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Among the various physiologic alterations that occur in normal pregnancy, few are as striking as those affecting the urinary tract.
The kidney is a very complicated organ that adjusts its function depending on the body's situation.
During pregnancy the kidneys also adapt to their new state and actually increase the functioning by cleaning the blood more than usual. Protein in the urine is also a very important part of the evaluation process of a patient's kidney function and especially so in pregnancy, as we will discuss later. HTN occurring as part of pregnancy is relatively common occurring in 12 to 22% of all pregnancies. Chronic HTN by definition either pre-dated pregnancy or had its onset prior to 20th week of pregnancy. As mentioned previously the main function of the kidney is to clean the blood of the impurities that naturally build up everyday in the body. If the blood levels are above the normal range this often suggests that the patient has impaired renal function.
A better way of measuring the kidney function is to collect a 24 hour urine sample and measure both the urine and blood for these levels and from that calculate the kidney function (Creatinine clearance: Cr Cl). In pregnancy the blood levels for BUN and Cr tend to be lower because the kidney function is often super-normal in the pregnancy state. Acute renal failure is defined as the relatively rapid progressive loss of kidney function occurring over a relatively short period of time (days to weeks). Acute illness wherein the patient has become seriously ill and usually multiple organ systems have become acutely injured. Acute obstruction of the ureters or urethra thus not allowing urine to flow out of the body.
During pregnancy or postpartum one can see on rare occasions ARF from any of the above situations. CRF is by definition distinguished from ARF by the fact that the patient has had loss of kidney function over a more prolonged period of time (more then 3 months and often a process that has been going on for years. Treatment to delay the progression of the loss of kidney function or possibly arrest the progression. Antenatal Strategy and Decision-Making: For a successful outcome, scrupulous attention must be paid to blood pressure control, fluid balance, increased hours of dialysis, and provision of good nutrition.
Scrutinize carefully for preterm labor, as dialysis and uterine contractions are associated.
Nutrition: despite more frequent dialysis, relatively free dietary intake should be discouraged. Fetal Surveillance and Timing of delivery: cesarean section should be necessary only for purely obstetric reasons.
Does CRF place the fetus at risk?There are multiple studies that have documented their results in women with CRF who become pregnant. This is by no means an accurate risk assessment for risk of fetal loss for pregnant women with CRF because it does not take into account the severity of CRF at time of conception. There is a marked increase in the risk of superimposed preeclampsia in women with CRF who become pregnant.
In women with CRF who become pregnant, there is a high risk of irreversible worsening of renal disease as a consequence of the pregnancy.
It has been noted that a longer interval between transplant and pregnancy is associated with decreased risk of low birth weigh and prematurity.
A woman should be counseled on the various treatments for renal failure and the potential for optimal rehabilitation.
Individual centers have their own specific guidelines, in most; a wait of 18 months to 2 years post-transplant is advised. It appears that pregnancy itself does not adversely affect the transplanted kidney as long as the kidney is functioning well at time of conception. Summary:In general, prognosis is good if renal dysfunction is minimal and hypertension is absent. I awoke and went down stairs and walked to the refrigerator to start retrieving what I had prepared earlier for my lunch. Changes in the urinary tract during normal pregnancy are so marked that norms in the nonpregnant cannot be used for obstetric management. There is no doubt that improvements in our knowledge of background physiology, in prenatal care generally, in technology for fetal surveillance, and in neonatal intensive care have meant better care for women with renal problems and their newborns.
The blood is pumped from the heart (about 20% of all the blood is pumped out of the heart goes to the kidneys) and goes to the kidneys via the arteries known as renal arteries. The bladder is like a muscle sac that stretches to accommodate the urine and then when we urinate, the bladder contracts and the urine is expelled out via another small tube called the urethra that connects the bladder to the outside world.
This is detected by examining blood levels of markers we use to roughly evaluate how "clean" the blood is. We can get a rough idea on how well the kidneys are functioning by measuring blood levels of certain molecules that build-up when the kidneys are not functioning at 100% capacity. Renal Failure) are typically identified by the increased blood levels of Cr and BUN on routine blood lab testing. One can detect this by lab testing which shows a steady increase in the creatinine (Cr) on repeat testing over the short time period.
These cases are often very serious and require immediate hospitalization and appropriate medical care by a team of doctors including the nephrologists.
This usually requires aggressive *blood pressure (BP) control and sugar control in diabetic patients.
These classes of BP meds provide added kidney protection more so than other BP medications.
In late pregnancy the gravid uterus and the supine posture may aggravate this by decreasing venous return. A daily oral intake of 70 gm protein, 1,500 mg calcium, 50 mM potassium and 80 mM sodium is advised, with supplements of dialyzable vitamins. This anemia is usually aggravated further in pregnancy; therefore, blood transfusion may be needed, especially before delivery. They report their results in pregnant women with varying degrees of CRF and only included those pregnant women who made it past the first trimester. In general it is often recommended, to wait for two years after transplant before considering pregnancy. This has turned out to be good advice because, by then, the patient will have recovered from the major surgery and immunosuppression will be at maintenance levels.
