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HEALTH
WEDNESDAY, JULY 9, 2008
THE NEWS HERALD
A9
Keep your kidneys healthy
BY ANNA WILSON
BLUE RIDGE HEALTHCARE
MORGANTON - Think of your kidneys as a very sophisticated waste
water treatment plant, and they
are so important that you have two
of them.
Each day the nephrons – which
contain tiny blood vessels plus urinecarrying tubules – filter about 200
quarts of blood. In the process, about
two quarts of waste products and
extra water are removed as urine.
The kidneys then make sure that the
clean blood remaining in the body
has exactly the right proportions of
chemicals such as sodium, phosphorus and potassium that your body
needs to stay healthy.
In addition, the kidneys release
three vital hormones – 1) erythropoietin, to stimulate the production of
red blood cells, 2) renin, to regulate
blood pressure and 3) the active form
of vitamin D to help maintain calcium, strong bones and overall health.
According to a recent Centers for
Disease Control survey, however,
as many as 17 percent of American
adults have some degree of chronic
kidney disease. The estimate was
based on urine samples taken from
12,785 civilians involved in national
health studies from 1999 to 2004, and
it represents a 16 percent increase
from the previous survey conducted
from 1988 to 1994.
PROGRESSIVE DAMAGE
Chronic kidney disease usually involves some kind of malfunction of
the filtering system. It may start with
damage to only a few nephrons, and
the kidney usually adapts by increasing the filtration rate in other nephrons. As a result, there may at first
be no sign of kidney disease even on
laboratory tests.
“Most people don’t realize they
have kidney disease,” said Inna
Malostovker, MD, a nephrologist
(kidney specialist) with Blue Ridge
HealthCare. “It will manifest either
in blood work or in something else
that you may not think of as kidney
disease – swelling, fatigue because
of anemia, tingling. You don’t necessarily associate these symptoms with
kidney disease.”
When kidney function goes down
to 20 percent or lower, serious health
problems occur. “Sometimes when
you start having symptoms, it’s almost too late,” Dr. Malostovker said.
“Damage has occurred.”
At 10 to 15 percent, the patient is
judged to have kidney failure, also
known as end-stage renal disease
(ESRD). Without dialysis or kidney
transplantation, the person dies.
“There are things a nephrologist
can do to hopefully prevent the progression of kidney disease and also
deal with the consequences,” she
said. “It’s been shown that patients
who get referred to a nephrologist
earlier and begin dialysis do better
than patients who start dialysis as
an emergency and haven’t seen a nephrologist before.”
Kidney failure can come suddenly
– usually because of an accident that
results in sudden severe loss of blood
or a poison or chemical that permanently damages nephrons. In most
cases, however, it’s a gradual process
over many years.
“The most common cause in America for kidney failure is diabetes,” Dr.
Malostovker said. “Keeping diabetes
and high blood pressure under control will help tremendously.”
She also recommends you quit
smoking, avoid salt and limit
fat intake.
Since there’s no cure, it’s impor-
Kidney facts
Your kidneys are vital organs
that keep your blood clean
and chemically balanced.
 The progression of kidney
disease can be slowed,
but it cannot always be
reversed.
Since there’s no cure, it’s important to know what you can do to keep your kidneys healthy so you won’t end up on dialysis.
 Dialysis and transplantation
can extend the lives of
people with ESRD.
‘Most people don’t realize they have a kidney disease. It
will manifest either in blood work or in something else that
you may not think of as kidney disease – swelling, fatigue
because of anemia, tingling. You don’t necessarily associate
these symptoms with kidney disease.’
 Diabetes and high blood
pressure are the two
leading causes of kidney
failure.
 You should see a
nephrologist regularly if
you have renal disease.
INNA MALOSTOVKER, MD
NEPHROLOGIST
Your kidneys are about
the size of your fist. They
are located in the back,
just below the rib cage.
