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Keeping your kidneys healthy

Created date

October 25th, 2011

Approximately 13% of the U.S. population over age 21 has chronic kidney disease. After age 60, the percentage goes up to about 38%, says Leslie Spry, M.D., a kidney specialist and spokesperson for the National Kidney Foundation. Chronic kidney disease (CKD) occurs when kidneys can no longer function efficiently. Diabetes and high blood pressure are the major causes of CKD in older adults, Spry says. By age 85, more than 90% of people have high blood pressure. And according to the American Diabetes Association, about 27% of people over age 65 have diabetes. Either of these conditions alone can put stress on your kidneys by damaging blood vessels, Spry explains. But many people have both high blood pressure and diabetes, which puts them at an even higher risk of CKD. You can also be at risk if CKD runs in your family. Other predisposing factors include recurrent urinary tract infections and kidney stones.

A very silent disease

Your kidneys do more than just make urine. They are sophisticated filters that remove waste and excess water from your blood. Other functions include releasing hormones responsible for blood pressure control, red blood cell production, and bone health; and maintaining the balance of minerals such as sodium and potassium in your blood. CKD can range from mild to severe. The damage that occurs to the kidneys happens very slowly, says Barbara Morris, M.D, medical director at Wind Crest, an Erickson Living community in Highlands Ranch, Colo. People rarely have symptoms until the disease is far advanced. Even then, symptoms such as fatigue, increased thirst, or puffy eyes may not seem alarming. These symptoms may be vague and have many causes, so people might dismiss them as insignificant, Morris adds. Other symptoms include swelling of the face, hands, abdomen, ankles, or feet; frequent or painful urination; and pink, dark, or foamy urine. CKD can cause other problems such as heart disease, nerve damage, or anemia. In addition, a recent study published in theAmerican Journal of Kidney Diseasesshowed that older adults with CKD are at a higher risk of cognitive problems. The only way to know if you have CKD is by a blood test.

Dialysis

There are medications that may help to prevent or delay worsening of CKD, but if it has advanced to kidney failure, the best treatments are dialysis or kidney transplantation, Spry says. There are two types of dialysis: hemodialysis and peritoneal dialysis. With hemodialysis, your blood is directly filtered through a machine. This can be done either at a facility or in some cases, at home. With peritoneal dialysis, a cleansing solution flows through a soft catheter into your abdomen, remains there for a period of time, and then drains back out. The membrane lining your abdominal wall (called the peritoneum) acts as a filter to draw waste from your blood. This procedure is often done at home.

Transplants

People with transplants have double the life expectancy as those on dialysis, Spry says. You can have a kidney transplanted from an anonymous donor who has recently died or from a living person usually a relative. Most kidney transplant programs will accept patients to be on a waiting list up until 65 or 70 years old if they are otherwise healthy, but every program has different criteria, Spry says. A transplanted kidney can last up to 15 years or even longer, depending on the recipient s health status and whether the donor was alive when the kidney was removed. Transplants are the best treatment for CKD, but they are not a cure, Spry explains. We only transplant one, so you do not end up having completely normal kidney function. And you need to take medications for as long as you have the new kidney to prevent your body from rejecting the organ.

Kidney health

Once you have been diagnosed with CKD, it is not inevitable your kidneys will fail. Controlling high blood pressure or diabetes are the best ways you can help your kidneys function better, Morris says. Keep track of your numbers and see your doctor regularly. Eating healthy foods and being active are particularly beneficial to your kidneys and your overall health. Following a low-salt diet is of utmost importance, Spry says. Salt not only is associated with high blood pressure, but even a moderate salt intake can harm your kidneys. We all grow up with a certain taste for salt, and many people think they are limiting salt but closer scrutiny of their diets shows they aren t, Spry continues. It seems like a small thing, but it can improve outcomes of people with CKD dramatically. With CKD you may also need to limit other nutrients in your diet such as potassium, phosphorus, or protein. Check your labels and ingredients lists carefully for amounts contained in foods. Even if you don t need treatment yet, you must tell all of your health care providers that you have CKD, even if it s very mild, Morris says. All treatments and medications that you are prescribed must be scrutinized for their potential harm to your kidneys. Have your primary doctor review all of your medications, and if you are prescribed something new, ask if it can worsen your kidney function. Taking an active role in management of your disease is the best way to live with CKD, Spry says. If you don t, this disease can quickly rob you of your independence and well-being.

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