Keeping your kidneys healthy

About the size of a deck of cards, kidneys are small but mighty organs that perform vital functions to maintain internal stability in our bodies. They do this by regulating the amount of water we hold or release, eliminating waste and sustaining normal blood value ranges, all of which are vital to our overall health.

“The kidneys are crucial to almost every system in the body,” says Dr. Janet Roscoe, Nephrologist at The Scarborough Hospital. “Failing kidneys can result in heart failure due to an inability to remove water, and predispose individuals to infection because of a reduced immune system and damage to other organs such as bones. This is in addition to the toxic effects of being unable to remove poisons.”

Primary risk factors for developing kidney disease include diabetes, heart disease, high blood pressure and a predisposition to kidney disease. Other risk factors can include autoimmune diseases such as lupus, rheumatoid arthritis and infections.

Age is also a risk factor. Our kidneys experience natural wear and tear as we get older, and living an unhealthy lifestyle accelerates the workload on kidney functions. Prevention is crucial to reduce the chances of kidney disease as we age, but even those who have already experienced kidney disease can use the following tips to improve their kidney health:

• Avoid regular and prolonged use of over-the-counter pain medication such as Tylenol, Aspirin, Advil, Motrin and Excedrin. These medications can cause kidney damage and should be used in emergency situations rather than on a daily basis. If your doctor has prescribed non-steroidal anti-inflammatory drugs, ask about the effect they may have on your kidneys.
• Stay hydrated, but avoid over-consumption of water as the kidneys work hard to produce urine.
• Exercise regularly and enjoy a healthy diet including kidney-friendly foods such as broccoli, cauliflower, brussel sprouts, cabbage, berries, apples, garlic, peppers and tomatoes.
• Moderate alcohol as high consumption can elevate blood pressure. Tobacco causes hardening of the arteries and damages the delicate filters in the kidney, which then reduces their ability to remove poisons from the body. Your best bet is to reduce alcohol consumption and quit smoking altogether.

“It’s also very important to book an annual physical with your family doctor to catch any potential problems at an early stage,” says Dr. Roscoe. “Learn about your family’s medical history, and talk to your doctor about getting tested if you think you may be at risk.”

Important information for patients starting dialysis

Patients diagnosed with kidney failure – where kidney functions drop below 15 per cent – have two choices for survival: dialysis treatments or kidney transplants.

Dialysis is a process for removing waste and excess water from the blood, and is used primarily as an artificial replacement for lost kidney function in people with renal failure. The Scarborough Hospital’s Chronic Kidney Disease Program is one of the largest in North America, treating more than 5,000 patients with kidney disease and another 750 dialysis patients.

Diabetes is the most common cause of kidney disease. High blood glucose levels and high blood pressure can damage the kidneys over time. But for long-time dialysis patient Terri Bradshaw, diabetes was not the diagnosis that turned her life upside down 10 years ago.

“It was glomerulonephritis, which is not diabetes-related,” Terri says. “When I was first diagnosed, I was in denial until I became so sick, I had no objections to going on dialysis because I just wanted to feel better.

“I won’t deny that dialysis is very invasive, and there is pain involved,” explains Terri, who is Chair of the Home Dialysis Peer Support Group at The Scarborough Hospital. “You really don’t understand what it means until it happens to you, but I always tell people that it beats the alternative.”

For newly diagnosed patients needing to start dialysis, Terri offers the following advice:

1. Gather as much information as possible provided by doctors and nurses, and review it at home with someone you trust who will help you. Go over it together in a quiet environment that’s less stressful because you can’t possibly absorb all that information in the doctor’s office.
2. Write out questions for your medical appointments even if they seem silly. Quite often during appointments, your discussion with the doctor takes another track. Keep a log of your questions and answers, because when you’re sick, it may be hard to remember everything.  Better yet, take someone with you to your appointment.
3. Don’t allow yourself to be intimidated by healthcare professionals. Be prepared for your appointments and be your own advocate. Be involved, be in charge, and take an interest in your treatment.
4. Take advantage of any non-clinical information or support, such as a peer support group, touring the facility, watching the dialysis machines in action and talking to other patients.
5. And the most important and probably the hardest thing is to stay positive, even when don’t feel good. Without a positive outlook, it’s very easy to slip into black hole of depression.

November is Diabetes Awareness Month. For more information on diabetes, visit www.diabetes.ca.

Ten signs of Chronic Kidney Disease

An estimated 2 million Canadians have kidney disease or are at risk. More than 20,000 Canadians require dialysis to stay alive. Currently, 1,055 people in Ontario are waiting for a kidney transplant.

With the largest Chronic Kidney Disease Program in North America, The Scarborough Hospital provides care to more than 3,000 pre-dialysis patients.

“At The Scarborough Hospital we focus on early detection and prevention. We try to identify patients who are at-risk of developing chronic kidney disease. We work with those patients, providing information, care and support to help prevent or delay the development of the disease and the need for dialysis,” says nephrologist Dr. Robert Ting.

The leading causes of kidney failure are diabetes and high blood pressure.

March is Kidney Awareness Month and Dr. Ting shares some of the signs of Chronic Kidney Disease:

1. High blood pressure
2. Puffiness of the eyes, hands and feet (called edema)
3. Passage of bloody, cloudy or tea-coloured urine
4. Presence of protein in the urine or foaming in the urine (proteinuria)
5. Shortness of breath
6. Frequent urination or passing of urine during the night (nocturia)
7. Passing less urine or difficulty passing urine
8. Fatigue
9. Loss of appetite or weight
10. Persistent generalized itching