The diagnosis can be difficult because irregular bleeding and amenorrhea accompany deteriorating renal function or even an intrauterine pregnancy. Awareness of all alterations is essential if kidney problems in pregnancy are to be suspected or detected and then handled correctly. The blood tests for creatinine (Cr) and blood urea nitrogen (BUN) are our best blood markers for evaluating kidney function. Idiopathic postpartum renal failure is also called postpartum malignant nephrosclerosis, irreversible renal postpartum renal failure, and postpartum hemolytic uremic syndrome (HUS). Dietary changes including a moderate restricted protein diet and avoiding potentially kidney damaging medications such as commonly used anti-inflammatory medications. Unfortunately these medications are CONTRAINDICATED during pregnancy because of their high risk of causing fetal malformations.
Caution is necessary because transfusion may exacerbate hypertension and impair the ability to control circulatory overload, even with extra dialysis. It could be argued; however, that elective cesarean section in all cases would minimize potential problems during labor. The standard immunosuppressive drugs (Cyclosporin and azathioprine) are not associated with increases in fetal abnormalities. Even after transplantation, stress will still be a major factor in everyday life, which will always have a "baseline of uncertainty". Also, if function is well maintained at 24 months, there is a high probability of allograft survival at 5 years. Patients may be at higher risk of ectopic pregnancy because of pelvic adhesions due to previous urologic surgery, peritoneal dialysis, pelvic inflammatory disease, or overzealous use of intrauterine contraceptive devices.


CRF) then the risk of accelerating the loss of renal function with pregnancy is similar to that seen in patients with CRF. Most women with mild to moderate renal disease tolerate pregnancy well and have a successful obstetric outcome without adverse effect on the natural history of the underlying renal lesion. On the other hand if one does not drink much fluid, then the urine becomes very concentrated.
To get a more precise evaluation of the kidney's cleaning of the blood we can measure in the 24 hour urine collection for creatinine and protein. The purpose of these filtering packets is to filter out the bad stuff and leave the good stuff like protein (building blocks of our muscles) in the blood. It is rare and frequently fatal syndrome, characterized by the onset of renal failure 3 to 10 weeks into the puerperium after the patient has had an uneventful pregnancy and delivery. Patients who are taking these medications and become pregnant must come off these medications immediately and alert their physicians right away. In addition, the placenta produces hydroxyvitamin D, one reason why oral supplementation may have to be curtailed.
Fluctuations in blood volume can be minimized if packed red cells are transfused during dialysis. Couples who want a child should be encouraged to discuss all the implications, including the harsh realities of maternal prospects of survival. The main clinical problem is that symptoms secondary to genuine pelvic pathology are erroneously attributed to the transplant. Crucial determinants are renal functional status at conception, the presence or absence of hypertension, and the type of renal disease. Because we have so many of these filtering packets and our lab tests are so sensitive we can actually measure the normal micro amounts of protein that a normal patient spills. The patient develops marked azotemia and severe hypertension and frequently associated with hemolytic anemia and disseminated intravascular coagulation (DIC).
Most studies have shown that the harm from these medications occurs if the medication is continued after the first trimester (after the 13th week).
There have been cases of women on dialysis during pregnancy going on to delivery but there is a high risk of prematurity and low birth weight in the newborn in these cases. All this poses risks for fetal nutrition, plus the fact that the exact impact on the uremic environment is difficult to access.
In the absence of severe maternal problems, the hazards of pregnancy in renal transplant patients are minimal, and successful obstetric outcome is the rule. As I started to pack my lunch box something caught my eye outside on the deck through the patio doors.
Near term, a 15 to 20% decrement in glomerular filtration rate (GFR) occurs, which affects serum creatinine minimally. A normal person can spill up to 20 mg of albumin (special protein we test the urine for) in a 24 hour urine collection. The use of parenteral nutrition supplementation in pregnancy in these gravidas has been advocated. I walked over and looked out into the dark and immediately was blinded by an immensely bright light with rays and spikes resembling fire.
Some kidney diseases damage these filtering packets which then become like a sieve and cause leakage of excess albumin in the urine.
Unnecessary blood sampling should be avoided in the face of anemia and lack of venipunture sites. Depending on the disease and the severity of protein spillage can be mild, moderate or severe.
The protocol for various tests usually performed in a particular unit should be followed strictly, with no more blood removed per venipunture than is absolutely necessary. Therefore, checking for protein spillage is very important in the evaluation of patient's kidney status.
