Pain and palliative care - Kozhikode

Pain and palliative care - Kozhikode Care and support of patients having life threatening diseases,
as well as their families. We expect your support to continue this movement..

Focus on the patients' psycho-social, economic
and the spiritual needs during their last days.

25/01/2013

Seven Tips for Preventing Heart Disease

If you have diabetes, heart disease can be a serious concern. In fact, cardiovascular disease leading to heart attack or stroke is by far the leading cause of death in both men and women with diabetes.

Control your weight.
One of the most important things you can do if you have diabetes is maintain a healthy weight. If you are overweight, talk to a registered dietitian about healthy ways to lose weight.

Get regular physical activity.
There is a significant body of research that proves the myriad cardiovascular benefits of regular physical activity (that goes beyond weight loss). Start off slowly, and build a plan that works well for you and meets your needs.

Don’t smoke.
If you already do, make plans to begin a smoking cessation program. "Ni****ne narrows and restricts blood vessels; diabetes will also do the same thing to your blood vessels.. You can't change having diabetes. But you can stop damage caused by ni****ne.

Maintain tight control over glucose.
Tight control can prevent many complications from diabetes and also protects your heart. Shoot for an A1C reading of less than 7%.

Lower your LDL cholesterol (the "bad" type).
Both the American Diabetes Association and the American Heart Association recommend an LDL cholesterol goal of less than 100 mg/dl. Eating fiber-rich foods, such as fruits, vegetables, and whole grains. Also, he recommends asking your healthcare provider about omega-3 fish oil supplements.

Control your blood pressure.
All people with diabetes should aim for a blood pressure reading of less than 130/80,

Consider incorporating aspirin into your daily routine.
If you are older than thirty years of age, you may want to speak to your doctor about taking a baby aspirin daily. In addition, taking a multivitamin can be extremely helpful for those with diabetes

25/01/2013

Not all smokers get cancer. Why?

You may know someone who smoked all their lives but lived to a ripe old age. Or you may know someone who never smoked but got cancer anyway. Does this mean that smoking doesn’t really cause cancer?

Not at all. Years of research have proven that smoking causes cancer. But this doesn’t mean that all smokers will definitely get cancer or that all non-smokers won’t. It means that smoking greatly increases the risk of this disease. Smokers are, on average, much more likely to get cancer than non-smokers.

In a similar way, we can say that eating sugary foods is a cause of tooth decay. This doesn’t mean that all children who eat sugary foods will end up with decayed teeth. It means that, on average, children who eat lots of sugary foods are more likely to develop tooth decay than those who avoid such foods.

The fact is that half of all smokers eventually die from cancer, or other smoking-related illnesses. And a quarter of smokers die in middle age, between 35 and 69.

Our How do we know? page has more information on the evidence linking smoking to cancer.

How does smoking cause cancer?
To***co smoke contains more than 70 different cancer-causing substances. When you inhale smoke, these chemicals enter your lungs and spread around the rest of your body.

Scientists have shown that these chemicals can damage DNA and change important genes. This causes cancer by making your cells grow and multiply out of control.

Giving up makes a difference
Thanks to research, health campaigns and new policies, the number of smokers in the UK has halved in the last 50 years. Because of this, the number of people who die from lung cancer has also halved. Clearly, giving up smoking saves lives.

But there is still a long way to go. Lung cancer is still the second most common type of cancer in the UK and kills over 35,000 people every year. And there are signs that the number of people who are quitting is starting to match the number who are taking it up.

If you are a smoker, giving up smoking is the best present you can give yourself. There are many techniques you can try to help you join the increasing numbers of smokers who are quitting for good. You can find more advice on quitting in this section.

Finding it hard to quit? Get involved with Stoptober. Research shows that if you can stop smoking for 28 days, you are five times more likely to stay smokefree, and Stoptober leads smokers through a detailed step-by-step programme to help them achieve this goal.

25/01/2013

5 Good Ways to Save Money on Medicine

1. Do Ask About Generic Options

“In most cases, generic drugs can save a great deal of money,” Almost 80% of FDA-approved drugs have generic alternatives that cost an average of four times less than the brand-name versions.

If you take a medication that is going off patent, however, you may need to wait six months to enjoy huge savings. Drug makers can limit generic competition for six months after a drug’s patent protection expires. In time, cheaper generic options become available.

