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Kidney Disease is an Under-Recognized Public Health Crisis

Courtesy, National Kidney Foundation

Kidney Disease is an Under-Recognized Public Health Crisis March is National Kidney Month. These vital organs, shaped like a bean, are located near the middle of your back, just below the ribs. They are involved in cleaning your blood – processing about 200 quarts of blood to remove two quarts of waste and excess water.

Surprised? Unfortunately, most of us don’t think about our kidneys … but chronic kidney disease is serious, causing more deaths than breast cancer or prostate cancer. It is the under-recognized public health crisis, affecting 30 million people in the U.S. (15 percent of the adult population).

Approximately 90 percent of those with kidney disease don’t even know they have it. For people at the earliest stages of kidney disease, 96 percent don’t know. Kidney disease is the ninth-leading cause of death in the U.S. and is growing in prevalence. The National Kidney Foundation (NKF) has led the way in rallying action on this problem. Because of increasing rates of diabetes and high blood pressure, chronic kidney disease is on the rise and is an urgent issue.

Chronic kidney disease (CKD) means your kidneys are damaged and losing their ability to keep you healthy. In the early stages, most people do not have symptoms. But as kidney disease gets worse, wastes can build up in your blood and make you feel sick. You may develop other problems like high blood pressure, anemia, weak bones, poor nutritional health, and nerve damage. Kidney disease also increases your risk of having heart and blood vessel disease. These problems may happen slowly and can lead to kidney failure. Once kidneys fail, dialysis or a kidney transplant is needed to stay alive.

The two main causes of chronic kidney disease are diabetes and high blood pressure, which are responsible for up to two-thirds of the cases.

Other conditions are: glomerulonephritis, diseases that damage the kidney’s filtering units; inherited diseases, such as polycystic kidney disease; malformations at birth that occur as a baby develops; lupus and other immune diseases; obstructions such as kidney stones or an enlarged prostate; and repeated urinary tract infections.

One in three American adults is at risk for kidney disease. Anyone can get chronic kidney disease at any age. Some demographic groups are at higher risk.

Almost 10,000 children and adolescents have kidney failure or end-stage renal disease (ESRD). They are 30 times more likely to die than healthy children. Young adults with ESRD since childhood have a life expectancy of 38 years if they are treated with dialysis, and 63 years if they receive a kidney transplant.

Risk factors for CKD include diabetes; high blood pressure; family history of kidney failure; age 60 or older; and minority populations that have high rates of diabetes or high blood pressure, such as African Americans, Hispanics, Asians, Pacific Islanders, and Native Americans. The prevalence among African Americans is roughly three times higher than whites, and nearly 1.5 times higher for Hispanics. Asians and Native Americans have a prevalence higher than whites.

How is CKD Treated?
The best treatment is early detection when chronic kidney disease can be slowed or stopped. Early treatment includes diet, exercise, and medications. However, once kidneys fail, treatment with dialysis or a kidney transplant is needed.

• Dialysis comes in two forms: hemodialysis or peritoneal dialysis. Hemodialysis is a treatment (usually three to four times a week) that removes wastes and extra fluid from your blood. It can be done at home or at a dialysis center. During hemodialysis, your blood is pumped through a dialysis machine, where it is cleaned and returned to your body. With peritoneal dialysis, your blood is cleaned inside your body through the lining of your abdomen using a special fluid that is periodically changed. Peritoneal dialysis can be done at home, at work, at school, or even during travel.

• A kidney transplant places a healthy kidney into your body from a deceased donor or from a living donor, such as a close relative, spouse, friend, or generous stranger. A kidney transplant, however, is a treatment, not a cure. Antirejection and other medications are needed to maintain the transplant.

How Big is This Problem? How Many Lives are Affected?
30 million American adults are estimated to have chronic kidney disease; about one third of adults with diabetes and 20 percent of adults with high blood pressure may have CKD. Over 660,000 Americans have irreversible kidney failure, or end-stage renal disease (ESRD), and need dialysis or a kidney transplant to survive.

Nationally, 200,000 Americans live with a kidney transplant; more than 100,000 are waiting for a kidney transplant. CKD shortens life expectancy by five to 11 years.

Prevention
Early detection is the most effective way to combat this condition. There are two simple, quick, and inexpensive tests for chronic kidney disease: A urine test, Albumin Creatinine Ratio (ACR), measures the amount of protein (albumin) in your urine. Damaged kidneys leak protein into your urine when it should be in your bloodstream. A blood test, (creatinine) is used to measure your Glomerular Filtration Rate (GFR), which tells how well your kidneys are working to remove wastes from your blood. It is the best way to check kidney function.

The National Kidney Foundation (NKF) is the largest, most comprehensive, and longstanding organization dedicated to the awareness, prevention, and treatment of kidney disease. For more information about NKF visit the website at Kidney.org.

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