The Science of Organ Transplantation – Part VII
Tips to protect your kidneys’ health
Chronic kidney disease is a major health problem in the US, India and many other countries. Nearly 14% of the adults in the U.S. suffer from it and is associated with high rates of hospitalization, complications and mortality. The link between kidney function and cardiovascular disease – coronary heart disease and heart failure – is particularly significant. Hence, it’s important for everyone to learn how to keep our kidneys healthy. I must say kidneys haven’t gotten the importance they deserve in the media, compared to the heart, lungs and brain. Here are a few tips that you can use.
1. Drink enough fluids: Nearly 70% of our body weight is composed of water and kidneys suffer when the body gets dehydrated for any reason — like diarrhea, vomiting, blood loss and excessive sweating. The recommendation is to drink about two liters (half a gallon) of fluid per day. This translates to eight times ‘8-ounce glasses’ — called the 8×8 rule and is easy to remember. Many health gurus think we’re always on the brink of dehydration and so should sip on water constantly throughout the day even when not thirsty. Clean water is the best drink but iced tea, hot beverages and diluted juices are OK too. Sorry, beer and other alcoholic beverages do not count!
2. Limit your daily salt intake: Well, we do have a love affair with salt (sodium chloride). Most of us in the U.S. consume anything from 3.5 to 8 grams of salt every day, and in countries like India, Japan, China, and Philippines, even much more. However, we need only 2-2.5 gram of salt daily and less for older people, only 1.5 gm (equivalent to a teaspoon) per day. Excess salt encourages water retention leading to hypertension and kidney damage. So, cut down on those pretzels and pickles and, of course, all the other stuff containing too much salt.
3. Eat a healthy diet: A diet low in saturated fats, sugar (including sugary drinks and sweets) and salt with moderate carbohydrate and adequate protein, and lots of colored vegetables and fruits would be ideal. Go easy on red meat (beef, pork, lamb, etc.), if you cannot stop it altogether. Shed the excess weight and keep your BMI (Body Mass Index) within the normal range of 20-25 (Never over 30). A high protein diet like Atkins diet can put a heavier load on the kidneys, leading to some degree of cellular damage, especially in high-risk patients. So, try to eat a balanced diet of whole wheat products, vegetables, fish, eggs (preferably egg white) and fruits.
4. Control your Blood Pressure: Hypertension plays a major role in the development of cardiovascular and renal diseases. About 25 percent of adult Americans and even more globally are living with the disease and many don’t even know it. You already know the factors that promote hypertension like obesity, high salt intake, lack of exercise, excessive alcohol indulgence and inadequate consumption of fruits, nuts and vegetables. Modification of these factors through self-education and participation in community health literacy programs will be helpful.
The recent ACC/ AHA recommendations suggest that intensive management of systolic BP to a target of <120 mm Hg reduced rates of complications of hypertension by 30% and lowered the risk of death by almost 25% compared to the previous recommendation of a systolic BP target of <140 mm Hg. Hence, the leading heart health experts tightened the guidelines for high blood pressure. The new threshold for hypertension is a reading of 130/80 and above. Optimal BP is regarded as below 120/80. (Log on to www.acc.org for details). Check with your doctor before you make any changes.
5. Control your Diabetes Mellitus (DM): Type 2 Diabetes Mellitus (T2 DM) is another leading cause of kidney failure. A person with uncontrolled diabetes for five to 10 years may develop significant kidney damage. T2 DM has become a common disease globally and Indians are especially susceptible to the disease. By the year 2050, up to one in three adults in the U.S. could be diabetic, a frightening prospect. Use the following guidelines for Fasting Blood Sugar (FBS) for the diagnosis of T2 DM. Normal < 100 mg/ dl; Pre-Diabetes 100 -125 mg/ dl; Diabetes > 126 / mg/ dl and follow your doctor’s advice verbatim to keep it under good control.
To be continued …
M.P. Ravindra Nathan, M.D., is a cardiologist and Emeritus Editor of AAPI Journal. For further reading: “Second Chance – A Sister’s Act of Love” by Dr. Nathan from Outskirts Press can be found at www.amazon.com