Why chronic kidney disease is called a ‘silent killer’

You’d think a health condition affecting 30 million American adults – one in seven – would be immediately familiar, a much-discussed health topic. But that isn’t the case with CKD: chronic kidney disease.

In its earliest stages, CKD is unrecognized by 96 percent of those who have it, and nearly half of people with severely reduced kidney function (but not on dialysis) are unaware that their kidneys are not functioning properly, according to a study done by the U.S. Centers for Disease Control and Prevention.

The findings were based on statistics gathered from 2011 to 2014, and should “serve as a warning bell that a major public health challenge is right in front of our eyes and more must be done to address it,” according to Kevin Longino, CEO of the National Kidney Foundation (himself a kidney transplant recipient).

Sebastian’s Saatiah Jaffry, MD, who is board-certified in nephrology and internal medicine, agrees there is cause for alarm.

“Chronic kidney disease is a silent killer,” she says. “Many with the condition have no symptoms until they their kidneys fail completely. And the number of people with CKD is increasing, mainly because of the epidemic of obesity. Obesity can lead to diabetes and diabetes can lead to kidney disease.”

The function of the kidneys is to filter waste and excess fluid from the blood. If the kidneys begin to fail, waste builds up, which can cause other health problems. Although CKD often has no symptoms (leading to it being so often unrecognized), those afflicted may experience digestive tract symptoms such as nausea and vomiting, fatigue, anemia, loss of appetite, sleep problems, swelling and itching.

There are simple urine and blood tests that screen for CKD, and Dr. Jaffry says “everyone should be tested at their annual physical. It is part of the basic metabolic panel to check on the function of the kidneys.”

The potential complications of CKD can affect almost every part of the body, and include:

  • Hyperkalemia, a sudden rise in the blood’s potassium levels, which can impair heart function and can be life-threatening.
  • Pericarditis, an inflammation of the saclike membrane that envelops the heart.
  • Weak bones, and an associated increased risk of bone fractures.
  • Damage to the central nervous system, which can cause difficulty concentrating, personality changes or even seizures.
  • Decreased immune response, increasing vulnerability to infection.

In addition to diabetes, cardiovascular disease is the most significant risk factor for CKD; almost half of those with CKD have one or the other, or both. High blood pressure and a family history of kidney disease are other risk factors. Women are slightly more likely than men to develop CKD, but men are significantly more likely to progress to kidney failure, which requires dialysis or a kidney transplant to stay alive.

Dr. Jaffry says, “Lifestyle makes all the difference in the world. Following a healthy diet, keeping BMI under 25, and exercising 30 minutes a day will help protect against kidney disease.” She is an advocate of the DASH diet, which includes reducing red meat, saturated fat and high-fat dairy products, along with an increase in whole grains, fruits and vegetables.

Once diagnosed, medications can help manage CKD and its symptoms (information courtesy of the Mayo Clinic):

  • High blood pressure medications. Your doctor may recommend medications to lower your blood pressure and preserve kidney function.
  • Cholesterol-lowing medications. People with chronic kidney disease often experience high levels of bad cholesterol, which can increase the risk of heart disease; “statin” drugs are often prescribed to lower those levels.
  • Medications to treat anemia. The hormone erythropoietin is sometimes recommended; taken as a dietary supplement, it aids in the production of red blood cells, which may relieve the fatigue and weakness associated with anemia
  • Medications to relieve swelling. As people with CKD may retain fluids, swelling in the legs can occur.  Diuretics – medications that promote the production of urine – can help maintain the balance of fluids in your body.

Dr. Jaffry wants the community to know  that there can be danger to kidney function lurking in over-the-counter medicines and dietary supplements. “People think that they are harmless, but they are not,” she says. “Aspirin and ibuprofen, taken too frequently, can be toxic to the kidneys. And some vitamins and supplements are not FDA-controlled, and may contain contaminants that the kidneys cannot filter out.”

Additionally, Dr. Jaffry says the drugs taken for heartburn and acid indigestion, such as Prilosec and Nexium, can cause nephritis – an inflammation of the kidneys – which can lead to impaired kidney function. These drugs have value in treating what they are designed to treat, but they should be taken with the knowledge and guidance of your health care team.

Dr. Jaffry’s practice is located at 7965 Bay Street in Sebastian; the phone number is 772-918-8487. 


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