Kidney Disease Healthy Christian Presentation May 25, 2016

Your Kidneys and You

Kidneys How Many? Two Kidneys Where are they? On either side of the spine at the lowest level of the rib cage Major Functions? Removes waste products and excess fluid from the body Filtering 200 quarts and returning filtered to the bloodstream Balance the body’s fluids Release Hormones that Regulate blood pressure Produce an active form of Vitamin D (bone health) Control the production of red blood cells

Chronic Kidney Disease Definition : Having some type of kidney abnormality or “marker” such as protein in the urine and having decreased kidney function for 3 months or longer Causes : High Blood Pressure (Hypertension) Diabetes (inadequate or resistance to insulin) Polycystic Kidney Disease Inherited Formation of cysts on the kidneys that grow May cause serious damage and even kidney failure

Other Kidney Diseases Other Kidney Diseases: Alport’s Syndrome Primary Hyperoxaluria Cystinuria Glomerulonephritis Inflammation of the filtering units (glomeruli) Damage from Drugs-NSAIDs, Heroin, Crack, Pesticides Kidney Stones Severe pain in your back and side Can be Related to medications (e.g. topirimate) and diet Can be inherited disorder that causes too much calcium to be absorbed from foods and UTIs Can pass but if too large-can be broken into smaller pieces (lithotripsy)

Chronic Kidney Disease RISK FACTORS Older age Diabetes High blood pressure Family member who has chronic kidney disease RACE African American Hispanic Asian Pacific Islander American Indian

Detecting Chronic Kidney Disease Albumin to Creatinine Ratio (ACR) -amount of albumin (protein) in your urine -excess indicates damage of the filtering units Blood Creatinine eGFR (estimated glomerular filtration rate) -an estimate of kidney function -less than 60 indicates kidney disease Ask your doctor to check one or more of these if you are at increased risk

Signs/Symptoms of Early Kidney Disease NONE

Signs of Kidney Disease High Blood Pressure Blood and/or Protein in the Urine Abnormal Creatinine and BUN (Blood Urea Nitrogen) GFR (glomerular filtration rate) <60 Urinary frequency Dysuria (painful urination) Puffiness around eyes, swelling of hands and feet (fluid reten tion)

How is Kidney Disease Treated? Careful Control of blood sugars Careful Control of high blood pressure ACE inhibitors (ACE-angiotensin converting enzyme) helps slow progression of CKD Peritoneal Dialysis Generally done at home Continuous cyling-requires use of a machine Continuous Ambulatory –doesn’t require machine Hemodialysis Usually three times a week Artificial kidney-machine through which the blood passes and is filtered Kidney Transplantation

AFRICAN AMERICANS AND KIDNEY DISEASE 3X more likely to experience kidney failure than Caucasians 35% of all patients in US receiving dialysis (although AAs comprise only 13% of overall US population) Progresses 5X faster to Kidney Failure Diabetes- #1 of leading cause of kidney failure in AAs Type 2 Diabetes is the most common in AAs High Blood Pressure-2 nd leading cause of kidney failure

AFRICAN AMERICANS AND KIDNEY DISEASE Risk Factors: HTN, DM, Inactivity, Large Waist size, Older age, POVERTY (worse for AA than white) Detected at later stages-secondary to provider bias’ Study of 3400 AA pts showed that although 20% had CKD, only ~15% knew it ONLY 1 in 6 knew that they had kidney disease Associated with increased risk for Heart disease & HTN ASK FOR YOUR URINE TO BE CHECKED FOR PROTEIN (ACR)