Are you Kidney’s healthy?

By Dr. Kelly McGrath

Our kidneys are vital to our health. They filter our blood continuously and if they stop working, we can become critically ill or die. The problem is that, until kidneys are in the final stages of failure, patients experience few if any symptoms. One in every 7 Americans has chronic kidney (CKD). Despite CKD being that common, 90% of those with chronic kidney disease do not even know that they have the condition. This is part of the challenge to prevent kidney failure for Americans. Although there are steps that can be taken to prevent or slow the progression of CKD, these are most effective early on – when symptoms are absent.
CKD is a very important disease to try and prevent or slow. The reason for this is that, once our kidneys fail, we require dialysis which is a life-altering, expensive treatment for patients. Some patients will even require a kidney transplant which also is a very difficult pathway. CKD is also important because, as it progresses, so does the risk of cardiovascular disease which can skyrocket. For this reason, in addition to preventing kidney failure, it is important to impact CKD to prevent cardiovascular disease and related death.
We want to identify patients early in the process of CKD. To do this, we focus on the groups at the highest risk. This primarily is patients with diabetes mellitus. One in 3 people with diabetes have some form of CKD – but likely do not aware of it. Patients with high blood pressure also have higher risk for CKD with 1 out of every 5 high blood pressure patients having CKD. Other risk factors can be age greater than age 60, race, obesity, history of smoking or family history of kidney failure. It is recommended that patients with diabetes have at least one kidney profile test each year to screen for CKD. This test looks at how well the kidneys are filtering the blood as well as checks for protein abnormally spilling into the urine. It ends up that at any level of CKD, the presence of protein in the urine increases the risk for cardiovascular disease as well as for more rapid decline of kidney function.
While no one wants to find out that they have a disease such as CKD, the good news is that with early intervention we can make a huge impact on the disease or even stop its progression altogether. Early on, this consists of just lifestyle modification and good management of blood pressure. At later stages, this may include adding medicines to protect the kidneys and reduce risk of cardiovascular disease. If you have diabetes, it may be useful to ask your doctor about screening for CKD and help prevent the associated health problems.