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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

When kidneys fail

Perched on either side of the spine below the rib cage, the kidneys clear the blood stream of the wastes and excess water that become urine. These fist-sized organs help control blood pressure and make several hormones needed to keep the body healthy.

Chronic kidney disease (CKD) stems from years of silent damage to small vessels and tubes that form the filtering units inside the kidneys. Waste begins to build up, harming the kidneys further. It sparks other health problems, too, such as cardiovascular disease (heart attacks, heart failure, heart rhythm disturbances and strokes), bone disease and anemia.

Untreated kidney disease often leads to kidney failure (also called end stage renal disease, or ESRD). Once that occurs, merely staying alive requires regular dialysis to clean the blood or a kidney transplant.

What causes kidney failure?

“Diabetes and high blood pressure are the top two causes of kidney disease, the first step on the path to kidney failure,” said Dr. Jan Cook, medical director of Blue Cross Blue Shield of Massachusetts. “That’s worrisome, because these serious health problems disproportionately affect the African American community. Worse, African Americans have higher rates of kidney failure than any other group.”

According to the National Kidney Foundation, African Americans are nearly twice as likely to have diabetes as white peers. High blood pressure, a problem for 44 percent of women and 39 percent of men in the black or African American community, results in more than one in three new kidney failure cases per year. Overall, kidney failure occurred nearly four times as often in African Americans as in whites in 2007, though health trends suggest this gap may be narrowing.

Other possible causes of kidney failure include kidney problems that are inherited or present at birth, infections or autoimmune disorders that attack the kidneys, poisoning or injury.

What steps help keep your kidneys healthy?

First, ask your doctor how often you should be tested given risk factors and your overall health (see “Testing for kidney disease”). Remember, kidney disease can worsen silently for years. No signs or symptoms alert people to early kidney disease, the stage easiest to treat.

Three other steps — eating well, cutting back on salt and exercising — help lessen the odds that you’ll develop diabetes, high blood pressure or heart disease, which raise the risk for kidney disease. If you have any of these health problems, these steps and others recommended by your doctor can help you manage the condition and boost the odds of avoiding kidney disease.

Eat healthy. Check out the African Heritage Diet Pyramid from Oldways, which emphasizes traditional healthy favorites like collards and other leafy greens and minimizes meat and sweets (www.oldwayspt.org/AHH-pyramid). Generally, load up on colorful veggies and fruit; choose whole grains, such as oatmeal, brown rice, cornmeal and whole wheat; eat lean protein, such as beans, tofu, fish, poultry and lean cuts of meat; nibble nuts and seeds; and select no-fat or low-fat dairy products. Use small amounts of heart-healthy oils (olive, corn, canola, safflower), limit saturated fats (butter, palm oil) and avoid trans fats (also called partially hydrogenated oil). Avoid too many sweets.

Cut down on salt (sodium). African Americans, people over 51, and people who have diabetes, high blood pressure or kidney disease should limit sodium to 1,500 mg a day. Snubbing the salt shaker goes only so far. A new report from the Centers for Disease Control and Prevention notes 10 types of food that contain over 40 percent of the salt in our diets: bread and rolls; cold cuts and cured meats; pizza; fresh and processed poultry; soups; sandwiches (cheeseburgers included); pasta dishes; meat-mixed dishes like meatloaf; and snacks like chips, pretzels and popcorn.

Check Nutrition Facts labels and keep a sharp eye on servings. Several slices of even low-sodium bread add up to trouble. Even foods that sound healthy — vegetable soup, turkey slices, cottage cheese or fresh chicken or pork — may have lots of sodium. Fast foods, take-out or restaurant meals can be a minefield. Fortunately, fresh fruits and vegetables are naturally low-sodium.

Get enough exercise. Federal health guidelines say all adults should spread throughout the week 150 minutes of moderate-intensity activities like walking or 75 minutes of vigorous activities like running or a mix. Aerobic activities (walking, biking, skipping rope, running or swimming) can be done in long or short bouts of at least 10 minutes each. Strengthening all major muscle groups is recommended twice weekly, too.

What if you already have kidney disease?

• Ask your health team what you should do about the steps above. You may need to see a kidney disease specialist called a nephrologist.

• Take medicines as prescribed.

• If you have high blood pressure, be sure it stays under 130/80 mmHg. That may require taking two or more kinds of medication, including a diuretic. Limit alcohol and caffeine. Try to keep weight in a healthy range.

• If you have diabetes, set a healthy target for controlling blood sugar with your doctor. Aim for this as often as possible. If you have trouble, talk to your health care team about changes that could help. Try to keep cholesterol and weight in a healthy range and blood pressure under 130/80 mmHg. Limit alcohol.

• Your doctor may recommend changes in diet, such as limiting protein and foods high in cholesterol. In addition fewer potassium-rich foods, such as bananas, oranges and dried beans, may be recommended because diseased kidneys have trouble removing potassium. Excess potassium can disturb heart rhythms.