These new approaches will help you beat this irreversible disease…

Imagine this: You’ve just had a routine checkup, and your doctor gives you some surprising news. Your blood and urine tests show that you’ve got chronic kidney disease (CKD). How could that be? You feel fine.

What most people don’t realize: Kidney disease can be “silent” and often sneaks up on you. Nine out of 10 people who already have early-stage CKD don’t realize it, and as a result, they aren’t taking the necessary steps to protect their kidneys.

ARE YOU AT RISK?

Our kidneys naturally lose some function as we age. If you are 60 or older, there’s a one-in-four chance that you already have CKD—though you may not know it.

You’re also at increased risk for this disease if you have high blood pressure, diabetes or a family history of CKD (in a first-degree relative such as a parent or sibling).

With the right tests (see below), it’s relatively easy to find out if you have CKD. But once your kidneys are damaged, you won’t be able to reverse the damage. The goal is to not develop the disease or slow its progression.

PROTECT YOUR KIDNEYS

Whether you’re trying to avoid CKD or prevent it from worsening, the best way to protect your kidney function is to control your blood sugar (crucial if you have diabetes), blood pressure and cholesterol levels, and to avoid smoking.

Other promising new approaches…

• Watch out for sleep apnea. Researchers have found that sleep apnea is associated with increased protein levels in the urine (an indicator of CKD). For this reason, sleep apnea is now considered an independent risk factor for CKD—and it may cause the disease to progress in people who already have it.

My advice: If you have sleep apnea, be sure to get your kidney function tested. Similarly, if you know you have CKD, you may also have sleep apnea, especially if you snore or sleep restlessly. Get tested.

If you’re diagnosed with sleep apnea, be vigilant about wearing your continuous positive airway pressure (CPAP) mask—the preferred treatment for this condition—while sleeping. Getting the proper amount of oxygen at night will help maintain your kidney function.

• Keep an eye on your diet. At one time, salt was the only potential dietary danger for anyone concerned about kidney health. People with CKD, especially those who also have high blood pressure, are still urged to follow a “no-salt-added” diet—that is, avoiding salty foods, such as canned soups, chips and lunch meats, and not adding salt to food when cooking or eating.

Other dietary advice…

• Eat more vegetable protein (instead of animal protein). Eating large amounts of any kind of protein can tax the kidneys. But when you do eat protein, vegetable protein—found in such foods as soybeans, legumes, nuts and quinoa—is healthier because it generally contains fewer calories, less saturated fat, less sodium and less acid than meat protein.

• Avoid soft drinks. High amounts of sugar (glucose) in your blood—a given with sugary soft drinks—will stress your kidneys. According to a recent Japanese study, consuming at least two soft drinks per day may increase protein levels in the urine and, in turn, one’s risk for CKD. If you’re at increased risk or already have CKD, it’s safest to drink water and avoid sugary soft drinks, especially if you have diabetes.

• Use caution with painkillers. Long-term use (more than 10 consecutive days) of nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen (Motrin) or naproxen (Aleve), can harm the kidneys. If you’re a frequent NSAID user, be sure that your doctor tests your kidney function routinely.

If you know that you have CKD, take an NSAID only if pain is severe and for no more than three to five consecutive days…or talk to your doctor about pain relievers that may be safer to take such as acetaminophen (Tylenol). Additionally, recent research has found that when an NSAID is combined with blood pressure drugs—an ACE inhibitor or angiotensin receptor blocker (ARB) and a diuretic (“water pill”)—it may create a “triple threat” that can cause acute kidney injury, further damaging the kidneys.

My advice: People who are concerned about their kidney health or who already have CKD should always ask a doctor before taking any new drug—even if it’s over-the-counter.

Also: Many supplements (such as potassium) and herbs (including­ periwinkle and aloe) can cause harm in people with kidney disease. Before taking any dietary supplement, consult your doctor—especially if you have CKD.

THE TESTS YOU NEED

If you are over age 40, you should have annual urine and blood tests to monitor your kidneys. People with diabetes or other chronic conditions should start sooner, and may need to be tested more often. What needs to be checked…

• Albumin. If this protein appears in your urine, it can be a sign of early kidney disease. Urine microalbumin/creatinine ratio (a very sensitive indicator of early kidney damage) should be less than 30 mg/g. Urine protein/creatinine ratio should be less than 150 mg/g.

• Creatinine. If your blood level of creatinine (a waste product filtered by the kidneys) is higher than 1.2 for women or 1.4 for men, you may have chronic kidney disease (CKD).

Your doctor may refer you to a nephrologist (kidney specialist) for more blood and urine tests and a renal ultrasound to check for kidney scarring or other conditions, such as kidney stones or a tumor.

• Estimated glomerular filtration rate (eGFR). Your creatinine result can also be calculated in a formula that includes your age, weight, race and sex to determine your eGFR, which indicates how well your kidneys are filtering blood and getting rid of waste. A normal reading for eGFR ranges from 90 ml/min to 130 ml/min, with no protein in the urine. A reading of 60 to 89 may indicate a mild decrease in kidney function. Many people are diagnosed with CKD at stage 3 (an eGFR of 30 to 59), which is considered “moderate.”