March is National Kidney Month

March is National Kidney Month and I would like to take this opportunity to discuss kidney health and what you can do to protect your kidneys. Most people are born with two kidneys, each the size of a fist. They are located on either side of the spine just above the waist. Each kidney weighs only one-quarter of a pound but plays an enormous and critical role in your health. Most people know that a major function of the kidneys is to remove waste products and excess fluid through the urine. Other functions performed by the kidneys include:

Keeping your body chemicals in balance which include sodium, potassium, calcium, phosphorus, and bicarbonate.

Helping to control blood pressure.

Helping to make red blood cells.

Producing vitamin D, which helps maintain the health of your bones.

Twenty-six million American adults have chronic kidney disease and millions of others are at increased risk. Early detection and treatment of chronic kidney disease are important to keep from progressing to kidney failure. Some simple tests can be done to detect early kidney disease. They are: blood pressure measurement, a test for protein in the urine and a test for blood creatinine which can be used to calculate your glomerular filtration rate (GFR). Your GFR tells how much kidney function you have. It is especially important for people who have increased risk for chronic kidney disease to have these tests.

According to the National Kidney Foundation there are several risk factors for developing kidney disease which include:

older age,

having diabetes,

having high blood pressure,

having a family member who has chronic kidney disease and

being African-American, Hispanic American, Asian and Pacific Islander or American Indian.

The leading causes of kidney disease are diabetes and high blood pressure. Other causes include glomerulonephritis (inflammation of the kidney’s tiny filtering units), inherited diseases such as polycystic kidney disease, kidney stones, urinary tract infections, congenital diseases (usually a problem occurs in the urinary tract when a baby is developing), and drugs and toxins (such as using over the counter pain relievers for a long time). Many kidney diseases can be treated successfully. Careful control of diseases such as diabetes and high blood pressure can help prevent kidney disease or keep it from getting worse. Treating high blood pressure with medications called angiotensin converting enzyme (ACE) inhibitors often helps slow the progression of chronic kidney disease. Blood pressure should be less than 140/90 for most people and less than 130/80 if you have diabetes or kidney disease. Diabetes can cause kidney disease to progress more rapidly. Studies show that good glucose control can lower the risk of developing kidney disease or delay its progression. A blood test to check hemoglobin A1c, which is a marker for glucose control, should be done every three to six months. According to the American Diabetic Association the hemoglobin A1c should be equal to or less than 6.9 percent. It is important for diabetics to check their blood glucose as recommended by their health care provider and know their hemoglobin A1c number. Kidney stones and urinary tract infections can usually be treated successfully. Unfortunately, the exact causes of some kidney diseases are still unknown.

Kidney disease usually affects both kidneys. If the kidney’s ability to filter the blood is seriously damaged by disease, wastes and excess fluid may build up in the body. Although many forms of kidney disease do not produce symptoms until late in the course of the disease, there are six warning signs of kidney disease:

1. High blood pressure.

2. Blood and/or protein in the urine.

3. A creatinine and blood urea nitrogen (BUN) blood test that is elevated above the normal range. BUN and creatinine are waste that builds up in your blood when your kidney function is reduced.

4. A glomerular filtration rate (GFR) less than 60. GFR is a measure of kidney function.

5. More frequent urination, particularly at night; difficult or painful urination.

6. Puffiness around eyes, swelling of hands and feet.

Some things you can do to help protect your kidneys:

1. Discuss all medications, even over the counter drugs with your health care provider.

2. Take all medications as prescribed.

3. If you have diabetes, keep your blood sugar under control by taking your medications, watching your diet, and monitoring your blood sugar level. Know your hemoglobin A1c number. Remember, it should be equal to or less than 6.9 percent.

4. Exercise with your health care provider’s approval.

5. If you have high blood pressure, check your blood pressure regularly. Take your medications even if you feel fine. Remember, your blood pressure goal is less than 140/90; and less than 130/80 if you have diabetes or kidney disease.

6. Follow any special diet instructions.

(References for this article include the National Kidney Foundation and Baxter Healthcare Corporation.)

Debra Adams, ARNP, is affiliated with Trimark Nephrology.