Most days, I feel like the most fortunate doctor in the world.
After completing my medical training, I came home to Niagara to work at Niagara Health. For the last five years, I have been lucky to work alongside wonderful colleagues to bring nephrology (kidney disease) care to thousands of people in our community.
March is National Kidney Month, making it a perfect time to raise awareness about chronic kidney disease and the ways we can keep our kidneys healthy. Despite being an uncommon topic in the news, kidney disease affects 1 in 10 Canadians, or around four million people. In the Niagara region, we care for many thousands of patients with chronic kidney disease. More than 400 patients have end-stage kidney disease and are on dialysis. We have dialysis units in St. Catharines, Welland and Niagara Falls. The new South Niagara Hospital will have a 42-bed dialysis unit. We also offer dialysis at home, which allows patients to have more control over their dialysis schedules.
My fellowship training is in kidney transplant and this is an area that remains close to my heart. In Niagara, we have facilitated transplants for 47 patients since last April. While transplant surgery and immediate care is done in tertiary sites (Hamilton, Toronto, London), we are proud to offer much of the transplant workup and assessment here in Niagara.
In recent years, we’ve been seeing more patients progress to end-stage kidney disease – those who need dialysis or a kidney transplant. We are also seeing the rate of kidney disease rising in younger patients.
Kidneys are one of the most complex and interesting organs in the human body. They are responsible for filtering the blood, clearing toxins, balancing electrolytes and acid levels, and controlling blood pressure.
Chronic kidney disease is a decline in kidney function. The natural process of aging can affect our kidneys and decline in kidney function is faster if you have conditions such as diabetes, hypertension, cardiovascular disease and obesity. Kidney decline can also happen if you smoke or use certain medications. Regular, long-standing use of non-steroidal anti-inflammatory medications, such as Advil, Ibuprofen, Naproxen, and Aleve, can cause significant scarring in the kidneys and permanent damage to kidney function. A less commonly known culprit is medication to treat stomach acid.
Here are few ways to protect your kidneys:
Diabetes control
Diabetes is the most common cause of chronic kidney disease. Keeping blood sugars as well controlled as possible will reduce your risk of kidney disease. Ensure that you regularly see your primary care physician for diabetes check-ups, which include blood and urine tests to monitor kidney health.
Blood pressure control
Hypertension is the other most common cause of chronic kidney disease. Measuring your blood pressure at home helps guide your doctor when making medication adjustments. For most patients with hypertension, we try to keep home blood pressure readings less than 135/85mmHg. There is good evidence that aiming for a "perfect" blood pressure of 120/80mmHg is ideal in certain patients.
If you have diabetes, the target blood pressure is less than 130/80mmHg. It is best to ask your doctor which target is relevant for you.
Limit salt
Salt is not good for your heart, kidneys, or blood pressure. As difficult as it may be, cutting back sodium intake to less than 2300 milligrams a day, will protect your kidneys. You would be surprised about the amount of salt in everyday foods. Canned soups, cured meats, processed foods tend to be the saltiest. Bread is another food item that contains a lot of salt. Check your labels.
Quit Smoking
Cigarette smokers have higher rates of chronic kidney disease than non-smokers. Kidney function also declines more quickly in smokers. Speak to your doctor about the process of smoking cessation. Aside from a nicotine patch, there are other medications that can be used to help you quit.
Water intake
Water intake helps to keep you hydrated and may also be helpful for kidney function. Unfortunately, it is not as straightforward as it sounds. The old saying of drinking eight glasses of water each day is not based on solid scientific evidence. Too much water can be harmful if you have advanced kidney disease, heart disease, or blood sodium issues. The easiest advice is to drink when you are thirsty and, most of the time, to choose water as the primary beverage. You can use your urine as the gauge – dark yellow can signify dehydration while pale yellow is the goal.
Diet and Exercise
Maintaining a healthy weight and staying physically active are extremely important for kidney health. Excess body weight puts pressure on the kidneys and causes damage. Kidney disease tends to slowly get worse over time, but with weight loss, many patients can successfully reduce the decline rate. Physical activity goes hand-in-hand with weight loss but is also important to maintain heart health. The most common cause of death in kidney disease is heart disease, not kidney failure. Reducing your risk for cardiovascular disease will be essential.
Dr. Kathleen Quinn is a nephrologist in Niagara Health’s Kidney Care Program.
