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Chronic Kidney Disease (CKD) Basics



I have had several members of my immediate family whose kidneys have failed. Both my brother and sister have been on dialysis, as well as several of my paternal aunts and cousins. Renal disease runs rampant in my family on my father’s side. My physician once remarked that she had never seen so many cases of renal failure in one family. That was years ago, but when she made that remark I sat up, paid attention and started educating myself about renal failure and what I could do to prevent it from happening to me.


My first job out of graduate school was as a medical social worker on the dialysis and kidney transplant unit of a major hospital. Much of my day would be spent on the renal unit, talking with patients while they were actually on the dialysis machine which was used to filter the patient’s blood. Since they were typically on the machine for four hours, three times a week, I was frequently on the unit to assess how they were doing, if they needed additional resources or help with completing various health forms. I held bi-weekly group counseling sessions with renal patients. Uh, I know I am making this sound like I was amazing, actually as a social worker I was pretty amazing, but reluctantly I had to leave the position after deciding that hypochondriacs really shouldn’t work in a hospital. Bad idea. Every week I worked there I thought I had some type of disease that was going to kill me. I was constantly running to my physician (wasting time and resources), trying to convince her I was sick or dying after the lab results kept showing her I wasn’t. One day, my husband asked to speak with me. He said: “Enough. You have to get another job!” This is absolutely true. Told you: I have issues. Actually, I had issues. Finally figured out living was better than dying. Thought I would start putting all my energy into living instead.


Back to the information. During today’s podcast Teresa and I spoke with Taniqua who is currently on dialysis. Taniqua was kind enough to share her story in an effort to educate others about the disease and treatment options, including organ donation. Both Teresa and I were inspired by Taniqua and her zest for life which has not been diminished by the disease. If you want to meet a warrior and be inspired too, listen in! (Title: "The Strength of Taniqua")

In addition to Taniqua’s story, since it’s National Kidney Month, I wanted to provide more information on Chronic Kidney Disease. The following information was taken from the website of the National Kidney Foundation www.kidney.org:


The kidneys are powerful chemical factories that perform the following functions:

  • remove waste and excess fluid products from the body (removed through urine)

  • remove drugs from the body

  • balance the body's fluids

  • release hormones that regulate blood pressure

  • produce an active form of vitamin D that promotes strong, healthy bones

  • control the production of red blood cells”

As you can see, the kidneys are vital to live. One in three American adults (approximately 80 million people) are at risk for chronic kidney diseaseChronic kidney disease is defined as having some type of kidney abnormality, or "marker", such as protein in the urine and having decreased kidney function for three months or longer.


CKD is more common in women (15%) than men (12%). CKD is the 9th leading cause of death in the U.S. In 2016, over 500,000 patients received dialysis treatment, and over 200,000 lived with a kidney transplant. African- Americans are at increased risk for CKD.


There are many causes of chronic kidney disease. In addition to high blood pressure, the kidneys may be affected by diabetes. Some kidney conditions are inherited (run in families). Others are congenital; that is, individuals may be born with an abnormality that can affect their kidneys. Drugs and toxins can also cause kidney problems. Using large numbers of over-the-counter pain relievers for a long time may be harmful to the kidneys. Certain other medications, toxins, pesticides and "street" drugs such as heroin and crack can also cause kidney damage.


Early detection and treatment of chronic kidney disease are the keys to keeping kidney disease from progressing to kidney failure. Simple analysis can be done to detect early kidney disease by testing for the amount of protein in your urine and testing for creatinine in the blood.


Warning Signs of Kidney Disease


Kidney disease usually affects both kidneys. If the kidneys' ability to filter the blood is seriously damaged by disease, wastes and excess fluid may build up in the body. Although many forms of kidney disease do not produce symptoms until late in the course of the disease, there are six warning signs of kidney disease:

  1. High blood pressure.

  2. Blood and/or protein in the urine.

  3. A creatinine and Blood Urea Nitrogen (BUN) blood test, outside the normal range. BUN and creatinine are waste that build up in your blood when your kidney function is reduced.

  4. A glomerular filtration rate (GFR) less than 60. GFR is a measure of kidney function.

  5. More frequent urination, particularly at night; difficult or painful urination.

  6. Puffiness around eyes, swelling of hands and feet.

Careful control of diseases like diabetes and high blood pressure can help prevent kidney disease or keep it from getting worse. Treating high blood pressure with special medications often helps to slow the progression of chronic kidney disease.


When the kidneys fail to do their job sufficiently, the person experiences renal failure.

Kidney failure may be treated with hemodialysis, peritoneal dialysis or kidney transplantation. Treatment with hemodialysis (the artificial kidney) may be performed at a dialysis unit or at home. Hemodialysis treatments are usually performed three times a week. Peritoneal dialysis is generally done daily at home. Continuous Cycling Peritoneal Dialysis requires the use of a machine while Continuous Ambulatory Peritoneal Dialysis does not.


Another treatment option is a kidney transplant. Kidney transplants have high success rates. Typically, African-Americans donate organs at a much lower rate than Caucasians. Taniqua shared important information about donation, including the fact that costs are covered for the donor; testing is free and painless. The kidney may come from someone who died or from a living donor who may be a relative, friend or possibly a stranger, who donates a kidney to anyone in need of a transplant.


A kidney specialist can best explain the different treatment options to help the patient make the best decision for themselves and their families. Many kidney diseases can be treated successfully.


Lou

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