You probably don’t think much about your kidneys. Did you know symptoms of kidney disease might not manifest until there is 90% loss of kidney function? Decline in kidney function can be caused by certain disease processes, genetic defects, exposure to certain bacteria or drugs or congenital defects during birth. Knowing your family history will alert your healthcare provider to test for it but knowing your numbers will heighten your awareness of what steps to take to maintain healthy kidney function.
We have two kidneys, each about the size of a fist, one on each side of the back of our abdomen. They filter all our blood several times a day while:
- maintaining fluid and electrolyte balance
- removing waste from our body
- removing drug end products
- producing an active form of vitamin D that helps strengthen our bones
- releasing hormones that regulate blood pressure
- making a hormone called erythropoietin that assists with the production of red blood cells
Types of Chronic Kidney Disease
Chronic Kidney Disease (CKD) is defined as having some kind of kidney abnormality (such as protein in the urine) that results in declined kidney function for three months or longer. There are many types of CKD.
Hypertension and Diabetes
Having poorly controlled diabetes is the most common cause of kidney damage. Diabetes is caused by a defect in insulin production or insulin use that results in high blood sugars. Think of high blood sugars being like sandpaper inside the arteries of the kidneys gradually destroying the filtering units of the kidneys. Poorly controlled high blood pressure is another very common cause of chronic kidney disease. High blood pressure causes damage to the fine meshwork of arteries inside the kidneys – visualize the impact of a heavy rain on the banks of small brooks.
Inherited Types of CKD
Polycystic Kidney Disease is the most common type that results in the formation of large cysts that gradually harm kidney function.
Inflammation of the Kidneys
There are tiny filtering units called glomeruli in the kidneys that can be damaged from exposure to bacteria. Some examples are E Coli from eating contaminated foods or streptococcus from strep throat. Autoimmune diseases like Systemic Lupus Erythematosas can also cause chronic inflammation of the kidneys.
These are defects that happen while the fetus is developing in the womb. A common defect involves the malfunction of a valve in the urine tube that causes urine to back up and damage the kidneys.
Drugs and Toxins
Many over-the-counter pain medications, such as Aleve and Ibuprofen, cause kidney damage. Repeated use of antibiotics can cause kidney damage. Exposure to poisons and pesticides and illicit drugs like crack and heroin can all cause kidney damage.
Simple Tests for Kidney Disease
There are several ways to detect kidney disease. Early detection can preserve kidney function.
- Check blood pressure with the goal of keeping your blood pressure under 130/80 for those with diabetes, and under 140/90 for those with hypertension. Checking your own blood pressure at different times of the day – even at work when it can be highest – is essential. Your heart is beating 24 hours a day, not just at the doctor’s office and often times the doctor office results can be less accurate due to anxiety, not sitting for five minutes or not having your arm at the right height. You can purchase a reliable one at Walmart for less than $50.
- Have your healthcare provider check for protein in your urine. The presence of protein in the urine indicates some damage to the filtering units of the kidneys. Heavy exercise can cause this so this should be repeated several times.
- Have your healthcare provider check your blood creatinine- this is a simple blood test that is part of a basic metabolic panel. Creatinine is a metabolic waste byproduct that are is indicative of how well your kidneys are working. Used in conjunction with your age, race, gender and other factors your estimated Glomerular Filtration Rate (GFR) can be calculated. A GFR under 60 is considered the threshold of CKD. Use this calculator to determine your GFR
Treatment for Chronic Kidney Disease
There is a lot that can be done to control the damage from CKD. There are many drugs that can control and preserve kidney function. There are many dietary changes that people can follow to keep kidneys healthy. Eating a low fat, low sodium diet can go a long way in protecting the delicate filtering system of the kidneys. The average American consumes well over 4000 mg of sodium daily. Getting that closer to 1500 mg by avoiding high salt foods like smoked foods and deli meats; canned, prepared and packaged goods that are not low sodium; pickles; olives and many cheeses to name a few, can make a big difference. Eating a low fat diet by reducing saturated and trans fats from foods like hot dogs, sausage, red meat, many chips and crackers, whole fat dairy will reduce the bad fat that leads to hardening of the arteries. In addition, eating mostly grains that are whole (they are high in natural fiber that act like sponges soaking up the bad artery-clogging fats) will go a long way in keeping your arteries soft and flexible. For those with diabetes, checking blood sugars, particularly checking 2 hours after a meal when blood sugars can be the highest, will give you an idea of your blood sugar control. Eating a diet of carbohydrates that are high in natural fiber like those in whole grains and fruits in portioned amounts; lean protein from fish, chicken and tofu and emphasizing your lunch and dinner plate being one half nonstarchy veggies, can be more effective than medications in controlling your diabetes. If this seems like a daunting task then schedule an appointment with a dietitian; dietary changes are as important as prescription medications in controlling hypertension and diabetes and often times can mean getting off some medications.
You Are In Control of Your Health
We can’t feel if our kidneys are being damaged. Visible signs of kidney disease only happen when there is serious damage. But being an educated health care consumer can alert you to early warning signs and put you in the driver’s seat of your health. Know your blood pressure, find our your blood creatinine and calculate your GFR. A result well over 60 (and hopefully over 90) is an indication that your are living a healthy life, a priceless payback!