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Chronic kidney disease is more prevalent than you may think

Do you really understand the full function of your kidneys? Most people know their kidneys filter their blood to remove excess salt and water, as well as turn toxins found in the blood into urine so that they can be flushed from the body. That is correct. But did you know that your kidneys also regulate your blood pressure, help the bone marrow produce blood and ensure bone strength?

You might also think that kidney stones are the most prominent ailment involving those organs. It’s a common misconception.  In Tennessee, 7 in 100 people will develop kidney stones.  One in nine, however, is at risk of developing chronic kidney disease. 

Chronic kidney disease, also called CKD, is a permanent condition where the kidneys stop functioning as well as they should. CKD is diagnosed when your kidneys function at below 60 percent of their capacity, however it can be present at higher kidney function also. It’s a very common disease that comes on with very little warning. In its early stages there are no symptoms. Once it becomes very advanced, you can have nausea, vomiting, lack of appetite, lack of energy, high blood pressure and swelling of the legs from fluid buildup. Unless you are looking for it, you won’t know you have chronic kidney disease until it’s too late. 

But there are some warning sign indicators or risk factors that can prompt simple blood and urine tests to determine the presence of CKD. The blood tests are known as Blood Urea Nitrogen (BUN) and Creatinine, which are toxins that should be readily eliminated from your body. When the levels are elevated in the blood, it indicates lower than normal kidney function. These two tests are used in an equation to calculate the estimated glomerular filtration rate (eGFR), which gives us an idea of the level of kidney function present.  An eGFR of 60 or less is consistent with CKD, which needs to be evaluated by a Nephrologist or kidney specialist. Also, urine can be tested for the presence of protein (albumin) or blood, which can also be a sign of CKD. 

The main risk factor for developing CKD is Diabetes Mellitus. Both types of Diabetes can lead to CKD.   High blood pressure, Coronary Artery Disease, age greater than 65 and a family history of diabetes, high blood pressure or kidney disease are also risk factors. Anyone with any of these should be screened annually for kidney abnormalities. 

What people need to understand about chronic kidney disease, first and foremost, is that if not controlled, the kidneys will eventually fail. The treatment could include transplant or dialysis, but the goal is to try to manage the disease so it stabilizes. Once diagnosed, like diabetes, kidney disease can only be managed, not cured. 

There are medications that help slow down the progression of CKD, but the most important management tool I recommend is lifestyle changes. 

One of the main reasons this disease is so prevalent in Tennessee is the availability of fried and other unhealthy foods. A lot of people in the South are diabetic and that is the main cause of CKD in the Southeast. If people can control their diabetes, it will help prevent further damage to the kidneys. So as simple as it may seem, eating right and exercising are your best defense, along with an annual blood test if you already have any warning signs or risk factors for CKD. 

At your next health care visit, be sure to find out what your eGFR is as well as if there is presence of blood or albumin in your urine. 

If you find you have reduced kidney function, another lifestyle change to implement is to avoid the class of medicines called NSAIDS, more commonly known as Motrin or Aleve. These are used a lot because they are easily available over the counter. For people with already compromised kidney function, NSAIDS have been shown to drop the amount of blood that is supplied to the kidney..  NSAIDS are fine, however for those with normal kidney function. 

Jennifer Santana, M.D., is board-certified in nephrology and hypertension and is a credentialed physician with Williamson Medical Center. 

Posted on: 9/18/2013


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