New York, NY (December 13, 2005) - Early detection and treatment can significantly slow the progression of chronic kidney disease (CKD) if you already have it. One in nine Americans have CKD and many don't know it, according to the National Kidney Foundation. If you don't know you're at risk for the condition, ask your doctor for the urine and blood tests that can detect it.
Once you know you have chronic kidney disease, follow these steps from the National Kidney Foundation:
- You may be told to see a nephrologist (a kidney specialist). Carefully follow your doctor's treatment plan, including having regular blood and urine tests and controlling the risk factors for the disease, including high blood pressure (hypertension), coronary heart disease and diabetes. The stage of your disease will determine treatment.
- It's a must that you keep your blood pressure under control. Your doctor may tell you to follow a diet called DASH (Dietary Approaches to Stop Hypertension). This is a diet that's basically low in salt and high in potassium and calcium. It emphasizes choosing low-fat dairy products instead of high-fat ones, choosing vegetable proteins instead of animal proteins and avoiding dark cola drinks. Talk with your doctor about the potassium factor, however. Not everyone with kidney disease needs to or should increase potassium in the diet.
- Be monitored for bladder infections and have them treated if you develop them.
- Those with Stage 3 CKD or above may be advised to limit phosphorous-containing foods such as meat, processed foods, dark sodas and dairy products in general. When your kidneys are not functioning properly, high levels of phosphorous can build up in your blood, leading to loss of calcium in and a weakening of your bones, making them more susceptible to breakage and arthritis. You also may be prescribed a type of medication known as a phosphate binder with your meals and snacks; this drug doesn't allow phosphorous to get into your blood.
- In addition, a prescription form of vitamin D may be recommended. When you have CKD in Stage 3 or above, the parathyroid glands may become hyperactive, leading to bone disease, arthritis, skin disease, itching and anemia. Vitamin D suppresses an overproduction of hormones released by the parathyroid glands (PTH), which prevents the complications of excess PTH (hyperparathyroidism). You may also be prescribed certain other medications, such as angiotensin converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs). Research indicates that these drugs may help protect your kidneys and slow progression of most forms of CKD.
- Avoid taking large amounts of painkillers, especially drugs containing a combination of caffeine, acetaminophen and aspirin. Combination agents such as these have been associated with an increased risk of kidney disease. Drugs containing acetaminophen alone can also be dangerous to the kidneys, although these are less harmful. All of these drugs can damage the inner parts of the kidneys, a condition known as interstitial nephritis. .It has been observed that eight to ten tablets or capsules of acetaminophen alone can damage the kidneys over a five-year period. Studies in humans and animals suggest that combination painkillers (as mentioned above) can cause damage in even less time). Non-steroidal anti-inflammatory drugs containing ibuprofen, as well as those containing naproxen sodium, can harm the kidneys, but only if the kidneys are already under stress. Dehydration from, for example, overexertion, can stress the kidneys. If you stay hydrated, these drugs generally are safe for the kidneys.
- Your doctor may tell you to avoid high-protein diets if you have Stage 3 CKD or above. These diets increase pressure inside the kidneys' filters. Over time, this pressure damages the filters, which then leak protein into the urine. This leakage over time further damages the kidneys' filters.
- If you have diabetes, keep it under control by constantly maintaining normal blood sugar levels and following the diet and taking any medications recommended by your doctor.
- If you develop anemia, make sure to have it treated. People with CKD often have anemia because their kidneys no longer make enough of the hormone erythropoietin (EPO), which stimulates the production of the body's red blood cells. Iron supplements, as well as injections of EPO, may be prescribed for you. Hyperparathyroidism (see above) can also make anemia worse.
- Watch your weight. Limit high-fat , fried foods and rich desserts. Obesity is linked to high blood pressure, heart disease and CKD. You may want to have a registered dietitian (R.D.) help plan your meals.
- Start an exercise program if you haven't already. An easy way to do this: Walk for 30 minutes three times a week or more. Exercise is a great way to keep your weight in check and improve overall health.
- Prevent heart problems, which CKD can cause as well be a risk factor for. This may involve controlling diabetes, high blood pressure and anemia and keeping cholesterol in check with diet and/or medication.
If you smoke, quit.
To learn more about chronic kidney disease, contact the National Kidney Foundation at (800)622-9010 or log on to www.kidney.org