The most important factors, which can adversely affect the kidneys, are untreated high blood pressure and high blood sugar levels. Severe obesity, nicotine consumption and long-term use of painkillers also stress the kidneys. You, as a GP or specialist, should therefore not tire of pointing out these risk factors to your patients and offering support to minimize their risk of kidney disease.
A lot can be done to keep the kidneys healthy!
Watch the Blood Sugar
Diabetes mellitus is one of the main causes of kidney disease. Elevated blood sugar levels damage the kidneys in the long term. Similar to kidney disease, elevated blood sugar levels may not cause any symptoms. This makes early recognition all the more important. Educated advice on a healthy and balanced diet should therefore be given to reduce the risk of diabetes.
If your patient already has diabetes, daily self-monitoring of blood glucose levels is essential. In addition, the patient should have their kidney function (eGFR) and urine albumin levels checked at least once a year so that any kidney damage can be detected early.
Observe Blood Pressure
Uncontrolled blood pressure can damage the kidneys in the long term. Therefore, it is important that the patient is checking her/his blood pressure regularly. Unfortunately, high blood pressure is often diagnosed at a late stage due to a lack of direct symptoms. If blood pressure is too high, lifestyle habits such as weight, diet, salt consumption and exercise should be checked and medication should be discussed between you and your patient. Please make sure that your patients take their prescribed medication regularly.
Avoid Excess Weight
Increasing numbers of people are overweight or obese, which often leads to increased blood pressure, blood sugar and lipid levels – the metabolic syndrome. Serious consequences of obesity include type 2 diabetes mellitus and an increased cardiovascular risk which are a threat to kidney health. Take the time and inform your patients about the importance of these factors in order to reduce the risk of kidney disease and to achieve treatment success for those who already suffer from kidney disease. Sufficient medical education about healthy eating and exercise should be in place, which will enable patients to reach and maintain their normal healthy weight.
Feel free to hand these guidelines to your patients to help them maintain a healthy diet to prevent kidney disease itself as well as many of the diseases that may cause damage to the kidneys in the first place.
Prepare as many fresh meals as possible.
Eat plenty of fruits and even more vegetables – as varied, regional and seasonal as possible.
Serve legumes such as beans, peas, lentils, etc. several times a week.
Nibble on a handful of nuts every day.
Give preference to whole grain products.
Eat fish instead of meat.
Avoid soft drinks and limit your intake of sweets – do not eat more than 25 grams of sugar a day, the equivalent of six teaspoons. Always beware of hidden sugar.
Reduce your salt consumption and alternatively season your dishes with herbs and spices. Since the kidneys have to excrete excess salt, they are put under strain by high salt consumption. In addition, salt consumption has a negative effect on blood pressure and blood vessels, thereby increasing the risk of cardiovascular disease. 2.3 grams of sodium per day are recommended, equivalent to 6g of salt (sodium chloride). This is equivalent to one teaspoon.
Even those who already suffer from high blood pressure and diabetes can achieve a lot with a healthy diet and lifestyle: blood pressure can improve and type 2 diabetes can often be resolved.
Besides nutrition, water balance and exercise also play an important role. As a doctor, you should never be tired of reminding and educating your patients about the risks of obesity and an unhealthy lifestyle.
For the kidneys to work well, sufficient fluid is necessary. For most, this is at least 1.5 to 2 litres a day, and 2 to 3 litres may be necessary in hot weather. Dehydration can contribute to kidney disease. Mineral water, unsweetened tea or occasionally some juice with water are ideal for an adequate fluid supply. Alcohol should only moderately be consumed.
Pay attention to the daily fluid intake of patients with low kidney function or heart failure. In this case, too much water can have a negative impact on your patients’ health.
The World Health Organization (WHO) recommends at least 150 minutes of moderate exercise every week. This corresponds to about one 30-minute walk on most days of the week. Even if your patients’ kidneys are already damaged, patients can still benefit from the positive effects of regular exercise. The European Association of Rehabilitation in Chronic Kidney Disease shares some useful exercises on their website. Regular exercise can, for example, help to lower blood pressure, strengthen the musculature and improve general well-being.
Regular nicotine consumption drives up blood pressure and causes damage to the renal filtering system. Therefore, you can also draw attention to non-smoking programs or detoxification programs in your country for your smoking patients.
Careful handling and attention to the duration of painkiller use of your patients
For patients who take painkillers on a regular basis, you as a doctor should pay special attention to the duration of the medication in order not to cause permanent damage to the kidneys. These substances affect a hormone, which regulates the renal blood flow.
Offer general kidney check-ups for your patients
Since kidney function can deteriorate over a long period of time without any symptoms, regular check-ups of those at risk are especially important.
The kidney check-up includes two tests, a urine test for albumin and a blood test to evaluate kidney function.
A rapid urine test should be part of every health check-up. It provides valuable information about the albumin concentration in the urine. The less albumin found in the urine, the healthier the kidneys are. Healthy people excrete up to 30 milligrams of albumin.