2. Do Look Into Splitting Higher-Dose Pills

Pill splitting is based on the fact that many pills cost about the same even if they contain twice as much medication. An 80 mg pill is often close in price to a pill with 40 mg of the same drug. Ask your doctor or pharmacist if your medication is safe for pill splitting. If so, ask your doctor to prescribe twice the dosage you really need, so you can split your pills in half.

Be aware, many pills are not safe to split, including time-released drugs, coated pills, and capsules, says Richard Sagall, MD, president and co-founder of NeedyMeds, a nonprofit organization in Gloucester, Mass, that provides information about financial assistance programs for prescription drugs. “The best person to ask whether it’s safe to split a pill is the pharmacist,” he says.

3. Do Talk Openly With Your Doctor

Your health care provider may not know how much you’re paying for the drugs he or she prescribes. “Patients should talk with their doctors so they can consider less expensive options,” says Sawaya. It also helps to review all your medications with your health care provider from time to time. If you’ve been taking a drug for a long time, it’s possible you no longer need it or could switch to something cheaper.

4. Do Shop Around

“Prices at pharmacies are fluid,” says Sagall, who recommends negotiating with your pharmacist. If one pharmacy has the best prices in town on all but one of the medications you’re taking, let the pharmacist know and see if she can give you a discount on that one drug. “Many pharmacies want relationships. They want to keep you as a patient, and this is one way they do it,” says Sagall.

5. Do Look Into Patient Assistance Programs

Many pharmaceutical companies have programs that provide their drugs at deep discounts or even free for people in need. If you have a prescription for a high-cost drug, check out the company’s web site to see if they offer assistance. You can also look up patient assistance programs on the NeedyMeds web site (needymeds.org), which provides information on almost 6,000 programs.

19/01/2013

Top 10 Weight Loss Foods

When it comes to weight loss, everyone wants it quick and easy. People don't realize that just like weight gain did not happen overnight; weight loss also cannot be expected with a blink of an eye. In the name of weight loss people follow all sorts of fad diets and funny methods which hardly show them any results. Weight loss basically is eating the right food at the right time. There is no one magic food which leads to weight loss. It is a combination of different foods. Let us discuss 10 foods which effectively help in weight loss.

1. Oats: is extremely high in fiber, hence one portion of oats in the morning for breakfast can keep you full and energetic throughout the day, reducing your caloric intake.

2. Greens: like spinach, methi, broccoli etc are very low in calories and high in fiber, vitamins and minerals thereby reducing water retention and bloating from your body.

3. Beans: like kidney beans, soya beans etc are filled with resistant fiber and proteins which help release energy slowly and keeping you full for a longer time. They also feed your muscles and help them tone up.

4. Lean chicken and fish: are good sources of protein which increase muscle and thereby metabolic rate which helps fat burning and also adds bulk to the meals.

5. Cucumber: is very high in water content and acts as a natural diuretic which helps to reduce water retention and bloating leading to weight loss.

6. Brown rice: are not only high in fiber but also in energy giving B complex vitamins which leads to faster burning of calories.

7. Almonds and walnuts: are excellent sources of vitamin and fiber. A handful of nuts as mid meal snacks can really do wonders.

8. Papaya: an extremely low calorie fruit which contains papain- aiding in faster digestion of proteins and helping in weight loss.

9. Oranges and lemons: are low in calories, high in fiber and Vitamin C which is important in fat burning.

10. Berries: like strawberries, raspberries etc are low calorie, high antioxidants foods. A few of them as mid meals can keep you satiated. You can also add them in breakfast cereals or yogurt.

19/01/2013

Caffeine:

Caffeine isn’t an essential nutrient but, like alcohol, it plays an important role in many people's eating and drinking habits. In terms of health, it’s important to understand what it is, the effect it can have and also the many different products that we find it in.

When caffeine is consumed, it is virtually all absorbed within approximately 45 minutes. Peak volumes of caffeine appear in the blood stream approximately 1 hour after consumption. It’s absorbed into the blood and circulatory system and brain. It is then transported to the liver where it is broken down ready to be eliminated. Caffeine is not stored and does not stay within the bloodstream, but is removed from the body within a few hours of consumption. Once caffeine has been taken to the liver, the liver's role is to break it down into products that can be eliminated safely from the body and removed by the urine and faeces. (Caffeine has no biological requirement within the body, and is a chemical that the body would prefer not to have).

