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November 28, 2006 > Catch Chronic Kidney Disease Before it Catches Up with You

Catch Chronic Kidney Disease Before it Catches Up with You

Condition Many Time Affects Those with Diabetes, Hypertension

by Washington Hospital

When it comes to many diseases, prevention is the best medicine. This is certainly true of chronic kidney disease. Early stages of the disease – when it is still highly treatable – many times have few outward symptoms.

“The kidney performs two functions: it gets rid of excess fluid in the tissues and it cleans the blood, including waste processes from metabolism and eating,” explains Dr. David Tay, a Washington Hospital Medical Staff nephrologist.


Chronic kidney disease, Dr. Tay says, is any state in which a person’s kidneys are not functioning at an optimal level. The condition is progressive, recognized in stages, one through five. Once diagnosed, physicians use scientific methods to determine how well the kidney cleans the blood.


Several different factors may lead to chronic kidney disease.


“The most common cause of chronic kidney disease in this area is diabetes,” Dr. Tay remarks of the Tri-City area. “Hypertension is a close second. In other areas, such as the South, the proportions are different, and hypertension is a more common cause of chronic kidney disease.”


A variety of factors, including ethnic background and genetics, as well as lifestyle and diet, have led to diabetes and hypertension being considerably higher in Alameda County.


Other causes of chronic kidney disease can include kidney inflammation, caused by an overproduction of certain antibodies. In cases like these, the condition, Dr. Tay says, is considered idiopathic, or lacking in a determinable cause, such as family or medical history.


A small percentage of cases is caused by overuse of nonsteroidals, such as pain killers like Motrin, Aleve and Ibuprofen.


So why is chronic kidney disease important to you? Similar to hypertension and diabetes, chronic kidney disease is known as a “silent” – and potentially fatal – condition.


“The first signs of kidney disease are often picked up when the doctor analyzes your urine sample,” Dr. Tay explains. “These things are hard to see until they are late in the progression, and by that point a lot of damage may have occurred. This is a progressive condition which may advance to kidney failure.”


Chronic kidney disease can cause fatigue, tiredness, listlessness and loss of appetite. In later stages, patients may suffer from continuous nausea and vomiting and possibly inflammation of the heart’s covering, known as pericarditis.


In early stages, the condition can be treated, but the window of treatment is oftentimes missed because you may not feel anything wrong with you, Dr. Tay says.


“The impact, of course, is huge because kidney failure makes people very fatigued and unable to work – many end up on disability because of it,” according to Dr. Tay. “Some hardy souls do continue to work, but many are too sick and weak to keep their jobs.”


For those who have other conditions – especially diabetes – that may contribute to chronic kidney disease, Dr. Tay recommends seeking regular care and monitoring by a physician.


There are typically three approaches to treatment, depending upon how far the disease has progressed as well as the patient’s overall health:



  1. drug therapy

  2. dialysis

  3. kidney transplant


According to Dr. Tay, drug therapy is primarily used early in the course of chronic kidney disease to help reduce the blood pressure in the kidney.

“The medical community is starting to use these medications more,” he says. “In later stages, these medicines may not have as much of an impact, but drug therapy can aid in prolonging the life of the kidneys and delay dialysis.”


Dialysis becomes necessary during late stages of kidney failure when the kidneys are functioning between 10 and 14 percent of normal, Dr. Tay notes.


Some patients, Dr. Tay says, are fortunate not to feel sick at this level of the disease and may not have symptoms of nausea, vomit and fatigue sometimes making it hard for them to accept that they need dialysis. Other patients are very symptomatic during later stages.


A kidney transplant is the only surgical option for kidney failure. The only problem with this treatment is the availability of kidneys, according to Dr. Tay, noting that organ donation may not occur to people in the prime of their lives when they’re healthy.


“An early diagnosis and regular follow-ups with their physician when they have hypertension and diabetes, as well as taking medications regularly, can help patients prevent or control kidney disease,” Dr. Tay stresses. “To make a difference, the disease must be diagnosed in the earlier phases, rather than later.”


If you have been diagnosed with chronic kidney disease or suffer from diabetes, high blood pressure or high cholesterol, it’s important to seek regular medical treatment. To find a specialist near you, visit www.whhs.com and click on “Find a Physician” or call Washington Hospital’s toll free Health Connection line at (800) 963-7070.

 
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