What to know about chronic kidney disease during National Kidney Month
March 1, 2022
Chronic kidney disease (CKD) affects approximately 15% of US adults, or roughly 1 in 7. However, 9 in 10 adults with CKD, and 2 in 5 of adults with severe CKD, are unaware that they have CKD.
The kidneys are the body’s recycling apparatus. In the course of a single day, the kidney processes our entire blood volume more than 30 times over, returning to the body all that is needed and excreting in the urine all that is not. This would include excess water and salt, electrolytes, toxins and acid produced by daily metabolism. The kidneys are also critical in the production and action of certain hormones that regulate blood production, blood pressure control, and bone and mineral metabolism.
There are no early symptoms of kidney disease and pain and a change in urine output are uncommon or late sign of kidney disease. It is important, therefore, to know how to keep one’s kidneys healthy. A simple blood and urine test are the best ways to evaluate kidney health, especially for those who are at risk for developing CKD.
The biggest risk factors for the development of CKD are diabetes mellitus and hypertension. Keeping a healthy weight and balanced moderate to high intensity activity of at least 150 minutes per week will reduce the risk of developing or controlling diabetes and hypertension. A discussion with a healthcare provider or a clinical dietician specialized in kidney care is useful as the optimum diet for a CKD patient will change as their health status changes.
Specific drugs for diabetes or hypertension are particularly protective to the kidneys. It is important that care decisions shared between the patient and their healthcare provider include options for these kidney-protective medications. Blood pressure goals must be individualized but the target is generally a properly obtained BP of < 120/70 mm Hg. Discuss with your healthcare provider the proper way to check and monitor your BP at home.
A regular review of all your medications, including over-the-counter, homeopathic, herbal and alternative medications, should be done with your healthcare provider. Many medications, including “natural” medications, are harmful to the kidneys or have doses that must be adjusted in CKD.
Promotion of water intake beyond that needed to satisfy thirst, or roughly 1-1.5 liters of free water/day, has not been shown to protect the kidneys. The body exquisitely regulates salt and water balance through a variety of mechanisms, including thirst. Augmenting water intake beyond our thirst signals offers little advantage in maintaining kidney health.
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