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Published: April, 2010; Vol 6, Num 11

 

Costly Toll of Chronic Kidney Disease

“When it comes to maintaining health, being proactive is essential,” says LHSFNA’s Management Co-Chairman Noel C. Borck. “CKD – chronic kidney disease – is a case in point.”

One in every nine adults has it. Another 27 million are at increased risk for it. “Yet, most are unaware,” says Borck. “In its early stages, CKD symptoms are subtle, but later, it can be catastrophic. CKD is another reason why every Laborer should take advantage of the free annual check-ups provided by most LIUNA health and welfare plans.”

CKD is progressive, incurable and costly. In 2005, more than 485,000 Americans with end stage CKD incurred $32 billion in health care expenses related to dialysis and transplants. These costly measures could likely have been delayed had patients known early on – medication and diet can slow CKD – that they were ill. Taxpayers foot much of the bill for this lack of awareness. More than a quarter of Medicare’s annual expenditures are CKD-related.   

Kidneys filter two quarts of waste from the bloodstream every day. The waste, which leaves the body as urine, comes from food and the normal breakdown of muscle tissue. Kidneys also manufacture hormones. Erythropoietin (EPO) stimulates red blood cells, rennin regulates blood pressure and calcitriol maintains bones. When kidneys are not functioning properly, the body suffers from hormone loss and waste buildup. Kidney failure and death can result.

Diabetes and hypertension (high blood pressure) are the main causes of CKD. Sometimes, it develops through overuse of painkillers, allergic reactions to antibiotics, drug abuse or injury. Genetic predisposition can also be a factor. Once the kidneys are harmed, the ability to remove waste and excess fluid from the body is lost. That is why, in addition to kidney failure, people with CKD are at an increased risk of stroke or heart attack.

African Americans, Hispanics, Pacific Islanders, Native Americans and seniors are the populations that have the greatest risk of CKD. However, no group is immune, and everyone should be vigilant. As CKD has virtually no symptoms, blood and urine tests are necessary to detect the disease. Check with your health care provider to see if your regular physical includes these tests.

If CKD is found, certain blood pressure medicines may be used in treatment even if high blood pressure is not the cause of the illness.  A change in diet also helps. Most people with CKD need to limit salt (sodium), fluids, protein, potassium and phosphorus.

“While CKD has no cure,” says Borck, “it does not have to be a death sentence or mean a life tethered to a machine. Early detection and an active role in disease management can make the difference between a life lived long and well and one dictated by dialysis or transplant.”

[Janet Lubman Rathner]

CKD Tips for People with High Blood Pressure

  • Check blood and urine for CKD.
  • Keep blood pressure below 120/80 mmHg.
  • Eat healthy with fruits, vegetables, grains and low-fat foods.
  • Limit daily sodium intake to one teaspoonful of salt or 2,300 milligrams (mg). This includes salt that is already in foods as well as what you add.
  • Be physically active.
  • Limit alcohol to no more than one drink per day for women or two drinks per day for men. One drink is a can of beer, a glass of wine (4-5 oz) or one shot (jigger) of liquor.
  • Take all medicines as prescribed – blood pressure medicines called ACE inhibitors and ARBs also protect kidneys.

CKD Tips for People with Diabetes

  • Check blood and urine for CKD:
    • For type 2 diabetes, test every year.
    • For type 1 diabetes, test every year starting five years after diabetes onset.
  • Keep blood pressure below 120/80 mmHg.
  • Aim for blood glucose targets
    • Upon waking and before meals: 70 to 130 mg/dL
    • Two hours after starting a meal: under 180 mg/dL
  • Keep cholesterol levels in the 200 mg/dL range or lower.
  • Take medicines as prescribed.
  • Eat healthy and cut back on salt.
  • Be physically active.