Living With Chronic Kidney Disease

By Seth Lamming

From PHN Issue 40, Summer/Fall 2019

Chronic kidney disease (CKD) is a common health problem in the United States.
CKD happens when the kidneys do not work as well as they should. The health
of your kidneys is closely related to the health of your heart and the health of
your blood vessels. When you hear about foods and activities that are healthy
for your heart, they are also good for your kidneys. This article will provide
some basic information about the kidneys, CKD, and some ways you can look
out for your own kidney health.

The kidneys are two organs about the size of a fist that are shaped like
beans. They are located below the ribs on the back side of your body. You have
one on your left side and one on your right side. They serve the important role
of filtering blood and maintaining the fluid and salt balance inside the body. The
kidneys take waste products out of the blood and dispose of them in urine.

When you are thirsty, the kidneys receive signals from your body to
conserve water. The kidneys also help your body absorb calcium for your bones
and make red blood cells, the cells that carry oxygen through your blood.

While the kidneys are extremely important, they are also fragile and can
get damaged easily. Chronic kidney disease is so common that about one in
every seven people have it. In CKD, the kidneys do not filter blood as well as
they should. People who have diabetes or a heart condition like high blood
pressure are more likely to develop CKD. If you are overweight or have people
in your family who have had CKD, you are also at a higher risk for developing
CKD. CKD is most common among African Americans and Native Americans,
due to lack of access to health care, stress, and other factors.

There are usually no symptoms associated with CKD until it progresses
to later stages. As CKD gets worse, signs might include swelling in your legs or
feet, peeing less, anemia (low blood cells), feeling tired, having high blood
pressure, or getting bone fractures more easily. Many people do not know they
have CKD until it gets worse. When CKD gets worse, every organ system is
affected. In its final stage, called kidney failure or end-stage renal disease, the
kidneys no longer filter blood. People who have kidney failure need to get their
blood filtered by a machine a few times every week, sometimes more. This
process is called dialysis.

There are ways to check for CKD before it causes health problems. If
you have diabetes, high blood pressure, or another risk factor for CKD, it is a
good idea to get your kidneys tested at least once every year. Your health care
provider can do a blood test and urine test to look for evidence of damage to
your kidneys and to see how your kidneys are working. They can do a blood test
to look for creatinine, a waste product that you are supposed to pee out. They
can also look for protein in your urine, because healthy kidneys do not make
protein in urine. These two tests are usually the first ones your providers look
at.

There are good treatment options for CKD. If you catch it early, you can take
medications to slow down the progression of the disease. These medications
include “ACE inhibitors” such as lisinopril and “angiotensin receptor blockers“
such as valsartan. These two types of medicine lower your blood pressure and
ensure that the kidneys continue filtering blood at a normal rate. People also
take diuretics (water pills) such as furosemide that make you pee a lot. This
helps you get rid of extra salt and water, so your body does not retain as much
fluid. When your body retains fluid, you might see swelling in your limbs or
your hands and feet. People also might take medicine that helps the body make
more blood, and they may take supplements such as calcium and iron.

The best ways to keep your kidneys healthy are to eat a balanced diet
and try to be active. Eating more fruits and vegetables and drinking plenty of
water are great ways to improve your health. If you have high blood pressure,
keeping your blood pressure in a normal range with medication and a low-salt
and low-fat diet can help. If you have diabetes, making sure that your blood
sugar is in a good range for you will also help your kidneys stay healthier. If you
can get put on a “diabetic diet” or other special diet, that can help.

If you have been diagnosed with kidney disease, you will need to follow
up with a health care provider. It is important to take medication so that your
kidneys can continue working properly. Have your doctor explain what your
medications do, and how to take them. Ask them to teach you about signs that
your CKD is getting worse. If possible, talk to a nutritionist or a nurse about
what you should eat to help your kidneys stay as healthy as possible.

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