Risk factors for kidney disease include:

• Advanced age
• Diabetes or family history of diabetes
• Family history of kidney disease
• High blood pressure or a family history of high blood pressure
• Kidney filtering disease (glomerulonephritis)
• Inherited kidney disorders like polycystic kidney disease.

If you have any of these conditions, consult your physician about assessing your risks and consider having your kidney function tested as early kidney disease may be difficult to detect on your own. In fact, according to the American Kidney Fund, 30 million people in the United States have chronic kidney disease and many do not know it. The danger of not knowing that you have the disease is that you do not seek treatment until the condition has advanced. Testing for kidney disease is simple. It involves a thorough physical examination and blood and urine tests.

As chronic kidney disease progresses, you may experience the following symptoms:

• Difficulty sleeping
• Fatigue
• Itchy skin
• Loss of appetite
• Swollen ankles
• Weakness

Since early detection gives you the best opportunity for treatment with a positive outcome, consult a nephrologist as soon as you notice any of these symptoms.  

Chronic kidney disease can cause complications such as an increased risk of heart disease, high blood pressure, abnormal levels of minerals in the blood, the accumulation of fluids in the body, and anemia – an abnormally low red blood cell count. When detected and treated early, it may be possible to prevent your condition from becoming more serious. In some cases, treatment can reverse the disease.

Kidney stones are hard deposits made of minerals and salts that form inside your kidneys. They can vary in size, from as small as a grain of sand to larger than a golf ball. Kidney stones can be painful. Our nephrologists have outstanding experience in managing kidney stones. In addition, we can help reduce your risk of developing more kidney stones. We work with Orlando Health urologists to use the best technique for treating your kidney stones.

Blood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Blood pressure readings are given as two numbers. The top number is called systolic blood pressure. The bottom number is called diastolic blood pressure. For example, 120 over 80 is written as 120/80 millimeters of mercury or mm Hg. One or both of these numbers can be too high. Hypertension is the term used to describe high blood pressure.

• Normal blood pressure is lower than 120/80 mm Hg most of the time. If you have heart or kidney problems or you have had a stroke, your doctor may want your blood pressure to be even lower.
• High blood pressure (hypertension) is when one or both of your blood pressure readings is higher than 130/80 mm Hg most of the time.
• Elevated blood pressure means your top blood pressure number is between 120 and 130 mm Hg and your bottom blood pressure number is less than 80 mm Hg.

These numbers apply to people who are not taking medicines for blood pressure and who are not ill.

You have a higher risk of high blood pressure if you are:

• African American
• Obese
• Often stressed or anxious
• Drinking more than one alcoholic drink per day for women and more than two alcoholic drinks per day for men
• Consuming too much sodium
• From a family with a history high blood pressure
• Diabetic
• A smoker

The following factors can affect blood pressure:

• The amount of water and salt you have in your body
• The condition of your kidneys, nervous system or blood vessels
• Your hormone levels

High blood pressure that is caused by another medical condition or medication you are taking is called secondary hypertension. It may be due to:

• Chronic kidney disease
• Disorders of the adrenal gland
• Hyperparathyroidism (a disorder of the thyroid gland)
• Medicines such as birth control pills, diet pills, some cold medicines, migraine medicines, corticosteroids, some antipsychotics, and certain medicines used to treat cancer
• A narrowed artery that supplies blood to the kidney, known as renal artery stenosis
• Obstructive sleep apnea
• Pregnancy or pre-eclampsia

When no cause of your high blood pressure is found – which is most often the case –your condition is known as essential hypertension.

Since there are often no symptoms of high blood pressure, your hypertension may go undetected until you visit your healthcare provider or have your blood pressure checked elsewhere. It is possible that you might develop heart disease and kidney problems without knowing you have high blood pressure.

A very serious form is malignant hypertension. This type of very high blood pressure can occur quickly and should be treated as an emergency. Symptoms may include:

• Confusion
• Nausea and vomiting
• Nosebleeds 
• Severe headache
• Vision changes

Diagnosing high blood pressure early can help prevent heart disease, stroke, eye problems and chronic kidney disease. If you are over the age of 18, you should have your blood pressure checked every year. More frequent measurement may be needed if you have a history of high blood pressure or if you have risk factors for high blood pressure.

You can also take your own blood pressure readings. To do so, follow these guidelines:

• Make sure you use a good-quality, well-fitting home blood pressure monitor. It should have a proper-sized cuff and a digital readout.
• Practice with your provider to make sure you are taking your blood pressure correctly.
• Relax and be seated for several minutes before taking a reading.
• Bring your home monitor to your appointments so your doctor can make sure it is working correctly.

In addition to taking a blood pressure reading, your doctor will do a physical exam to detect signs of heart disease, damage to the eyes and other changes in your body. Other tests may be indicated to reveal:

• Heart disease, using tests such as an echocardiogram or electrocardiogram
• High cholesterol levels
• Kidney disease, using tests such as a basic metabolic panel and urinalysis or ultrasound of the kidneys

In some cases, to make an accurate diagnosis, we may recommend 24-hour ambulatory blood pressure monitoring (ABPM). This monitoring involves wearing a small battery-powered blood pressure monitor for 24 hours as you go about your daily activities. Some situations in which ABPM may be helpful are if you:

• Experience symptoms such as dizziness while taking blood pressure medications
• Have blood pressure readings below 140/90 mm Hg at home, but your blood pressure readings are higher than 140/90 mm Hg in the doctors’ office

ABPM is considered the gold standard in blood pressure assessment. 

We are expert in the detection, evaluation and management of blood pressure, using state-of-the-art diagnosis and treatment. The goal of treatment is to reduce your blood pressure to reduce your risk of health problems. You and your provider should set a blood pressure goal for you.

Treatment may include:

Medication

Most of the time, your provider will try lifestyle changes first and check your blood pressure two or more times. Medicines will likely be prescribed if your blood pressure readings remain at or above these levels:

• Top number: systolic pressure of 130 or more
• Bottom number: diastolic pressure of 80 or more

There are many different medicines to treat high blood pressure. Often, a single drug may not be enough to control your blood pressure and you may need to take two or more drugs. It is very important that you take the medicines prescribed to you. If you have side effects, your doctor can substitute a different medicine. 

Lifestyle Changes

You can do many things to help control your blood pressure, including:

• Drink plenty of water.
• Eat a heart-healthy diet, including potassium and fiber.
• Get at least 40 minutes of moderate to vigorous aerobic exercise at least three to four days a week.
• Limit how much alcohol you drink to no more than one drink a day for women, and two or fewer a day for men.
• Limit the amount of sodium (salt) you eat. Aim for less than 1,500 mg per day.
• Quit smoking.
• Reduce stress. Try to avoid things that cause you stress and do meditation or yoga to relieve your stress.
• Maintain a healthy body weight.

Your provider can help you find programs to help you lose weight, quit smoking and maintain an exercise program. You may also ask for a referral to a dietitian who can help you plan a healthy diet.

Glomerulonephritis is related to your immune system and diseases that affect your immune system. Expert medical advice is required to diagnose and treat both the underlying disease and the resulting kidney condition. In addition, it is important to get a diagnosis and treatment early enough to prevent serious loss of kidney function. To treat glomerulonephritis and related conditions, our kidney specialists work closely with rheumatologists and other medical specialists..

Our level of experience means the best care for you. Each type of glomerular disease requires specific treatment. In general, controlling your blood pressure and taking diuretics to reduce swelling may be part of your treatment plan. We personalize a treatment plan just for you. Your care may involve pathology, rheumatology and hematology specialists working together. We also collaborate with your referring doctor, ensuring you have support every step of the way.