Dipak-001/mistril_dataset huggingface dataset:
user: What is (are) Insulin Resistance and Prediabetes ?

assistant: Metabolic syndrome, also called insulin resistance syndrome, is a group of traits and medical conditions linked to overweight and obesity that puts people at risk for both CVD and type 2 diabetes. Metabolic syndrome is defined* as the presence of any three of the following2:
                
- large waist sizewaist measurement of 40 inches or more for men and 35 inches or more for women  - high triglycerides in the bloodtriglyceride level of 150 milligrams per deciliter (mg/dL) or above, or taking medication for elevated triglyceride level  - abnormal levels of cholesterol in the bloodHDL, or good, cholesterol level below 40 mg/dL for men and below 50 mg/dL for women, or taking medication for low HDL  - high blood pressureblood pressure level of 130/85 or above, or taking medication for elevated blood pressure  - higher than normal blood glucose levelsfasting blood glucose level of 100 mg/dL or above, or taking medication for elevated blood glucose
                
In addition to type 2 diabetes, metabolic syndrome has been linked to the following health disorders:
                
- obesity  - CVD  - PCOS  - nonalcoholic fatty liver disease  - chronic kidney disease
                
However, not everyone with these disorders has insulin resistance, and some people may have insulin resistance without getting these disorders.
                
People who are obese or who have metabolic syndrome, insulin resistance, type 2 diabetes, or prediabetes often also have low-level inflammation throughout the body and blood clotting defects that increase the risk of developing blood clots in the arteries. These conditions contribute to increased risk for CVD.
                
*Similar definitions have been developed by the World Health Organization and the American Association of Clinical Endocrinologists.
user: What to do for Insulin Resistance and Prediabetes ?

assistant: - Insulin is a hormone that helps cells throughout the body absorb glucose and use it for energy. Insulin resistance is a condition in which the body produces insulin but does not use it effectively.  - Insulin resistance increases the risk of developing type 2 diabetes and prediabetes.  - The major contributors to insulin resistance are excess weight, especially around the waist, and physical inactivity.  - Prediabetes is a condition in which blood glucose or A1C levelswhich reflect average blood glucose levelsare higher than normal but not high enough for a diagnosis of diabetes.  - The Diabetes Prevention Program (DPP) study and its follow-up study, the Diabetes Prevention Program Outcomes Study (DPPOS), confirmed that people with prediabetes can often prevent or delay diabetes if they lose a modest amount of weight by cutting fat and calorie intake and increasing physical activity.  - By losing weight and being more physically active, people can reverse insulin resistance and prediabetes, thus preventing or delaying type 2 diabetes.  - People with insulin resistance and prediabetes can decrease their risk for diabetes by eating a healthy diet and reaching and maintaining a healthy weight, increasing physical activity, not smoking, and taking medication.  - The DPP showed the diabetes medication metformin to be most effective in preventing or delaying the development of type 2 diabetes in younger and heavier people with prediabetes and women who have had gestational diabetes.
user: What is (are) I Can Lower My Risk for Type 2 Diabetes: A Guide for American Indians ?

assistant: Diabetes causes blood glucose levels to be above normal. People with diabetes have problems converting food to energy. After food is eaten, it is broken down into a sugar called glucose. Glucose is then carried by the blood to cells throughout the body. The hormone insulin, made in the pancreas, helps the body change blood glucose into energy. People with diabetes, however, either no longer make enough insulin, or their insulin doesn't work properly, or both.
                
Type 2 diabetes
                
Type 2 diabetes is the most common type in American Indians. This type of diabetes can occur at any age, even during childhood. People develop type 2 diabetes because the cells in the muscles, liver, and fat do not use insulin properly. Eventually, the body cannot make enough insulin. As a result, the amount of glucose in the blood increases while the cells are starved of energy. Over time, high blood glucose damages nerves and blood vessels, leading to problems such as heart disease, stroke, blindness, kidney failure, and amputation.
                
Other kinds of diabetes
                
Type 1 diabetes
                
Type 1 diabetes is rare in American Indians. People develop type 1 diabetes when their bodies no longer make any insulin. Type 1 is usually first diagnosed in children or young adults but can develop at any age.
                
Gestational diabetes
                
Gestational diabetes is first diagnosed during pregnancy. It occurs when the body doesn't use insulin properly. Having an American Indian family background raises the risk of developing gestational diabetes. Although this form of diabetes usually goes away after the baby is born, a woman who has had it is more likely to develop type 2 diabetes later in life.
user: What are the symptoms of I Can Lower My Risk for Type 2 Diabetes: A Guide for American Indians ?

assistant: Many people have no visible signs or symptoms of diabetes. Symptoms can also be so mild that you might not notice them. More than 5 million people in the United States have type 2 diabetes and do not know it.
                
