Renal disease, also known as chronic kidney disease (CKD), affects more than 10 percent of adults over the age of 20 in the United States. That percentage equates to approximately 20 million people living with irreversible kidney damage.
The two main causes of CKD are diabetes and high blood pressure. Both diabetes and hypertension have the potential to damage organs in the body when left untreated or when poorly managed, and both conditions affect a large portion of the Hispanic community.
Latinos are 50 percent more likely to die from diabetes than non-Hispanic whites, according to the Office of Minority Health, and because of the prevalence of this disease, Hispanics have a high rate of end-stage renal disease. In a 2008 survey (last year information is available for), Hispanics were 1.6 times more likely than non-Hispanic whites to begin treatment for renal disease directly related to diabetes.
What causes renal disease?
While diabetes and hypertension are responsible for as many as two-thirds of CKD cases, renal disease is classified by the National Library of Medicine as “the slow loss of kidney function over time”, and the damage can be caused by many other medical conditions.
Irreversible CKD is less commonly caused by:
- Certain prescription medications
- Chronic kidney stones or infections
- Toxic chemicals
- Birth defects
- Autoimmune conditions
- Other forms of kidney disease
- Backward flow of urine into the kidneys (reflux neuropathy)
- Inflammatory conditions
What are the symptoms of renal disease?
Chronic kidney disease progresses slowly and the majority of people with early-stage CKD have no symptoms. By the time warning signs appear, kidney function has generally deteriorated to approximately one tenth of what is considered normal.
With decreased function comes an increase of toxins in the body, and symptoms will eventually manifest as:
- Trouble concentrating
- Swollen legs or feet
- Dry, flaking skin
- Frequent urge to urinate, most often at night
- Muscle cramping at night
- Loss of appetite
- Excessive thirst
- Easy bruising or bleeding
- A very specific odor to the breath, known as the smell of ketones (alcohol)
The National Kidney Foundation states anyone at any age can have CKD; however, some individuals and populations are in higher risk categories.
CKD is most likely to affect:
- Individuals with diabetes
- Individuals with high blood pressure
- People with a family history of the disease
- Hispanics, African-Americans, Asians (people from ethnicities with high diabetes/hypertension rates)
- Age (risk increases as an individual ages)
The diabetes link
Diabetes is the number one cause of renal disease and puts an individual at risk of CKD because elevated blood sugar affects vessels in the kidneys. Over time, unregulated levels of blood sugar damage a kidney’s nephrons — the filtering agents for the blood. Because there are millions of nephrons in each kidney, damage takes time to build to dangerous levels.
Once the nephrons have been damaged, the negative effects on the body begin to progress as toxins cannot be filtered. Diabetic-related CKD, according to Kidney Health Australia, can cause:
- An increase of protein in the urine. Known as proteinuria, too much protein in blood stream will lead to swelling in the legs, face, hands, and feet.
- Increased blood pressure: When CKD causes hypertension it is because proteinuria gradually restricts blood flow, causing blood pressure increases. If left untreated, an increase in blood pressure can add to renal damage already present.
- Urinary tract infections: Damage to the kidneys has been shown to leave an individual vulnerable to infection.
- Nerve damage: In severe cases, diabetes will damage nerves in the bladder, and a weakened bladder can cause a backflow of urine into the kidneys, causing further damage. High levels of sugar can also damage other nerves in the body.
Untreated CKD can lead to end-stage renal disease, a condition only treated through an organ transplant or dialysis. Because of this, early detection is important.
While CKD can’t be cured, steps can be taken to slow the progression of the disease.
To keep kidneys healthy, the Center for Disease Control recommends:
- Staying active
- Taking medications as directed
- Eating a healthy, well-rounded diet, high in antioxidants
- Avoiding processed foods and caffeine drinks
- Eating a low-salt diet
- Increasing water intake
- Being aware of personal target cholesterol range
- Keeping blood pressure below 130/80 mm/hg
- Regulating and monitoring blood sugar levels
- Treating urinary tract infections immediately
- Drinking alcohol in moderation or avoiding all together
For people concerned about the possibility of CKD, testing is simple to detect kidney damage and includes:
- Blood pressure screening
- Blood test to evaluate kidney values of BUN, calcium, albumin and creatinine
- Urinalysis to look for proteinuria
Should CKD be indicated in preliminary screening, more advanced tests such as kidney biopsy, ultrasound and MRI may be necessary.