Kidneys may not get as much attention as some other major organs, yet these filters that clean the blood, removing waste that would otherwise become toxic, are crucial to our health. Fortunately, increased awareness campaigns have highlighted the importance of healthy kidneys and the prevention of chronic kidney disease.
“Many risk factors for the development and progression of chronic kidney disease exist: chronic medical conditions (diabetes, hypertension, hyperlipidemia and cardiovascular disease), aging, family history and being African-American,” says Dr. Danijela Mataic, a nephrologist on staff at SSM St. Clare Health Center. “In addition, obesity and smoking have been linked to chronic kidney disease and its progression.”
Symptoms may be vague or nonexistent for some time as the disease progresses and may mimic a variety of other conditions. For instance, people may notice the need to urinate frequently, especially at night, fluid retention causing puffiness around the eyes or in the legs, high blood pressure, fatigue, loss of appetite, anemia (which is marked by itching, easy bruising and pale skin), shortness of breath, headaches, numbness in hands or feet, confusion and insomnia.
“Diagnosis is made through simple urine analysis and blood tests,” explains Dr. Sana Waheed, a physician specializing in internal medicine with Mercy Clinic. “These tests can provide significant insight into how the kidney is functioning. Through values from these tests, one can calculate a person’s glomerular filtration rate (GFR), which tells us how well the kidneys are functioning. As kidney disease progresses, GFR falls.” An ultrasound of the kidneys also may help physicians diagnose specific kidney problems, such as tumors.
Kidney disease often follows diabetes or hypertension, and preventive strategies for all these conditions include maintaining a healthy weight and not smoking. However, once the kidneys are damaged and unable to function properly, the only options are dialysis or organ transplantation.
Two types of dialysis are available: hemodialysis and peritoneal dialysis. “Hemodialysis uses a dialysis filter to remove waste and water from the bloodstream, while peritoneal dialysis uses the abdominal lining, the peritoneal membrane, as a natural filter,” Mataic says. “Peritoneal dialysis is conducted at the patient’s home, while hemodialysis can be performed either at home or at an outpatient dialysis clinic. When performed in a dialysis facility, hemodialysis treatments typically range in length from three to four hours, and they are usually done three times a week.” For many patients with kidney failure, kidney transplantation has the greatest potential for restoring a healthy, productive life, but donors are not abundant, she adds.
“Perhaps the most recent development is the realization that blood pressure is the most important aspect of treatment,” says Dr. Leslie Spry, a nephrologist and spokesman for the National Kidney Foundation (NKF). “Targeting blood pressure to less than 140/90 is key to slowing the progression of chronic kidney disease.”
A healthy lifestyle and management of other types of chronic disease are your best defense against joining the more than 26 million American adults who have chronic kidney disease. Information on free kidney health screenings is available through NKF’s Eastern Missouri website, kidneyemo.org.