Knowing the Signs

Understanding kidney disease can bring brighter days

Kidney disease is very discreet.

Because it doesn’t show early warning signs, millions of Americans — an estimated 10 percent of those with kidney disease — don’t know they have it. Many find out only when their kidneys stop working and they need dialysis or a new kidney.

Fortunately, it doesn’t have to be this way.

A simple screening test can detect kidney disease at its earliest stage, and doctors — along with healthy lifestyle changes — can slow its progression.

A Growing Epidemic

About 26 million American adults have chronic kidney disease with about 350,000 in the final stages of the disease, requiring dialysis or transplantation, says UVA’s Mark D. Okusa, M.D, chief of UVA’s Division of Nephrology, the branch of medicine focused on kidney (or renal) disease.

“Another 20 or 30 million people in the United States have reduced kidney function. By 2020, kidney disease could double or even triple, and will be a huge public health issue,” he says. “But, if caught early through screening, for the most part, we can slow down the disease’s progression.”

Are You at Risk?

Many people with chronic kidney disease also have adult onset diabetes, high blood pressure, obesity or a family history of kidney disease.  Other factors include recurring kidney infection, lupus and urinary tract blockages.

According to the National Institutes of Health, chronic kidney disease may also result from:

• A direct and forceful blow to the kidneys
• Prolonged consumption of some over-the-counter painkillers that combine aspirin, acetaminophen, and other medicines such as ibuprofen.
• Hereditary factors, such as polycystic kidney disease
  

Why Get Screened

Significant symptoms of kidney disease only appear in the later stages of the disease. These include increased urination (especially at night); blood in the urine; swelling of hands, feet and eyes; loss of appetite; nausea; thirst; bad taste in the mouth; weight loss; muscle twitching and cramping.

Untreated, kidney disease leads to abnormally low levels of calcium phosphate and vitamin D, causing poor bone health.

It also raises the risk of early death, heart attack, stroke and high blood pressure. And it can lead to complications such as uremic syndrome (where levels of toxins rise in the bloodstream); electrolyte imbalances; fluid imbalances; and anemia.

This is why screening is critical.

Simple blood and urine tests can reveal early signs of kidney disease. The latter test quickly detects protein in urine, a sign that a person’s kidneys are not eliminating wastes as they should.

“If you think you may be at risk, see your family physician for screening,” Okusa urges. “And if tests show your kidney function is declining, ask your doctor for a referral to UVA.”

Get Treated by the Experts

UVA’s Kidney Center offers patients access to progressive research studies and a dedicated staff of nurses, doctors, dietitians, an ultrasonographer and social worker — all focused only on the treatment of kidney disease.

And to make it easier for patients, says Okusa, “We’re set up so a patient can see everyone in a single visit.”

Treatment does not mean just taking a pill; it means changes in diet and exercise and often creating a healthier lifestyle by quitting smoking.

In addition to providing treatment for earlier stages of reduced kidney function, UVA performs more than 100 kidney transplantations each year at its main Charlottesville hospital, and provides dialysis to several hundred patients at convenient locations throughout Virginia.

The focus, says Okusa, is to provide comprehensive services, easy access and cutting-edge research available at few other hospitals. “We always work to meet the needs of referring physicians and patients.”