How Is Your Kidney? Kidney Problems Are Hard to Detect

It’s National Kidney Month and it’s a great time to pay attention to the greatest filter known to man – your kidney. In my mind I thought of my kidney as the organ that takes in all the junk I eat and separates the good from the bad. That certainly isn’t all true. There are other organs and processes that also extract the nutrients from our food and give us energy, but the kidney is a key part of the process. I’ve always thought that our body has spares of the things that are very important, eyes, ears, lungs and, since we have two kidneys, they must be very important, and they are.

As I always try to do when we talk about disease days, weeks, or months, I try to focus on a particular part of the prevention, detection, and treatment cycle of the disease and, since kidney problems have few early symptoms that an individual can identify, I want to focus on the early detection portion of the cycle.

So as not to completely ignore the prevention and treatment steps, I’ll touch on those important aspects of kidney disease. Prevention of kidney disease reads like the standard things your doctor tells you when you go in for your physical:

• Make healthy food choices
• Make physical activity part of your routine
• Aim for a healthy weight
• Get enough sleep
• Stop smoking
• Limit alcohol intake
• Manage diabetes, high blood pressure, and heart disease

The treatment of kidney disease can include some stringent dietary and lifestyle changes but, thankfully, the ultimate solution to treatment for total kidney failure is the result of the fact that we have two kidneys. If one of our kidneys quits, we can still have a normal life due to our second kidney. If we lose the function of both kidneys, we can get a kidney from a matching donor and both the donor and the recipient can live relatively normal lives.

The detection of kidney disease is difficult, because it has few early symptoms. Consider this, more than 1 in 7 have chronic kidney disease (CKD) but 90% of those with stage 3 CKD don’t know they have it and 40% of those with severe CKD don’t know they have any type of kidney disease. The sad part of these statistics is the fact that the onslaught of kidney disease can be significantly slowed if discovered early. Kidney disease can be detected through blood and urine tests. You can take charge of knowing the health of your kidney by asking your doctor the following questions after having blood and urine tests.

What was my GFR? Your GFR stands for glomerular filtration rate which shows how well your kidney is filtering your blood. The permissible rate is affected by age.

• A GFR of 60 or higher is in the normal range.
• A GFR below 60 may mean kidney disease.
• A GFR of 15 or lower may mean kidney failure.

What was my urine albumin results?

• A urine albumin result below 30 is normal.
• A urine albumin result above 30 may mean kidney disease.

These questions and answers can ensure that your doctor is paying attention to your kidneys and gives you the chance to know exactly what the results were. If you were on the borderline of normal, it would be a great time to ask your doctor what you can do to improve your numbers.

There is a kidney disease hereditary situation that you should be aware of. Autosomal dominant polycystic kidney disease, or ADPKD, is a type of polycystic kidney disease (PKD). PKD is a group of inherited genetic diseases that cause multiple cysts, or pouches filled with fluid, to form in your kidneys. If one of your parents had this disease you have a 50% chance of getting it. Your doctor needs to know this and will prescribe an appropriate testing schedule so the disease can be detected early.

There is another situation that you should be aware of. People with type 1 diabetes have an estimated 50% risk of developing CKD over their lifetime. CKD can progress to kidney failure, requiring dialysis or a kidney transplant. The study that identified this risk used over 30 years of participant data and identified three levels of CKD risk that were associated with a later CKD diagnosis. They then developed a model to estimate the optimal screening intervals for people with type 1 diabetes to detect CKD at its earliest stages. This link between diabetes and kidney disease is key to understanding the correct treatment requirements for each disease. While your doctor will know of this connection it is always good to understand the ramifications and to be your own advocate.

Kidney stones are another part of kidney health that affects many of us. Over a half million people go to the hospital each year for kidney stones. Around 20% of men and 10% of women will experience kidney stones in their lifetime. If one of your family members experience kidney stones the likelihood of you developing them increases. Avoiding dehydration and drinking lemon water will help to avoid kidney stones. If you experience a kidney stone, the odds of having another are greatly increased. The sad fact is that 15% of those who have had one kidney stone will not take their medicine and 41% won’t follow the nutritional advice to avoid another stone. You would think that people would do everything possible to avoid the severe pain of a kidney stone.

When it comes to early detection of kidney problems, knowledge is a great ally. Knowing your numbers, your hereditary risks and other diseases that could make you vulnerable are key to early detection. It’s to our benefit to keep the greatest filter in the world healthy.

Best, Thair