Information for Patients
Chronic Kidney Disease
You have two kidneys, each about the size of your fist. Their main job is to filter your blood. They remove wastes and extra water, which become urine. They also keep the body's chemicals balanced, help control blood pressure, and make hormones.
Chronic kidney disease (CKD) means that your kidneys are damaged and can't filter blood as they should. This damage can cause wastes to build up in your body. It can also cause other problems that can harm your health. Diabetes and high blood pressure are the most common causes of CKD.
The kidney damage occurs slowly over many years. Many people don't have any symptoms until their kidney disease is very advanced. Blood and urine tests are the only way to know if you have kidney disease.
Treatments cannot cure kidney disease, but they may slow kidney disease. They include medicines to lower blood pressure, control blood sugar, and lower cholesterol. CKD may still get worse over time. Sometimes it can lead to kidney failure. If your kidneys fail, you will need dialysis or a kidney transplantation.
You can take steps to keep your kidneys healthier longer:
- Choose foods with less salt (sodium)
- Control your blood pressure; your health care provider can tell you what your blood pressure should be
- Keep your blood sugar in the target range, if you have diabetes
- Limit the amount of alcohol you drink
- Choose foods that are healthy for your heart: fruits, vegetables, whole grains, and low-fat dairy foods
- Lose weight if you are overweight
- Be physically active
- Don't smoke
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
High Blood Pressure
What is blood pressure?
Blood pressure is the force of your blood pushing against the walls of your arteries. Each time your heart beats, it pumps blood into the arteries. Your blood pressure is highest when your heart beats, pumping the blood. This is called systolic pressure. When your heart is at rest, between beats, your blood pressure falls. This is called diastolic pressure.
Your blood pressure reading uses these two numbers. Usually the systolic number comes before or above the diastolic number. For example, 120/80 means a systolic of 120 and a diastolic of 80.
How is high blood pressure diagnosed?
High blood pressure usually has no symptoms. So the only way to find out if you have it is to get regular blood pressure checks from your health care provider. Your provider will use a gauge, a stethoscope or electronic sensor, and a blood pressure cuff. He or she will take two or more readings at separate appointments before making a diagnosis.
|Blood Pressure Category||Systolic Blood Pressure||Diastolic Blood Pressure|
|Normal||Less than 120||and||Less than 80|
|High Blood Pressure (no other heart risk factors)||140 or higher||or||90 or higher|
|High Blood Pressure (with other heart risk factors, according to some providers)||130 or higher||or||80 or higher|
|Dangerously high blood pressure - seek medical care right away||180 or higher||and||120 or higher|
For children and teens, the health care provider compares the blood pressure reading to what is normal for other kids who are the same age, height, and sex.
What are the different types of high blood pressure?
There are two main types of high blood pressure: primary and secondary high blood pressure.:
- Primary, or essential, high blood pressure is the most common type of high blood pressure. For most people who get this kind of blood pressure, it develops over time as you get older.
- Secondary high blood pressure is caused by another medical condition or use of certain medicines. It usually gets better after you treat that condition or stop taking the medicines that are causing it.
Why do I need to worry about high blood pressure?
When your blood pressure stays high over time, it causes the heart to pump harder and work overtime, possibly leading to serious health problems such as heart attack, stroke, heart failure, and kidney failure.
What are the treatments for high blood pressure?
Treatments for high blood pressure include heart-healthy lifestyle changes and medicines.
You will work with your provider to come up with a treatment plan. It may include only the lifestyle changes. These changes, such as heart-healthy eating and exercise, can be very effective. But sometimes the changes do not control or lower your high blood pressure. Then you may need to take medicine. There are different types of blood pressure medicines. Some people need to take more than one type.
If your high blood pressure is caused by another medical condition or medicine, treating that condition or stopping the medicine may lower your blood pressure.
NIH: National Heart, Lung, and Blood Institute
You have two kidneys, each about the size of your fist. They are near the middle of your back, just below the rib cage. Inside each kidney there are about a million tiny structures called nephrons. They filter your blood. They remove wastes and extra water, which become urine. The urine flows through tubes called ureters. It goes to your bladder, which stores the urine until you go to the bathroom.
Most kidney diseases attack the nephrons. This damage may leave kidneys unable to remove wastes. Causes can include genetic problems, injuries, or medicines. You have a higher risk of kidney disease if you have diabetes, high blood pressure, or a close family member with kidney disease. Chronic kidney disease damages the nephrons slowly over several years. Other kidney problems include:
Your doctor can do blood and urine tests to check if you have kidney disease. If your kidneys fail, you will need dialysis or a kidney transplant.
NIH: National Institute of Diabetes and Digestive and Kidney Diseases
General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
- Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
- No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
- Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.
Index of Diseases and Injuries Definitions
- And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
- Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
- Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
- Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
- Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
- Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
- NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
- See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
- See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
- 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
- With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.