The kidney’s main job is
to filter waste products
and excess fluid from
your blood. Every day,
the kidneys filter about
200 quarts of fluid.
About two quarts leave
the body in the form
of urine, while the
remainder is retained in
the body.
tant to know what you can do to keep
your kidneys healthy.
CONTROL YOUR BLOOD SUGAR
The major cause of kidney disease is diabetes. Together, diabetes
and high blood pressure account for
about two thirds of cases of kidney
disease. When there are high levels
of sugar in the blood, the kidneys
have to work extra hard. The blood
sugar also acts as a toxin, damaging
the nephrons in a disease known as
diabetic nephropathy.
Eventually, the tiny blood vessels
in the kidneys begin to leak, letting
protein escape into the urine. If your
urine is foamy, it could be a sign that
it contains protein.
When nephrons in the kidneys become damaged enough, their filtering capacity becomes compromised,
allowing toxins and chemicals to
build up in the body. To avoid progressive loss of kidney function,
keep your blood sugar as low as possible if you have diabetes. And keep
MARK YOUR
CALENDARS
FOR FREE
LIPID
SCREENING
your blood pressure low, particularly
if you have diabetes. Even a slight
rise in blood pressure can make kidney disease worse.
Losing weight, exercising, lowering cholesterol and not smoking are
all ways to keep your blood pressure
low, your heart healthy and your risk
of diabetes low.
Carbohydrate-counting weight loss
plans can be effective, but they are
usually high in protein, and eating too
much protein can stress the kidneys.
GO EASY ON PAINKILLERS
Full dose aspirin, ibuprofen,
naproxen and other non-prescription
pain-killing medications can damage the kidneys if taken regularly or
when the body is dehydrated (such
as immediately after exercise).
CONTROL YOUR BLOOD PRESSURE
It’s a two-way street: chronic kidney disease causes blood pressure to
rise, and high blood pressure, over
time, damages the tiny blood vessels
 End-stage renal disease
(ESRD) is the total loss of
kidney function.
(capillaries) in the kidneys, reducing
their filtering capacity and making
kidney disease worse.
One of the best things you can do for
your kidneys is to check your blood
pressure regularly and keep it low.
Diuretics help the body get rid of
excess fluids that accumulate when
the kidneys are not working properly and re-establish proper balance of
sodium and potassium. ACE inhibitors and angiotensin receptor blockers have benefits both for blood pressure and the kidneys – particularly
in patients with diabetes.
A low sodium diet – usually 2,000
milligrams a day or less – is recommended for persons with high blood
pressure and also those with kidney
disease. “When kidneys are damaged, they have a hard time removing
excess sodium, and that causes fluid
to build up,” Dr. Malostovker said.
Most sodium in the American diet
is hidden in processed foods and restaurant meals. To keep your sodium
level down, try to fix most of your
 Chronic kidney disease
(CKD) increases the risk of
heart attacks and strokes.
 If you are in the early
stages of renal disease, you
may be able to save your
remaining renal function
for many years by
controlling your blood
glucose
controlling your blood
pressure
following a low-protein
diet
maintaining healthy
levels of cholesterol in
your blood
taking an ACE inhibitor
or an ARB
quitting smoking.
meals from scratch and avoid eating
out more than once or twice a week.
Water is a natural diuretic, and
under normal circumstances, you
should drink plenty, particularly
when you’re physically active.
TAKE PREVENTIVE MEASURES
Most people with chronic kidney
disease don’t know they have it, and
symptoms may not appear until a
significant part of kidney function
has been lost. Basic preventive efforts make sense for everyone: watch
your blood pressure, follow your
treatment plan if you have hypertension or diabetes and respect the
potential risks of over-the-counter
medications.
FOR MORE INFORMATION on kidney disease or to make an appointment with Dr.
Malostovker, call Family Medical Associates at
580-4010.
ANNA WILSON is a writer and graphic artist for Blue Ridge HealthCare’s Marketing and
Public Relations Department.