In honor of National Kidney Month this March, let’s discuss ways to protect kidney function and prevent chronic kidney disease (CKD). There are currently 90,000 individuals in need of a kidney transplant. Although one way to decrease this number would be to increase the number of donors, another option is to promote CKD from occurring in the first place.
CKD affects about 26 million adult Americans, according to the National Kidney Foundation, with this number expected to increase if the U.S. obesity epidemic continues. Patients with risk factors for CKD, including a family history of CKD, hypertension and diabetes, should be screened annually for proteinuria to identify kidney damage.
In addition, ACE inhibitors or ARBs should be initiated for all patients with CKD and type 2 diabetes, even if they are normotensive. Keep in mind that getting patients to comply with daily hypertension and hyperglycemia medications is often challenging, as these conditions are generally asymptomatic until damage to vital organs ensues.
In general, there is a need for patient education to bridge the obesity-diabetes-hypertension-CKD knowledge gap. Many patients are unaware of the link between these diseases. Providers should explain the physiology of the kidneys to their patients to help them understand the importance of this organ to their health and overall quality of life. Explain that the kidneys regulate BP, maintain fluid and electrolyte balance, remove drugs and toxins from the blood, make red blood cells and promote bone strength.
Patients often have trouble understanding health outcomes that they cannot see. It is our job as health-care providers to help patients understand the way the body works in efforts to increase patient compliance with treatments for chronic conditions like CKD, diabetes and hypertension.
Leigh Montejo, MSN, FNP-BC, provides health care to underserved populations at the Metropolitan Community Health Service’s Agape Clinic in Washington, North Carolina.