Five Reasons to Care About the Risks of Chronic Kidney Disease

The kidneys are a multi-tasking marvel, filtering the blood and balancing our body’s fluids every second of the day and night. If this complex cleaning system becomes impaired, chronic kidney disease (CKD) can develop, an underrecognized and incurable condition that is, amongst other risk factors such as high blood pressure or smoking, closely linked to diabetes and heart disease. Here are five reasons to recognize the risks of CKD.

The health of the kidneys is key to our survival.

The kidneys are the size of two clenched fists, and they fight hard to protect our bodies from harm. Acting as a chief purification system, the kidneys perform a life-sustaining balancing act of filtering excess waste and fluid from the blood (at the rate of about 140 liters per day) and balancing important electrolytes such as sodium and potassium, and help regulate blood pressure.¹ When the kidneys are damaged, they may not work as well as they should. If the damage continues to get worse, this can result in chronic kidney disease, which means a gradual loss of kidney function over a period of months to years,² causing wastes to build up in the body, as the kidneys are increasingly unable to balance the salts and minerals, filter waste products, help control blood pressure and produce red blood cells. 

The kidneys and the heart work hand in hand.

The kidneys and the heart have a symbiotic relationship in regulating blood pressure. The heart pumps at least 10,000 liters of oxygen-rich blood per day throughout all parts of our bodies, enabling the kidneys to perform their job.³ Neither organ could function properly without the other, which is why having heart disease is a risk factor for developing kidney disease and vice versa.⁴ Over time, if CKD goes untreated, it increases a patient’s risk of heart attack, stroke, and heart failure.⁵ 

Millions of people with type 2 diabetes will develop CKD.

Of the approximately 400 million people living with type 2 diabetes worldwide, up to 40% will develop CKD.⁶ Despite guideline-directed medicines, and maintaining well-controlled blood sugar levels and blood pressure, CKD still progresses in many patients, which can considerably shorten their lives.^7,8,9 Chronic kidney disease in type 2 diabetes leads to an increased risk of cardiovascular events and is the main cause of end-stage kidney disease, which means patients ultimately require dialysis or a kidney transplant to stay alive.¹⁰ Therefore, everyone with type 2 diabetes should regularly be monitored by their doctor for the earliest signs of kidney disease.¹¹

Chronic kidney disease is a silent and underrecognized disease.

An insidious disease, CKD progresses gradually and silently, as most patients have no symptoms in the early stages. As the condition worsens, many patients experience symptoms only in the later stages of the disease. Swollen legs, ankles or feet, fluid in the joints, tiredness, nausea, muscle cramps, pain, and memory problems, may be among the warning signs. The only way to know if you have CKD is to have a doctor check whether there is albumin (a protein) in your urine which is a sign of kidney damage, and to do a blood test measuring kidney function, to see how well your kidneys are filtering your blood.¹²

Chronic kidney disease is treatable, but early diagnosis is important.

There is no cure for CKD, but the risk of its life-threatening consequences – cardiovascular events as well as end-stage kidney disease – may be reduced by effective preventive measures and advances in treatment. For example, a healthy diet and lifestyle, well-controlled blood pressure and blood glucose levels are vital. Despite these measures, patients with CKD and T2D remain at risk of CKD progression, therefore it is important to get regular medical check-ups. Everyone at risk should talk to their doctor about getting tested, with a urine test and a blood test, to measure kidney damage and kidney function.

References

¹ National Institute of Diabetes and Digestive and Kidney Disease 2018. Your Kidneys & How They Work. Viewed June 16, 2021, https://www.niddk.nih.gov/health-information/kidney-disease/kidneys-how-they-work
²Kidney Research UK. The Kidneys – a Basic Guide. Viewed June 16, 2021. https://www.nhs.uk/Livewell/Kidneyhealth/Documents/kidney%20guide.pdf
³Library of Congress, Biology and Human Anatomy. What is the strongest muscle in the human body? Viewed June 16, 2021. https://www.loc.gov/everyday-mysteries/biology-and-human-anatomy/item/what-is-the-strongest-muscle-in-the-human-body/ 
⁴National Kidney Foundation. The Heart and Kidney Connection. Viewed June 16, 2021. https://www.kidney.org/atoz/content/heart-and-kidney-connection 
⁵American Kidney Fund. Heart disease & chronic kidney disease (CKD). Viewed June 17, 2021. https://www.kidneyfund.org/kidney-disease/chronic-kidney-disease-ckd/complications/heart-disease/#:~:text=Complications%20of%20CKD%20and%20heart%20disease,-There%20are%20several&text=High%20blood%20pressure%3A%20Damaged%20kidneys,congestive%20heart%20failure%20and%20stroke. 
⁶National Institutes of Health. Diabetic Kidney Disease. Viewed June 16, 2021. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7724636/;
International Diabetes Federation. Diabetes and the kidney. 2020. Available at: https://idf.org/our-activities/care-prevention/diabetes-and-the-kidney.html
⁷Anders H J, et al; Nat Rev Nephro. CKD in diabetes: diabetic kidney disease versus nondiabetic kidney disease. 2018;361-377. Viewed June 16, 2021. https://pubmed.ncbi.nlm.nih.gov/29654297/ 
⁸Thomas M C, et al; Nat Rev. Diabetic kidney disease. 2015;1:1-19. Viewed June 16, 2021. https://pubmed.ncbi.nlm.nih.gov/27188921/
⁹Wen C P, et al; Kidney Int. Diabetes with early kidney involvement may shorten life expectancy by 16 years. 2017;92:388-396. Viewed June 16, 2021. https://pubmed.ncbi.nlm.nih.gov/28577854/ 
¹⁰National Institute of Diabetes and Digestive and Kidney Disease. The Link Between Diabetes and Kidney Disease. March 4, 2020. Viewed June 16, 2021. https://www.niddk.nih.gov/health-information/professionals/diabetes-discoveries-practice/the-link-between-diabetes-and-kidney-disease
¹¹American Diabetes Association (ADA) Standards of Medical Care in Diabetes. Diabetes Care 2019;42(Suppl. 1):S124–S138. 11. Microvascular Complications and Foot Care. Viewed June 17, 2021. https://care.diabetesjournals.org/content/42/Supplement_1/S124 
¹²National Kidney Foundation. Diabetes - a Major Risk Factor for Kidney Disease. Viewed June 17, 2021. https://www.kidney.org/atoz/content/diabetes