Chronic kidney disease - do you have it? World Kidney Day is March 13

March 8, 2014

On World Kidney Day, March 13, the National Kidney Foundation urges everyone over the age of 60 to be screened for kidney disease. One in nine adults has chronic kidney disease, and most don't know it.

Chronic kidney disease is a condition in which the kidneys are damaged and cannot filter blood as well as healthy kidneys. Some 26 million Americans (13 percent of the U.S. adult population) suffer from CKD - a figure experts predict will rise due to high obesity rates, the link between obesity, diabetes and high blood pressure and the aging of the baby boomer generation.

Approximately one of three adults with diabetes and one of five adults with high blood pressure have CKD. Both diabetes and high blood pressure damage the small blood vessels in your kidneys and can cause kidney disease without you feeling it. You can't feel kidney disease, so it is very important to get tested if you are at risk, especially family history.

Kidney disease is often called a silent disease, because most people have no symptoms with early kidney disease. Blood and urine tests are the only way to check for kidney damage or measure kidney function. The blood test checks your GFR. GFR stands for glomerular filtration rate. GFR is a measure of how much blood your kidneys filter each minute. This shows how well your kidneys are working. It is the best way to check kidney function.

Doctors measure blood creatinine (waste buildup) levels and perform a calculation based on race, age and gender. A GFR of 60 or higher is in the normal range; less than 60 for three months indicates kidney disease and a GFR of 15 or lower may mean kidney failure. The urine test looks for albumin, a type of protein, in your urine. A healthy kidney does not let albumin pass into the urine. A damaged kidney lets some albumin pass into the urine.

Kidneys performs a lot of important functions. They regulate fluid levels, activate Vitamin D for healthy bones, filter wastes from the blood and direct production of red blood cells. Therefore, when your kidneys start failing it leads to other health problems including your body holding in too much fluid, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs.

The potassium levels in your blood can go up suddenly, which could keep your heart from working as it should. It can even lead to death. Your bones may become weak and brittle, and more likely to break. The number of red blood cells can become low, making you feel tired and weak. Your immune system can become weakened, which makes you more likely to get an infection. You may become depressed or have a lower quality of life.You can become malnourished.

Signs of advancing CKD include swollen ankles, fatigue, difficulty concentrating, decreased appetite, blood in the urine and foamy urine. When your kidneys stop working, waste can no longer be removed from your blood, meaning you have kidney failure. Kidney failure is also called end-stage renal disease or Stage 5 CKD. When you have ESRD you need dialysis or a kidney transplant to survive.

The most efficient way to reduce personal suffering and financial costs of CKD is to prevent and treat its risk factors to avoid getting the disease at all. Some of the things you can do to prevent kidney disease are exercising regularly; eating a low-salt diet; controlling weight and losing weight if needed; monitoring blood pressure, cholesterol and glucose levels and keeping them in normal range; not smoking; drinking moderately; avoiding non-steroidal anti-inflammatory drugs (NSAIDs) and other drugs which cause kidney damage; and getting an annual physical.

Treatments for early kidney disease include both diet and lifestyle changes, and medications. Choose and prepare foods with less salt and sodium. Aim for less than 1,500 milligrams of sodium each day. Buy fresh food more often. Sodium (a part of salt) is added to many packaged foods. Read the Nutrition Facts label on food packages for sodium carefully, as salt is hidden in many foods. A Daily Value of 20 percent or more means the food is high in sodium. Rinse canned vegetables, beans, meats, and fish with water before eating to remove the excess salt used as a preservative.

Salt substitutes like Mrs. Dash are very popular, but there are many more options to help those with chronic kidney disease be creative in the kitchen, Alternative to salt in cooking are barbecue grilling spices and rubs, Cajun and Creole spices, fajita seasoning, fresh garlic, fresh lemon or lime juice, Italian seasoning, lemon pepper, pepper and paprika. Szechwan and Thai seasonings are also good alternatives, but look for the salt content. Other spices like allspice, basil, bay leaves, cloves, curry, dill, ginger, mustard powder, parsley, rosemary and thyme can also be used to spice up food. Avoid using salt substitutes or seasonings that contain potassium chloride. Potassium can actually be more harmful than salt, as potassium is usually high in kidney disease patients, and it can cause irregular heartbeats.

Eat the right amount of protein. Although it is important to eat enough protein to stay healthy, excess protein makes your kidneys work harder. Eating less protein may help delay progression to kidney failure. Talk to your dietitian or other healthcare provider about what is the right amount of protein for you.

Kidney disease kills more people each year than breast and prostate cancer combined. Of the more than 120,000 Americans on the national organ transplant waitlist, more than 98,000 await a life-saving kidney. So be proactive and take steps to prevent the disease by leading a healthier lifestyle and getting regular checkups.

Dr. Uday Jani is board certified in internal medicine and fellowship trained in integrative medicine.  His office, Shore View Medical, PA, is at 28312 Lewes-Georgetown Highway, Milton; 302-684-0990.




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