- increased thirst  - increased hunger   - fatigue   - increased urination, especially at night   - unexplained weight loss   - blurred vision   - sores that do not heal
user: Who is at risk for I Can Lower My Risk for Type 2 Diabetes: A Guide for American Indians? ?

assistant: - My mother had diabetes when I was born.   - I am overweight.  - I have a parent, brother, or sister with diabetes.  - My family background is American Indian.  - I have had gestational diabetes, or I gave birth to at least one baby weighing more than 9 pounds.  - My blood pressure is 140/90 mmHg or higher, or I have been told that I have high blood pressure.  - My cholesterol levels are higher than normal. My HDL cholesterol"good" cholesterolis below 35 mg/dL, or my triglyceride level is above 250 mg/dL.  - I am fairly inactive. I exercise fewer than three times a week.
user: What is (are) Renal Artery Stenosis ?

assistant: Renal artery stenosis is the narrowing of one or both renal arteries. Renal means kidney and stenosis means narrowing. The renal arteries are blood vessels that carry blood to the kidneys from the aortathe main blood vessel that carries blood from the heart to arteries throughout the body.
                
RVH is high blood pressure caused by RAS. Blood pressure is written with two numbers separated by a slash, 120/80, and is said as 120 over 80. The top number is called the systolic pressure and represents the pressure as the heart beats and pushes blood through the blood vessels. The bottom number is called the diastolic pressure and represents the pressure as blood vessels relax between heartbeats. A persons blood pressure is considered normal if it stays at or below 120/80. High blood pressure is a systolic pressure of 140 or above or a diastolic pressure of 90 or above.1
user: What is (are) Renal Artery Stenosis ?

assistant: The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid.
user: What causes Renal Artery Stenosis ?

assistant: About 90 percent of RAS is caused by atherosclerosisclogging, narrowing, and hardening of the renal arteries.2 In these cases, RAS develops when plaquea sticky substance made up of fat, cholesterol, calcium, and other material found in the bloodbuilds up on the inner wall of one or both renal arteries. Plaque buildup is what makes the artery wall hard and narrow.
                
Most other cases of RAS are caused by fibromuscular dysplasia (FMD)the abnormal development or growth of cells on the renal artery wallswhich can cause blood vessels to narrow. Rarely, RAS is caused by other conditions.
user: Who is at risk for Renal Artery Stenosis? ?

assistant: People at risk for artherosclerosis are also at risk for RAS. Risk factors for RAS caused by artherosclerosis include
                
- high blood cholesterol levels  - high blood pressure  - smoking  - insulin resistance  - diabetes  - being overweight or obese  - lack of physical activity  - a diet high in fat, cholesterol, sodium, and sugar  - being a man older than 45 or a woman older than 55  - a family history of early heart disease
                
The risk factors for RAS caused by FMD are unknown, but FMD is most common in women and people 25 to 50 years of age.3 FMD can affect more than one person in a family, indicating that it may be caused by an inherited gene.
user: What are the symptoms of Renal Artery Stenosis ?

assistant: In many cases, RAS has no symptoms until it becomes severe.
                
The signs of RAS are usually either high blood pressure or decreased kidney function, or both, but RAS is often overlooked as a cause of high blood pressure. RAS should be considered as a cause of high blood pressure in people who
                
- are older than age 50 when they develop high blood pressure or have a marked increase in blood pressure  - have no family history of high blood pressure  - cannot be successfully treated with at least three or more different types of blood pressure medications
                
Symptoms of a significant decrease in kidney function include
                
- increase or decrease in urination  - edemaswelling, usually in the legs, feet, or ankles and less often in the hands or face  - drowsiness or tiredness  - generalized itching or numbness  - dry skin  - headaches  - weight loss  - appetite loss  - nausea  - vomiting  - sleep problems  - trouble concentrating  - darkened skin  - muscle cramps
user: What are the complications of Renal Artery Stenosis ?

assistant: People with RAS are at increased risk for complications resulting from loss of kidney function or atherosclerosis occurring in other blood vessels, such as
                
- chronic kidney disease (CKD)reduced kidney function over a period of time  - coronary artery diseasenarrowing and hardening of arteries that supply blood to the heart  - strokebrain damage caused by lack of blood flow to the brain  - peripheral vascular diseaseblockage of blood vessels that restricts flow of blood from the heart to other parts of the body, particularly the legs
                
RAS can lead to kidney failure, described as end-stage renal disease when treated with blood-filtering treatments called dialysis or a kidney transplant, though this is uncommon in people who receive ongoing treatment for RAS.
user: What to do for Renal Artery Stenosis ?

