March is National Kidney Month, which provides a great opportunity to review the role of this vital organ, signs of kidney disease, and the ways that chronic kidney disease is treated.
Your kidneys are vital organs with a range of functions. Among other functions, your kidneys:
- Clean your blood of waste products, filtering waste out of 200 liters of blood daily
- Help to produce red blood cells
- Release hormones that regulate blood pressure
- Regulate your body’s potassium, salt and acid content
- Help to produce vitamin D
Chronic kidney disease, or CKD, can put these functions at risk. CKD has been on the rise for the last 30 years and unfortunately is far from a rare disease. More than 20 million Americans have CKD, which is 1-in-10 adults, and that number is increasing, primarily due to the rise in diabetes and high blood pressure. CKD can be stable for many years or it can eventually progress to complete kidney failure. In either case, it remains a risk factor for cardiovascular disease like stroke or heart attack.
What Causes Kidney Disease?
CKD occurs when your kidneys are unable to filter the body’s natural toxins or are inappropriately leaking protein. Risk factors of CKD include:
- High blood pressure
- Family history of kidney disease
- Aging (60+)
- Excessive use of over the counter pain relievers, or other nephrotoxic medications
So why does having diabetes or high blood pressure lead to kidney problems? In some people with diabetes, over time, high glucose levels can damage the blood vessels that filter blood. This causes a buildup of waste products in the blood and the kidneys have to work harder to try to remove it. High blood pressure can also damage blood vessels in the kidneys, which inhibits their ability to function properly.
Common pain relievers such as ibuprofen and naproxen (with brand names such as Motrin, Advil, and Aleve) can harm your kidneys, especially if used in large quantities for prolonged periods of time. Be aware of the effects that over-the-counter medications, supplements, and vitamins have on your body.
What Are the Symptoms of Kidney Disease?
People with early CKD tend not to feel or notice any symptoms. In fact, many people with early CKD aren’t aware they have it. But the following are all symptoms that could be related to CKD and should be checked out by your doctor. CKD can be diagnosed with blood and urine tests.
- Poor appetite
- Swollen extremities
- Muscle cramping at night
- Puffiness around your eyes
- Dry and itchy skin
- Change in frequency of urination
When severe, CKD causes unrelenting nausea, vomiting, shortness of breath, severe fatigue, or even death. It can also increase your risk for vascular and heart disease, strokes, and peripheral artery disease.
Those at higher risk for CKD include people with diabetes, high blood pressure (hypertension), autoimmune diseases (such as lupus or rheumatoid arthritis), inherited kidney malformations, large kidney stones, enlarged prostate gland, or recurrent urinary tract infections. Some ethnic groups are also at higher risk, including African Americans, Native Americans, and Latinos. Screening individuals at higher risk for CKD may allow for interventions to prevent or delay progression.
How is Kidney Disease Treated?
Kidney disease treatment options can vary depending on the cause and severity of the disease. Proper treatment can slow down how quickly the disease progresses and minimize complications.
Early CKD treatment may include drinking plenty of fluids, maintaining a healthy body weight, exercising regularly, not smoking, and eating a balanced diet. Your doctor may suggest reducing the amount of protein in your diet to reduce the amount of work your kidneys must do to remove the waste products in your blood that are caused by excess protein. If your kidneys are already damaged, it’s best to avoid medications that could cause more damage or other problems.
Most people with CKD don’t reach end-stage renal disease (stage 5 of CKD), which requires dialysis or a kidney transplant. This is more common among adults over 70 years of age, is more likely to occur in African Americans or Hispanics, and is usually associated by diabetes or hypertension. If you have a severe form of CKD or reach end-stage renal disease, a support network of family and friends, and connecting with others who suffer from CKD, will help you live well despite the disease.
What should be obvious to all of us is not to take our kidneys for granted and to pay attention to symptoms that could be early signs of chronic kidney disease.
by Ilan Zawadzki, MD, nephrologist
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