Motivation is defined as the general desire or willingness of someone to do something. Coaches motivate athletes. Preachers motivate congregations. Doctors motivate their patients. But I often ask myself: “How successful am I in motivation?” At times throughout my career, it has seemed like no one was listening to me at all.
My choice of Family Medicine as a career was based upon my desire for continuity of care, enriching relationships with my patients, and the opportunity to provide preventive medicine counseling. Satisfaction for me is not defined by how many patients are on my roster or how many awards I have received. My inner fulfillment occurs when my patients are maintaining healthy lifestyles and making healthier choices. And if I have assisted the patient in preventing unwanted complications like chronic kidney disease (CKD), I am overjoyed.
If I were to quiz the general population on the risks of uncontrolled hypertension or diabetes, I guarantee you that most people would easily identify strokes or heart attacks. Not getting enough blood flow to the brain or heart have been hammered into the psyche of most people. However, our educational campaigns need to again ramp up and include more robust learning materials about chronic kidney disease and its relationship with high blood pressure and diabetes.
In 2017, approximately 30 million people had chronic kidney disease. However, only 42 percent of those with CKD were aware that they had it. CKD is present in about one in five patients with high blood pressure. Sixteen percent of women and 13 percent of men are estimated to have CKD. As in most other disease states as well, non-Hispanic blacks have a greater percentage of CKD as compared to non-Hispanic whites, 18 percent vs. 13 percent.
Lack of symptoms at presentation is one of the reasons hypertension is well-established as a silent killer. CKD is no different. Most patients typically find out about their abnormal kidney function through incidental blood work, such as a urine test or basic metabolic panel.
Normally the kidneys filter blood in your body about every 30 minutes, and this process eliminates wastes and toxins. But in CKD, the kidneys are damaged and do not function properly, causing a buildup of unwanted substances. The damage may start out mild and then progress to end-stage renal disease and early cardiovascular disease, if not managed appropriately. Per the Centers for Disease Control and Prevention, every 24 hours more than 300 people begin dialysis treatment for kidney failure. Other health issues such as anemia, electrolyte abnormalities, and depression are all consequences of CKD.
In addition to hypertension, diabetes and lupus, medications such as aspirin, ibuprofen and certain antibiotics can also damage the kidneys and must be monitored carefully.
There are several steps you can take to help prevent CKD: keep blood pressure below 130/80; if you are overweight, lose weight; avoid medications that are toxic to the kidney; control blood sugars; if you smoke, stop smoking; get tested for CKD if you are at risk; exercise regularly
In honor of National Kidney Month, I encourage everyone to speak to their healthcare providers about this important subject. Protect your kidneys. You only have two!
Denise Hooks-Anderson, M.D., is assistant professor at SLUCare Family Medicine. Email yourhealthmatters@stlamerican.com.
Keep blood pressure below 130/80.
If you are overweight, lose weight.
Avoid medications that are toxic to the kidney.
Control blood sugars.
If you smoke, stop smoking.
Get tested for it if you are at risk.
Exercise regularly.
