Northwest Health Fall 2011

Conquering Illness

Chronic Kidney Disease Is On the Rise

Diet, exercise, and a healthy weight are key to managing chronic kidney disease.

Go to: Northwest Health Index

Three times a week, Sharon McIntosh spends four hours at a time hooked up to a dialysis machine to rid her blood of toxins, a procedure that robs her of time to do other things and often leaves her tired. A longtime Group Health member, McIntosh has chronic kidney disease, or CKD. She was diagnosed with it some 30 years ago at age 26, after suffering an allergic reaction to a drug that damaged her kidneys and led to a slow deterioration of her kidney function.

CKD is far from a rare disease. McIntosh is among the 10 to 12 million Americans with CKD, and that number is increasing, primarily due to the rise in diabetes, says Group Health Physicians nephrologist Ilan Zawadzki, MD.

Symptoms and Risk

The kidneys are vital organs that clean the blood of waste products and also play an important role in sustaining overall health by helping to produce red blood cells, and regulating blood pressure, among other functions. CKD occurs when the kidneys are unable to filter the body's natural toxins or are inappropriately leaking protein, says Dr. Zawadzki.

Early on, the disease can be without symptoms. But poor appetite; swollen extremities; muscle cramping at night; puffiness around the eyes; dry, itchy skin; or a change in the frequency of urination are all symptoms that could be related to CKD and should be checked out. CKD is diagnosed with blood and urine tests.

"When severe, CKD causes unrelenting nausea, vomiting, shortness of breath, severe fatigue, or death," says Dr. Zawadzki. It poses major risks for vascular and heart disease, strokes, and peripheral artery disease.

Those at higher risk for the disease include people with diabetes, high blood pressure, autoimmune diseases (such as lupus or rheumatoid arthritis), inherited kidney malformations, kidney stones, enlarged prostate gland, or recurrent urinary tract infections. Some ethnic groups are also at higher risk, including African Americans, South Asians, American Indians, and Alaska Natives.

Common pain relievers such as ibuprofen and naproxen (with brand names such as Motrin, Advil, and Aleve) can harm the kidneys if used in large quantities or for prolonged periods of time, says Donald Rappe, MD, a personal physician who practices at Group Health Medical Centers Puyallup clinic. "Be aware of the effects that over-the-counter medications, supplements, and vitamins may have on your body," he says.

Living with CKD

For most people with CKD, dialysis is never needed, or not for many years. It's only been in the last two years that McIntosh has had to rely on dialysis. Before that, she managed the disease by following the recommendations of her doctor, nephrologist David Charney, MD, and a Group Health nutritionist.

Those recommendations include drinking plenty of fluids, maintaining a healthy body weight, exercising regularly, not smoking, and eating a balanced diet. It also helps to have a support network of family and friends, says McIntosh. That support can help you stick with a program your doctor recommends, which isn't always easy. "Remember that the doctors are not your enemy. The diets and treatments they prescribe will help keep you as healthy as possible," she says.

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