Protect Yourself from Kidney Disease

It’s not too late to reduce your risk of this dangerous complication

Like fine lace, all of your body’s systems are intricately woven together, each depending on the other to function. When your blood sugar goes haywire, for example, your blood pressure climbs. “High blood pressure can damage the blood vessels in your kidneys and can eventually destroy them,” says kidney specialist (nephrologist) Nelson Kopyt, D.O., of Lehigh Valley Hospital and Health Network. “That’s why it’s best to control blood pressure and blood sugar to prevent kidney disease and other complications.”

Your kidneys, two bean-shaped organs located near the middle of the back, filter waste from your blood and make urine. Then your kidneys send the urine to your bladder so it can be excreted. “Normal blood sugar levels help regulate the pressure inside your kidney’s delicate capillaries and protect them from damage,” Kopyt says.

Detecting kidney problems

“We used to call hypertension the silent killer, because it damaged the kidneys and you had no idea it was happening until you had kidney failure,” Kopyt says. Today there are tests to check your kidneys and detect disease earlier. Ask your doctor about these tests:

Urine test. This test checks for microalbuminuria (MY-crow-al-BYOO-min-OO-ree-uh), which are small amounts of the protein albumin. Microalbuminuria is an early sign of kidney disease. You should have this test at least once a year.

Blood test. Your doctor can check for creatinine (kree-AT-i-nin), waste from the protein in your diet and muscles, with a blood test. Healthy kidneys remove creatinine from your body, but as kidney disease progresses, blood levels of this protein increase. You should have this test done at least once a year.

GFR. The most reliable test of kidney function looks at your GFR, or glomerular (glow-MEHR-yoo-lar) filtration rate. It’s based on your creatinine level and a formula based on your age, sex and race. “The GFR measures your kidney's ability to filter and remove waste from your system,” Kopyt says. “The more severe your kidney disease, the more frequently you should have this test. However, everyone should have this test when they’re first diagnosed with diabetes.”

HA1c. The worse your blood sugar control, Kopyt says, the more likely you’ll damage those tiny blood vessels This blood test gives you a picture of your average blood-sugar level for the past three months.. Your HA1c should be 6.5 percent or below, and you should have your HA1c tested every three months.

Reduce your risk today

Getting An
Accurate Reading

Edwin Morales of Allentown shows how to position yourself and your blood pressure cuff before you hit the “start” button.

• Sit comfortably with your legs uncrossed.
• Wrap the cuff snugly around your bare arm.
• Place arm, palm upward, on a table about the height of your heart.

Work closely with your family doctor or endocrinologist (diabetes specialist) to help reduce your risk of kidney disease and other diabetes complications, Kopyt says. Here are some great ways to start.

Buy a home blood pressure kit. Track your blood pressure at home at least twice a week. For the greatest accuracy, buy an automatic monitor with an arm cuff, not one that takes blood pressure at the wrist or finger. Before shopping, measure your arm to ensure the cuff will fit properly. The standard cuff fits 9- to 13-inch biceps; some models let you trade it in for a larger or smaller size.

Keep your blood pressure below 130/80. “If you have a microalbumin level of 1,000 or more, you should keep it at 120/70,” Kopyt says. Need help getting your blood pressure under control? Try losing weight, eating less salt and exercising regularly.

Think “ACE” and “ARB.” Ask your doctor if you’re taking—or should be taking--an ACE (angiotensin converting enzyme) inhibitor or an ARB (angiotensin receptor blocker) to lower your blood pressure. “ARBs may reduce the damaging protein (microalbuminurea) in people with type 2 diabetes,” Kopyt says. “They also help prevent unhealthy blood vessel changes.” Although these drugs are beneficial, Kopyt says only 39 percent of people with kidney disease take them.

Lower your “bad” - or LDL - cholesterol High cholesterol and hardening of the arteries can lead to kidney problems and heart disease. “Adults with diabetes are two to four times more likely to have a stroke or die of heart disease, and kidney disease increases your heart disease risk even more,” Kopyt says. You should try to keep your LDL cholesterol below 70,” Kopyt says, “and you may need a statin drug to help you reach this goal.”

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