assistant: Limiting intake of fats, cholesterol, sodium, and sugar can help prevent atherosclerosis, which can lead to RAS. Most sodium in the diet comes from salt. A healthy diet that prevents people from becoming overweight or obese can also help prevent atherosclerosis. People with RAS that has caused decreased kidney function should limit their intake of protein, cholesterol, sodium, and potassium to slow the progression of kidney failure. More information about nutrition for CKD is provided in the NIDDK health topics, Nutrition for Early Chronic Kidney Disease in Adults and Nutrition for Advanced Chronic Kidney Disease in Adults. People should talk with their health care provider about what diet is right for them.
user: What to do for Renal Artery Stenosis ?

assistant: - Renal artery stenosis (RAS) is the narrowing of one or both renal arteries. The renal arteries are blood vessels that carry blood to the kidneys from the aortathe main blood vessel that carries blood from the heart to arteries throughout the body.  - Renovascular hypertension (RVH) is high blood pressure caused by RAS.  - About 90 percent of RAS is caused by atherosclerosis. Most other cases of RAS are caused by fibromuscular dysplasia (FMD), which can cause blood vessels to narrow.  - RAS often has no symptoms until it becomes severe. The first symptoms of RAS are usually either high blood pressure or decreased kidney function, or both, but RAS is often overlooked as a cause of high blood pressure.  - People with RAS are at increased risk for chronic kidney disease (CKD), coronary artery disease, stroke, and peripheral vascular disease.  - Imaging tests used to diagnose RAS include duplex ultrasound, catheter angiogram, computerized tomographic angiography (CTA) scan, and magnetic resonance angiogram (MRA).  - Treatment for RAS includes lifestyle changes, medications, and surgery.
user: What is (are) Amyloidosis and Kidney Disease ?

assistant: Amyloidosis is a rare disease that occurs when amyloid proteins are deposited in tissues and organs. Amyloid proteins are abnormal proteins that the body cannot break down and recycle, as it does with normal proteins. When amyloid proteins clump together, they form amyloid deposits. The buildup of these deposits damages a persons organs and tissues. Amyloidosis can affect different organs and tissues in different people and can affect more than one organ at the same time. Amyloidosis most frequently affects the kidneys, heart, nervous system, liver, and digestive tract. The symptoms and severity of amyloidosis depend on the organs and tissues affected.
user: What is (are) Amyloidosis and Kidney Disease ?

assistant: The kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 quarts of blood to produce about 1 to 2 quarts of urine, composed of wastes and extra fluid. The urine flows from the kidneys to the bladder through tubes called ureters. The bladder stores urine. When the bladder empties, urine flows out of the body through a tube called the urethra, located at the bottom of the bladder. In men, the urethra is long, while in women it is short.
user: What is (are) Amyloidosis and Kidney Disease ?

assistant: Primary amyloidosis and dialysis-related amyloidosis are the types of amyloidosis that can affect the kidneys.
                
Primary Amyloidosis of the Kidneys
                
The kidneys are the organs most commonly affected by primary amyloidosis. Amyloid deposits damage the kidneys and make it harder for them to filter wastes and break down proteins. When the kidneys become too damaged, they may no longer be able to function well enough to maintain health, resulting in kidney failure. Kidney failure can lead to problems such as high blood pressure, bone disease, and anemiaa condition in which the body has fewer red blood cells than normal.
                
Dialysis-related Amyloidosis
                
People who suffer from kidney failure and have been on long-term dialysis may develop dialysis-related amyloidosis. This type of amyloidosis occurs when a certain protein, called beta-2 microglobulin, builds up in the blood because dialysis does not remove it completely. The two types of dialysis are
                
- hemodialysis. Hemodialysis uses a special filter called a dialyzer to remove wastes and extra fluid from the blood.  - peritoneal dialysis. Peritoneal dialysis uses the lining of the abdominal cavitythe space in the body that holds organs such as the stomach, intestines, and liverto filter the blood.
                
Dialysis-related amyloidosis is a complication of kidney failure because neither hemodialysis nor peritoneal dialysis effectively filters beta-2 microglobulin from the blood. As a result, elevated amounts of beta-2 microglobulin remain in the blood. Dialysis-related amyloidosis is relatively common in people with kidney failure, especially adults older than 60 years of age, who have been on dialysis for more than 5 years.1
                
More information is provided in the NIDDK health topics:
                
- Treatment Methods for Kidney Failure: Hemodialysis  - Treatment Methods for Kidney Failure: Peritoneal Dialysis
user: What are the symptoms of Amyloidosis and Kidney Disease ?

assistant: The most common sign of primary amyloidosis of the kidneys is nephrotic syndromea collection of signs that indicate kidney damage. The signs of nephrotic syndrome include
                
- albuminuriaan increased amount of albumin, a protein, in the urine. A person with nephrotic syndrome excretes more than half a teaspoon of albumin per day.  - hyperlipidemiaa condition in which a persons blood has more-than-normal amounts of fats and cholesterol.  - edemaswelling, typically in a persons legs, feet, or ankles and less often in the hands or face.  - hypoalbuminemiaa condition in which a persons blood has less-than-normal amounts of albumin.
                
