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Celebrate World Kidney Day

Get screened for chronic kidney failure

Date: March 8, 2012

Location: Cathedral Housing Community Room
1472 Washington Street

Time: 3-7 p.m.

Contact: Kendall Maggi at 800-542-0001

Sponsored by the National Kidney Foundation Serving New England

Regular screenings key to prevention

Alex Drumm didn’t know that drinking large quantities of protein smoothies combined with chronic high blood pressure could result in kidney failure. Drumm, a chef at Four Seasons Boston, is on dialysis waiting for a kidney transplant. (Photo by Tony Irving)
Years before he started dialysis, Alex Drumm, 39, was pretty easy to find — inside the neighborhood gym. He was there six days a week walking on the treadmill and pumping iron — trying his best to get those 20-inch biceps. Nineteen and a half inches just wouldn’t do.

“All my life I’ve been in shape,” said Drumm. Or so he thought.

His days in junior Olympics have long since passed. Still he pushed his body, trying to maintain a competitive edge over his exercise buddies. “There was no limitation,” he explained, as he worked out sometimes up to three hours at a time.

Drumm admitted that he did not have regular screenings. Back then he didn’t even have a doctor. Like many young men, he reasoned that he was in good health and did not require any medical attention. That also means that he was not keeping a sharp eye on his blood pressure or sugar levels — two strong indicators that the kidneys may be going awry.

Dr. Winfred W. Williams is the director of the Program in Interventional Nephrology for the Transplantation Unit at Massachusetts General Hospital. Nephrology is the treatment of kidney diseases. Williams explained that it is possible to halt or slow down the progression of kidney failure, but most people are unaware of initial problems. “In the beginning, it is silent,” he said.

Though a person can live with just one kidney, in chronic kidney failure, both kidneys are impacted uniformly. Williams emphasized that in patients with hypertension or diabetes or in the early stages of kidney injury, strict adherence to blood pressure control and certain medications called ACE (angiotensin-converting enzyme) inhibitors or ARBs (angiotensin receptor blockers), can be critical. “These medications are often kidney protective,” he said, “and a first line of attack.”

Generally, when kidney function falls to 15 percent, dialysis or transplantation is indicated. Transplantation is the preferred treatment. “Lifespan is shortened on dialysis,” Williams lamented, “even for the very young.”

Winfred W. Williams, M.D.
Director of the Program in
Interventional Nephrology
Transplantation Unit
Massachusetts General Hospital
Not everyone is a candidate for transplantation, according to Williams. Those with a debilitating illness, active cancers and certain chronic infections, such as bone infections, are not good candidates. People who are unable to comply with medical follow-up will not be referred to a transplant team. History of non-compliance, such as failure to show up for dialysis, is enough to deny recommendation.

Like many people, Drumm was unaware that he was headed for kidney failure. According to health experts, high-protein diets may accelerate the loss of kidney function in people with early problems. Such was probably the case with Drumm.

To help him bulk up, he consumed large amounts of protein drinks — more than the average 50 grams a day, as recommended by the Centers for Disease Control and Prevention. Those drinks promised lean muscle growth and sustained energy while promoting recovery from exercise. But they never said anything about kidney failure. The whirring of his blender as he churned up power smoothies was a familiar sound. “I was addicted,” he said.

About five years ago, Drumm’s creatinine level, which measures how well your kidneys are working, was four times the amount it should have been, according to Drumm. But when he bounced back and was allowed to resume damped-down workouts, he put his health aside, and failed to keep appointments with a kidney team. His recovery was short-lived.

A couple of years ago, Drumm blamed his fatigue, loss of appetite and sleep problems on his hectic schedule. “I was so tired I had to pull myself out of bed,” he said. He finally went to his doctor, but he was not prepared for what the doctor told him. “You have kidney failure,” he said. He didn’t hear much more after that.

Drumm is on dialysis three times a week for four hours at a time. He was evaluated for a kidney transplant and has been added to the list of those in wait.

He admits this change has been hard to take. “I have never been sick before,” he explained. “I never missed a day of work.”

Drumm continues to work as a chef at Four Seasons Hotel Boston. He imparts words of wisdom to other young men. “Have your blood drawn and pee in a cup,” he recommended. “That’s all the doctors need to find out what’s going on in your kidneys.”

I didn’t know

Courtesy of Ron Minor and the Fine Line Productions East
Indeed, African Americans and other ethnic minorities must be their own advocates, said Williams. Those with diabetes or high blood pressure should keep a sharp eye on their kidney function as well as blood pressure, glucose and cholesterol levels. Any indication of abnormal kidney function, such as an abnormal amount of protein in the urine, should prompt consideration of an early referral to a nephrologist, a kidney specialist. This is especially true if there is a family history of kidney failure.

If subsequent tests indicate a worsening condition despite adherence to medications and lifestyle changes, request an evaluation by a kidney transplant program. It’s almost never too soon to be considered for transplant evaluation, according to Williams. If your doctor does not come through, “refer yourself,” he said. (Call 800-936-1627 for a list of transplant centers).