Preventing chronic kidney disease: regular check-ups, healthy diet
At least 7 million Filipinos are suffering from chronic kidney disease (CKD) as of 2021. Unfortunately, many of them do not have any symptoms or physical signs to indicate they have renal (kidney) disease until they reach the late stages.
With social media platforms like Facebook, X, and Messenger, we can help reduce the number of our friends, relatives, and patients from getting into the late stages of CKD.
How can we reduce CKD?
Those who have a family history of kidney disease, diabetes, high blood pressure, or had urine tests showing persistent protein or red blood cells should see a physician for a checkup that should include creatinine and GFR (glomerular filtration rate), and Hemoglobin A1C (best test for diabetes), aside from the standard blood test that most primary care physician habitually request for. If their GFR is below 60 ml/min/1.73m2 or with high blood creatinine, they should be seen by a kidney specialist or board-certified internist with long experience in care for patients with CKD.
Patients with CKD, when seen by an experienced kidney physician, should be given a printed copy of steps on how to prevent the creatinine from going higher or delay the deterioration of the GFR to end-stage renal disease (ESRD).
What are these steps? The two common causes of CKD are high blood pressure (hypertension) and diabetes. These two conditions should be managed so their blood sugar is normal (below 120 mg/dl) for a long time and with blood pressure below 140 mm systolic.
While controlling their hypertension and diabetes with medications, and lifestyle changes, they should follow a diet protocol that will give the kidney a chance to maintain or improve their GFR. This is best done with the help of a registered dietician with experience caring for CKD patients.
Patients should be given a list of foods that should be avoided and foods that are good for them.
Good foods in our country that are kidney-friendly are red bell pepper, cabbage, cauliflower, garlic, onion, apple, red grape, egg white, fish, olive oil, malunggay (moringa), and mangosteen.
Bad foods that increase creatinine or lower GFR are dark-colored soda, avocado, canned food, whole wheat bread, brown rice, banana, dairy products, orange and orange juice, processed meat (hot dog, bacon, pepperoni, jerky, sausage, chips with high sodium, etc.), pickles, olives and relish, apricot, potato, sweet potato, tomato, packaged and pre-made meals, Swiss chard, spinach, beet greens, dates, raisins, prunes, pretzels, and crackers.
Black coffee is okay for kidney disease but not more than three cups (473 to 710 ml) every day without added sugar.
Dark chocolate is rich in antioxidants and may help reduce inflammation of the kidneys but should be taken in moderation.
Individuals with CKD should always read the labels of food packages like chips and canned foods and avoid high sodium, potassium, and phosphorus.
Every four to six months, depending on the signs and symptoms of the patient, creatinine and GFR should be repeated before they see their physician.
Most patients with CKD will not need X-ray, CT scan, and MRI unless they have frequent fever, persistent back and abdominal pain, headache, vomiting, diarrhea, and other recurring symptoms.
If you are a senior citizen or with disabilities and with difficulty traveling, ask your physician if you can communicate with them online. Some physicians who are comfortable with technology will allow this modern way of medical practice.
Leonardo Leonidas, M.D.
