What is chronic kidney disease and who gets it?

Your kidneys are vital to the overall health of your body. These bean-shaped organs located near the middle of your back work to remove wastes and fluid from your blood.

When your body digests food, it takes the nutrients it needs and sends the leftover wastes through your blood for the kidneys to filter. Your hard-working kidneys filter about 200 quarts of blood each day. The end result is about 2 quarts of waste products and excess fluid, which is passed from the body as urine.

Along with removing waste products, your kidneys are responsible for other important functions:

• Balancing bodily fluids
• Filtering drugs from the body
• Regulating the production of red blood cells
• Releasing hormones that maintain blood pressure
• Producing a form of vitamin D that supports healthy bones and helps maintain chemical balance in the body

You may have heard of renal function. This is a term used by doctors and other health care providers to indicate how well your kidneys are currently functioning. For instance, if you have two healthy, normal kidneys, you have 100 percent renal function. In reality, this is more renal function than is needed for survival. In fact, a person born with just a single kidney can go on to live a long and healthy life.

When a person’s kidneys get damaged or diseased, their function is compromised. With chronic kidney disease, kidneys can lose function over the years. As kidney function decreases to less than 60 percent, a person may start to feel symptoms. When renal function falls below 10 percent to 15 percent, an individual is diagnosed with end stage renal disease and will need either dialysis or a kidney transplant in order to survive.

Who is at risk for kidney disease?

There are a number of different groups of Americans who are at particular risk for developing kidney disease:

• Diabetics
• People with hypertension (high blood pressure)
• Those who inherit genes carrying certain kidney disorders
• African Americans
• Hispanic Americans
• Pacific Islander Americans

Diabetes is the number one cause of chronic kidney disease among the general population of the U.S., causing about 40 percent of all kidney failure.

High blood pressure is the second leading cause, responsible for about 25 percent of chronic kidney disease cases. High blood pressure can make your heart exert itself more, and, over a period of time, blood vessels throughout the body can become damaged. Once the blood vessels in the kidneys begin to deteriorate, they may be unable to remove wastes and excess fluid from your body. A vicious cycle begins, since excess fluid means blood pressure may rise further.

Because African Americans are more likely than Caucasian Americans to suffer from high blood pressure, they are at greater risk for kidney disease, even when their blood pressure is only slightly elevated. In fact, high blood pressure is the leading cause of kidney failure among African Americans. In the 20- to 49-year-old age group, African Americans are 20 times more likely to develop CKD from conditions related to high blood pressure.

American Indians, Hispanic Americans, and Pacific Islander Americans are also at greater risk of kidney disease.

Some people suffer from a genetic disorder called polycystic kidney disease (PKD). People with PKD have inherited a gene that causes them to grow numerous cysts in their kidneys. About 600,000 Americans have PKD, and it is the fourth leading cause of kidney failure.

Another form of kidney disease is glomerulonephritis (or nephritis), a general term for many types of kidney inflammation. Autoimmune diseases, birth defects, and long-term use of certain drugs can also cause kidney disease.

Taking steps for better kidney health

Kidney disease can be a silent illness, with few or no symptoms. Anyone who has diabetes or high blood pressure, or who has a family member with one of these conditions, should be tested regularly to ensure that their kidneys are working properly, as should anyone from the higher-risk groups listed above.

In addition, older people and those who are overweight should also make it a habit to have their urine tested on a regular basis to be certain that their kidneys are functioning in the normal range. Testing is the only way to determine your kidneys’ health. If you do have chronic kidney disease, the sooner you can get tested and treated, the better your long-term health is likely to be.

If you are diagnosed with chronic kidney disease, you are not alone – more than 26 million adults in the U.S. have chronic kidney disease. However, 90 percent of them do not even realize they have it. What’s more, another 20 million Americans are at risk for kidney disease but have no idea that their health is in jeopardy. If you believe that you may be at risk for kidney disease, see your health care practitioner without delay.

Treatment for chronic kidney disease

If you are diagnosed with chronic kidney disease, early detection and proper treatment may delay or prevent kidney failure.

Getting the facts is the first step to becoming empowered in your care. Your health care provider can tell you about your disease. Often, renal dietitians can work with you change your diet to help maintain or improve kidney health. If you have diabetes or high blood pressure, getting treated for those diseases can help slow additional damage to your kidneys.

If you’re an end stage renal patient (someone who has lost significant kidney function), there are two treatments for your disease:

1. When your kidneys can no longer filter waste and excess fluid from your blood, and you become sick from the build-up, your health care provider may recommend that you have dialysis performed. Dialysis is a painless procedure that does some of the work of the kidneys by removing water and waste products from your blood. More than 350,000 Americans today are living productive lives with end stage renal disease thanks to dialysis.
2. The second treatment for end stage renal disease is a kidney transplant. This surgery removes the damaged kidney and replaces it with one that is able to function more effectively.

Talk to your doctor if you are at risk for kidney disease.