In pregnancy, patients are at risk for increase protein leakage and often it can be the earliest sign of kidney disease in pregnancy. I hung on with every last ounce of breath that I had-- for I had known from the start that this was pure evil. Slowly but it was leaving the house and vanishing into the night like a balloon drifting into the atmosphere and then disappearing.
I staggered back completely exhausted knowing that a battle just had been fought for my soul. I believe the battle was real and that I really experienced it but maybe in a different dimension or realm. I had defeated the devil with the name of Jesus.===================================================================Sometime in our life we all will have to battle demons that try to control us. Whether it is a fight for our soul or some other evil in our life, it will be a fight that you need to win. In the book The boy who came back from heaven, Alex Malarkey says that Heaven is guarded by large angels. In the book of Daniel a messenger from God tells Daniel in Chapter 10:12-14 --"Daniel, do not be afraid. Then Michael, one of the most important angels, came to help me, because I had been left there with the king of Persia. Battles are surely being fought every minute of every day in the supernatural and spiritual world. Call on the name of the Lord Jesus Christ today for it is written that the devil will lose in the end. If a man owns a hundred sheep, and one of them wanders away, will he not leave the ninety-nine on the hills and go to look for the one that wandered off?
13 And if he finds it, truly I tell you, he is happier about that one sheep than about the ninety-nine that did not wander off. 14 In the same way your Father in heaven is not willing that any of these little ones should perish. Si un hombre tiene cien ovejas y una de ellas se ha descarriado, no deja las noventa y nueve en los montes, y va en busca de la descarriada?13Y si sucede que la halla, en verdad os digo que se regocija ms por sta que por las noventa y nueve que no se han descarriado.14As, no es la voluntad de vuestro Padre que est en los cielos que se pierda uno de estos pequeitos.Never believed in God? Jesus still loves you.Colossians 1:13 Holman Christian Standard Bible (HCSB)13 He has rescued us from the domain of darkness and transferred us into the kingdom of the Son He loves, Porque El nos libr del dominio de las tinieblas y nos traslad al reino de su Hijo amado,Broken hearted, beaten, and broken? 29 All of you, take up My yoke and learn from Me, because I am gentle and humble in heart, and you will find rest for yourselves.
28Venid a m, todos los que estis cansados y cargados, y yo os har descansar.29Tomad mi yugo sobre vosotros y aprended de m, que soy manso y humilde de corazn, y HALLAREIS DESCANSO PARA VUESTRAS ALMAS.Failed?
He'll save you!"As que, los que son de fe son bendecidos con Abraham, el creyente.Fortaleced las manos dbilesy afianzad las rodillas vacilantes.Feel you are not worthy? 2 Corinthians 5:17-19 New Century Version (NCV)17 If anyone belongs to Christ, there is a new creation. Through Christ, God made peace between us and himself, and God gave us the work of telling everyone about the peace we can have with him.19 God was in Christ, making peace between the world and himself. So I wrote the following that is below: A ==========================================================================================================================A Season Finale--- This may be my last Pastor Pop-Pop Sermon. I may leave the web site up and running for a year in case it picks up but there probably will not be new words of wisdom in a message.
I feel that in body, mind, and soul that I am under attack from the evil one and it is totally exhausting me spiritually and physically. At one time there was a period that I was getting over 200 hits per month but now it is down to just a few. One child only comes here when coached and the other I have not seen or heard from in months. Here are some of my prouder moments: Hundreds have visited my Altar Call tab (souls have been saved), I taught a Spanish gentleman who had never prayed before to pray, several people said that I would make a good Pastor, one young man who did not go to Church told me that if I started one he would come to it, at one time I was rated #1 by several internet web service search engines, and through Jesus I helped cure someone of an affliction. You can still follow me on Twitter if you choose and I may come back to this site occasionally to add a Bible verse or two. Consider this a season finale in which you dont know if the show will be cancelled or back next season.
He stated that he did not want the Lord to come back yet even though all the people he knew could not wait for Jesus to come back.


Pastor said that when people tell him that they want Christ to come back that he says, No, not yet, there is at least one more soul to save! I pondered and prayed on that for a minute or two and decided not to cancel my web site and mission. Since posting the latest message my hits again went well over 200 and I was again rated by one search engine as #1 and another at #2. After publishing the latest message I had two Spanish people seek the Lord more and now a friend has asked to go to Church with me. I will take out the stubborn hearts of stone from your bodies, and I will give you obedient hearts of flesh.A What is my point? And most importantly, do not give up trying to save souls in your family, work place, community, or the world. Encourage them with great patience and careful teaching,A Matthew 16:26 --- It is worthless to have the whole world if they lose their souls.
You see, we did not have video games then unless you count Pong and the snow made the four channels we did get on TV full of static. As we rounded a portion of the mountain the ledge that I was walking on gave way and I fell about 20 feet down a cliff. The snow below cushioned my fall but where I landed - there was about a 60 degree slope covered with snow and ice.
