According to the National Kidney Foundation, chronic kidney disease affects 26 million Americans annually. Bernard Fischbach, MD, a nephrologist on the medical staff at Baylor All Saints Medical Center at Fort Worth, sat down with us to answer some frequently asked questions about kidney disease.
What is kidney disease?
The kidneys perform several vital roles: They remove extra fluid, cleanse our blood of waste products, maintain salt and mineral balance, and regulate blood pressure.
When a patient develops kidney disease, excess fluid and waste products can accumulate. The result is generalized fatigue, weakness, accumulation of fluid in the lungs causing shortness of breath, and swelling in the legs.
Untreated kidney disease can ultimately be fatal.
When talking about kidney disease, we look at the kidney’s ability to filter blood. A term that is commonly used when discussing kidney function is the glomerular filtration rate (GFR).
A normal GFR is 80 to 120 milliliters per minute. So if you have normal kidney function, your kidneys filter 80 to 120 milliliters of blood per minute.
There are several blood and urine tests that are obtained to determine your GFR.
We break down kidney disease into two categories: Acute kidney injury, and chronic kidney disease.
Acute kidney injury results when there has been a traumatic injury to the kidneys. Traumatic injury to the kidneys can be the result of certain medications, infections, or a compromise of the blood supply to the kidneys.
This is relatively rapid in onset, and is commonly seen in hospitalized patients. If the cause of acute kidney injury is determined, it is often very treatable, and reversible.
Chronic kidney disease is damage to the kidneys that has been present for more than three months. Patients with chronic kidney disease will have a glomerular filtration rate (GFR) of less than 60 milliliters per minute.
It is typically a much slower process, and patients often do not have any symptoms of kidney disease.
Causes of kidney disease
The causes of kidney disease can vary but include hypertension and diabetes as the two most common causes. Polycystic kidney disease is a common genetic cause of chronic kidney disease. Viral illnesses such as HIV/AIDS, Hepatitis C and B can also cause kidney disease. Glomerular disease is a process that directly affects the kidneys, and can cause both acute kidney injury and chronic kidney disease.
The long term use of nonsteroidal anti-inflammatory medications (NSAID’s) such as ibuprofen (Motrin and Advil), and naproxen (Aleve) are often overlooked causes of chronic kidney damage.
The cause of kidney disease requires a detailed evaluation by a kidney specialist. The evaluation will require blood and urine tests. In certain cases, a biopsy of the kidneys may be required.
Can kidney disease be prevented?
Kidney disease can be prevented. Maintaining a healthy lifestyle with diet and exercise is often the best way to prevent both diabetes and hypertension, which are the two most common causes of chronic kidney disease.
If a patient has already been diagnosed with hypertension or diabetes, maintaining blood pressure and blood sugar control is crucial for the prevention of kidney disease.
Avoiding NSAID’s can also help to prevent kidney disease. It is important to always discuss with your doctor before starting any new medicines or herbal remedies (even over-the-counter ones).
Treatment for kidney disease
The first line of treatment for kidney disease is prevention. If a patient has already been diagnosed with kidney disease, it is important to be evaluated by a kidney disease specialist.
A kidney doctor will determine the extent and cause of kidney damage. Once the cause of kidney damage has been determined, specific treatment can be initiated.
The control of blood pressure is critical for those patients with hypertension.
For diabetic patients, the control of blood glucose can help to prevent, or slow down the progression of kidney disease.
If a patient’s kidneys stop working completely, there are three different treatment options available. These treatment options include hemodialysis, peritoneal dialysis, and kidney transplantation.