How to Prevent Kidney Disease

Unless you have a family member with chronic kidney disease – the gradual loss of kidney function over time – then you may not have known that 33 percent of adults in the U.S. are at risk for developing this potentially life-threatening condition.

There are many causes of kidney disease, including congenital kidney issues, vesicoureteral reflux, polycystic kidney disease and other uncontrollable factors. While some people are born with these conditions, there are many lifestyle and behavioral risk factors that can increase your risk of developing kidney disease.

What do the kidneys do?

The human body has two kidneys, each about the size of a fist, that are situated near your lower back at the bottom of the rib cage.

The kidneys have many important roles, including the regulation of electrolytes (sodium, calcium, potassium, chloride) and hormone production.

Most notably, the kidneys act as a large filtration system, cleaning toxins and waste (urea, creatinine and acids) from your blood and removing them through your urine. Once blood flows to the kidneys through the renal artery, blood vessels help filter the blood and return it to your body through the renal vein. The waste products and excess fluids form urine that is transported to your bladder until it is released during urination.

The kidneys also produce renin, a hormone that regulates blood pressure, and erythropoietin (EPO), a hormone that tells bone marrow to make red blood cells. The kidneys also convert vitamin D from the sun or foods to an active form the body can use to promote bone growth. This occurs through the release of calcitriol, a hormone that aids in calcium absorption.

What is the functional unit of the kidney?

Each time your blood is filtered by the kidneys, functioning units called nephrons help separate water, ions and small molecules. Each kidney contains as many as a million nephrons, which consists of glomeruli and renal tubules. Glomeruli filters the blood in a process called glomerular filtration. The filtered fluid moves to the renal tubules, where water and nutrients return to the blood and waste products and excess fluid are removed through diffusion.

Your kidneys are constantly at work 24 hours a day filtering around 200 quarters of fluid per day. This amounts to about a half cup of blood per minute. Of the 200 quarts, 198 quarts are reabsorbed and the remaining 2 quarters exit the body as urine.

What happens when kidney function is low?

Chronic kidney disease occurs when your kidneys can’t properly filter waste and fluid from your body. The stage of kidney disease determines how well your kidney functions. CKD consists of five stages, with stage 1 being mild and stage 5 being kidney failure. The kidneys must work harder as the disease progresses through each stage.
When the kidneys don’t work well, too much fluid and waste products remain in the blood and can lead to many health problems.

At first, the inability to filter fluids can make you urinate more often and cause swelling in your extremities, including puffy eyes. Poor kidney function creates a buildup of toxins that can also lead to fatigue, loss of appetite, nausea, vomiting, insomnia and trouble concentrating.

High blood pressure is a common issue in people with kidney disease. High blood pressure puts you at risk of having a stroke or developing heart disease. Kidney disease can also cause weak bones, gout, anemia and metabolic acidosis, a condition created by an acid-base imbalance.

Prevention of kidney disease

When chronic kidney disease progresses to stage 5 and results in kidney failure, diabetes (leading cause) and high blood pressure (second leading cause) are usually the culprit.
While you may not be able to outright prevent kidney disease (aging is a risk factor), there are steps you can take to keep your kidneys healthy.

Manage high blood pressure: When blood pressure increases, it can damage blood vessels responsible for transporting blood to your kidneys. If you have diabetes, strive to keep your blood pressure under 140/90 mm Hg. ACE inhibitors and angiotensin receptor blockers are two blood pressure medications that can keep your kidneys healthy. In addition, weight loss and exercising can help keep blood pressure levels in check.

Better food choices: Many packaged foods and restaurant items are loaded with salt. The kidneys can only process so much sodium, so too much salt in your diet can lead to high blood pressure. Choose spices over added table salt when cooking at home and try to keep sodium intake less than 2,300 milligrams per day. 

Reduce stress: Chronic levels of stress can cause blood pressure and blood sugar levels to spike, two risk factors for developing kidney disease. Control your stress levels by taking up yoga, practicing meditation or performing daily positive affirmations. 

Lower risk of developing type 2 diabetes: People with type 2 diabetes have issues controlling their blood sugar. Rapid blood sugar spikes can damage your kidneys over time and disrupt the ability to filter out waste products. If you do have diabetes, managing your condition can help keep glucose levels at an appropriate level.

Stay hydrated: Drinking enough water helps your kidneys process waste products and also keeps blood vessels open so blood can flow smoothly to and from the kidneys.

Stay on top of UTIs: Urinary tract infections don’t usually cause kidney damage, mostly because they’re limited to the bladder. In some cases, though, bacteria can travel from the bladder and through the ureters to the kidneys, a condition called pyelonephritis. When not treated immediately, a kidney infection can cause scarring that leads to a loss of kidney function.

Talk to your doctor about drugs and medicines: Long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs) can impact kidney function over time. They can also impact blood pressure, another risk factor for kidney disease. That’s why acetaminophen is the preferred over-the-counter painkiller for people with kidney problems or who are at risk of developing kidney disease.

Stop smoking: In general, the chemicals in cigarettes slow down blood flow to organs. Decreased blood flow to the kidneys can impact its function.

Limit alcohol: Alcohol causes an increase in renin, a hormone that makes blood vessels smaller and can lead to high blood pressure. Alcohol is also high in calories and sugars, which can lead to weight gain and added stress on your kidneys.

Can kidney disease be reversed?

Unfortunately, there isn’t a cure for kidney disease and chronic kidney damage can’t be reversed (acute kidney damage that occurs in a matter of hours or days can be reversed). However, there are ways to treat it to slow down its progression and live with the disease.

As the disease progresses, you may ultimately need to be treated with dialysis or receive a kidney transplant.

Kidney failure may be treated with hemodialysis, peritoneal dialysis or kidney transplantation. Peritoneal dialysis involves using a catheter and the lining of your abdomen to filter your blood. Hemodialysis uses a machine and an artificial kidney to filter your blood. Peritoneal dialysis is a daily treatment, while hemodialysis is usually three times a week.

Kidney transplants are usually successful for recipients with a five-year survival rate of 80 percent. Transplants can either come from a living donor or a deceased donor.

Contact your primary care physician or ask for a referral to a nephrologist to see if you’re at risk of developing chronic kidney disease. If you or a loved one has late-stage kidney disease, contact the Kidney and Pancreas Transplant Center at the INTEGRIS Health Nazih Zuhdi Transplant Institute to learn more about if you qualify for a kidney transplant.