Caffeine has been associated with a number of physiological effects and these include:

Vitamin and Mineral absorption - Excessive caffeine consumption compromises the body’s ability to utilise B vitamins. It also decreases the absorption of essential minerals, such as calcium, magnesium, iron and zinc. Caffeine causes the excretion of these minerals in the urine, especially calcium, potassium, magnesium, zinc and iron.
Acidity - Caffeine consumption also raises blood acidity levels, which causes calcium to be pulled from the bones to alkalise the blood, further increasing the risk for osteoporosis. It can also bring on heartburn.
Increased fat breakdown – Paraxanthine, or 1,7-dimethylxanthine a metabolite of caffeine, is responsible for an increase in the release of glycerol and fatty acids into the blood to be used as a source of fuel by the muscles
Increased sensitivity - Caffeine can cause increased sensitivity of the fat cells and nervous system, widening and relaxing the blood vessels increasing the amount of oxygen and nutrients to the muscles, increasing its sensitivity.
Hypothermia - Hypothermia is a condition in which an organism's temperature drops below that required for normal metabolism and bodily functions. Its link to hypothermia is due to its stimulatory effect increasing the heart rate and so speeding up the effect of excessive cold temperatures/environments on the body.
Stimulant - Caffeine acts as a psychoactive drug, which means that it has the effect of altering brain function, resulting in temporary changes in perception, mood, consciousness and behaviour. It acts primarily on the central nervous system having the effect of temporarily warding off drowsiness and restoring alertness.
Diuretic - A diuretic is a drug that elevates the rate of bodily urine excretion. This can lead to dehydration if an individual is not careful to replace this fluid that is excreted.
It’s generally accepted that moderate amounts of caffeine do not pose any real risks to our health; where as consistent high intakes may have a detrimental effect. It’s widely agreed that coffee should be avoided by anyone with high blood pressure, gastritis or ulcers, and particularly by pregnant or nursing mothers.

Moderate intakes are considered to be 200-250mg of caffeine. This is the equivalent of 2-3 cups (200mls each) of coffee or 4-5 cups of tea.
Diet coke contains 45.6mg of caffeine per 340ml (12oz).
Brewed coffee contains 112mg of caffeine per 140g (5oz).
Pro plus contains 50mg of caffeine per tablet.
Chocolate contains 6mg of caffeine per 28g (1oz).
Tea contains 6mg of caffeine per 28ml (1oz).

If you were to exclude all sources of caffeine from your diet, it takes about 4-6 days to wash out all the effects of caffeine from your system. Depending on how much caffeine you are consuming, you may experience quite severe headaches as part of the withdrawal process. To reduce the undesirable effects of eliminating caffeine in one go, it is best to gradually reduce intakes.

19/01/2013

No matter how bit or how small, your donations matter to help heal and empower. Thank you for your support !!

16/01/2013

Drinking Alcohol and Stomach Cancer Risk

The moderate consumption of alcohol is not a risk factor for developing stomach or gastric cancer. This is the conclusion of the National Institutes of Health, the National Cancer Institute, the American Cancer Society, the American Society of Clinical Oncology, Cancer Research UK, the Mayo Clinic, and other medical organizations.

Alcohol and Health
Over 10,000 people die each year in the U.S. from stomach or gastric cancer. The cause of most stomach cancer appears to be infection from Helicobacter pylori (H pylori). There is strong evidence that alcohol consumption fights H pylori infection.1 However, most people who have this germ in their stomachs never develop cancer.

In addition to H pylori infection, there are a number of risk factors associated with gastric cancer. Having risk factors increases the chances of developing cancer, but many victims have no risk factors.

Symptoms of stomach cancer include:

Abdominal pain
Excessive belching
Nausea and vomiting
Vomiting blood
Loss of appetite
Difficulty swallowing, especially if that difficulty increases over time
Heartburn
Indigestion
Dark Stools
Diarrhea
Constipation
Premature abdominal fullness after eating
Vague abdominal fullness
Weakness or fatigue
Unintentional weight loss
General decline in health
A person experiencing any of these symptoms should consult with a physician.

Drinking alcohol in moderation is not a risk factor for developing stomach cancer. On the other hand, the moderate consumption of alcohol is associated with better health and greater longevity than is either abstaining from alcohol or drinking abusively.

