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Deadly kidney disease can make a sneak attack

March 2, 2015


Before she was diagnosed with chronic kidney disease, or CKD, Kerri Gwinn-Harris, 51, never gave her kidneys much thought. "Every year, I got a mammogram, Pap smear and exam, but who thinks to check their kidneys?" she said.

In January 2014, she awoke in the hospital to the faces of her worried children. "I thought I had sat down at home to watch a movie," recalled the Ballwin, Mo., corporate trainer. "But Iíd passed out, and my daughter got me to the hospital." The next four months were a blur of medical procedures and doctor referrals. She did not get relief from symptoms, including back pain, ankle swelling and lethargy, until she assembled a team that included a nephrologist (kidney specialist), urologist and renal (kidney) dietitian.

"They taught me to manage the disease," Gwinn-Harris said. "I learned what I canít eat, like beef, and should eat, like certain vegetables. I lost 50 pounds and started drinking a gallon of water a day, walking and doing Zumba dancing." While there is no cure for CKD, she slowed its progression, eliminated symptoms and avoided the treatments for later-stage CKD ó dialysis (cleaning the blood with a machine) or kidney transplant.

Gwinn-Harris is among the 26 million Americans who have kidney disease, according to the National Kidney Foundation. Not everyone catches it in time; it kills 47,000 people a year.

"The best way to prevent kidney disease is to change your genes," joked foundation spokesman Dr. Leslie Spry, a Lincoln, Neb., nephrologist. "Other than that, 60 percent of it is preventable."

Located on either side of the abdomen, the kidneys are the bodyís "wastewater-treatment center," Spry said. They filter your blood, help regulate blood pressure, produce red blood cells, process vitamin D and balance sodium, phosphorous and potassium.

Most of us are born with two kidneys, but we can live with one. In fact, 1 to 5 percent of people are born with one.

Unchecked, CKD contributes to heart disease, hypertension, weak bones, nerve damage, kidney failure and death.

Fortunately, lifestyle changes can prevent or slow kidney disease:

Learn the symptoms ó or lack of.

CKD and kidney cancer can progress quietly without symptoms. Kidney stones (crystallized minerals), though, may hurt like heck.

Later-stage CKD may make you tired and thirsty, with swollen extremities. You may have to urinate often, with foamy or dark urine. Or, like Gwinn-Harris, you may black out.

Assess your risk.

Kidney disease and its risk factors run in families. So intertwined are obesity, hypertension and diabetes in families with kidney disease, Gwinn-Harris describes them as the perfect storm. "When I got sick," she said, "we connected the dots."

Youíre more likely to develop kidney disease if youíre older than 60, smoke or have recurrent urinary-tract infections or an autoimmune disease.

Blacks and Hispanics are much more likely to develop kidney disease than are Caucasians or Asians. Men are twice as likely to get kidney cancer than are women. Kidney stones favor Caucasians and men.

Kidney disease from long-term use of some painkillers is so common that thereís a name for it: analgesic nephropathy. If you have chronic pain, a nephrologist can tell you which drugs are easier on your kidneys.

If your birth weight was low, your kidneys have fewer nephrons (tiny filters), so they have reduced filtering ability.

Being frequently dehydrated can cause kidney stones.

Get tested.

Simple tests signal kidney disease.

Hypertension, measured by an arm cuff, can mean you have damaged blood vessels in the kidneys.

"The window to your health," urine, shows multiple kidney-disease red flags, said Dr. Propa Ghosh, a urologist at Hunterdon Healthcare System in Flemington, N.J.

A blood test may point to CKD by measuring levels of waste products such as creatinine. Based on your age, race and gender, your doctor calculates your glomerular filtration rate.

So silent is kidney cancer, itís usually found incidentally, Ghosh said. "You have a scan for another problem, and we find a mass on your kidney," she said.

To identify kidney stones, a blood test measures excess calcium or uric acid, while urine shows excretion of stone-forming minerals. A CAT scan or ultrasound test locates the stones.

Watch your diet.

A kidney-friendly diet keeps your blood pressure, cholesterol and blood-sugar levels in check. If you do not have kidney disease or are in the early stages, a menu like the DASH diet is a good template, said Linda McCann,renal dietitian with Satellite Healthcare in San Jose, Calif. "It has fewer salts, sugars and meats, and more fruits, vegetables and whole grains," she said. Bottom line, "cook from scratch and avoid processed food."

Advanced-stage kidney disease calls for the advice of a renal dietitian. "Then, your kidneys can handle less protein, potassium, calcium and dairy products," McCann said. "And the drugs you take could compromise vitamins from food."

Skip grapefruit, which interacts with many drugs. Scan food labels for additives such as phosphorous and salt, which affect kidneys. Beware the effects of herbal supplements. Too much alcohol can lead to hypertension ó bad news for your kidneys.

Regular exercise goes hand in hand with a good diet. It prevents obesity, a kidney-disease harbinger. "Try to at least walk," McCann tells CKD patients who are too tired or nauseous for more taxing exercise.

Know whatís ahead.

Especially if kidney disease lurks in your family tree, keep up with advances such as new home-dialysis machines that save you from commuting to the hospital.

The biggest news, Ghosh said, is in surgery, which is less invasive and more precise thanks to robotics. More kidney surgeries are laparoscopic, with small incisions, and more often spare the kidney.

Some procedures require no scalpel, such as the blasting of kidney stones with shock waves from the outside of the body or the breaking of them by lasers reached via the bladder.

"Often, the patient goes home the same day," Ghosh said. "Thereís less pain and less blood loss."

Be your advocate.

While enduring decades of chronic pyelonephritis (kidney infections) and multiple surgeries, including a kidney transplant, Bobbi Wager, 57, of San Antonio, Tex., learned to be the No. 1 advocate for her health. Then she became a nephrology nurse to help others too.

"Be proactive," Wager said. Although she had to have a second transplant, she outlived each life span her doctors predicted. Now she runs a hospital renal-care unit, plays tennis and keeps up with her four Scottish terriers.

Wager pays it forward by urging people to register for organ donation (after they die) and enroll in shared-donor programs that match recipients with live donors. About 185,000 Americans live with kidney transplants, according to the National Kidney Foundation, but thousands die every year while waiting for kidneys.

Gwinn-Harris urges people at risk to educate their families. "I even called all the cousins," she said. "My kids are exercising, eating healthy foods and keeping their weight and blood pressure down. Their generation can break the cycle."

 

 


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