DR ELLIE CANNON: My kidney disease is chronic – so why did my GP not tell me?

I found told me I happened to have chronic kidney disease when I was called for a flu vaccine – I’m 64. The GP said I was eligible for the jab because of my kidney problem – he called it CKD 3a – which had been picked out a year earlier in routine blood tests . I asked why I hadn’t been told that before, and he said he didn’t want to worry me. A nurse said the same thing, but it played on my mind. Is there anything I should do?

I imagine there are many people who are unaware that they are labeled as chronic kidney disease (CKD).

It is important to note that despite the alarming name, the condition is not always significant. It is often viewed by doctors as a risk factor for other health problems, rather than as a disease in itself.

But your doctor should definitely have told you about the diagnosis.

CKD is essentially a reduced ability to filter blood in the kidneys, which often occurs with aging. We also see it alongside conditions such as high blood pressure, type 2 diabetes, heart disease and obesity.

It is important to keep in mind that chronic kidney disease can worsen and lead to an increased risk of heart disease.

CKD 3a is the earliest stage and means that someone has persistent mild renal impairment. Stage 4 is severe, while stage 5 indicates kidney failure.

Treatment for chronic kidney disease 3a involves monitoring the kidneys to make sure the situation doesn’t worsen, and checking blood pressure regularly to make sure other conditions aren’t damaging them.

This can be maintained through annual urine checks, monitoring for diabetes, treating any underlying high blood pressure and possibly offering a cholesterol-lowering statin because of the heart risk.

Healthy lifestyle advice also applies: avoid smoking, eat a balanced diet, keep salt consumption low (the NHS suggests less than 6 grams per day) and regular exercise.

Someone with chronic kidney disease should also be careful about taking anti-inflammatories such as ibuprofen, and avoid protein supplements and herbal remedies – all of which can damage the kidneys.

The patients are in the high-risk groups for flu and Covid, so it is crucial that you stay up to date with the vaccines.

My 30 year old daughter has always struggled with her mental health and has been taking citalopram since her late teens. She and her partner talk about trying to get pregnant, and I worry that taking an antidepressant could be dangerous for a developing child. What would your advice be?

Taking medications is always about weighing the risks and benefits, and this is especially true for pregnant women and women trying to conceive.

Before deciding to reduce or discontinue treatment, consider the effect on the woman’s overall health and how this may affect the pregnancy.

Citalopram is an antidepressant known as a selective serotonin reuptake inhibitor (SSRI) and these can be taken during pregnancy without any concern.

Some studies have linked the use of these tablets to premature and low birth weight babies, but doctors cannot say for sure whether this is really due to the pills or the mother’s circumstances. It was thought that SSRIs taken during early pregnancy could cause heart problems in a developing fetus, but recent research has proven this to be untrue.

Most women who take an SSRI while carrying a child will have a normal pregnancy without any problems.

My mother recently died in her 90s from C. diff. Her last weeks were very traumatic, not least the terrible and acute diarrhea from which she suffered. Before that, she had been given antibiotics for a leg infection and when she was diagnosed with C. diff, she was prescribed even more. I have now read that this was not appropriate. If she hadn’t been given these drugs, would she still be alive?

Clostridium difficile, also known as C. diff, is the name of a diarrhea-causing bacterial infection of the intestines.

For someone who is older and frail, it can be extremely serious; Such intestinal problems can quickly lead to severe dehydration and kidney damage. This is much more likely to happen in a patient who has been taking strong antibiotics. These drugs kill bacteria, but also deplete healthy bacteria from the intestines, allowing C. diff to take hold. That is why we often see outbreaks in retirement homes and hospital wards.

There has been a huge push within the NHS to prevent this through careful prescribing of antibiotics and strict hygiene and isolation in hospitals.

Unfortunately, recent figures show that more than 13 percent of people with C. diff die – usually over the age of 85.

The treatment of C. diff uses very specific antibiotics, which must be provided by a hospital microbiology team. It is also important to consume enough fluids and stop taking other medications that may affect intestinal or hydration levels.

This may mean stopping certain high blood pressure treatments and antacids such as omeprazole.

It is also advised not to use anti-diarrhoea medicines, including loperamide, which are available without a prescription under the brand name Imodium.

This drug targets the Jolie gene, but I won’t risk it

Angelina Jolie

Drug regulators have given the green light to a drug called anastrozole for women with a high genetic risk of developing breast cancer.

At first glance, this seems like great news. But while anastrozole helps, by lowering the levels of estrogen hormones in the body, there are some significant drawbacks – most notably the serious side effects.

Because of my family history, I am one of 250,000 women in Britain who this decision could help. Actress Angelina Jolie, pictured, thought her risk of having the ‘defective’ gene, BRCA1, was so high that she opted for a double mastectomy. But I’m not sure I’d choose to take a tablet that would put me into early menopause and put me at risk of osteoporosis, just two of a significant list of side effects.

I want to know what you think. Would you use anastrozole to prevent breast cancer? Did you take it and suffer?

Please write to me at the email address below.

Is physio all it’s cracked up to be?

Physiotherapy sessions can be prescribed to treat a range of conditions.

There are physios who help with injury recovery, joint replacements and stroke rehabilitation.

Some may specialize in working with people with disabilities, and there are even physios who tackle incontinence and other pelvic problems.

I believe this is positive, but not everyone agrees.

I’ve come across a number of doctors on social media debating the measurable benefits physios provide, and the conflicting and confusing advice they sometimes give on how to treat ailments.

I am interested in your experiences. Was physical therapy really helpful, or just pointless?

Send me an email to the address on the right.