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Tuesday, March 21, 2023

Chronic Kidney Disease

Taking steps to maintain kidney health

The kidney is a vital organ in the body that cleans the blood of toxins we consume daily in our diet. Each kidney comprises over one million filters that work 24/7 to ensure the blood is free of all potentially harmful chemicals. Several different causes can damage these filters, resulting in the kidney being unable to clean the blood adequately. This is called chronic kidney disease (CKD).

One in seven American adults is estimated to have chronic kidney disease: That’s over 37 million Americans. Another 80 million are at risk of developing CKD over their lifetime. The damage caused by CKD can go on for a long time without any symptoms. Nine out of 10 people with CKD may not have any clinical indicators. Most of the time, with CKD, kidneys do not hurt, urine flow is not affected, and until the number of functional filters is less than 30 percent, patients seldom have any idea that the kidneys are weakening. Kidney disease often worsens over time and may lead to kidney failure, also called end-stage kidney disease, and other health problems, such as stroke or heart attack. Unfortunately, Black individuals are at higher risk for end-stage kidney disease. For every white individual who develops end-stage kidney disease, so do three Black individuals.

While there are no symptoms as kidneys weaken initially, symptoms may appear once the function is below 30% of normal (when more than 70% of the kidney has failed). Waking up frequently at night to urinate, making less urine than usual and sudden changes in the color of urine may all be signs of kidney disease. One may also experience swelling in the face, legs, ankles and feet, as well as fatigue and weakness. Severe CKD will also cause anemia (low blood count), affect the acid level in your blood, lower your blood calcium level and increase the potassium level in your blood, amongst other changes.

Many factors can cause CKD. Diabetes and high blood pressure are among the most common risk factors for developing kidney disease. Nearly one in three people with diabetes and one in five people with high blood pressure have kidney disease. Heart disease, certain cancers, chronic use of over-the-counter medication (Aleve/Ibuprofen, etc.), kidney stones, prostate disease in men, urine infection and abuse of illicit street drugs are other causes of CKD.

If you have any condition that puts you at a higher risk of kidney disease, it is important to see a doctor. Your doctor will run urine and blood tests to determine if you have CKD.

Only routine testing (yearly for patients at risk) will identify chronic kidney disease. Early recognition of the damage to kidney cells is essential. We are born with a fixed number of filters in the kidney. Once these filters die, from any cause, they will never come back. The earlier we find the cause of the damage and control the condition, the better the chances that we save any additional injury to the kidney.

Many promising medications and therapies to manage chronic kidney disease have been developed in the last five years. But, if you have diabetes or high blood pressure, you may need to take extra steps. Keeping your blood sugar levels under control can help prevent kidney damage. If you have elevated blood pressure or have a family history of hypertension, it must be checked and kept under a blood pressure of less than 130/80 mmHg. Talk to your doctor about using medications that have been shown to slow the rate of loss of kidney function in patients who already have CKD.

Dietary changes are a crucial part of the management of kidney disease. Processed foods high in added chemical preservatives increase the risk of accumulating toxins. Restaurant fast food tends to have high salt, which can worsen blood pressure and kidney disease risk. Smoking has been linked with a higher rate of kidney disease as well. Adopting a healthier lifestyle through regular 30-minute exercise and a healthy balanced diet high in fruits and vegetables can help slow the rate of kidney disease progression.

If, despite the best efforts, the kidney cannot be saved, there are effective ways to replace kidney functions that have developed over time, such as dialysis or transplant. Dialysis is a treatment that helps filter your blood and remove waste when your kidneys are not working. A kidney transplant involves having a new kidney implanted into your body to replace the function of the damaged kidney. These procedures allow for a normal, healthy lifestyle. For example, Alonzo Mourning continued to play basketball after a successful transplant in 2003. Selena Gomez continues to lead a productive life despite kidney failure/dialysis and a kidney transplant in 2017.

Here are some tips for living healthily with chronic kidney disease:

• Exercise regularly: Regular exercise can help improve your overall health and well-being.

• Eat a healthy diet: A diet low in salt, high in fruits and vegetables and moderate in animal protein can help improve kidney function.

• Stay hydrated: Drink plenty of fluids, but avoid those that contain sugars, caffeine and alcohol.

• Monitor your blood pressure and blood sugar levels: Keeping these levels under control can help prevent kidney damage.

• Get regular check-ups: Regular check-ups with your doctor can help monitor your condition and make any necessary changes to your treatment plan.

• Take your medication as prescribed: If you have been prescribed medication to manage your chronic kidney disease, it is important to take it as directed.

Chronic kidney disease is a serious condition that can greatly impact your health. However, by working closely with your doctor, making lifestyle changes and following a treatment plan, managing the disease and living a healthy and fulfilling life is possible. If you have any symptoms of chronic kidney disease, do not hesitate to see a doctor. Early detection and treatment can make all the difference.

Bharat Sachdeva, M.D., is chief and professor of nephrology at LSU Health Shreveport. Ruhani Sachdeva is a student at Northwestern University Chicago Biomedical Engineering School.


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