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23 November, 2009

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Kidney disease - prevention

More than 500,000 Australians a year consult their doctors about kidney disease and urinary tract infections. One in seven Australian adults have some sign of chronic kidney disease and one in 35 actually have serious kidney disease. During their lifetime, one-third of women and one in ten men will suffer a bladder infection and one in 35 women will have kidney stones.

Risk factors for chronic kidney disease
You are more ‘at risk’ of chronic kidney disease if you:

Have diabetes
Have high blood pressure
Are obese
Are over 50 years of age
Have a family history of kidney disease
Smoke
Are of Aboriginal or Torres Strait Islander descent.

Many diseases can affect the kidneys
Many illnesses can affect the kidneys. The most important are:

Diabetes
Inflammation of the kidneys (nephritis)
High blood pressure
Hereditary kidney diseases, such as polycystic kidney disease
Scarring of the kidney caused by backflow of urine from the bladder.

High blood pressure can damage kidneys
High blood pressure (hypertension) is increased pressure inside the arteries that carry blood from your heart to all parts of your body. Untreated, high blood pressure can damage your kidneys. All high blood pressure strains the heart and damages arteries. If blood pressure is uncontrolled and remains high, it can damage the vessels that supply blood to your internal organs. The very small vessels are often the first to be affected. If left untreated, this can lead to kidney disease, heart attack, strokes and loss of vision.

There are a number of different causes of high blood pressure but most high blood pressure has no known cause. You are more at risk of high blood pressure if you are older or have a family history of the condition. High blood pressure can also develop as a result of kidney disease or renal artery stenosis (narrowing of the main artery to one or both kidneys). Your kidneys control the amount of fluid in your blood vessels and produce a hormone called renin that helps to control blood pressure.

Medication and lifestyle changes can lower blood pressure
A range of medication is available for high blood pressure. Different blood pressure medications work in different ways so it is not unusual for more than one type to be prescribed. The dose may alter according to your needs.

Medications that can lower blood pressure include:

ACE inhibitors
Angiotensin receptor blockers
Calcium channel blockers
Beta blockers
Low-dose diuretics (fluid tablets)
Alpha blockers.

Healthy lifestyle choices are important to improve your overall health and lower your risk of high blood pressure. They can also reduce the amount of medication you need or make your medication work better. Healthy lifestyle choices include not smoking, eating a healthy diet, drinking plenty of water, staying fit, maintaining a healthy weight, avoiding certain medications and avoiding stress.

Symptoms of kidney disease
Kidney disease is called a ‘silent disease’ as there are often few symptoms. Some signs and symptoms include:

Change in frequency and quantity of urine passed, especially at night (usually increase at first)
Blood in the urine (haematuria)
Foaming urine
Puffiness around the eyes and ankles (oedema)
Pain in the back (under the lower ribs, where the kidneys are located)
Pain or burning when passing urine.

When the kidneys begin to fail, there is a build-up of waste products and extra fluid in the blood as well as other problems, gradually leading to:

Tiredness, inability to concentrate
Generally feeling unwell
Loss of appetite
Nausea and vomiting
Shortness of breath.

Treatments
Reduction in kidney function cannot usually be reversed. However, if detected early enough, the progress of kidney disease can be slowed and sometimes even prevented. In the early stages, changes to diet and medication can help to increase the life of the kidneys.

If kidney function is reduced to less than 10 per cent of normal, the loss of function must be replaced by renal dialysis or a kidney transplant. Dialysis is a treatment for kidney failure that removes waste products and extra water from the blood by filtering it through a special membrane (fine filter).

Early detection can save lives
Early detection of kidney disease can be life saving. Medication and changes to lifestyle, along with an early referral to a kidney specialist, can prevent or delay kidney failure. If you are ‘at higher risk’ of chronic kidney disease, talk to your doctor about having a regular kidney health check. This includes:

Blood pressure test
Blood test for kidney function
Urine test for protein (proteinuria).

Lifestyle changes can keep your kidneys healthy
Making healthy lifestyle choices can help to keep your kidneys functioning well:

Eat lots of fruit and vegetables including legumes (peas or beans) and grain-based food like bread, pasta, noodles and rice.
Eat some lean meat like chicken and fish each week.
Eat only small amounts of salty or fatty food.
Drink plenty of water instead of other drinks.
Maintain a healthy weight.
Stay fit. Do at least 30 minutes of physical activity that increases your heart rate on five or more days of the week including walking, lawn mowing, bike riding, swimming or gentle aerobics.
Don’t smoke.
Limit your alcohol to two small drinks per day if you are male or one small drink per day if you are female.
Have your blood pressure checked regularly.
Do things that help you relax and reduce your stress levels.

Where to get help

Your doctor
Kidney Health Australia Information Line Tel. 1800 4 KIDNEY (543 639), TTY 1800 005 881

Things to remember

You can look after your kidneys by eating healthy food, staying active and maintaining a healthy weight.
Many diseases can affect your kidneys.
Have your blood pressure checked regularly.

You might also be interested in:
Blood pressure.
Blood pressure (high) - hypertension.
Cystitis explained.
Diabetes and kidney failure.
Kidney disease - tests.
Kidney disease and cardiovascular risks.
Kidney failure.
Kidney reflux.
Kidney stones.
Kidneys - age related problems.
Kidneys - cystic kidney disease.
Kidneys explained.
Steroids.
Urinary tract infections.

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