How to Protect Your Kidney Function

Give your kidneys a bit of a break by using the tips below:

• Drink lots of water to flush out wastes. Drinking water also helps lower the chances of kidney stones and infections.
• Keep your blood pressure in the target range. Weight control, exercise, and drugs can control blood pressure—and prevent or slow the risk of kidney failure. Also, blood pressure drugs in the ACE-inhibitor and ARB class help slow down a loss of protein in the urine and protect the kidneys. Blood pressure puts a lot of stress on your kidneys. If you have high blood pressure and any other kidney problem, treating your blood pressure will help protect your kidneys.
• If you have diabetes, keep your blood sugar in the target range. Weight control, exercise, medication, and tight control of blood sugar can prevent or slow the risk of kidney failure.
• Have blockages (e.g., narrowed arteries) treated. Sometimes blockages can be opened to help save function in a blocked kidney. If you think you have a blockage, ask your doctor what can be done about it.
• Take steps to prevent kidney stones if you are prone to them.
• Take steps to prevent infections if you are prone to them.
• Check with your doctor to see if there is a special diet you should be on, such as low protein, low salt (sodium), and low phosphorus.

Avoid Known Kidney Toxins

• Limit use of over-the-counter or prescription painkillers that contain ibuprofen (Advil®, Motrin®), naproxen (Aleve®), or acetaminophen (Tylenol®). These non-steroidal anti-inflammatory drugs (NSAIDS) cause blood vessels in the kidneys to shrink, so less blood flow comes through. If you take any of these drugs often, be sure to tell your doctor. Taking these drugs with caffeine can also further harm the kidneys. Drinking a large glass of water when you take an NSAID can help your kidneys flush the drug out.
• Know your own drug allergies. Sometimes taking a drug that you are allergic to can damage the kidneys.
• Ask about a drug’s effects on the kidneys any time you take a new medication. Some antibiotics and chemotherapy drugs are known to be hard on the kidneys. If you know that your kidney function is less than normal, avoid these drugs if you can and see if your doctor can prescribe something else.
• Avoid X-ray dye tests or have your doctor take steps to protect your kidneys. Less toxic dye can be used (this costs more), the dye can be diluted, and it can be flushed out of your body with extra fluid. Some doctors prescribe a drug called Mucomyst ® to help protect the kidneys from the dye.
• Get a throat culture if you have a sore throat—and treatment if it is caused by Strep bacteria.
• Avoid use of street drugs. If you use them, know that they can harm your health and seek help to stop. Be honest with your doctor about what you are using so he or she can help treat you.
• Quit smoking. In people with CKD, research has linked smoking to an increase in the amount of protein in the urine. In smokers with diabetes, kidney disease may progress twice as fast . Get help to quit smoking and prolong your kidney function.

Other steps you take do to keep your kidneys working well for as long as possible include:

• Visit your doctor for check ups.
• Take all drugs as prescribed—in the right amount, at the right time.
• Tell your doctor about any herbs, supplements, or over-the-counter drugs you take. Just because some products are sold without a doctor’s prescription does not mean they are safe for people with less than normal kidney function.
• Follow any dietary limits as prescribed.
• Know your blood or urine test names and what the results mean.

Do Your Part

If you are at risk for kidney disease, there are many things you can do to help keep your kidneys working. With knowledge of the signs and symptoms of CKD and early treatment you can protect your kidneys and live long and well with CKD.

Are You At Risk?

• Calculate Your Kidney Function
• Take the CKD Quiz
• 10 Reasons to Get Tested for CKD

About CKD

• Kidney Diagnosis Guide
• Symptoms of CKD
• CKD - A Public Health Crisis
• Kidney Disease and Your Heart: The Hidden Link
• Other Resources on CKD
• Kidney Disease Glossary

What You Can Do

• How To Protect Your Kidneys
• How to Talk to Your Doctor

Checking Your Kidney Function

Since kidneys clean the blood and make urine, blood and urine tests are a good way to check whether the kidneys are doing their job. If your blood or urine has high levels of substances the kidneys should filter out, something may be wrong. Knowing the names of your tests and what the results mean is a way for you to track your kidney function and see how you are doing over time. The two most common kidney function tests are creatinine (blood) and albumin (urine).

