Chronic kidney disease affects millions

DEAR DR. DONOHUE: My wife is 63, not overweight and not diabetic. She was recently diagnosed with chronic kidney disease, CKD. Her glomerular filtration rate is 49. Her doctor indicated she should limit sugar, lower her LDL cholesterol and keep her blood pressure down.

This came as a surprise. Can you help us understand the causes, treatment and prognosis of her condition? -- E.S.

ANSWER: Chronic kidney disease affects 20 million Americans. Often, it develops insidiously, without any signs or symptoms until routine lab tests indicate the kidneys are not functioning up to par. Invariably, the news comes as a shock.

The causes are many. Diabetes, hardening of the kidney arteries, high blood pressure, artery inflammation, kidney inflammation, polycystic kidney disease and scleroderma are just a few of the possible causes. In some instances, identifying a cause is impossible. The end result for all is the same. The kidneys can't maintain the optimum environment for the body and its organs. Protein is lost in the urine. Blood pressure rises, and the body becomes more acidic. Blood potassium often goes up. People can become nauseated and lethargic. Anemia is a common consequence. Your wife is not near the stage of these symptoms.

There are five stages to CKD, based on glomerular filtration rate. Glomeruli are the kidney filters. Your wife's glomerular filtration rate puts her in stage three.

The rate of progression to stage five is highly variable and unpredictable. Your wife might never reach that stage.

The focus of her attention should be prevention of heart disease, which is what usually leads to the death of people with CKD. She has to watch her cholesterol by adhering to a low-fat, low-cholesterol diet; she has to control her blood pressure meticulously; she should restrict salt intake; she might, in time, need to cut back on protein. If she progresses rapidly, dialysis is an option, as is possibly kidney transplantation.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com. 2006 North America Syndicate Inc. All Rights Reserved