World Kidney Day

Have we turned the corner on kidney disease?

I came of age as a kidney specialist during the rise of the American kidney epidemic. Kidney disease used to be an interesting little corner of human pathology, however over the last 30 years this obscure corner has risen to be a major problem.

Every March, during Kidney Awareness Month the stories were the same: more people with diabetes, more hypertension, more obesity and, most tragically, more and more patients on dialysis.

We, in the nephrology community, became increasingly frantic and strident as we pressed to head off this growing epidemic. We educated people about kidney health. We prescribed more blood pressure medications and newer, more effective, blood pressure medications. We advised patients to stop gaining weight and start exercising. We researched new diets low in sodium and rich in potassium and calcium. We created international practice guidelines and started local educational initiatives.

The National Kidney Foundation of Michigan went to barbershops and beauty shops around the state and trained the barbers and cosmetologists to talk about kidney disease and health issues with their clients. The NKF of Michigan spoke at churches, to HeadStart, and fraternal organizations. These and other outreach programs reached over 100,000 Michiganders.

Despite all this work and energy it felt futile as the rates of disease rose year after year. Until it didn’t rise. And then it went down. And then it fell for another year. We pinched ourselves and didn’t wake up. This is the first World Kidney Day where we can accept that the epidemic that had been raging our entire careers had peaked. In 2006, Michigan had 390 people start dialysis per million citizens. Since then the rate has plummeted.

The current is changing; we are beating kidney disease. For a while it felt like there was inevitability to the epidemic, but now we know that we can turn this around. Actions that we take, make a difference.

What you can do prevent kidney disease:

• Control your blood pressure between 120/70 and 140/90
• Measure your blood pressure at home and bring the readings to your doctor to discuss the results
• If you have diabetes, keep your blood sugars under control, aim for a hemoglobin A1c of less than 7
• Exercise
• Avoid unnecessary use of NSAIDs like ibuprofen, Advil, Motrin and Aleve
• Talk to your doctor about your risk of kidney disease and if you should see a kidney specialist

There was a time when a patient with kidney disease was told to drink more water dismissed out of futility, thankfully, those days are over.