Symptoms, Consequences, and How to Reduce Your Risk
A pair of fist-sized, bean-shaped organs, your kidneys sit on either side of your spine, just below the rib cage. Their main function is to filter your blood by removing waste and excess water to make urine. Dr. Christopher Poole, a partner at Nephrology Associates of Chattanooga, shares, “Our kidneys receive and process our entire blood volume 20 to 25 times each day.”
In addition to filtering blood, your kidneys also stabilize electrolytes like potassium, sodium, and phosphorus, and release hormones that help regulate blood pressure, create red blood cells, and produce an active form of vitamin D. In short, kidneys are vital organs that perform life-sustaining functions that the body requires. In the event they have some type of abnormality or become damaged, they lose the ability to perform their crucial functions, which results in kidney disease. “Kidney disease is defined as any damage to the kidneys that is found by laboratory testing,” explains Dr. Poole.
“When function in the kidneys become irreversibly damaged, we call that chronic kidney disease, or CKD,” shares Dr. Rafael Duchesne, a nephrologist with Nephrology & Hypertension Specialists. With CKD, the kidneys cannot filter blood, which means excess fluid and waste build up in the body.
Thirty million people– that’s 15% of U.S. adults– likely have CKD, but many are entirely unaware, since the disease often doesn’t produce symptoms until it’s more advanced. In fact, nearly half of those who have severely reduced kidney function are unaware they have the disease, while 96% of people with some level of kidney damage or mildly reduced kidney function have no idea their kidneys aren’t healthy.
“CKD is a progressive disease, and unfortunately, CKD symptoms are nonspecific and can go unnoticed until the disease has progressed to the later stages,” explains Dr. Duchesne.
The signs that might arise in later stages include fatigue, trouble concentrating, poor appetite, nausea and vomiting, dry and itchy skin, bloody urine, increased urination (particularly at night), painful urination, and swelling in the lower extremities.
Who’s Most at Risk?
Approximately 1 in 3 adults with diabetes and 1 in 5 adults with high blood pressure may have chronic kidney disease. CKD is more common in women than men and more prevalent in African Americans, Hispanics, Pacific Islanders, Asians, and Native Americans. Seniors over 60 are more likely to develop CKD due to the natural loss of kidney function, combined with an increased risk of diabetes and hypertension.
CKD occurs when a disease or condition impairs kidney function, causing abnormalities or permanent damage. The leading cause of CKD is diabetes, which prevents your body from producing enough insulin or using it normally, resulting in a high blood sugar level. Over time, the high levels of glucose in the blood can damage the kidneys.
High blood pressure, also known as hypertension, is the second leading cause of CKD. Uncontrolled hypertension can cause the arteries around the kidneys to narrow, weaken, or harden. This means that over time, they become unable to deliver enough blood to kidney tissues. “Diabetes and hypertension are responsible for two thirds of all CKD cases,” says Dr. Duchesne. “Anyone with either disorder should have a blood and urine test at least yearly.”
The third leading cause of kidney disease is glomerulonephritis, an inflammation of the tiny filters in your kidneys. This condition may arise on its own, or as part of another disease like diabetes or lupus.
Other conditions that can affect your kidneys include kidney stones and infections, diseases that affect the body’s immune system, acute kidney injury (which can results from injuries, major blood loss, or reactions to some medicines), or genetic diseases such as polycystic kidney disease, which causes large cysts to form on the kidneys and damage the surrounding tissue.
While the damage done to your kidneys cannot be reversed, there are treatments that can help your kidneys perform their functions.
Dialysis: Typically, when kidney function is reduced to 10-15%, dialysis becomes a viable treatment option. There are two versions, depending on severity and other factors.
Hemodialysis: With this form of dialysis, a patient is connected to a dialysis machine and an artificial kidney, called a dialyzer, which pumps blood, filters it, and returns it to the body. This method, which is usually done three times a week for approximately four hours, is most often completed at a hospital or dialysis center.
Peritoneal dialysis: With this form of dialysis, a catheter is surgically implanted in the abdomen, and a sterile cleansing fluid, called dialysate, is sent through to filter and wash. Treatments can be done at home, at work, or while traveling. However, peritoneal dialysis isn’t possible for some patients. Those who are obese or who have had multiple prior abdominal surgeries may not be ideal candidates.
Kidney Transplant: For people whose CKD has advanced to the point of complete kidney failure, a kidney transplant may be the best option. The kidney can be donated from a living relative or friend, or from a stranger who wished to donate their organs upon death. Studies show that people with kidney transplants live longer than those who remain on dialysis. However, Dr. Duchesne explains, “It is important to note that transplantation is not a cure, but another treatment.” Those considered for a transplant must be healthy enough for operation and cancer- and infection-free.
Early detection is crucial to slow or prevent the progression of kidney disease. If you are 60 or older, have a family history of kidney disease, or have any high-risk conditions that are likely to cause CKD like diabetes or hypertension, it’s important to discuss prevention methods with your doctor.
Most likely, you’ll need to undergo two simple tests as a part of your annual physical. Dr. Poole explains, “The lack of any outward symptoms is why seeing your primary care provider regularly to have blood work and urine studies done is vital to diagnosing and managing chronic kidney disease.”
A urine test can identify the amount of the protein called albumin in your urine; too much of this type of protein indicates damage. Dr. Poole explains, “The filters in the kidneys are set up to retain almost all of the protein they are exposed to. If the filters are damaged, protein will leak out and will appear in the urine.”
The second test, a blood test, can measure kidney function by checking your creatinine (a waste product that is removed by the kidneys) levels to determine how well the kidneys are removing waste.
It is also important to manage blood pressure and blood sugar levels. Even pre-hypertension and pre-diabetes (slightly elevated blood pressure or blood sugar levels) can cause damage to your kidneys. Quitting smoking will help keep levels in check.
Maintaining a healthy weight, incorporating regular exercise, and making good food choices reduce your risk of developing not only kidney disease but many other health ailments that are closely linked to CKD.
Exercise caution when taking both over-the-counter and prescription pain medications. Part of the kidneys’ job is to filter these types of medications from your body, meaning they have to work especially hard when pain medication is ingested on a regular basis. Take care to avoid excessive use of non-steroidal anti-inflammatory drugs such as ibuprofen and naproxen, as NSAIDs can lower kidney function over time.
Since kidney disease is often asymptomatic, it’s vital to be vigilant and visit your doctor regularly. Don’t be afraid to ask questions if you fall into a risk category, and don’t ignore any signs that don’t sit well with you. With early diagnosis and proper treatment, you can continue a happy, healthy life for years to come.