Chronic kidney disease: More than kin and less than kind

March is National Kidney Month. Which is rather odd because kidneys don’t take days off from filtering blood; removing wastes, toxins, and excess fluid; helping control blood pressure; promoting red blood cell production; keeping bones healthy; and regulating essential blood chemicals. Not unsurprisingly, if the kidneys fail, the whole outhouse can go up in flames. This is the case of chronic kidney disease (CKD; not to be confused with CKY), a lifelong, progressively worsening condition that starts with damaged kidneys or reduced kidney function for more than 3 months and ends with end-stage renal disease – when the kidneys  finally shut down completely (and  so usually does the person who was so unkind to them).

The good news is that CKD can be treated early. And by early we don’t mean when you need either a new kidney or a machine to do your kidneys’ dirty work. That would be, in fact, the opposite of early. You just can’t wait to experience the symptoms of chronic kidney disease because the early stages of CKD are asymptomatic. On the other hand, you shouldn’t go on ahead and assume you have it – more than 10% of American adults have chronic kidney disease, but that still leaves out about 200 million people. The only surefire way to settle the matter is to get tested – a little blood and urine will do – which you should do regularly if you’re at risk.

Risk factors for CKD include the following:

·         High blood pressure.

·         Diabetes.

·         Heart disease.

·         High cholesterol.

·         A family history of chronic kidney disease.

·         Age 50 or older (CKD is most common in adults aged 70 and older, but it can affect people of any aged).

·         African American, Hispanic/Latino American, and American Indian ethnicity.

These conditions – especially high blood pressure and diabetes – damage the nephrons; little filters that the kidneys are made of (and which may or may not write romantic comedies in their spare time). There are millions of nephrons, and healthy ones can pick up the slack for ailing ones like Liev Schreiber in Jakob the Liar, but without treatment, things will get worse before they get better. Regular testing is the best method for detecting – and thus for treating – chronic kidney disease early. Treatment usually consists of medications and lifestyle changes.

How to be kind to your kidneys

·         Keeping blood pressure levels below 140/90 mm Hg (or the target established by a doctor).

·         Staying within the target blood sugar range as much as possible if there is diabetes.

·         Helping to control blood pressure and blood sugar levels with physical activity.

·         Losing excess weight.

·         Getting tested for CKD regularly if there are risk factors present.

·         Creating a kidney-healthy eating plan with a dietitian to help manage CKD.

·         Taking medications as prescribed, and asking the doctor about blood pressure medicines called ACE inhibitors and ARBs, which may protect the kidneys and lower blood pressure.

·         Quitting smoking.

·         Assembling a healthcare team that includes a kidney specialist.

More than 300 people start treatment for kidney failure every 24 hours. This is not cheap. Treating Medicare patients aged 65 or older with chronic kidney disease cost the United States $44.6 billion in 2012. Therefore, prevention is essential to save not only lives, but also a boatload of money.

How to prevent CKD


CKD is often untreated because people do not have symptoms at first. Blood and urine tests allow doctors to determine how well the kidneys are working.


Lifestyle changes can deter the progress of early CKD. Kidney failure can only be treated with dialysis – in which a machine cleans waste, salt, and fluid from the blood – or with a kidney transplant.


The risk for CKD can be decreased by 33% to 40% by maintaining healthy blood sugar and blood pressure levels – which can be measure with these and these medical supplies online, respectively. 


Cases of kidney failure in people with diabetes or high blood pressure dropped by about 1% during 2010–2012, possibly indicating that these people are getting better treatments.


New cases of CKD and kidney failure may be reduced by improving treatment for people with diabetes and high blood pressure and helping them manage their health better.


Related: Early symptoms of chronic kidney disease