Ask a Health Care Professional – Kidney Disease

By Latha Raja Shankar, M.D., Chief Medical Officer, Blue Cross and Blue Shield of New Mexico

According to the Centers for Disease Control and Prevention (CDC), an estimated 37 million people in the United States have chronic kidney disease — that’s more than one in seven adults. Unfortunately, many people living with the disease don’t even know they have it; the CDC reports that about nine in 10 adults with chronic kidney disease are unaware of their condition and approximately two in five adults with severe chronic kidney disease don’t know they have it. Furthermore, kidney function declines as we age. That’s why it’s so important that we take action to support kidney health and decrease the risk of developing kidney disease.

What do our kidneys do?

Kidneys filter our blood and separate waste. They help regulate substances in the blood — such as salt, water and potassium — and maintain acid-base balance. Kidneys help with the production of red blood cells and activate vitamin D, which supports calcium absorption and bone health. 

What is chronic kidney disease, and does it lead to kidney failure?

Chronic kidney disease occurs when there is reduced kidney function over time or when kidney damage is present. When the filtration rate of the kidneys decreases below a certain level or when protein gets secreted in the urine beyond a certain level over the course of three months, one may be diagnosed with chronic kidney disease. Not everyone with the above findings progress to kidney failure. Kidney failure happens when the kidney filtration levels drop below a critical level. Having uncontrolled diabetes, high blood pressure, heart disease, HIV infection or a family history of kidney disease increases your risk for progression of kidney disease. Obesity and older age are also risk factors for chronic kidney disease.

What can you do to reduce the progression if you are diagnosed with chronic kidney disease?

Follow up with your health care provider routinely. Your provider can perform blood and urine tests to assess kidney functions. Keep your blood pressure under control with a goal below 140/90 mmHg. Persistent high blood pressure can lead to inflammation and abnormal changes to the kidney, causing decreased function. If you have diabetes, control your blood sugar levels according to the goal number agreed upon with your provider. Uncontrolled diabetes causes high blood sugar levels, which can damage blood vessels in the kidney.

Many lifestyle changes can reduce the progression of chronic kidney disease. Stop smoking if you smoke. If needed, lose weight. Maintain a healthy diet and get the right amount of exercise. Talk to your health care provider about the actions that are appropriate for you. A dietician can also help you understand your dietary needs, such as low sodium intake — depending on blood levels — decreased potassium or phosphorus intake, or other nutritional recommendations.

Your health care provider may prescribe medications to protect your kidneys from worsening. Take medications as directed by your health care provider and avoid substances that could cause kidney injury, including contrast agents for X-ray studies and medications such as ibuprofen or others that can damage your kidneys.

Where can you find additional information?

You can find more information about kidney disease at the National Institute of Diabetes and Digestive and Kidney Diseases at https://www.niddk.nih.gov/.

If you have a health question that you would like to be considered in Ask a Health Care Professional, please email [email protected] BCBSNM will select questions that may appear. Questions will not be personally answered. The opinions expressed in this column are solely those of the author and not necessarily those of BCBSNM. This column is not intended to be a substitute for professional medical care.

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