By Dr. Ralph Wagner, Medical Adviser
Progressive loss of kidney function over time is called chronic kidney disease, (CKD). Our kidneys remove waste from the blood into the urine which is essential to our overall health. The kidneys also play important roles in controlling blood pressure, maintaining proper chemistry balance, and making red blood cells. Chronic kidney disease which may affect 20 million people in the United States may interfere with any of these important processes.
Most people with CKD have no symptoms early on, but a diagnosis may be suggested on blood testing. As the disease progresses symptoms may become more prominent including swelling of the feet, weakness, fatigue, loss of appetite, and difficulty thinking clearly. The most common causes of CKD are high blood pressure, diabetes mellitus, and heart disease. Inflammatory conditions, infections, and urinary tract blockages can also cause CKD. Testing for diagnosis includes checking the urine for protein, check blood pressure, and testing the blood for creatinine levels (a waste product in the blood).
Several important steps can help prevent or possibly slow the progression of CKD. Controlling blood pressure is important if it’s high to minimize further kidney damage. Medications called ACE inhibitors and AR blockers are often used to help “protect” kidney function. Exercise and weight control with proper diet are important to help control blood pressure as well. Controlling blood sugars with diet and medication is essential in those with diabetes. Your doctor will help guide you with this. Quitting smoking can help lower blood pressure and help you preserve kidney function.
Treatment for CKD depends on the underlying cause. Anemia (low hemoglobin) is often associated with CKD and can cause fatigue. Certain CKD patients can benefit from injections that stimulate the bone marrow to produce more red blood cells and improve the symptoms of anemia. Advanced CKD can weaken bones by the way the body processes calcium and phosphorus. Specific medications might help this condition also. Dietary control of eating too much protein is often recommended so the kidneys don’t have to work as hard. Guidance by a dietician or nutritionist can be invaluable to help with proper diet.
Regular medical testing and care is necessary as CKD can progress over time even with good treatment. Your doctor will measure your kidney function tests and adjust medications as appropriate to help. If kidney function continues to decline, dialysis may become necessary to remove waste products from the blood. Prevention and treatment of CKD is another important reason to monitor blood pressure and do what we can to live a healthy lifestyle.