Glossary
A
ACCESS - in dialysis, the point on the body where a needle is inserted and blood can be safely removed and returned to the body. It is usually in the forearm.
ACCESS CLOTTING - In dialysis, an aggregation of blood platelets massed together around the point on the body where a needle is inserted and blood can be safely removed and returned to the body.
ACUTE RENAL FAILURE - sudden and temporary loss of kidney function. Some cases may lead to chronic renal failure.
ALBUMIN - is a type of protein made from the dietary protein. A low albumin may be due to inadequate protein or calorie intake. In kidney disease, albumin is lost in the urine which adds to the low albumin level caused by poor nutrition. Albumin may drop after surgery or with blood loss. It may also drop during periods of infection.
ALBUMINURIA - more than normal amounts of albumin in the urine and an early indicator of diabetic nephropathy.
ANEMIA - the condition of having too few red blood cells commonly seen in chronic kidney disease. Damaged kidneys do not produce enough erythropoietin to stimulate the production of red blood cells. Red blood cells carry oxygen throughout the body. If the red blood cell count is low, the body does not get enough oxygen.
ANURIA - a condition in which a person stops making urine seen in renal failure.
ATHEROSCLEROSIS - hardening of the arteries from plaque build-up.
ARTHEROTHROMBOTIC EVENT - an occurrence of a blood clot adhering to the wall of an artery and blocking blood flow causing a stroke or myocardial infarction.
AV FISTULA - Mostly referred to simply as "fistula". A surgical connection of an artery directly to a vein, usually in the forearm, created in patients requiring maintenance hemodialysis.
B
BLOOD UREA NITROGEN (BUN) - a measurement of urea in the blood. An elevated Bun may mean the kidneys are not working properly.
C
CARBIDOPA - administered with L-dopa in the treatment of Parkinson's disease to increase the amount of L-dopa available for transport to the brain.
COBALAMIN - Vitamin B12 a water soluble vitamin important for metabolism helps form red blood cells and maintain central nervous system; to be absorbed, it must bind to the intrinsic factor--exception--see Kuzminski Study.
CHRONIC RENAL FAILURE - slow and progressive loss of kidney function over several years or even decades. CRF often results in permanent kidney failure requiring dialysis or transplantation.
CREATININE - the waste product that comes primarily from the breakdown of muscle. Creatinine levels increase as kidney function decreases. The higher the creatinine, the worst the kidneys are working.
CREATININE CLEARANCE - A creatinine clearance test shows how fast your kidneys remove creatinine from the blood. Clearance is measured in milliliters per minute (ml/min). In general, the lower the creatinine clearance, the worse the kidneys are working. Although it differs slightly for men and women, normal values are between 100-140 ml/min. Below this range, kidneys are not working at capacity.
CYSTEINE - amino acid by-product of homocysteine metabolism.
D
DEMETHYLATION - process by which methionine is metabolized into homocysteine.
DIABETIC KIDNEY DISEASE - Diabetic kidney disease is the largest single cause of kidney failure. It is also referred to as diabetic nephropathy. Both Type 1 and Type 2 Diabetes cause chronic kidney disease. Because of the higher prevalence of Type 2 Diabetes (90-95% of all Diabetics are Type 2), it is the more common cause of diabetic kidney disease. Diabetic kidney disease usually has a characteristic clinical course after the onset of diabetes, first manifested by microalbuminuria, then clinical proteinuria, hypertension, and declining GFR.
DIALYSIS - the process of cleaning wastes from the blood artificially with special equipment. The two major forms of dialysis are hemodialysis and peritoneal dialysis.
- Hemodialysis - the use of a machine to clean waste from the blood. The blood travels through tubes to a dialyzer (artificial kidney) which removes wastes and extra fluid. The cleaned blood then flows through another set of tubes back into the body.
- Peritoneal dialysis - cleaning the blood by using the lining of the abdominal cavity as a filter. It needs no machine. A cleansing liquid, called dialysis solution is drained from a bag into the abdomen. Fluids and wastes flow through the lining of the cavity and remain &trapped& in the dialysis solution. The solution is then drained from the abdomen, removing the extra fluids and wastes from the body.
DIALYZER - attached to the hemodialysis machine and is also called &artificial kidney&. The dialyzer filters the blood during hemodialysis. The dialyzer has two sections separated by a membrane. One section holds the dialysis solution. The other holds the patient's blood.
