Breaking the silence on chronic kidney disease
By David E. Henner, D.O.
It’s another one of those silent, but deadly diseases that’s readily detectable and ultimately manageable with better self-care and communication between doctors and their patients.
Chronic kidney disease (CKD) affects some 30 million American adults – that’s 15 percent or 1 in 7 people – but the vast majority of people who have it don’t know it. Recent surveys have shown that 96 percent of people with CKD in the form of mildly reduced kidney function or kidney damage are not aware they have the disease. Even for those with severely reduced kidney function, 48 percent are unaware of having CKD.
The reason for that silence is that CKD, in much the same way as other chronic conditions like hypertension and diabetes, usually has no outward symptoms. While some may experience fatigue, some swelling in the feet and ankles or other effects, most sufferers aren’t suffering those symptoms.
So it is that kidney specialists (nephrologists) and primary care providers throughout the country are turning up the volume with patients on the importance of kidney health and two simple screening tests that can be done to ensure your kidneys are functioning as they should.
Your kidneys are vital organs, necessary for your survival in the same way as your heart and lungs. Your kidneys perform essential functions in your body, including the removal of toxic substances produced from the breakdown of foods you eat. Your kidneys also help regulate your blood pressure and fluid levels, direct the production of red blood cells and activate Vitamin D for healthy bones.
CKD is a condition in which the kidneys are damaged, their function is disrupted and they cannot filter blood as well as healthy kidneys. As a result, excess fluid and waste from the blood remain in the body and may cause a myriad of other health problem, including high blood pressure (hypertension), cardiovascular disease, heart attack, stroke, electrolyte disorders, anemia and bone disease. Though most identified CKD patients are treated successfully with medication and lifestyle management, about 10% of patients with CKD will eventually suffer from kidney failure and require either dialysis or transplantation.
The two leading risk factors and causes of CKD are diabetes and high blood pressure, which together account for two-thirds of CKD cases. So you can help prevent it by controlling your blood pressure if you have hypertension and your blood sugars if you have diabetes. The risk grows higher with age, affecting 20 to 30 percent of people 60 and older.
It’s important for your doctor to talk to you and for you to press them on the subject of kidney health. Two basic lab tests should be part of your routine annual physical. A simple blood test measuringwhat’s called your Glomerular Filtration Rate (GFR) tells how well your kidneys are working to remove wastes from your blood. A simple urine test measuring what’s called your Albumin/Creatinine Ratio (ACR) looks for the presence of the protein albumin in your urine. Virtually no albumin is present in the urine when the kidneys are functioning properly, so if it’s there and rising, it’s an indicator of CKD.
As part of your own self-care, limiting the amount of salt, simple sugars (such as soda, candy, and processed foods) and consuming more fruits, vegetables, and foods high in fiber not only can help prevent heart disease, but also can help prevent you from developing kidney disease. However, diet certainly won’t help prevent kidney disease in everyone, and that’s why those annual blood and urine tests are important.
Early detection and regular treatment can help keep chronic kidney disease from getting worse. So keep open those the lines of communication between you and your doctor.
David E. Henner, D.O., is the Division Chief of Nephrology and Medical Director of the Kidney Disease & Hypertension Center at Berkshire Medical Center.