Drinking in moderation has been described by the National Institute on Alcohol Abuse and Alcoholism (NIAAA) as a man consuming four drinks on any day and an average of 14 drinks per week. For women, it is consuming three drinks in any one day and an average of seven drinks per week.

A standard alcoholic drink is:

A 12-ounce can or bottle of regular beer
A 5-ounce glass of dinner wine
A shot (one and one-half ounces) of 80 proof liquor or spirits such as vodka, tequila, or rum either straight or in a mixed drink.
Standard drinks contain equivalent amounts of alcohol.

There is no evidence that any particular form of alcoholic beverage (beer, wine, or distilled spirits) confers greater health benefits than any other.

16/01/2013

What are the risk factors for stomach cancer?

A risk factor is anything that affects your chance of getting a disease such as cancer. Different cancers have different risk factors. Some risk factors, like smoking, can be changed. Others, like a person's age or family history, can't be changed.

But risk factors don't tell us everything. Having a risk factor, or even several risk factors, does not mean that you will get the disease. And many people who get the disease may not have had any known risk factors.

Scientists have found several risk factors that make a person more likely to get stomach cancer. Some of these can be controlled, but others cannot.

Helicobacter pylori infection

Infection with Helicobacter pylori (H pylori) bacteria seems to be a major cause of stomach cancer, especially cancers in the lower (distal) part of the stomach. Long-term infection of the stomach with this germ may lead to inflammation (chronic atrophic gastritis) and pre-cancerous changes of the inner lining of the stomach. Patients with stomach cancer have a higher rate of H pylori infection than people without this cancer. H pylori infection is also linked to some types of lymphoma of the stomach. Even so, most people who carry this germ in their stomachs never develop cancer.

Stomach lymphoma

People who have been treated for a certain type of lymphoma of the stomach known as mucosa-associated lymphoid tissue (MALT) lymphoma have an increased risk of getting carcinoma of the stomach. That is probably because MALT lymphoma of the stomach is caused by infection with H pylori bacteria.

Gender

Stomach cancer is more common in men than in women.

Aging

There is a sharp increase in stomach cancer after the age of 50. Most people are diagnosed with stomach cancer when they are between their late 60s and 80s.

Ethnicity

In the United States, stomach cancer is more common in Hispanic Americans and African Americans than in non-Hispanic whites. It is most common in Asian/Pacific Islanders.

Geography

Where you live may be important. Stomach cancer is more common in Japan, China, Southern and Eastern Europe, and South and Central America. This disease is less common in Northern and Western Africa, South Central Asia, and North America.

Diet

An increased risk of stomach cancer is seen in people with diets that have large amounts of smoked foods, salted fish and meat, and pickled vegetables. Nitrates and nitrites are substances commonly found in cured meats. They can be converted by certain bacteria, such as H pylori, into compounds that have caused stomach cancer in animals.

On the other hand, eating fresh fruits and vegetables that contain antioxidant vitamins (such as A and C) appears to lower the risk of stomach cancer.

To***co use

Smoking increases stomach cancer risk, particularly for cancers of the upper portion of the stomach closest to the esophagus. The rate of stomach cancer is about doubled in smokers.

Obesity

Being very overweight or obese is a possible cause of cancers of the cardia (the upper part of the stomach nearest the esophagus), but the strength of this link is not yet clear.

Previous stomach surgery

Stomach cancers are more likely to develop in people who have had part of their stomach removed to treat non-cancerous diseases such as ulcers. This may be because it allows more nitrite-producing bacteria to be present. Also, acid production goes down after ulcer surgery, and there may be reflux (backup) of bile from the small intestine into the stomach. The risk continues to increase for as long as 15 to 20 years after surgery.

Pernicious anemia

Certain cells in the stomach lining normally make a substance called intrinsic factor (IF) that we need to absorb vitamin B12 from foods. People without enough IF may end up with a vitamin B12 deficiency, which affects the body's ability to make new red blood cells. This condition is called pernicious anemia. Along with anemia (low red blood cell counts), there is an increased risk of stomach cancer for patients with this disease.

Menetrier disease (hypertrophic gastropathy)

This is a condition in which excess growth of the stomach lining forms large folds in the lining and leads to low levels of stomach acid. Because this disease is very rare, it is not known exactly how much this increases the risk of stomach cancer.

Type A blood

Blood type groups refer to certain substances that are normally present on the surface of red blood cells and some other types of cells. These groups are important in matching blood for transfusions. For unknown reasons, people with type A blood have a higher risk of getting stomach cancer.

