Understanding and Managing Kidney Disease

Recent estimates suggest at least 20 million people in the United States have chronic kidney disease and about another 20 million are at risk of developing the disease. Kidney disease occurs when a person’s kidneys are no longer able to filter waste products and fluids from the blood. The leading cause of chronic kidney disease in the United States is type 2 diabetes. According to the National Kidney Foundation (NKF), approximately one-third of new cases of chronic kidney failure each year is caused by diabetes. High blood pressure is the second leading cause, accounting for about 30 percent of all cases. And as with hypertension, you may not realize you have kidney disease. The NKF lists the following as warning signs of chronic kidney disease:

High blood pressure
Blood and/or protein in the urine
A creatinine blood test greater than 1.2 for women and 1.4 for men (Creatinine is a waste product removed from the blood by healthy kidneys. In kidney diseases, creatinine levels in the blood may increase.)
More frequent urination, particularly at night
Difficult or painful urination
Puffiness around eyes and swelling of hands and feet

There are ways to control kidney disease. “One of the most important things for managing chronic kidney disease is blood pressure control because high blood pressure tends to be a common complication of kidney disease and it is also one of the major factors that causes progression of kidney disease,” says Dr. Frank C. Brosius III, chief of the University of Michigan Health System’s Division of Nephrology. Patients can be treated with drugs that lower blood pressure while protecting the kidneys. Smoking cessation is also essential. “A lot of people aren’t aware that smoking is actually a significant risk factor for progression of kidney disease. There are a lot of good reasons to stop smoking, and this is just one more good reason,” Dr. Brosius stresses.

Patients with kidney disease should control blood glucose and cholesterol levels and eat a healthy diet, because certain foods can make the problem worse. It’s best to check with a registered dietitian or nutritionist to tailor a meal plan that’s right for you. Here are some other general diet guidelines from WebMD:

Limit Sodium: Read food labels and avoid foods that list salt (sodium) or MSG near the beginning of the list. Don’t eat processed cheeses or canned, pickled or smoked meats. Don’t add salt to your food. Check with your doctor about using a salt substitute.
Limit Protein: Work with a dietitian to develop an eating plan that balances your need for less protein with enough protein to stay healthy. Learn about the sources of protein. Include high-quality protein ─ lean meat, chicken, fish, cheese or eggs ─ in your diet.
Limit Fluid: Don’t drink more than 48 fl. oz. of fluids per day. Be aware that some fruits and vegetables contain a lot of water and will count in your fluid intake.
Limit Phosphorus: Reduce your intake of dairy products. Avoid nuts, peanut butter, seeds, lentils, peas and beans. Avoid drinks such as beer, colas and cocoa.

It is possible for kidney disease patients to live a long, healthy life. “Twenty years ago, we were much more pessimistic about outcomes, but with good control and good attention to preventing cardiovascular risk, many of our patients can have stable, even reduced kidney function for years and not be at as high risk of cardiovascular disease,” Dr. Brosius says.

You can learn more about chronic kidney disease at the National Kidney Foundation of Michigan’s “Frequently Asked Questions” Web page.