Take Charge of Your Health - The Ins and Outs of Kidney Disease
Individuals with kidney disease who are able to obtain treatment early experience a higher quality of life and are able to maintain more of their day-to-day activities...
-Xavier Becerra
Over three quarters of a million Americans have end stage Kidney/Renal Disease with 71% on dialysis and 29% having had a kidney transplant. By way of background, each of us has two kidneys, bean-shaped organs that are approximately the size of our fist and located just below the rib cage on each side of the spine. The primary function of our kidneys is to filter waste and excess fluids from the blood, which are then eliminated in the urine. Healthy kidneys filter about ½ cup of blood every minute. The kidneys also help control blood pressure, make red blood cells, help maintain healthy bones, and regulate chemicals in our bodies that are essential to life.
There are five stages of kidney disease – from Stage 1 which is very mild to Stage 5 which indicates kidney failure. Physicians determine the stage of kidney function according to the glomerular filtration rate (GFR) - a number based on the amount of creatinine found in the blood. In addition physicians also consider factors such as age, race, and gender.
A diagnosis of chronic kidney disease indicates that dangerous levels of waste have built up in the body. This can lead to a myriad of other health complications such as heart disease, damage to the nervous system, and fluid in the lungs. In the first three stages of kidney disease, there are typically very few symptoms and so it is not unusual for the condition to be detected only when it is more advanced. Symptoms of kidney disease tend to be nonspecific and can include: nausea, vomiting, dizziness, loss of appetite, fatigue, muscle cramps, swelling/edema, problems or changes with urination, confusion, and respiratory and/or cardiac issues as fluids build up in the body. The primary factors that increase a person’s risk of kidney disease are high blood pressure and diabetes, followed by smoking and obesity.
Tests to detect kidney disease typically include urine tests, blood tests, imaging (ultrasound, MRI, CT scan) and, in some cases, a biopsy of the kidney tissue is examined to determine the amount of kidney damage. Medications for high blood pressure, anemia, swelling of the legs and feet, brittle bones, and high cholesterol as well as vitamins and dietary changes can help treat some of the complications caused by kidney disease. As examples, an ACE inhibitor can reduce blood pressure, a diuretic can reduce fluid buildup, and Vitamin D and calcium can help minimize bone loss.
Chronic kidney disease can progress to kidney failure unless it is treated with either kidney dialysis or a kidney transplant. When a person can no longer properly clear waste and excess fluid, a dialysis machine can artificially filter their blood. According to the Cleveland Clinic there are two types of dialysis:
Hemodialysis: With hemodialysis, blood is circulated through a machine that removes waste products, excess water, and excess salt. The blood is then returned to the body. Hemodialysis requires three to four hours, three times a week, and is performed at a clinic, hospital, or dialysis center.
Peritoneal dialysis: In peritoneal dialysis, a dialysis solution is run directly into the abdomen. The solution absorbs waste and then is removed via catheter. Fresh solution is added to continue the process of cleaning. Patients can perform this type of dialysis themselves. There are two types of peritoneal dialysis: continuous ambulatory peritoneal dialysis (CAPD), which involves a change in dialysis solution four times a day; and continuous cycling peritoneal dialysis (CCPD). CCPD uses a machine to automatically fill, remove wastes, and refill the fluid during the nighttime.
Only one healthy kidney is needed to meet the body’s needs. With a transplant, one healthy kidney from a deceased or living donor is surgically placed. Compared to a lifetime of dialysis, a kidney transplant is often the preferred treatment. In fact, kidneys are the most common organ transplanted.
With proper detection and treatment, people with kidney disease can live productive lives. As we always suggest, it is important to take ownership of your health and consider areas of your life you can control including managing your high blood pressure and blood sugar levels, eating a healthy diet with less fat and salt, not smoking, exercising, and managing a healthy weight.