Thursday, March 9, 2017

Most people with kidney disease don’t know they have it, yet more than 26 million Americans are diagnosed with kidney disease and suffer the consequences, according to the National Kidney Foundation. Approximately one-in-three Americans are at risk due to diabetes, high blood pressure or a family history of the ailment.

March is National Kidney Month. Gaurav Gupta, M.D., transplant nephrologist at VCU Health’s Hume-Lee Transplant Center, offers critical information about kidneys, kidney disease and what VCU Health can do to help.  

What function does the kidney serve in the body?

The kidneys function as the body’s waste removal system and chemical factory. Most people are aware that kidneys remove waste and excess fluid, which is then eliminated as urine. But, they also produce hormones to stimulate red blood cell production, regulate blood pressure and manage the delicate balance of salt, potassium and acid in the body.

What lifestyle habits are important to maintain a healthy kidney?

Like other organs, kidneys need a healthy diet to perform optimally. A moderate salt-limited diet that is full of healthy, whole foods can help you avoid high blood pressure and diabetes, the two most common causes of kidney disease. Regular exercise is also helpful. Avoid smoking and overuse of NSAID medications such as ibuprofen and naproxen, as they are filtered through the kidneys. If you do rely on NSAIDS for a chronic pain issue, do so only under the care of a doctor.

What are signs of kidney disease?

Often there are no symptoms of kidney disease until it has progressed to a late stage. At that point, warning signs can include high blood pressure, frequent or painful urination, the presence of blood or protein in the urine, swelling of the hands and feet due to a build-up of fluids in the body, and a higher than normal amount of waste in your blood that can be detected through a blood test. Since kidney disease is a “silent killer,” seeing a primary care doctor on a regular basis could [help] detect the disease early and prevent further progression.

What medical methods are available to treat kidney failure?

Early stage kidney failure is treated primarily by targeting the cause of kidney disease. Most patients need to be referred to kidney specialists, called nephrologists. Once kidney failure reaches end stage, a patient will require either regular dialysis to perform the necessary functions of the kidneys or a kidney transplant to replace the failed kidneys with a donor’s healthy kidney. Although dialysis is lifesaving in the short term, in the long term it can have detrimental consequences with high complication rates. A kidney transplant on the other hand has improved long-term outcomes. Kidney transplantation typically has a very high success rate at large and experienced transplant centers like the Hume-Lee Transplant Center. Research shows that transplanting the kidney prior to end-stage disease and limiting dialysis time improves outcomes and shortens patient recovery.

How does kidney failure effect quality of life?

Our bodies simply cannot survive without a functioning kidney. When dialysis is the treatment method of choice, patients are required to be connected to the dialysis machine for several hours a day, several days a week. This significantly diminishes quality of life and carries a host of side effects such as heart problems, strokes and vascular problems that continue to progress. A kidney transplant can minimize many of these problems.

What are the benefits of a kidney transplant?

“A living donor can be a relative, a loved one or friend, or a stranger willing to donate a kidney without knowing the recipient.”

A kidney transplant can return a patient back to a state of good kidney function, without forcing them to be tethered to a dialysis machine. This has made it the standard of care for most patients. Living kidney donation offers the best chance of a good outcome, while eliminating the need to wait on the national organ transplant list — a wait that can take years while a patient’s kidney failure continues to progress. A living donor can be a relative, a loved one or friend, or a stranger willing to donate a kidney without knowing the recipient. In 2016, approximately 35 of Hume-Lee’s patients received a living kidney, and we expect this number to grow as we continue to introduce new innovations that improve the experience and outcomes for our donors and recipients.

How does VCU Health medically treat its kidney patients?

VCU Health has a dedicated team of kidney specialists who have special expertise in different aspects of kidney disease including glomerulonephritis, diabetic kidney disease, kidney stones and high blood pressure. If a patient has advanced kidney failure, options for dialysis include in-center hemodialysis as well as home therapies including peritoneal and hemodialysis. All patients are also referred to the kidney transplant center for evaluation to assess whether transplant is a good option. The kidney transplant center is highly equipped and well known in the region for dealing with medically/surgically complex patients and highly sensitized patients with prior failed kidney transplants. Several of our patients have been declined at other centers prior to referral to VCU. All patients are followed in the post-transplant clinic for several months to ensure their recuperation. After that, they’re given the option to return to their local doctors. For more information, visit vcuhealth.org/transplant.

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