E
EDEMA - swelling caused by too much fluid in the body.
END-STAGE RENAL DISEASE - (ESRD) total and permanent kidney failure requiring treatment to replace the work of the failed kidneys.
ERYTHROPOIETIN - a hormone made by the kidneys to help form red blood cells. Lack of this hormone may lead to anemia. In advanced kidney failure, erythropoietin must be supplemented.
F
FENOFIBRATE - a medication used with diet changes (restriction of cholesterol and fat intake) to reduce the amount of cholesterol and triglycerides (fatty substances) in your blood.
FOLATE/FOLIC ACID/FOLACIN - an essential water-soluble vitamin that is necessary for DNA synthesis necessary for cell division and repair, metabolism of neurotransmitters and the methylation of homocysteine into methionine.
G
GLOMERULI - plural of glomerulus.
GLOMERULOSCLEROSIS - scarring of the glomeruli. It may result from diabetes.
GLOMERULUS - a tiny set of looping blood vessels in each nephron. This is where blood is filtered in the kidney.
GLOMERULAR FILTRATION RATE (GFR) - provides an estimate of the filtering capacity of the functioning nephrons. It can be measured directly but can also be calculated with a formula.
GRAFT - a vascular access surgically created using a synthetic tube to connect an artery to a vein in patients requiring dialysis. Most often it is surgically placed in the forearm.
H
HEMATOCRIT - the proportion of blood that consists of red blood cells. The hematocrit is expressed as a percentage. 33-36% is the acceptable range for dialysis patients.
HEMOGLOBIN - the oxygen-carrying pigment and predominant protein in red blood cells. 11-12 is the acceptable range for dialysis patients.
HOMOCYSTEINE - amino acid by-product of methionine metabolism.
HYPERTENSION - high blood pressure which can be caused either by too much fluid in the blood vessels or by narrowing of the blood vessels.
I
INTRINSIC FACTOR - natural substance normally found present in the stomach essential to the metabolism of vitamin B12.
K
K/DOQI - Kidney Disease Outcomes Quality Initiative. Launched by NKF to develop clinical practice guidelines to improve outcomes of patients with chronic kidney disease.
KIDNEY FAILURE - loss of kidney function. May also be referred to as end-stage renal disease or renal failure.
KUZMINSKI STUDY - Effective Treatment of Cobalamin [B12] Deficiency With Oral Cobalamin. Demonstrates that 2mg of B12 effectively treats B12 deficiency in people without the intrinsic factor. Taking 2mg of B12 daily is as effective as a monthly B12 shot.
L
L-DOPA, LEVODOPA - converted to dopamine in the brain, and is used in treating Parkinson's disease.
M
MEGALOBLASTIC ANEMIA - B12 deficiency
METFORMIN - an anti-diabetic drug prescribed to treat type II diabetes
METHIONINE - amino acid by-product of the metabolism of protein.
METHOTREXATE - in a class of drugs known as antimetabolites; it slows the growth of certain cells in your body. It is used to treat rheumatoid arthritis, severe psoriasis trophoblastic neoplasms and leukemias. It increases homocysteine levels. Study shows that in addition to lowering homocysteine levels, folic acid helps prevent side effects of mouth ulcers, nausea or vomiting, thus raising compliance with doctor's orders.
MICROALBUMINURIA - small amounts of protein found in the urine. A highly sensitive indicator of glomerular disease and a sign that kidneys are not functioning properly.
MICROVASCULAR DISEASE - disease of the smallest vessels. The smallest vessels in the kidney are called glomeruli. In kidney disease, the walls of the glomeruli become abnormally thick but weak, and therefore bleed, leak protein, and slow the flow of blood through the kidney.
MORBIDITY - sickness
MORTALITY - death
MTHFR - the enzyme that reduces folic acid to its most active form, methyltetrahydrofolate.
MYOCARDIAL INFARCTION - irreversible injury to the heart muscle (heart attack).
N
NEPHROLOGIST - physician who treats patients with kidney problems or hypertension.
NEPHROPATHY - disease of the small units in the kidneys (nephrons) that clean the blood.
NEPHRON - the working units of the kidney that remove waste and extra fluids from the blood. Each kidney is made of approximately 1 million nephrons.
NKF - National Kidney Foundation.
P
PARENTERAL - administration by intravenous, intramuscular or subcutaneous injection
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