National Kidney Month – Speaking with Your Doctor about CKD

WRITTEN BY

Yasmin Brahmbhatt, MD FASN, Practice Change Medical Director, CVRM

Recognizing National Kidney Month

March is National Kidney Month—a time to raise awareness about the importance of kidney health. The kidneys play a critical role in filtering your blood and regulating the body’s salt, potassium and acid content by removing waste and excess fluid. People with type 2 diabetes (T2D), high blood pressure or a family history of kidney failure may be at risk for chronic kidney disease (CKD), which can be a serious, progressive condition defined by declining kidney function.

What is Chronic Kidney Disease (CKD)?

CKD affects an estimated 37 million Americans, and even more surprising is that of those who have CKD, 9 in 10 don’t know it. This is in part because CKD is a “silent” disease, meaning most patients don’t feel symptoms until it has progressed to more advanced stages. In addition to experiencing kidney function decline, patients with CKD may be at increased risk for other conditions, such as heart disease, hyperkalemia (also known as high potassium), and more. Worsening kidney function decline can lead to end stage kidney disease (ESKD) and this can only be treated with dialysis (a procedure to help remove waste products and excess fluid and potassium) or a kidney transplant to keep the body functioning when kidneys fail.

Because CKD may be overlooked until symptoms appear at advanced stages, it is especially important to have ongoing discussions with your doctor so you are aware of your risk factors. It is also important to keep track of your blood work on a regular basis to see how your kidneys are functioning.

Early Intervention and the Importance of Understanding Your Numbers

(Credit: Adapted from the National Kidney Foundation)

 

The only way to confirm you have CKD is through specific blood and urine tests. One marker of kidney health and a critical part of managing CKD is knowing your eGFR, or estimated glomerular filtration rate, which is a measure of how well kidneys are filtering waste from the body. This test is included in routine blood work. As CKD gets worse, your eGFR number will go down. If your eGFR is less than 60 for three months or more, you are likely in stage 3 CKD, meaning your kidneys may not be working well and it’s important to talk with your doctor about how you can keep your kidneys as healthy as possible. Another important test to help confirm CKD is the urine albumin-to-creatinine ratio test, that checks for high protein (albumin) in the urine. High urine albumin-to-creatinine-ratio is a sign of kidney damage.

The earlier CKD is identified and diagnosed, the sooner it can be treated—which is important if you have risk factors such as T2D, high blood pressure (hypertension), heart disease or a family history of kidney failure. Early intervention has been shown to slow disease progression, preserve kidney function, and reduce the risk of other conditions that are commonly associated with CKD.

Speaking with Your Doctor

Until recently, there have been limited treatments to delay the progression of CKD. With the evolution of modern therapies, CKD treatments are now available to help slow kidney disease progression to delay end stage kidney disease. CKD has traditionally been managed by treating the underlying risk factors, using certain medicines if there is protein in the urine with high blood pressure, and stopping certain medicines which may be causing kidney damage. Now, with newer treatments available, patients and HCP’s have more options to reduce the risk of ESKD even further.

It’s important that people with CKD risk factors, such as T2D and high blood pressure, review their blood work results and talk with their doctor to understand their eGFR number and discuss the best treatment option for them.

You may consider using this discussion guide during your next doctor visit. Through frequent and honest conversations with your healthcare team, you can feel empowered to take control of your kidney health.