Chronic Kidney Disease

CKD means the kidneys are at least 40% less able to filter out wastes and water from the blood, and the damage is permanent. In time, CKD may lead to kidney failure, in which case dialysis (blood cleaning) or a kidney transplant is needed to support life.

The two most common causes of CKD are type 2 diabetes and high blood pressure. Among Americans with kidney failure, 75% have one or both of these problems. The rest have genetic diseases, infections, birth defects, kidney stones, or other causes.

If CKD is caught early, it may be possible to slow it down or even stop it. The National Kidney Foundation lists five stages of CKD. Each stage is based on the percent that the kidneys can filter, or “glomerular filtration rate” (GFR). GFR is not a blood test; it’s a formula used to figure out how well your kidneys are filtering your blood.

The stages of CKD are:

• Stage 1 – Kidney damage (protein in the urine) and normal GFR (>90)
• Stage 2 – Kidney damage and mild drop in GFR (60-89)
• Stage 3 – Moderate drop in GFR (30-59)
• Stage 4 – Severe drop in GFR (15-29)
• Stage 5 – Kidney failure: dialysis or kidney transplant needed (GFR <15)

how to protect your kidneys

If you have type 2 diabetes, high blood pressure, or other risk factors, you are at a higher risk of having kidney problems in the future. The good news is, if you’re at risk for kidney disease you can protect your kidneys.

• Chronic Kidney Disease
• Checking Your Kidney Function
• Symptoms of CKD
• How to Protect Your Kidney Function

The list of advice includes for protecting kidney

• strict control of any tendency towards hypertension. The blood pressure should be kept well under the usual guideline of 140 (systolic) over 90 (diastolic).
• Use of a type of prescription medication for hypertension that's called an "ACE-inhibitor" There's one ACE-inhibitor that's been approved by the US FDA(1) for use to protect the kidneys in people with diabetes: its brand name is Capoten (the generic name is captopril). Probably all the ACE-inhibitors work about the same to protect the kidneys, and should be as good as captopril.
• Use of a modified meal plan, with a fairly small amount of protein. A Registered Dietitian should be consulted to develop a workable meal plan for people with the dual disorders of diabetes and kidney disease.
• Avoidance of certain medications that aggrevate kidney disorders. The list to avoid includes some over-the-counter pain medications such as ibuprofen (Motrin and others) and Alleve, but does not include aspirin and Tylenol (acetominophen). Certain prescription drugs that are used for the treatment of arthritis and pain, called "non-steroidal anti-inflammatory drugs" (NSAID's) are all to be avoided.
• Avoidance of dehydration. If there's vomiting or severe diarrhea, go to an Emergency Room or other facility, and get "tanked up" with intravenous fluids. You'll feel much better, and avoid any risk of kidney shutdown from dehydration.
• Avoidance of X-rays that involve the injection into your blood vessels of liquids called "radioopaque contrast agents" (a frequent slang term for these agents is "X-ray dyes") unless there's a nephrologist (kidney specialist) assisting with the case. These contrast agents are eliminated from the body through the kidneys, and can clog up the kidneys if there's already some kidney damage.
• Prompt treatment of any problems with urination, such as painful urination or blood in the urine.
• Cessation of smoking.
• Control of blood sugar level (see comments about the results of the DCCT).
• Referral to a nephrologist (kidney specialist) for additional advice when the urine protein level exceeds 1000 mg (the normal amount should be below 150) or the creatinine level in the blood is over 3.0 (creatinine normally should be below 1.5), or upon the request of the patient.

This is now a standard list of recommendations that should increase the time between the initial diagnosis of diabetic kidney damage, and the inevitable dialysis, transplant, or death.

