels in dialysis patients. In renal insufficiency, vitamin C levels were elevated, but not oxalate levels. Caution is advised with regard to vitamin C and renal insufficiency.

“Relationship Between the Serum Concentration of Oxalic Acid and Ascorbic Acid in Chronic Renal Insufficiency”, Gerold, M., et al, Nieren-Und Hochdruckkrankheiten, May 1992;21(Suppl. 1): pp.58-61. (Address: Dr. G. Stein, Erlanger Allee 101, O-6902 Jena-Lobeda, Germany)



Key

Weak or unproven link
Strong or generally accepted link
Proven definite or direct link
Strongly counter-indicative
Very strongly or absolutely counter-indicative
Likely to help
Highly recommended
May have adverse consequences
Reasonably likely to cause problems
Avoid absolutely

Glossary

Acute

An illness or symptom of sudden onset, which generally has a short duration.

Chronic Renal Failure

(CRF) Irreversible, progressive impaired kidney function. The early stage, when the kidneys no longer function properly but do not yet require dialysis, is known as Chronic Renal Insufficiency (CRI). CRI can be difficult to diagnose, as symptoms are not usually apparent until kidney disease has progressed significantly. Common symptoms include a frequent need to urinate and swelling, as well as possible anemia, fatigue, weakness, headaches and loss of appetite. As the disease progresses, other symptoms such as nausea, vomiting, bad breath and itchy skin may develop as toxic metabolites, normally filtered out of the blood by the kidneys, build up to harmful levels. Over time (up to 10 or 20 years), CRF generally progresses from CRI to End-Stage Renal Disease (ESRD, also known as Kidney Failure). Patients with ESRD no longer have kidney function adequate to sustain life and require dialysis or kidney transplantation. Without proper treatment, ESRD is fatal.

Glomerulonephritis

Inflammation of glomerulus. The glomerulus is part of a nephron, which in turn is the basic functional (working) unit of a kidney. Millions of nephrons acting together filter the blood to produce urine.

Hypertension

High blood pressure. Hypertension increases the risk of heart attack, stroke, and kidney failure because it adds to the workload of the heart, causing it to enlarge and, over time, to weaken; in addition, it may damage the walls of the arteries.

Alport Syndrome

Alport syndrome is caused by a mutation in a gene for collagen. This inherited disorder is uncommon, affecting about 2 out of 10,000 people. It causes chronic glomerulonephritis with destruction of the glomeruli (the tiny blood vessels within the kidneys that filter the blood) and eventually progresses to end-stage renal disease at an early age. It was first described by an English doctor, A. Cecil Alport. Because of the way Alport Syndrome is inherited, the disease tends to be more severe in men than in women.

Reflux Nephropathy

Reflux nephropathy occurs when the normally one-direction-only valve-like mechanisms between the ureters and bladder fail. This allows urine to flow back up the ureter directly to the kidney. If the bladder is infected or the urine contains bacteria this exposes the kidney to the possibility of infection (pyelonephritis).

Kidney Stone

A stone (concretion) in the kidney. If the stone is large enough to block the tube (ureter) and stop the flow of urine from the kidney, it must be removed by surgery or other methods. Also called Renal Calculus. Symptoms usually begin with intense waves of pain as a stone moves in the urinary tract. Typically, a person feels a sharp, cramping pain in the back and side in the area of the kidney or in the lower abdomen. Sometimes nausea and vomiting occur. Later, pain may spread to the groin. The pain may continue if the stone is too large to pass; blood may appear in the urine and there may be the need to urinate more often or a burning sensation during urination. If fever and chills accompany any of these symptoms, an infection may be present and a doctor should be seen immediately.

Analgesic

Agent which relieves pain without causing loss of consciousness.

Diabetes Mellitus

A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.

Congestive

Pertaining to accumulation of blood or fluid within a vessel or organ.

Iron

An essential mineral. Prevents anemia: as a constituent of hemoglobin, transports oxygen throughout the body. Virtually all of the oxygen used by cells in the life process are brought to the cells by the hemoglobin of red blood cells. Iron is a small but most vital, component of the hemoglobin in 20,000 billion red blood cells, of which 115 million are formed every minute. Heme iron (from meat) is absorbed 10 times more readily than the ferrous or ferric form.

