Dr. Anthony Cusano, a board certified Nephrologist in Waterbury, Connecticut spoke with us about kidney disease. Dr. Cusano practices at Connecticut Kidney and Hypertension Specialists and is an Associate Clinical Professor at Yale University School of Medicine.
He shared some of his vast knowledge with us about the importance of our kidneys and how to keep them healthy.
Understanding Kidney Disease
Chronic kidney disease ("CKD") affects more than 25 million adults in the US, however many of us are not aware of it, and it can happen at any age.
Your kidneys are vital organs that contribute to your overall health. In fact, one fifth of every heartbeat flows directly into the kidneys. Each of our two kidneys is filled with a million tiny nephrons that work to filter the blood, regulate blood pressure and help the body maintain the balance of many essential nutrients, vitamins, minerals, water and other chemicals in the body.
But what happens when the kidneys can’t do their job?
What is Chronic Kidney Disease?
The human body can function on half the number of nephrons because the remaining nephrons adapt and get larger to accommodate. When a person’s kidneys have less than half the normal number of nephrons, their remaining nephrons have to work very hard, and that is chronic kidney disease.
Eventually the nephrons progressively wear out faster than normal, which leads to kidney failure. This can be treated with dialysis, which does the job of the nephrons, or with a kidney transplant, but it is better for the patient to preserve the remaining nephrons with proactive life style changes and treatment so that kidney failure doesn’t happen.
How Do Doctors Detect Chronic Kidney Disease?
Kidney conditions can have symptoms like unusually frequent urination, excessive thirstiness, foamy urine (caused by a buildup of protein in the kidneys), swollen feet or ankles, insomnia and more. Diabetes and hypertension are also closely linked to chronic kidney disease, so staying aware of kidney function can prevent more severe illness in the future.
Doctors can discover kidney damage with blood tests that measure overall kidney function, or through urine tests that measure proteins and cells in the urine that indicate that the nephrons are being damaged or working too hard. They may also perform an ultrasound or CT scan to check the size of the kidneys and whether or not there are kidney stones or tumors present. In extreme cases, physicians will perform a biopsy of a small piece of the kidney to check for specific damage or disease.
While hypertension and diabetes are the main causes of chronic kidney disease, other conditions can contribute. Smoking negatively impacts every organ, including the kidneys. Urinary tract blockages from prostate disease in men or dropped bladders in women can also cause CKD. Certain blood cancers are toxic to the kidneys, and inflammatory diseases like systemic lupus erythematosus can cause kidney problems. There are also kidney-specific diseases that can cause chronic kidney disease, known as glomerulonephritis, or polycystic kidney disease.
How Is Chronic Kidney Disease Treated?
In cases where the nephrons are healthy enough to function and no dialysis is needed, the most common treatments for chronic kidney disease include: diet, medication to control blood pressure, and treatment for any underlying conditions that are causing nephron damage, like lupus.
Conditions like glomerulonephritis and polycystic kidney disease are not always treatable with medications, so a healthy diet and good blood pressure are the key to keeping chronic kidney disease manageable. In certain cases, medication is prescribed to battle anemia, a condition that occurs because the kidneys produce a substance that prevents red blood cells from forming.
Additionally, medicines to supplement vitamin D, to keep phosphorus out of the body or to reduce bodily acids are sometimes used to treat the complications of reduced kidney function.
- Salt - As for diet, it is absolutely essential to monitor the amount of salt consumed. The kidney, especially when compromised by disease, has to work especially hard to filter salt, causing the body to retain it.
A person with normal kidney function can get rid of a day’s worth of salt in two days, while a person with kidney disease hangs on to it for a week or more. Processed foods are full of salt, so avoiding cold cuts, cheeses, cured meats and other high sodium foods is important.
- Protein - It’s also important to pay close attention to the type of proteins ingested. Diseased kidneys have to work very hard to process protein, which is why it’s best to stick to vegetable protein because the body absorbs it slower and it is less toxic to the system.
- Fats - Avoiding saturated fats can keep blood pressure down and give the kidneys less to do, allowing them to function more easily. It's better to stick to unsaturated fat sources such as polyunsaturated and monounsaturated fats. Examples are nuts, olive oil, and fish.
A healthy diet and regulated blood pressure are great ways to keep your kidneys functioning the way they should. In addition, it’s important for a patient with chronic kidney disease to have regular visits with their nephrologist. Your doctor can make sure your medications are working the right way and monitor kidney activity to make sure the disease is not progressing.
If you have additional questions about kidney disease, you may want to check out Dr. Cusano's website at www.ctkidneyspecialists.com, or if you want to learn about our clinical trial enrolling participants with Chronic Kidney Disease, don't hesitate to contact us using the button below!