Chronic Kidney Disease: 7 Things Doctors Want You to Know

Doctor William C Lloyd Healthgrades Medical Reviewer
Medically Reviewed By William C. Lloyd III, MD, FACS
Written By Ashley Festa on November 30, 2020
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    Experts Shed Light on a Symptomless Disease
    More than 25 million Americans have chronic kidney disease, and most of them don’t realize they have it because there are usually no symptoms until the later stages of the disease. If left untreated, chronic kidney disease can lead to kidney failure, dialysis and the need for a kidney transplant. However, you don’t have to be completely in the dark. There are several factors to indicate you might be at higher risk. As these real doctors describe, early screening and detection by a nephrologist can often help prevent the progression to later stages of chronic kidney disease
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    1. “Know the risk factors.”
    “Major risk factors are diabetes and high blood pressure,” says Dr. Les Spry, the medical director at the Dialysis Center of Lincoln, Neb., and the spokesperson for the National Kidney Foundation. “About 60% of people who have chronic kidney disease have one or both of those diagnoses. Another major risk factor is race. The black population has over three times the incidence of chronic kidney disease than white people. Hispanic and American Indians have about twice the incidence, and Pacific Islanders also have a higher risk.”
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    2. “Manage your risk factors carefully.”
    “Since chronic kidney disease is often a result of something else, it is managing the ‘something else’ that becomes important,” says Dr. Dennis Ross, a nephrologist at the Kansas Nephrology Research Institute in Wichita, Ks. “The vast majority of people who have chronic kidney disease die from complications such as heart attacks and strokes. Therefore, it is important to focus on blood pressure control, cholesterol control, exercise and a good diet.”
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    3. “Screening is the best prevention.”
    “The good news is because of the increased emphasis on screening, new cases of kidney disease are leveling off,” Dr. Spry says. “For the last two years, the [Centers for Disease Control and Prevention] reported a leveling off of this incidence. If we can push a little harder and get people screened, we can help. For anyone over 18, we recommend annual screening if you have a risk factor. If the screening is negative, you can go to every three years.”
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    4. “Visit your doctor early.”
    “Typically, patients come to see or get referred to the nephrologist at stage II-III, but it isn’t unusual to see patients at stage IV or V when there is little that can be done to improve the picture,” says Dr. Marcos Rothstein, medical director of dialysis services at Barnes-Jewish Hospital in St. Louis. “Then patients have to be transitioned to kidney replacement therapy, such as dialysis or kidney transplantation. The lack of education and understanding of the signs and symptoms of kidney disease is the number one reason [people delay going to see a doctor]. There is a great amount of denial in our society. Without question, lack of access to care is a formidable barrier for the proper identification of chronic kidney disease.”
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    5. “Follow your doctor’s orders.”
    “Only about 50% of people take their medication, and only 30% take it as prescribed,” Dr. Spry says. “Every time someone comes in my clinic, we go over their pills. I ask what they are and how often they take them. If they fumble about it, I assume they aren’t taking it. Adherence means they listen to what I’m telling them, and the adherence part is up to them. They also need to adopt a healthy lifestyle, and this is a difficult thing. We spend a lot of time talking about how you need to change your diet. Decrease salt and increase fruits and vegetables, and we encourage low-fat dairy.”
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    6. “Take ownership of your health.”
    “I tell patients to take responsibility for their problems, learn how to monitor their vital signs like blood pressure and weight, and be absolutely sure not to take any over-the-counter medications without asking.” Dr. Rothstein says. “There are many over-the-counter medications and seemingly benign pills that could have a deleterious effect on kidney disease. And there is no substitute for having a blood test that checks your kidney function [every year].”
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    7. “Understand what your options are.”
    “The first thing people ask is, ‘Am I doing to die?’” Dr. Spry says. “Many times people don’t understand dialysis. They equate dialysis with death. We help them understand that we can help with dialysis and hopefully get them a transplant before dialysis.” Dr. Spry warns there is a critical shortage of available kidneys, adding urgency to the need for organ donation. With 120,000 people on the kidney transplant waiting list, “There are about 18,000 transplants per year, and we are trying to get more living donors,” he says.
Chronic Kidney Disease: 7 Things Doctors Want You to Know

About The Author

Ashley Festa is a Greenville, S.C.-based freelance writer and editor who has been writing professionally for nearly two decades. In addition to Healthgrades, she also has written for Johns Hopkins School of Nursing, the University of Texas at Arlington School of Nursing and Health Innovation, and Fit Pregnancy magazine.
1. About Chronic Kidney Disease. National Kidney Foundation.

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Last Review Date: 2020 Nov 30
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