Your Kidneys And a Brown Paper Bag
01 Sep 2002
Can a brown paper bag decrease the epidemic of renal disease in this country? Today, more than 20 million North Americans suffer from chronic kidney disease. That’s 1 in 9 adults. Another 20 million are at risk.
But the number of cases is growing. A report from Johns Hopkins University claims the number of people with advanced kidney disease has doubled during the last 10 years. And the number with end-stage kidney disease who require renal dialysis is growing at the rate of 7 percent a year. And it’s creating a huge economic problem.
Some people are more prone to renal disease than others. Getting older gradually decreases kidney function. Certain ethnic groups such as African-Americans, Asians and Hispanics have a higher risk of developing kidney disease.
Others are born with polycystic kidneys that function poorly. Or early in life some patients may develop glomerulonephritis, a chronic renal disease.
But the current epidemic of diabetes is primarily responsible for the huge increase in kidney disease. It’s almost beyond belief that every 45 seconds a new diabetic is diagnosed in North America. And one child in five born today is destined to develop this illness.
Diabetes results in atherosclerosis which narrows arteries, decreases blood supply and damages kidneys, heart and other vital organs.
Another major problem is hypertension. It’s estimated that 50 million North Americans have high blood pressure and only 10 million are being adequately controlled by medication. This excess pressure is constantly pounding and injuring the kidneys’ microscopic tissues.
But how can a brown paper bag help? I often say to patients, “Put all your medicines in a brown paper bag and bring it to me at the next visit.” Time and time again I’m amazed at the huge assortment of medications that patients dump onto my desk.
For this there is often a price to pay. For instance, minor painkillers, taken to excess, can result in renal damage and the eventual need for kidney dialysis. Never forget that every drug we consume has to be processed and removed by the kidney. And like any other organ it can tolerate only so much abuse.
For years I’ve written that today’s society is addicted to “pillitis”. It requires a pill for every ache and pain. As Sir William Osler once remarked, “The one thing that separates man from animals is man’s desire to take pills.”
What people don’t understand is that, unlike a headache or an irritable bowel, chronic renal disease is a silent killer. Symptoms appear only after the kidney has suffered significant damage. And luckily you can live a normal life with 50 percent of kidney function has been destroyed. That’s why it’s possible to donate one kidney and still survive.
Finally, when symptoms appear patients complain of fatigue, headache and dry itchy skin. Later, as kidney function further deteriorates patients complain of nausea and they may pass urine frequently or less often. Finally, swelling of the feet occurs and fluid collects in the heart and lungs.
Regular checkups can detect kidney disease. A urine test measures the amount of albumin, a protein that appears when renal function is impaired. Blood tests will also show an increase in creatinine, a breakdown product of muscle metabolism.
The best way to protect kidneys is to keep thin and protect yourself from diabetes. Today 90 percent of diabetics are obese. But if diabetes is already present it must be carefully monitored by either pills or insulin to decrease the risk of renal failure.
Kidney disease cannot be cured once it has developed. But treating diabetes and hypertension can decrease its progression. To treat hypertension drugs known as ACE inhibitors will reduce blood pressure. This lessens the amount of work that the kidneys must do. It’s been shown that by using ACE inhibitors patients who are destined for renal dialysis can postpone this need for several years.
My advice is to be careful you don’t overload the brown paper bag with questionable medication. Renal dialysis is not a pleasant way to live.
