Wednesday, April 4, 2018
Thirty million American adults have chronic kidney disease (CKD) and millions of others are at risk. Higher incidences of hypertension and diabetes are pushing the numbers upwards. Knowing your risk, recognizing symptoms, getting tested, and staying healthy are crucial steps to excellent kidney functioning over time.
According to the National Kidney Foundation, kidneys perform a variety of functions. The kidneys regulate the body’s fluid levels. They act as a filter for wastes and toxins form the blood. In addition, kidneys release a hormone that regulates blood pressure. Hence, hypertension causes CKD and CKD causes hypertension. This organ also activates vitamin D to maintain healthy bones, releases hormone that directs production of red blood cells, and keeps blood minerals in balance. If the kidneys are not functioning normally, CKD can cause cardiovascular disease, heart attack and stroke, high blood pressure, weak bones and nerve damage (neuropathy).
To assess your risk, speak to your physician if you have diabetes, high blood pressure, or cardiovascular disease OR if you have a family history of kidney disease, diabetes, or high blood pressure. Other risk factors include African-American, Native American, Hispanic, Asian, or Pacific Islander heritage, being 60 or older, obesity, low birth weight, prolonged use of NSAIDs such as ibuprofen or naproxen, lupus or other autoimmune disorders, chronic urinary tract infections, or kidney stones.
According to the National Kidney Foundation, most people with early CKD have no symptoms, which is why early testing is so critical. Symptoms can often be misleading so it is important to listen to your body and discuss any of the following with your physician: fatigue, weakness, difficult/painful urination, increased need to urinate (especially at night), foamy urine, pink, dark urine (blood), increased thirst, puffy eyes, or swollen face, hands, abdomen, ankles, or feet.
Your doctor may perform four simple life-saving tests if you or a loved one are in the risk categories:
Blood Pressure – High blood pressure can damage small blood vessels (glomeruli) in the kidneys. It is the second-leading cause of kidney failure after diabetes.
Protein in Urine – Traces of a type of protein, albumin in urine (albuminuria) is an early sign of CKD. Persistent amounts of albumin and other proteins in the urine (proteinuria) indicate kidney damage.
Creatinine in Blood – Healthy kidneys filter creatinine (a waste product from muscle activity) out of the blood. When kidney function is reduced, creatinine levels increase.
Glomerular Filtration Rate – This is the most sensitive and accurate gauge of kidney function. Doctor’s measure blood creatinine levels and perform a calculation based on age, race, and gender.
If you have chronic kidney disease, your doctor will most likely recommend the following steps to improve your kidney health:
1) Lower high blood pressure.
2) Keep blood sugar levels under control if diabetic.
3) Reduce salt intake.
4) Avoid NSAIDs, painkillers such ibuprofen and naproxen.
5) Moderate protein consumption.
6) Get an annual flu shot.
To keep your healthy kidneys in good working order, the National Institutes of Health recommend these lifestyle choices:
· Exercise regularly. Walk, dance, garden, clean, bike, or anything else that keeps your body in motion and gets up your heart rate. Be active for 30 minutes or more on most days. If you are not active now, ask your health care provider about the types and amounts of physical activity that are right for you.
· Control your weight. Discuss your BMI with your doctor.
· Follow a balanced diet high in veggies, fruits, whole grains, and lean proteins.
· Quit smoking.
· Drink alcohol in moderation. Drinking too much alcohol can increase your blood pressure and add extra calories, which can lead to weight gain. If you drink alcohol, limit yourself to one drink per day if you are a woman and two drinks per day if you are a man. One drink is 12 ounces of beer, 5 ounces of wine, or 1.5 ounces of liquor.
· Stay hydrated. Staying hydrated is important but there is no evidence that over hydrating (drinking water in excess) enhances kidney function. The average person could drink 32 - 48 ounces of a water a day in addition to fluids from food and be well hydrated. Your healthcare professional can offer insight specific to you based on exercise intensity, heat, age, body build, and gender.
· Monitor cholesterol levels. A simple blood test will reveal a complete cholesterol profile.
· Get an annual physical. Annual physicals require a urinalysis as well as blood work. Early chronic kidney disease may not have any discernable symptoms but these tests may reveal early signs.
· Know your family medical history and share it with your health care provider.
For more information about kidney health, visit The National Kidney Foundation at https://www.kidney.org/.
Lorraine Wichtowski is a community health educator at UR Medicine Noyes Health in Dansville, NY. To discuss this and other health topics, contact Lorraine at firstname.lastname@example.org or (585) 335-4327.