More information is provided in the NIDDK health topic, Nephrotic Syndrome in Adults.
                
Other signs and symptoms of primary amyloidosis may include
                
- fatigue, or feeling tired  - shortness of breath  - low blood pressure  - numbness, tingling, or a burning sensation in the hands or feet  - weight loss
user: What are the symptoms of Amyloidosis and Kidney Disease ?

assistant: The symptoms of dialysis-related amyloidosis may include
                
- pain, stiffness, and fluid in the joints.  - abnormal, fluid-containing sacs, called cysts, in some bones.  - carpal tunnel syndrome, caused by unusual buildup of amyloid proteins in the wrists. The symptoms of carpal tunnel syndrome include numbness or tingling, sometimes associated with muscle weakness, in the fingers and hands.
                
Dialysis-related amyloidosis most often affects bones, joints, and the tissues that connect muscle to bone, called tendons. The disease may also affect the digestive tract and organs such as the heart and lungs. Bone cysts caused by dialysis-related amyloidosis can lead to bone fractures. Dialysis-related amyloidosis can also cause tears in tendons and ligaments. Ligaments are tissues that connect bones to other bones.
user: How to diagnose Amyloidosis and Kidney Disease ?

assistant: A health care provider diagnoses primary amyloidosis of the kidneys with
                
- a medical and family history  - a physical exam  - urinalysis  - blood tests  - a kidney biopsy
                
Medical and Family History
                
Taking a medical and family history may help a health care provider diagnose amyloidosis of the kidneys. He or she will ask the patient to provide a medical and family history.
                
Physical Exam
                
A physical exam may help diagnose primary amyloidosis of the kidneys. During a physical exam, a health care provider usually
                
- examines a patients body to check for swelling  - uses a stethoscope to listen to the lungs  - taps on specific areas of the patients body
                
Urinalysis
                
A health care provider may use urinalysisthe testing of a urine sampleto check for albumin and amyloid proteins in urine. The patient provides a urine sample in a special container at a health care providers office or a commercial facility. A nurse or technician can test the sample in the same location or send it to a lab for analysis. More-than-normal amounts of albumin in urine may indicate kidney damage due to primary amyloidosis. Amyloid proteins in urine may indicate amyloidosis.
                
Blood Tests
                
The health care provider may use blood tests to see how well the kidneys are working and to check for amyloid proteins and hyperlipidemia. A blood test involves drawing a patients blood at a health care providers office or a commercial facility and sending the sample to a lab for analysis. Blood tests for kidney function measure the waste products in the blood that healthy kidneys normally filter out. Hyperlipidemia may indicate nephrotic syndrome. Amyloid proteins in blood may indicate amyloidosis.
                
Kidney Biopsy
                
Only a biopsy can show the amyloid protein deposits in the kidneys. A health care provider may recommend a kidney biopsy if other tests show kidney damage. A kidney biopsy is a procedure that involves taking a piece of kidney tissue for examination with a microscope. A health care provider performs a kidney biopsy in a hospital with light sedation and local anesthetic. The health care provider uses imaging techniques such as ultrasound or a computerized tomography (CT) scan to guide the biopsy needle into the kidney and take the tissue sample. A pathologista doctor who specializes in diagnosing diseasesexamines the tissue in a lab for amyloid proteins and kidney damage.
                
The biopsy results can help the health care provider determine the best course of treatment. More information is provided in the NIDDK health topic, Kidney Biopsy.
user: How to diagnose Amyloidosis and Kidney Disease ?

assistant: A health care provider diagnoses dialysis-related amyloidosis with
                
- urinalysis  - blood tests  - imaging tests
                
A health care provider can use urinalysis and blood tests to detect the amount of amyloid proteins in urine and blood. Imaging tests, such as x-rays and CT scans, can provide pictures of bone cysts and amyloid deposits in bones, joints, tendons, and ligaments. An x-ray technician performs imaging tests in a health care providers office, an outpatient center, or a hospital. A radiologista doctor who specializes in medical imaginginterprets the images. A patient does not require anesthesia.