Are you at risk?
- Do you have high blood pressure?
- Do you suffer from diabetes?
- Do you have a family history of kidney disease?
- Are you overweight?
- Do you smoke?
- Are you over 50 years?
- Are you of African, Hispanic, Aboriginal or Asian origin?
If you have answered yes to one or more of these questions, you should discuss with your doctor, you may need testing for kidney disease! Early chronic kidney disease has no sign or symptoms. You can help delay or prevent kidney failure by treating kidney disease early.
Did you know?
A person can lose up to 90% of their kidney function before experiencing any symptoms.
Most people have no symptoms until CKD is advanced. Signs of advancing CKD include swollen ankles, fatigue, difficulty concentrating, decreased appetite, blood in the urine and foamy urine.
Detection of Kidney Disease
The majority of individuals with early stages of CKD go undiagnosed. On WKD we are calling on everyone to check if they are at risk for kidney disease and encouraging people with any risk factors to take a simple kidney function test.
Kidney disease usually progresses silently, often destroying most of the kidney function before causing any symptoms. The early detection of failing kidney function is crucial because it allows suitable treatment before irreversible kidney damage or deterioration manifests itself through other complications.
Simple laboratory tests are done on small samples of blood (to measure creatinine content and estimate GFR) and on urine (to measure creatinine and albumin excretion).
Your doctor uses the results of your Serum Creatinine measured in the blood to estimate your overall kidney function, or Glomerular Filtration Rate (GFR) and your blood sugar to be sure you do not have diabetes. A simple “dipstick” test may be used to detect excess protein in the urine.
- Serum Creatinine: Creatinine is a waste product in your blood that comes from muscle activity. It is normally removed from your blood by your kidneys, but when kidney function is reduced, the creatinine level rises. Your doctor can use the results of your serum creatinine test to calculate your GFR, which refelcts how well your kidney is functioning.
- Glomerular Filtration Rate (GFR): Your GFR tells how much total kidney function you have. It may be estimated from your blood level of creatinine. Normal is about 100 ml/min, so lower values indicate the percentage of normal kidney function which you have. If your GFR falls below 60 ml/min you will usually need to see a kidney disease specialist (called a nephrologist), If the treatment you receive from the nephrologist does not prevent a further reduction in GFR, your nephrologist will speak to you about treatments for kidney failure you might need later like dialysis or kidney transplant. A GFR below 15 indicates that you may need to start one of these treatments soon.
- Urine albumin. The presence of excess protein in the urine is also a marker of CKD and is a better indicator of the risk for progression and for premature heart attacks and strokes than GFR alone. Excess protein in the urine can be screened for by placing a small plastic strip embedded with chemicals that change color when protein is present (urine dipstick) into a fresh urine specimen or can be measured more accurately with a laboratory test on the urine.
- Urine albumin-to-creatinine ratio. A urine albumin-to-creatinine ratio (UACR) on a spot urine specimen is a laboratory test to measure and monitor urine albumin. UACR is a ratio between two measured substances – albumin and creatinine – in the urine. UACR is usually expressed as mg albumin/g creatinine and estimates 24-hour urine albumin excretion. UACR is unaffected by variations in urine concentration and is therefore more accurate than a dipstick. .Albuminuria is diagnosed when UACR is greater than 30 mg/g and is a sign of CKD. (Source: http://nkdep.nih.gov/lab-evaluation/faqs.shtml)
8 Golden Rules for Prevention
Kidney diseases are silent killers, which will largely affect your quality of life. There are however several easy ways to reduce the risk of developing kidney disease. Check out the 8 Golden Rules!
Secondary Prevention – slowing disease progression:
Key preventative measures have been defined and proven successful in those with early stages of CKD as secondary prevention measures, which help slow disease progression and protect against both kidney and cardiovascular disease, such as:
- Reduction of high blood pressure -the lower the blood pressure (within the normal range) , the slower the GFR decline
- Specific medications to reduce proteinuria as well as lower blood pressure – angiotensin converting enzyme inhibitors (ACE inhibitors) or angiotensin receptor blockers (ARBs)
- Reduce salt intake to lower blood pressure
- Control of glucose, blood lipids and anemia
- Smoking cessation
- Increase of physical activity
- Control of body weight
Treatment: Clinical research over the last two decades has shown the potential benefit of blockade of the renin-angiotensin system by medicines known as ACE inhibitors and ARBs. This can significantly delay the progression of CKD, especially in people with diabetes and hypertension at relatively low cost.
What you should ask your doctor?
Here are some key questions that you can ask your doctor:
- What is my GFR?
- What is my urine albumin result?
- What is my blood pressure?
- What is my blood glucose (for people with diabetes)?
Other important questions:
- What happens if I have kidney disease?
- What should I do to keep my kidneys healthy?
- Do I need to be taking different medicines?
- Should I be more physically active?
- What kind of physical activity can I do?
- What can I eat?
- Do I need to talk with a dietitian to get help with meal planning?
- Should I be taking ACE inhibitors or ARBs for my kidneys?
- How often should I get my kidneys checked?