Inherited cancer syndromes

Some inherited conditions may raise a person's risk of stomach cancer.

Hereditary diffuse gastric cancer: This is an inherited syndrome that greatly increases the risk of developing stomach cancer. This condition is quite rare, but the lifetime stomach cancer risk among affected people is about 70% to 80%. Women with this syndrome also have an increased risk of getting a certain type of breast cancer. This condition is caused by mutations (defects) in the gene E-cadherin (CDH1). Some cancer centers can test for these genetic mutations.

Hereditary non-polyposis colorectal cancer: HNPCC, also known as Lynch syndrome is an inherited genetic disorder that causes an increased risk of colon cancer. People with this syndrome have an increased risk of getting stomach cancer as well. In most cases, this disorder is caused by a defect in either the gene MLH1 or the gene MSH2, but at least 5 other genes can cause HNPCC: MLH3, MSH6, TGBR2, PMS1, and PMS2.

Familial adenomatous polyposis (FAP): In FAP syndrome, patients get many polyps in the colon as well as in the stomach and intestines. People with this syndrome are at greatly increased risk of getting colorectal cancer and have a slightly increased risk of getting stomach cancer. It is caused by mutations in the gene APC.

BRCA1 and BRCA2: People who carry mutations of the inherited breast cancer genes BRCA1 and BRCA2 may also have a higher rate of stomach cancer.

A family history of stomach cancer

People with several first-degree relatives who have had stomach cancer are more likely to develop this disease. (First-degree relatives include parents, siblings, and children.)

Some types of stomach polyps

Polyps are non-cancerous growths on the lining of the stomach. Most types of polyps (such as hyperplastic polyps or inflammatory polyps) do not seem to increase a person's risk of stomach cancer, but adenomatous polyps -- also called adenomas -- can sometimes develop into cancer.

Epstein-Barr virus infection

This virus causes infectious mononucleosis (also called mono). Almost all adults have been infected with this virus at some time in their lives, usually as children or adolescents. It has been linked to some forms of lymphoma. Epstein-Barr virus is found in the cancer cells of about 5% to 10% of people with stomach cancer. These people tend to have a slower growing, less aggressive cancer with a lower tendency to spread. It isn't yet clear if this virus actually causes stomach cancer, just that the virus has been found in stomach cancer cells.

Certain occupations

Workers in the coal, metal, and rubber industries seem to have a higher risk of getting stomach cancer.

Immune deficiency

People with common variable immunodeficiency (CVID) have an increased risk of stomach cancer. The immune system of someone with CVID can’t make enough antibodies in response to germs. People with CVID have frequent infections as well as other problems, including atrophic gastritis and pernicious anemia. They are also more likely to get gastric lymphoma and stomach cancer.

15/01/2013

BE AN ORGAN DONOR

Have you ever thought about donating an organ?

Many people who need transplants of organs and tissues cannot get them because of a shortage of donations. Every month, more than 2,000 new names are added to the national waiting list for organ transplants, and about 18 people die every day while waiting for an organ transplant.Organ and tissue donation helps others by giving them a second chance at life.

15/01/2013

Newly diagnosed with Kidney Disease? Knowledge is Power

Being diagnosed with chronic kidney disease (CKD) can be a very trying and difficult time for everyone involved-the patient, along with family and friends. But information can go a long way towards helping gain control of the situation. A patient who knows what's coming up, what to watch out for and what treatment options are available if his kidneys fail totally can make educated decisions about his own healthcare.

At first, talk with your doctor about pinpointing your diagnosis to assess your kidney function to help plan your treatment. Tests are conducted to determine the stage and type of kidney disease, the size of the kidneys and the damage already done. After receiving these results, your doctor and you will need to sit down and create a plan of action.

People who have kidney disease also have an increased chance of developing heart problems. Therefore, one of the first things to do upon CKD diagnosis is to get control of other health problems, including diabetes, high blood pressure and anemia.

If you have diabetes, you will need to monitor your blood sugar, follow a specific diet and take your medication as ordered by your doctor. If you have high blood pressure, your doctor may recommend you lose weight, cut down on salt in your diet and take your medication. Anemia (low blood count) can also lead to heart damage and may be controlled by taking a hormone called EPO and iron supplements. You should also have healthy cholesterol levels and not smoke.

