National Kidney Month: Expert Interview & Advocacy Guide
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“I can’t say it enough: kidney disease is extremely common, so know your risk and get checked. I think that is the message that I would love people to think about throughout National Kidney Month and pass it along to their friends and family,”
Dr. Susan Quaggin, President of the American Society of Nephrology (ASN)
Kidneys are essential organs in the body. They are responsible for filtering waste and excess fluid from the body. Unfortunately, kidney disease is hard to detect before it becomes serious. Symptoms can include puffiness, lethargy, trouble concentrating, blood in urine, and more.
March is National Kidney Awareness Month. The aim of this month is to educate the public about this unknown and often undetected disease. “It is about getting the word out there that kidney disease is a very common deadly disease, and we have ways to prevent it,” shares Dr. Susan Quaggin, president of the American Society of Nephrology (ASN).
According to the CDC, more than 37 million Americans live with kidney disease. This translates into more than one in seven people. Approximately two out of five people with the disease don’t know they have it. Kidney disease is more prevalent in women, Blacks, Hispanics, and those over 65. The most significant risk factors for kidney disease are high blood pressure and diabetes.
This year for National Kidney Month, the National Kidney Foundation asks people to take five simple steps to help protect their kidneys. These steps are to:
- Get tested for kidney disease if they are high risk
- Reduce the use of over-the-counter pain medicines such as NSAIDs (nonsteroidal anti-inflammatory drugs)
- Eat less processed foodS
- Exercise regularly
- Control blood pressure and diabetes
In addition, there is a short online quiz sponsored by the National Kidney Foundation, ASN, and the US Department of Health and Human Services that can give people an idea of their risk of kidney disease. While this is not a substitute for screening by a medical professional, it can be a place to start.
Continue reading to learn more about kidney disease from Dr. Quaggin, including ways to prevent it and advances in treatments.
Meet the Expert: Susan E. Quaggin, Northwestern University
Dr. Susan Quaggin is the Charles Horace Mayo Professor of Medicine, Chief of Nephrology/Hypertension and Director of the Feinberg Cardiovascular and Renal Research Institute at Northwestern University, as well as the president of the American Society of Nephrology (ASN). She is also a Fellow of the American Society of Nephrology (FASN), a distinction awarded to outstanding ASN members.
She earned her MD from the University of Toronto, where she completed her residency and served as a chief medical resident for the University’s St. Michael’s Hospital. She completed her nephrology fellowship at the University of Toronto and Yale University, where she also undertook research and post-doctoral training.
What is Kidney Disease?
Simply put, kidney disease is when the kidneys are damaged and can’t filter blood the way they should. This damage can happen for many reasons: “Kidney disease is really kidney diseases,” says Dr. Quaggin. “It is caused by a group of diseases. By far and away, the most common cause here and around the world is diabetes. Also, high blood sugar, hypertension, or high blood pressure are other major risk factors for kidney disease. And, then there are lots of other causes that might not be so common.”
Dr. Quaggin continues, “Currently, another risk factor for developing kidney disease is having a Covid-19 infection. We’ve seen a lot of kidney disease in patients who were acutely infected. Unfortunately, we’re expecting to see a big boost over the coming years in the number of patients and people living with kidney diseases because of this.”
Whom Does Kidney Disease Affect?
As with most diseases, kidney disease disproportionately affects some Americans more than others: ”In the United States, there is definitely an increased burden of kidney disease in certain communities. For example, if you are Black or African American, you’ve got a three- to fourfold higher risk of developing kidney failure than if you’re white in this country,” shares Dr. Quaggin.
“If you’re Hispanic or Latinx, that number is about one-and-a-half fold higher. And if you are Native American, Alaskan Native, or Pacific Islander, that’s about two- to threefold higher. This is largely due to things such as where you live, access to medical care, and social determinants of health.”
“But the bottom line is, it’s a really common disease. One in three people is at risk. So it can affect anybody at any age,” Dr. Quaggin remarks, adding that certain health conditions can put people at a higher risk of developing kidney disease: “You’re at higher risk and should absolutely get your kidney function checked if you have diabetes or prediabetes, high blood pressure, a family history of kidney disease, have any relatives who’ve had a kidney transplant or have been on dialysis, or if you have heart disease or heart failure,” she says.
Symptoms of Kidney Disease
Awareness of kidney disease is critical because, often, there aren’t symptoms. “I think one of the reasons why a lot of people with kidney disease don’t know they have it is because until it’s very late, symptoms can be very silent unless you get your kidney function checked with a simple blood test and a urine test,” warns Dr. Quaggin. “Without a test, you wouldn’t know until it’s very late in the progression of the disease. Oftentimes, when it’s too late to intervene.”
Typical symptoms can vary from patient to patient. “Late in the progression of kidney disease, patients will develop symptoms of fatigue, their appetite can be reduced, and they can have a metallic taste in their mouth. They can also have issues with their skin,” says Dr. Quaggin.
Thanks to advances in treatments, early detection can halt the progression of kidney disease. Dr. Quagging shares, “There are some of the really powerful new therapies that can prevent progression to kidney failure. So the bottom line is, early on, you need to know your risk, and you need to get checked. The big opportunity in fighting kidney disease is for us to prevent it.”
How to Prevent Kidney Disease
Despite the seriousness of kidney disease, many things can be done to help prevent it. “Since diabetes is the most common cause, preventing diabetes through diet and exercise is really important,” encourages Dr. Quagging. “Exercise is also important to control blood pressure, which is another big contributor to kidney disease. Keep your blood pressure under control and get your blood pressure checked often. Make sure your blood pressure is controlled with medication if needed.”
However, the easiest way to prevent kidney disease is to work with a primary care physician to monitor risk and kidney function. “I can’t say it enough: kidney disease is extremely common, so know your risk and get checked. I think that is the message that I would love people to think about throughout National Kidney Month and pass it along to their friends and family,” urges Dr. Quaggin.
“I think everybody knows that kidneys are important for urinating, but they do so much more in the body. They also maintain your bone health, calcium and vitamin D status, and red blood cells. They make hormones that maintain your blood pressure. So, if your kidneys fail, it’s not only that you can’t control all of those things and you need to go on dialysis or get a transplant, but it’s also that it amplifies other things like heart disease and vascular disease,” shares Dr. Quaggin.
“So you’re at much higher risk of having a heart attack or heart failure if you’ve got kidney disease, even if you’re not on dialysis. Most patients with kidney disease die from cardiovascular disease before they ever even make it to dialysis.”
Advances in Kidney Disease Treatment
“Over the past three years, we’ve had a number of new therapies that have come on the market that are incredibly powerful to protect the kidney,” shares Dr. Quaggin. “One of the biggest breakthroughs recently is something a group of drugs that are known as flozins, which are kidney targeted drugs. So, it’s a pill you just take once a day, and it is like giving your kidneys a holiday and letting them kind of relax. The way it works is by blocking the uptake of sugar and salt by your kidneys (sodium and glucose) and it reduces the pressure inside the kidney.”
She continues, “Originally, they were developed to treat patients with kidney disease due to diabetes. It turns out that in a very large clinical trial, it not only did that and reduced the progression of kidney disease but also for kidney disease due to nondiabetic causes. So they’re very potent therapies, and we want to empower patients to know about them so they can ask their primary care provider.”
There are other recent advances in addition to pharmaceutical therapies. “Another area of innovation is in devices. So, dialysis is like an artificial kidney. Patients go to dialysis units three times a week or so in order to live. They have to get hooked up to a machine and have their blood cleaned and take the role of the kidney. But there are new ways that patients can do this at home on their own that are much gentler,” she shares.
