March 29, 2011 in Features

Symptoms may be pointing to kidney disease

Dr. Alisa Hideg

Most everyone knows that your kidneys clean your blood and that you eliminate what the kidneys clean out in the form of urine.

But did you also know that your kidneys produce vitamin D and release hormones that regulate your blood pressure and control the production of red blood cells?

Chronic kidney disease (CKD) is when your kidneys lose their ability to do these jobs over time. Most people in the early stages of the disease do not even know that they have it.

Those early symptoms may be mild and can include fatigue; poor appetite; muscle cramps at night; swollen feet and ankles; puffiness around the eyes (especially in the morning); dry, itchy skin; and a change in urination frequency.

Many of these symptoms also happen with other diseases, so how do you know if you have chronic kidney disease or if you are at risk for it?

There are a number of causes, including high blood pressure, diabetes, autoimmune diseases, inherited kidney malformations and diseases, kidney stones, tumors, an enlarged prostate gland and repeated urinary infections.

It can be helpful to know if you are at a higher risk of developing chronic kidney disease, and should be more alert for the onset of symptoms.

Having diabetes, high blood pressure and a family history of CKD, being older, or belonging to certain ethnic groups can all make you more at risk for developing the disease.

As with so many diseases, it is impossible to have an impact on many of the risk factors. But the ones you can do something about, you should.

In December, I wrote about a friend who is getting a kidney from her brother. I asked her what she would say if she could tell other people with chronic kidney disease anything she wanted.

She said, “Do everything your doctor tells you to, especially when it comes to your blood pressure.”

This makes sense because no matter what the cause of your chronic kidney disease, controlling your blood pressure, your blood sugar and other factors that can affect kidneys may stop or slow down further damage.

Whichever risk factors you have for CKD, your health care provider is likely to recommend regular exercise and dietary changes (i.e., lower salt, sugar and protein intake) to make you healthier and to lower your risk.

If you already have diabetes or high blood pressure, your doctor may recommend medication for these conditions.

When a person has lost 85 to 95 percent of kidney function, a doctor will usually recommend dialysis. Some people choose to stay on dialysis for the rest of their lives, while others seek a kidney transplant.

Dialysis cleans your blood when your kidneys can no longer do it adequately, but it is difficult for doctors to help you compensate for the other jobs your kidneys perform.

They clean your blood 24/7, whereas typical dialysis treatment is for three or four hours, three times a week. Many people report fatigue and a “washed out” feeling after their treatments. Going to dialysis several times a week can also feel a bit overwhelming.

You can read about types of dialysis and your choices for where to have it done at either the National Kidney Foundation website ( Topic_Dialysis.cfm) or the National Kidney and Urologic Diseases Information Clearinghouse website ( kudiseases/topics/dialysis.asp).

Kidney transplants have their pros and cons, too. There are no more trips to the dialysis center, and no more ups and downs from the treatment.

But there is always risk associated with surgery and anesthesia, the possibility of rejection of the kidney, and the need to take anti-rejection medication every day for the rest of your life.

No treatment for kidney failure is perfect. It is easy to see why keeping your kidneys as healthy as you can is important.

If you have risk factors for chronic kidney disease, talk to your doctor and find out what you can do to keep your kidneys healthy and whole.

Dr. Alisa Hideg is a family medicine physician at Group Health’s Riverfront Medical Center in Spokane. Her column appears every other Tuesday in the Today section. Send your questions and comments to

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