How To Protect Yourself Against Liver Damage

Medical researchers who co-ordinated this study had 106 participants take 4 grams of acetaminophen (the equivalent of eight 500 mg tablets of extra-strength Tylenol) every day for two weeks. Thirty-nine participants received placebo pills.

The key results were as follows:

• Among the particpants who took acetaminophen, almost 40 percent showed signs of acute liver damage
• Those who showed signs of acute liver damage continued to show signs of liver stress four days after they stopped taking acetaminophen; it took a full eleven days for their liver enzymes to return to normal levels

Why is your liver so susceptible to damage by acetaminophen? Because almost everything that enters your mouth, travels down your digestive tract, and gets absorbed into your blood stream must travel directly to and through your liver before it travels through the rest of your circulatory system.

Your liver acts as a processing plant. It receives everything that you put into your mouth and that ends up in your blood stream, does its best to sort out useful nutrients and harmful substances, and then packages these nutrients and harmful substances to be delivered to your cells and eliminated from your body, respectively.

When certain drugs like those that contain acetaminophen reach your liver for processing, they can cause direct injury to your liver cells, sparking an inflammatory reaction that leads to increased production of liver enzymes, which a standard blood test can detect. If your liver cells are injured repeatedly, they can go through a series of degenerative changes, the last ones being cirrhosis (hardening) and cancer of the liver.

Medical drugs that list liver damage as a potential "side" effect and all forms of alcohol are the two groups of substances that can most efficiently and predictably cause liver damage in the fashion described above.

Protecting yourself against liver damage must begin with avoidance of said medical drugs (whenever possible and under the guidance of your doctor) and alcohol. It's true that not everyone who takes medical drugs and drinks alcohol regularly over many years ends up with irreversible liver damage. Genetics and lifestyle changes can help to ward off liver damage despite a history of alcohol and drug use. Still, you should be aware that any amount of these two substances can and do heap unnecessary stress onto your liver cells.

Beyond doing your best to avoid drugs and alcohol, here are some additional steps that you can take to protect yourself against liver damage:

1. Stay away from foods that are high in unhealthy fats and/or sugar. Donuts, deep fried fast food, and soda are three of the worst foods for your liver. And yes, chicken McNuggets and McChicken sandwiches are deep fried.
2. Eat mainly fresh, minimally processed foods. Focus on green vegetables and produce that comes in rich colors like field tomatoes, carrots, avocado, mango, blueberries, and blackberries. These richly colored fruits and vegetables contain naturally occurring antioxidants that can help to protect your liver cells against physical injury.
3. Use extreme caution and common sense when it comes to being physically intimate with another person. Hepatitis B and C are viruses that can cause significant liver damage. These viruses live in all body fluids, including blood and seminal fluids.
4. Be aware that hepatitis C is most commonly spread via blood, and can be acquired through contaminated needles used for IV drug injections, body piercing, and tattooing.
5. Strive to stay away from chemicals of all types, particularly pesticide and insecticide sprays, which can inflict direct damage to your liver cells once they make their way into your blood stream. Many chemicals are capable of entering your blood stream through your skin, so try to use on your skin only those products that you feel comfortable eating.

One final note: if you rely on regular intake of acetaminophen to deal with intolerable pain, I encourage you to try taking a high quality cod liver oil or fish oil for their omega-3 fatty acids, which can be extremely effective at decreasing inflammation.

Do children need sunglasses?

Yes. Children are at special risk from the harmful effects of UV, since their eyes do not have the same ability as adults to protect from UV radiation.

Here are some helpful suggestions for choosing sunglasses for children:

• Check to make sure the sunglasses fit well and are not damaged,
  
  
• Choose sunglasses that fit your child's lifestyle-the lenses should be impact resistant and should not pop out of the frames,
  
  
• Choose lenses that are large enough to shield the eyes from most angles, Find a wide-brimmed hat for your child to wear along with the sunglasses.