Story URL: http://news.medill.northwestern.edu/chicago/news.aspx?id=230541
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Megan Dawson/MEDILL

Dialysis machines deliver a treatment that filters the blood, removing waste, salt and excess water to prevent them from building up in the body.


Expert warns kidney failure rising in middle-age adults

by Megan Dawson
May 14, 2014


KIDNEY01

Megan Dawson/MEDILL

Dialysis treatments last about four hours and are done three times per week.
 

Diabetes, high blood pressure and obesity are contributing to an alarming rise in kidney disease in mid-life, according to a kidney failure expert.

“More young people are neglecting their hypertension, diabetes and especially obesity and ending up on dialysis,” said Dr. Beata Kisiel, a nephrologist at Provena Saint Joseph Medical Center in Joliet.

Kidney failure occurs when the kidneys stop working and waste can no longer be removed from the blood. Kidney failure patients need dialysis three days a week or a kidney transplant to survive. Dialysis is a treatment that filters the blood, removing waste, salt and excess water to prevent them from building up in the body.

Kidney failure is more common among adults over 70 years of age, according to the Centers for Disease Control and Prevention. However, an increasing number of patients in their 40s are visiting Kisiel’s office to receive treatment for kidney disease.

“I see a lot of younger people who are very obese, and at the age of 40 they are ending up on dialysis, which I think is unbelievable,” Kisiel said.

Diabetes and hypertension are the leading causes of kidney failure, according to the CDC. It estimates that more than 10 percent of adults in the U.S. – more than 20 million people – have chronic kidney disease.

“If they are ending up on dialysis because of diabetes and hypertension as a diagnosis, I think it’s kind of a shame, because these are preventable diseases. They didn’t have to end up this way,” Kisiel said.

When people have hypertension, it means their blood pressure is too high, according to Dr. Clyde Dawson, a general and vascular surgeon at Presence Saint Joseph Medical Center in Joliet.

“Every time the heart beats, it’s pounding on the blood vessels with too much force,” Dawson said. “It’s like hammering the arteries, and it injures the arteries, your heart, brain and also your kidneys. That’s why hypertension is so important to control, because it’s so damaging to your kidneys – and once it does that damage you can’t ever take it back.”

At birth, each kidney holds a large network of nephrons, the basic structural and functional tubules of the kidney that produce urine. A normal kidney contains about 800,000 to 1.5 million nephrons.

“You can lose a huge number and still not be in renal failure,” Dawson said. “However, once you get down to less than one quarter of the number of nephrons you were born with (due to diabetes, hypertension, etc.), you have renal failure and you can never get them back. You only lose them.”

Losing nephrons is part of the normal aging process, too, Dawson said.

“You just hope that you have at least a million of them by the end of your life so you’re not in kidney failure. With kidney disease, you can stop it from progressing but you can’t make it go back.”

Many people are unaware of the correlation between diabetes, high blood pressure, obesity and kidney failure, according to Kisiel.

“There’s a huge population out there that really doesn’t even realize that all three are related,” Kisiel said. “Number one, it can be prevented. Number two, later on if you leave it untreated, you are going to be in the hospital for renal disease.”

Kisiel recalls one 40-year-old woman who was extremely overweight and came to her to treat kidney problems.

“She ended up in my office because she started to have kidney (function) slowing,” Kisiel said. “I’m like, ‘You’re young, you’re too young to have this problem already. These are the problems that you can expect from a 60-year-old, not a 40-year-old.’”

People can prevent the onset of kidney disease due to hypertension, diabetes and obesity by maintaining proper nutrition and physical activity, according to Kisiel. “If you’re trying to avoid salt in your diet, if you’re trying to eat a healthy and balanced diet, overall you will have a less tendency toward diabetes and hypertension and this way have less chance of renal disease,” Kisiel said.

Kidney disease and kidney failure can also be prevented or delayed with screening, according to the CDC. A primary care physician can give screenings with a simple blood test.

Those who should be screened include people at high risk – adults older than 50; those with a history of diabetes, hypertension, or cardiovascular disease; and those with family history. People who already have kidney disease can slow down its progression with proper treatment.