Anemia

A condition resulting from an unusually low number of red blood cells or too little hemoglobin in the red blood cells. The most common type is iron-deficiency anemia in which the red blood cells are reduced in size and number, and hemoglobin levels are low. Clinical symptoms include shortness of breath, lethargy and heart palpitations.

Nausea

Symptoms resulting from an inclination to vomit.

Potassium

A mineral that serves as an electrolyte and is involved in the balance of fluid within the body. Our bodies contain more than twice as much potassium as sodium (typically 9oz versus 4oz). About 98% of total body potassium is inside our cells. Potassium is the principal cation (positive ion) of the fluid within cells and is important in controlling the activity of the heart, muscles, nervous system and just about every cell in the body. Potassium regulates the water balance and acid-base balance in the blood and tissues. Evidence is showing that potassium is also involved in bone calcification. Potassium is a cofactor in many reactions, especially those involving energy production and muscle building.

Phosphorus

The second most abundant mineral in the body found in every living cell. It is involved in the proper functioning of both muscles and nerves. It is needed for metabolic processes of all cells, to activate many other nutrients, and to form energy-storage and energy-releasing compounds. The phosphorus content of the body is approximately one percent of total body weight. Phosphorus combines with fats to form phospholipids.

Electrolyte

An element or compound that, when melted or dissolved in water or other solvent, breaks up into ions and is able to carry an electric current.

Dialysis

The artificial process of cleaning wastes from the blood when kidneys fail.

Chronic

Usually Chronic illness: Illness extending over a long period of time.

Over-The-Counter

A drug or medication that can legally be bought without a doctor's prescription being required.

Hormones

Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.

Red Blood Cell

Any of the hemoglobin-containing cells that carry oxygen to the tissues and are responsible for the red color of blood.

Metabolite

Any product (foodstuff, intermediate, waste product) of metabolism.

Magnesium

An essential mineral. The chief function of magnesium is to activate certain enzymes, especially those related to carbohydrate metabolism. Another role is to maintain the electrical potential across nerve and muscle membranes. It is essential for proper heartbeat and nerve transmission. Magnesium controls many cellular functions. It is involved in protein formation, DNA production and function and in the storage and release of energy in ATP. Magnesium is closely related to calcium and phosphorus in body function. The average adult body contains approximately one ounce of magnesium. It is the fifth mineral in abundance within the body--behind calcium, phosphorus, potassium and sodium. Although about 70 percent of the body's magnesium is contained in the teeth and bones, its most important functions are carried out by the remainder which is present in the cells of the soft tissues and in the fluid surrounding those cells.

Metabolism

The chemical processes of living cells in which energy is produced in order to replace and repair tissues and maintain a healthy body. Responsible for the production of energy, biosynthesis of important substances, and degradation of various compounds.

Gout

A disease characterized by an increased blood uric acid level and sudden onset of episodes of acute arthritis.

Epidemic

Describes a disease occurring in extensive outbreaks, or with an unusually high incidence at certain times and places.

Epidemiology

The study of the causes and distribution of disease in human populations.

Seizure

While there are over 40 types of seizure, most are classed as either partial seizures which occur when the excessive electrical activity in the brain is limited to one area or generalized seizures which occur when the excessive electrical activity in the brain encompasses the entire organ. Although there is a wide range of signs, they mainly include such things as falling to the ground; muscle stiffening; jerking and twitching; loss of consciousness; an empty stare; rapid chewing/blinking/breathing. Usually lasting from between a couple of seconds and several minutes, recovery may be immediate or take up to several days.

Serum

The cell-free fluid of the bloodstream. It appears in a test tube after the blood clots and is often used in expressions relating to the levels of certain compounds in the blood stream.

Edema

Abnormal accumulation of fluids within tissues resulting in swelling.

Dopamine

A neurohormone; precursor to norepinephrine which acts as a stimulant to the nervous system.

Fibromyalgia

(FMS): Originally named fibrositis, it is a mysteriously debilitating syndrome that attacks women more often than men. It is not physically damaging to the body in any way, but is characterized by the constant presence of widespread pain that often moves about the body. Fibromyalgia can be so severe that it is often incapacitating.

Anesthesia

Loss of sensation caused by neurological dysfunction or a pharmacological depression of nerve function.

Uremia

Condition characterized by excessive urea and other nitrogen compounds in the blood due to renal insufficiency.

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