What are five common causes of kidney disease?

 What are five common causes of kidney disease?

The kidneys, though small, play crucial roles in removing waste and maintaining fluid balance in the body. They regulate levels of key nutrients and control blood pressure, contributing to overall health. When functioning properly, they operate like a well-oiled machine. However, various health conditions can disrupt their function, potentially leading to kidney failure if left untreated. According to experts like nephrologist Cassandra Kovach, MD, high blood pressure and diabetes are the primary causes of chronic kidney disease, both of which are often preventable. The Centers for Disease Control and Prevention (CDC) report that these conditions account for three-quarters of kidney failure cases in the United States. Understanding these common causes and managing associated risk factors is essential for kidney health.

Diabetes, whether Type 1 or Type 2:

Diabetes, whether Type 1 or Type 2, stands as the leading cause of kidney failure in the US, according to the NIDDK. Roughly one-third of all adults with diabetes also grapple with kidney disease.

"When you have too much glucose in your blood, over time it damages both the blood vessels and filters in your kidneys," explains Dr. Kovach. Ultimately, this damage can impair your kidneys' ability to function properly.

If you have diabetes, Dr. Kovach advises having your urine checked at least annually to detect any protein presence—a potential sign of kidney issues. Tight control of your diabetes is also crucial. "Diabetes is one of the most modifiable risk factors," notes Dr. David Goldfarb, Clinical Chief of Nephrology at NYU Langone Health.

A study published in The Lancet in 2018 revealed that about half of people with Type 2 diabetes who participated in an intensive weight-management program achieved complete remission. Remission, in this context, refers to their average blood glucose levels returning to normal without diabetes medications.

While adhering to a rigorous weight-management program can be challenging, simple lifestyle adjustments such as dietary changes and regular exercise—such as brisk walking—can significantly help.

Before embarking on any new diet or exercise regimen, it's essential to seek guidance from your healthcare provider to ensure safety. They can also routinely monitor your A1C levels—a blood test reflecting your average blood glucose level over the past three months. For most individuals, the target A1C is below 7%, as per the NIDDK's recommendation.

High blood pressure:

High blood pressure ranks as the second leading cause of kidney failure in the United States, trailing behind diabetes, according to the NIDDK.

The adverse effects of high blood pressure on the kidneys stem from its ability to damage blood vessels within these vital organs. As Dr. Goldfarb explains, this damage can impede the kidneys' ability to adequately filter waste and excess fluid from the body. Furthermore, the accumulation of extra fluid within blood vessels can exacerbate high blood pressure, perpetuating a harmful cycle.

Dr. Kovach emphasizes that the most effective strategy to slow or prevent kidney disease caused by high blood pressure is to manage blood pressure levels. Individuals with elevated blood pressure—considered anything over 120/80, per the American Heart Association (AHA)—can potentially lower it through lifestyle adjustments.

These lifestyle changes are pivotal for overall well-being and may involve maintaining a healthy weight, engaging in regular exercise, adhering to a suitable diet, and refraining from smoking or quitting if currently smoking.

The NIDDK outlines several dietary recommendations to promote kidney health, including:

• Reducing salt intake
• Consuming appropriate portions of protein to lessen strain on the kidneys
• Opting for heart-healthy food preparation methods, such as grilling or roasting instead of frying, while limiting trans and saturated fats
• Choosing foods and beverages with lower phosphorus content (e.g., meats, dairy, beans, nuts)
• Ensuring an adequate but controlled intake of potassium-rich foods and drinks

For individuals diagnosed with kidney disease and concurrent high blood pressure, healthcare providers may prescribe medications to manage blood pressure effectively. Notably, angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) have demonstrated efficacy in both reducing blood pressure and slowing kidney disease progression, according to Dr. Goldfarb.

Furthermore, it's common for individuals with both conditions to require at least two medications to achieve optimal blood pressure control. Additionally, diuretics may be prescribed to facilitate fluid and sodium elimination from the body, aiding in blood pressure regulation by reducing blood volume.

Glomerulonephritis:

Glomerulonephritis, as outlined by StatPearls, denotes inflammation of the kidney's filters, known as glomeruli. According to the National Kidney Foundation (NKF), there are two main types: acute and chronic.

Dr. Robert Greenwell, Chief of Nephrology at Mercy Medical Center, explains that acute glomerulonephritis can result from bacterial infections like strep throat or autoimmune diseases such as lupus. Its symptoms typically include facial swelling, blood in the urine, and decreased urine output.

Chronic glomerulonephritis, on the other hand, may have a genetic basis or arise from autoimmune disorders. It can also develop years after an acute episode. Symptoms resemble those of kidney failure, including urinary protein loss, ankle swelling, and nocturia.

If symptoms manifest following a bacterial infection like strep, prompt medical attention is crucial, advises Dr. Greenwell. In cases of acute glomerulonephritis, timely intervention may involve temporary dialysis to alleviate fluid overload and forestall kidney failure. Additionally, in rapidly progressing cases, plasmapheresis—a procedure to filter harmful proteins from the blood—may be necessary, as per the NKF.

Polycystic kidney disease;

Polycystic kidney disease, according to MedlinePlus, is a genetic disorder characterized by the formation of cysts on the kidneys. These cysts hinder the kidneys' ability to filter waste products from the blood. The condition affects approximately 500,000 people in the United States, typically manifesting in adulthood at a rate of about 1 in 500 to 1,000 individuals.

Symptoms often go unnoticed until the cysts reach a significant size, usually at least half an inch. Dr. Richard Glassock, Professor Emeritus at the David Geffen School of Medicine at UCLA, explains that by this point, patients may experience bloating, discomfort, and a diminished appetite due to kidney compression against the digestive organs. Other indicators may include back or side pain, blood in the urine, headaches, high blood pressure, and kidney stones.

MedlinePlus notes that around 90% of individuals with polycystic kidney disease inherit it from their parents, while approximately 10% develop the condition without a family history. Genetic testing or further evaluation by a healthcare provider can help ascertain familial predisposition.

Management typically involves blood pressure medication to mitigate hypertension and slow kidney disease progression, along with a low-sodium diet, as recommended by Dr. Glassock. Additionally, tolvaptan, an FDA-approved vasopressin receptor antagonist, may be prescribed to decelerate disease advancement.

Kidney obstructions:

as explained by Dr. Kovach, can result from factors such as kidney stones or an enlarged prostate gland in males. These obstructions hinder the drainage of urine from one of the kidneys, leading to kidney swelling.

The primary symptom of kidney obstructions is flank pain, often accompanied by pain during urination and increased frequency of urination. In some cases, individuals may also experience nausea and fever if urine backup triggers an infection.

Healthcare providers typically begin by examining urine for signs of blood or bacteria to detect infection and rule out kidney stones. Blood tests may also be conducted to assess kidney function, and a kidney ultrasound may be performed if abnormalities are suspected.

Treatment revolves around addressing the underlying cause. Infections may require antibiotics, while kidney stones may necessitate medications and possibly surgical intervention. In certain instances, healthcare professionals may drain trapped urine from the bladder using a catheter. Dr. Kovach emphasizes the importance of prompt intervention to prevent permanent kidney damage.