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people at risk of kidney disease require yearly testing, says nephrologist
kidney disease is a silent condition that often goes unnoticed until it’s advanced
according to recent estimates, 1 in 10 canadians currently have kidney disease; that’s 4 million people, with most being completely unaware of this. getty
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kidneys are vital to your overall health. these remarkable organs remove waste from your body through urine, help produce red blood cells and regulate blood pressure. one of their primary functions is to filter waste from the blood and return the cleaned blood back into circulation.
kidney disease is common in people living with diabetes, with up to one-half demonstrating signs of kidney damage in their lifetime. all individuals with chronic kidney disease (ckd) are also considered a high risk for cardiovascular events and should be treated to reduce this risk. therefore, understanding the connection between diabetes, heart health, and kidney function is crucial for maintaining kidney health.
ckd is especially dangerous because it’s a silent threat — it often has no symptoms until the disease has reached an advanced stage or complications have developed. this means that people can have ckd without even knowing it.
according to recent estimates, 1 in 10 canadians currently have kidney disease; that’s 4 million people, with most being completely unaware of this.
ckd occurs when the kidneys are damaged which affects their ability to filter the blood. the condition is divided into five stages, ranging from mild loss of kidney function (stage 1) to end-stage kidney failure (stage 5), the point at which the kidneys have failed or are close to failure and may require dialysis or a kidney transplant.
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a holistic approach to care
some of the common risk factors for kidney disease include living with diabetes, high blood pressure or having a family history of kidney disease.
“diabetes is a major factor for kidney disease progression, and as many as 50 per cent of people who live with either type 1 or type 2 diabetes (t2d) develop evidence of kidney disease at some point during their lifetime,” says dr. david cherney, professor of medicine and gabor zellerman chair in nephrology research at the university of toronto and a nephrologist at the university health network and mount sinai hospital. “diabetes is by far the most common cause of kidney disease in canada.”
both diabetes and high blood pressure put added stress on the body. high blood sugar can lead to damaged blood vessels, including the kidney filters, causing decreased kidney function. controlling blood pressure is one of the most effective ways to slow the progression of kidney disease. high blood pressure can scar the filters in your kidneys, leading to decreased kidney function. high blood pressure is also the number one risk factor for stroke and a major risk factor for heart disease.
“when these conditions coexist, this accelerates the risk of kidney disease as well as the risk of related cardiovascular disease,” says dr. cherney.
dr. david cherney is a professor of medicine and gabor zellerman chair in nephrology research at the university of toronto and a nephrologist at the university health network and mount sinai hospital. supplied
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given the connection of these conditions, dr. cherney advocates for a holistic approach to care. “probably the biggest misconception is that diabetes, kidney disease and heart disease are separate conditions and that they’re treated by individual specialists,” he says. “in reality, they’re interconnected, and we’re recognizing more and more that as doctors, we’re all involved in the totality of care, from the heart and kidneys to blood sugar and weight management.”
screening is essential
if you have t2d or high blood pressure, both you and your health-care professional (hcp) play key roles in helping detect kidney disease. early diagnosis and treatment are critical when it comes to ckd, as identifying kidney disease sooner may help reduce the potential for serious complications down the road. appropriate treatment, along with diet and exercise, can help delay the progression of the disease and reduce the risk of conditions like cardiovascular complications, kidney failure or death.
to identify kidney disease early, screening is essential. “if we screen for kidney disease in the context of diabetes, there’s a very high chance that we’ll actually be able to detect it,” says dr. cherney.
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there are two tests available to everyone at risk, including those living with t2d or high blood pressure that can help assess kidney function and identify signs of damage or injury: the urine albumin-to-creatinine ratio (uacr) and the estimated glomerular filtration rate (egfr) tests. the uacr is a urine test that detects protein in the urine, providing information about the kidneys’ health, while the egfr is a blood test that measures how well the kidneys are filtering the blood. both tests should be a part of regular screenings for people with diabetes or high blood pressure.
“we see that, in practice, less than half of people with diabetes actually end up having these important screening tests, which can identify ultimately life-threatening conditions,” says dr. cherney. “kidney disease is life-threatening. cardiovascular disease is life-threatening. and so these tests have to be prioritized.” he encourages high-risk patients to advocate for early and complete testing, and for health-care practitioners to ensure that these tests are ordered on a yearly basis at minimum.
besides screening, the basics of self-management are as pertinent as ever. “the foundation for managing kidney disease is always lifestyle: exercising, eating a healthy and individualized diet, maintaining a healthy body weight and controlling blood pressure and blood sugars,” says dr. cherney.
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if you are living with diabetes, have high blood pressure, or have a family history of kidney disease, you’re at risk at developing ckd. take a step towards better health by talking to your health-care provider about getting screened for kidney disease.
visit itsconnected.ca to learn more about the link between type 2 diabetes, your heart and your kidneys.
this story was created by healthing content works, healthing.ca’s commercial content division, on behalf of boehringer ingelheim.
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