It took years for me, as a primary care doctor, to fully appreciate the many challenges patients face with chronic kidney disease. I still remember one of the first patients I ever admitted to the hospital when I was an intern. She was a dialysis patient who was in the hospital for cancer treatment. Seeing her condition made me realize how much I had to learn about chronic kidney disease.
Here are the numbers on kidney health in the U.S.:
- 37 million Americans have chronic kidney disease
- More than 725,000 are on dialysis for end stage renal disease (which is advanced chronic kidney disease)
- Nearly 100,000 people are on a waiting list for a kidney transplant
To explain why it’s so important to take care of your kidneys, let’s first understand what kidneys do in the body.
How Do Our Kidneys Work?
Our kidneys are one of the most critical organs in the body. Thank goodness we have two of them! (Although, surprisingly, we can survive with just one.) These bean-shaped organs are about the size of your fist. Each one is located on either side of your spine below your rib cage.
The main job of your life-sustaining kidneys is to filter waste (including medications you take) and extra water from your blood, which produces urine. In addition to filtering the blood, kidneys also:
- Balance the water, salts, and minerals in your blood
- Release hormones that regulate blood pressure
- Keep your bones strong and healthy by producing an active form of vitamin D
- Make red blood cells to prevent anemia
Inside each kidney are small, ball-shaped structures called glomeruli — about one million, in fact — that are responsible for filtering blood. Imagine your kidneys as powerful chemical factories, and the glomeruli are the workers.
Every 24 hours, your kidneys process about 150 quarts of blood. That’s nearly 40 gallons! One to two quarts are removed in the form of urine, which is moved to the bladder, and the remaining filtered blood is returned to your bloodstream.
Are There Signs of Chronic Kidney Disease?
There aren’t many symptoms or signs of chronic kidney disease until after the condition has progressed. Chronic kidney disease is often described as a “silent” condition because it is very hard to detect without a blood test.
Unfortunately, many people with early stage chronic kidney disease are completely unaware and don’t discover it until it has progressed to end stage renal disease. That is why it’s so important to have regular check-ups with your primary care doctor and complete your routine blood work when it’s prescribed.
Anyone can get chronic kidney disease, but some people are at higher risk. If you have any of the risk factors listed below, it’s important to be screened for chronic kidney disease at least once every year. The top risk factors for chronic kidney disease are:
- Poorly controlled diabetes
- Poorly controlled high blood pressure
- Heart disease
- Having a family member with kidney disease
- Being African-American, Hispanic, Native American, or Asian
- Being older than 60
Some signs of chronic kidney disease that appear in advanced stages are changes in urination (going more or less), fatigue, itching, swelling in hands or feet, shortness of breath, pain in the small of your back, nausea, no appetite, and poorly controlled blood pressure.
What Are the Best Ways to Take Care of Your Kidneys?
Since diabetes and high blood pressure are the most common causes of chronic kidney disease, it is crucial to manage these diseases and follow your doctor’s treatment plan. Your kidneys will also benefit from a healthy diet. A kidney-friendly meal plan includes foods that are low-salt and low-fat.
In addition, be sure to aim for at least 30 minutes of exercise on most days of the week, avoid tobacco products, and limit how much alcohol you drink.
It’s also important to be aware of the over-the-counter medications you take. Remember, it’s your kidneys’ job to filter these drugs from your bloodstream. Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen, are usually safe for occasional use when taken as directed, but long-term use with higher doses may harm normal kidneys.
Support Is Available for Independence Members
Chronic kidney disease can be a dangerous and costly disease. Not only are many patients required to get dialysis either daily or many times a week, but patients with advanced chronic kidney disease (end stage renal disease) are also at high risk for hospitalization.
If you are living with chronic kidney disease and would like more support, remember that help is just a phone call away! Members can talk to a registered nurse Health Coach 24/7 by calling the Customer Service number on the back of your member ID card and saying “Health Coach” when prompted for a call reason. If you’re an Independence Blue Cross member, you may also be covered for visits with a registered dietitian at no cost to you. A registered dietitian can help guide you on the proper diet for managing chronic kidney disease.
If you think you might benefit from palliative care to improve your quality of life with end stage renal disease, I encourage you to discuss it with your primary care doctor. You can also talk to a Health Coach about palliative care to help you decide if it would be right for you.