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Hardworking kidneys deserve good treatment


Article Last Updated; Monday, September 07, 2009  12:01AM
You would be amazed at how many jobs the kidneys do for the body every day.

Most people know that kidneys filter the blood of water and waste, and produce urine. Many are not aware that kidneys control mineral balance in the bones, control the production of red blood cells to prevent anemia and assist with controlling blood pressure.

Chronic kidney disease is among the leading causes of chronic illness in the United States. Death rates from chronic kidney disease in the United States exceed death rates for colorectal, breast and prostate cancers, which are three of the leading causes of cancer deaths.

Data from the National Health and Nutrition Examination Survey conducted by the Centers for Disease Control and Prevention indicate that more than 20 million Americans have some form of chronic kidney disease. There are an additional 20 million Americans at risk.

When most people think of chronic kidney disease, they think of dialysis. Yet the spectrum of chronic kidney disease ranges from mild asymptomatic illness to severe life-threatening illness. Dialysis is reserved for those with the most advanced stage of illness.

The early signs of chronic kidney disease may be evident only from an assessment of blood pressure or laboratory measures of kidney function from samples of blood and urine.

Often in these early stages, there are no symptoms. Yet, early intervention with lifestyle measures and medical therapy has been shown to slow the progression of chronic kidney disease. For this reason, targeted screening of people at risk for chronic kidney disease can reduce the risk of disability and death from the illness.

So who is at risk?
The leading causes of acquired chronic kidney disease in the United States are diabetes mellitus and high blood pressure, which are among the most common chronic diseases suffered by Americans.

Other risk factors include autoimmune diseases such as rheumatoid arthritis, frequent urinary infections or urinary tract stones, and advancing age. People with family history of kidney disease and certain ethnic minorities are at higher risk for chronic kidney disease.

Screening is recommended for those in high-risk groups. In particular, people with known diabetes or high blood pressure should have a routine annual assessment of the urine and blood to evaluate for any sign of kidney effects.

People with early stages of chronic kidney disease benefit from measures to ensure good blood sugar and blood pressure control. The use of certain prescription medications with a proven protective benefit to the kidneys often is recommended, especially for diabetics and those with high blood pressure.

For the general population, preventive measures for chronic kidney disease include weight management, regular physical activity, avoidance of smoking and a balanced diet low in dietary sodium, saturated fats and concentrated sweets.

Routine blood pressure assessment to screen for high blood pressure is recommended yearly for adults. For people who are overweight or who have a strong family history of diabetes mellitus, screening for diabetes also is recommended.

Dr. Matthew A. Clark is a
board-certified physician in internal medicine and pediatrics practicing at the Southern Ute Health Center in Ignacio.

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