Once your kidney disease and other health problems are under control, it is vital to track your progress. Your glomerular filtration rate (GFR) should be checked regularly to clarify the status of your kidney disease. Also, the amount of protein in your urine will be checked from time to time to make sure your kidneys are doing their job. Lastly, nutritional tests may be done to make sure you are getting enough protein and calories to maintain your overall health. Your doctor can refer you to a registered dietitian who will help you plan your meals to get the right foods in the right amounts.

14/01/2013

Early detection of kidney disease can be life saving

Very importantly, lifestyle changes can keep your kidneys healthy.

Here are those 12 tips

1. Avoid contact with all the toxic and harmful items listed at the beginning of this article.

2. Eat lots of fresh fruit and vegetables (particularly the latter) together with grass fed beef and free range chicken and eggs.

3. Stay away from sugars, sodas and artificial sweeteners, processed salty foods and the bad trans fats and change to natural salt and good fats such as butter from raw cream, olive oil and organic cocnut oil. Stevia is a safe replacement for sugar.

4. Try to drink only water instead of other drinks. This should be pure filtered water – at several glasses per day.

5. Maintain a healthy weight and of course this will be achieved through the other lifestyle changes that you make.

6. Stay fit by at least 30 minutes of physical activity that increases your heart rate on five or more days of the week – suggestions include: including walking, lawn mowing, bike riding, swimming or gentle aerobics.

7. Don’t smoke and limit your alcohol to two small drinks per day if you are male or one small drink per day if you are female.

8. Have your blood pressure checked regularly. If you blood pressure levels are higher than they should be, lower them with natural remedies rather than statins which can actually lead to kidney damage.

9. Do things that help you relax and reduce your stress levels.

10. Spirulina (from a safe source) helps to protect your kidneys. As kidneys are one of the first organs to suffer damage after significant radiation exposure, Spirulina is used but research also suggests that spirulina helps protect from the nephrotoxicity of cancer treatments, antibiotics and analgesics.

11. Please be aware that many people today are gluten intolerant and as such can suffer from gluten induced kidney damage. If you are not sure or are suspicious that you might be gluten intolerant, get genetically tested for gluten sensitivity. If you have actually have kidney disease, make sure your doctor checks your 25 OH D levels (vitamin D). Additionally, make sure that he measures for other nutritional deficiencies as well. Malabsorption is a common cause of secondary diseases for those with intolerance or sensitivity to gluten.

12. It cannot be overemphasized how important vitamin D is to your general health including the kidneys. Vitamin D is not a vitamin at all but a steroid hormone that is probably the single most important factor in human health. The optimum level for good health is to be between 40 ng/ml and 100 ng/ml and if you are not receiving sufficient sunlight exposure, the average adult needs to take a daily dose of 8000 IUs daily to elevate their levels above 40 ng/ml.

Remember that avoiding all toxins, taking regular exercise, along with a balanced diet and drinking plenty of water will help to keep your kidneys working well and in peak condition.

14/01/2013

Ways in which you can harm your kidneys:

Being obese
Through fluoride in your water supply
Using non stick cookware (Teflon) and other common household items
Undergoing root canal treatment along with dental mercury amalgams
Exposure to toxic mold in the home and elsewhere
The use of pesticides and laundry detergents and other toxic cleaning materials
Artificial sweeteners of all types
Consuming fructose, sodas and candies
The emotion often associated with problems with the kidney is fear
Emotions can play a part with the health of our organs too, and so be mindful that if you are frequently fearful, you may well be affecting your kidneys and their function.

Disease factors

Kidney disease risk factors include diabetes, high blood pressure, obesity, smoking and age. Early detection and treatment can increase the life of the kidneys. Remember too that high blood pressure can lead to or be a sign of kidney disease.

Kidney disease is called a ‘silent disease’ as there are often few symptoms but here some of the signs and symptoms:

Change in frequency and quantity of urine passed, especially at night (usually increase at first)
Blood in the urine (haematuria)
Foaming urine
Puffiness around the eyes and ankles (oedema)
Pain in the back (under the lower ribs, where the kidneys are located)
Pain or burning when passing urine
Later on, when the kidneys begin to fail, there is a build-up of waste products and extra fluid in the blood as well as other problems, gradually leading to:

Tiredness, inability to concentrate
Generally feeling unwell
Loss of appetite
Nausea and vomiting
Shortness of breath

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