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By Emily Johnston, RN, MSN, FNP-C
You may be surprised to learn that our kidneys perform seven extremely important functions. Not only do they maintain water balance, but they also clean our blood of toxins, control blood pressure, produce a hormone needed to create red blood cells, control acid-base balance, activate Vitamin D, and maintain electrolyte balance.
Each kidney contains over one million nephrons or filters. As we age, these filters naturally decrease in number and do not regenerate. As a result, a decline in kidney function is expected to some degree and is just one of the many joys of growing older! Thankfully, aging alone is not responsible for severe kidney disease. In the US, the most common causes of chronic kidney disease and ultimate kidney failure are diabetes and hypertension. These diseases cause damage to all vessels, including those in our kidneys. Other, less common, causes of kidney disease include congenital kidney disorders, autoimmune processes, infections, and some cancers.
Stages of Chronic Kidney Disease, categorized according to eGFR, or estimated glomerular filtration rate:
- Stage I: eGFR > 90 ml/min (no change to function but with some indication of kidney disease)
- Stage II: eGFR 60-89 ml/min
- Stage III: eGFR 30-59 ml/min
- Stage IV: eGFR 15-29 ml/min
- Stage V: eGFR < 15 ml/min
Ideally, an individual is referred to a nephrologist (kidney doctor) with eGFR < 60 ml/min. Unfortunately, no medication or action can be taken to regain lost kidney function. The goal of kidney disease management is to delay the progression of kidney decline and ensure associated functions are medically managed.
How to Slow the Progression of Kidney Disease:
- Most important! Optimal management of injuring agents, specifically, diabetes and hypertension!
- Avoid all NSAIDs, which include every OTC medication for pain, except for acetaminophen. Examples include ibuprofen, Aleve, Motrin, Naprosyn, Advil, etc. Baby aspirin is OK. Examples of prescription NSAIDs include meloxicam and Celebrex.
- Routine medical care, including lab work, if kidney disease is present and routine appointments with kidney specialists.
- Maintaining a healthy lifestyle including regular exercise, a balanced and low sodium diet. Avoid excessive alcohol intake and achieve recommended body weight. Unless instructed by a physician, specific dietary limitations or changes are not typically warranted.
- Ensure hydration, and avoid excessive intake of caffeinated beverages.
Surprising Facts about our Kidneys:
- More than 30% of those 60 years and older have some degree of CKD.
- Many people are born with only one kidney and are none the wiser.
- Anyone can suffer from kidney disease. In fact, celebrity Selena Gomez has had a kidney transplant.
- Your kidneys filter approximately 50 gallons of blood daily!
Do not despair if you are one of the millions of people in the US with chronic kidney disease. Routine monitoring and management of kidney disease is a critical step to slow the progression of kidney decline. If you follow up regularly with a nephrologist, “urine” good hands.