Below me was a very large straight down drop that would have been disastrous for me if I went over it. I dug in my heals and my hands but could not stop or slow down so I started to steer myself toward a small tree.
Knowing that I would not be able to hang on to it with my hands, I decided to let it hit me in the body. Stopping within 3 feet of going over the edge I hurt all over with the breath knocked out of me. I could have stayed there and yelled for help or rested awhile but knowing that my friend was up there alone and I had to get out of this situation, I just started to slowly and safely climb back up. A You may make a climb to the top of the ladder at work and end up falling due to a lay-off or closure. A You may get married and start a family and it end up in divorce or maybe a spouse will die. Your exhausted, depressed, tired and disgusted and feel just like giving up or taking a rest on life for a time.
Dont allow yourself to be buried in that pit you have fallen in and (one step at a time) climb out of that valley and charge up that hill. It may take time, maybe years, but if you stay put and do not move forward (even a little at first) you will be like that bear caught in a trap in the middle of the dark woods.
A And sometimes a person starts to climb out of their mess and then starts to back-slide so doubt sets in.
Peter, one of Christs disciples trusted the Lord and actually walked on water but when the storm kept up - his faith started to slip. The Lord will not give you something that He knows is disastrous for you even if you think it might be good.
She had her hand on the throttle of an F-16 and she had her orders: Bring down United Airlines Flight 93.
Penney, one of two combat pilots in the air that morning, was told to stop the plane before it reached the nations capitol. The problem was that her and her wing man had to scramble so fast that there was no time to load ammunition or missiles. This was the end of her life and she knew it but this would be the ultimate sacrifice for her country and would save Washington from the airliners destruction. Fortunately for her (not the passengers) the airline crashed in a field inPennsylvania before the F-16s arrived at the scene. The priest will perform the acts to remove that person's sin so he will belong to the Lord.
7 " 'But if the person cannot afford a lamb, he must bring two doves or two young pigeons to the Lord as the penalty for his sin. One bird must be for a sin offering, and the other must be for a whole burnt offering.8 He must bring them to the priest, who will first offer the one for the sin offering. In this way the priest will remove the person's sin so he will belong to the Lord, and the Lord will forgive him.However, God decided that this practice was going to end and through His love he was going to offer His own blood sacrifice for all of our sins. He asked His son to give His life as a perfect blood sacrifice and an offering for all that we have done badly. He gave the ultimate sacrifice for us on that cross that day even though we did not deserve it.
As Heather Lucky Penny was willing to do for her country, Jesus was willing to do the same for His Father and all of His followers. All those who accept Jesus as Lord and Savior shall now have the forgiveness of their sins through His blood.
That new person is made to be like Godmade to be truly good and holy.=============================================Check out the new song by Tricia Brock --"Always", on my Song tab.
We as humans can live to be 100 years old if we are not struck with cancer, a major disease or hit by a car. This latter group is the one that I will address.Lets look at the validity of the Bible for a minute. Some people will argue that you can't believe the Bible because it was written by followers who believed in God or Jesus.
If you were to use this argument regarding autobiographies, biographies, and history books, you would have to remove all these books off the library selves.
Others would argue that the Bible can't be trusted because we do not know if the original manuscripts are accurate. To determine the accuracy of the manuscripts, we can compare the Bible manuscripts to manuscripts of other literature.
If we are going to be fair, we should not require more of the Bible than we do other literature, but the Bible will hold up to even more scrutiny. Notice that the time frame for the New Testament of the Bible is much much smaller and there are many more copies. Over and over again, archaeological digs are finding artifacts that prove the various stories that are in the Bible. There were over 40 authors so there is no way they could have conspired with each other.So, if we are to consider the Bible as factual then lets look at what it says about getting to Heaven where the Father resides. This is true for all who believe in Christ, because all people are the same:As you see, according to the Bible, there is only one God and the only way to Him is through faith in Jesus and accepting Him as your Lord and Savior. There are many more passages to quote but I encourage you to get a Bible in an easy to read translation and read it yourself. The other religions, besides Christianity, in the world follow a person, thing, idol, the earth, nature, or a prophet.
The Jewish and Muslim people believe in the same Father (the Muslims follow a prophet though) but Jesus declared himself part of God and proved it through numerous miracles. We Christians believe in a Trinity the Father, the Son (Jesus), and the Holy Spirit, as proved through the Bible. Nothing you do here on Earth can save you only the belief of this God and acceptance of His son Jesus.
He was mad at the idea that his wife became a Christian and went on a journey to prove that Jesus was a work of fiction. The book contains, in an easy to read format, all the evidence that he found and the interviews with experts. Click on the shopping cartat the bottom of this page to go to my store and purchase this book or find it at a book store near you.



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