Get Well Wednesday: March Is National Kidney Month

Orlando M. Gutiérrez, M.D., M.M.Sc., obtained his medical degree from the University of Toledo College of Medicine in 2002. He then completed internship and residency training at the Massachusetts General Hospital in Boston from 2002 to 2005, and a clinical and research fellowship in nephrology from the Brigham and Women’s Hospital/Massachusetts General Hospital Joint Nephrology Training Program in 2008.

With the support of an American Kidney Fund Clinical Scientist in Nephrology Fellowship award, he completed a Masters in Medical Science degree in human clinical investigation from Harvard Medical School during his fellowship, graduating as the valedictorian of his class. Dr. Gutiérrez joined the faculty of the Division of Nephrology and Hypertension at the University of Miami Miller School of Medicine as an Assistant Professor of Medicine in 2008.

Gutierrez is now an Associate Professor of Medicine in the School of Medicine and the section head for outcomes and epidemiology research in the Division of Nephrology at UAB. His focus on kidney disease making him one of the leading doctors in the field.

What are the signs that your kidneys are not working properly?

Swelling, tiredness, nausea, loss of appetite, high blood pressure.

Does drinking 8 glasses daily help your kidneys?

Not necessarily; there is no good evidence that everyone needs to drink that much per day.

What is a nephrotic kidney?

This refers to a kidney that is spilling a lot of protein in the urine.

Can you reverse kidney damage?

In certain cases, kidney damage can be reversed, but not in all cases.

Does hepatitis affect kidney functions?

Certain forms of hepatitis like hepatitis C or B can certainly damage the kidney.

Can you get rid of high blood pressure?

Yes! In many cases, exercise, weight loss, and reducing sodium (salt) in the diet can lower blood pressure.

What would be the earliest signs of possible kidney problems?

Unfortunately, early kidney problems do not have signs or symptoms; that is why screening with blood or urine tests is important in high risk individuals (those with diabetes, high blood pressure, or strong family history).

What can I do about proteinuria?

This depends on the cause of proteinuria; different medications may be effective depending on the cause.

Is frequent urination a sign of kidney disease?

Not necessarily; many things can cause frequent urination.

How do diabetes and alcohol effect kidneys?

Diabetes is the number one cause of kidney disease in the US; poor blood sugar control can damage the kidneys. Alcohol normally does not cause kidney problems.

How much water would you recommend on a daily basis to help prevent kidney disease?

This depends on the person; in general, I advocate letting your body tell you– if you are thirsty, drink water; if not, don’t.

Hey, Doctor, I’m a whey protein drinker as I’m a weight lifter. Is it necessary to cycle off of it for a period of time?

From a kidney perspective, this is not necessary.

Hey doctor, I think I might have a prostate problem because I bleed a lot. 

This may be a serious problem that should be evaluated by a urologist.

Can a person who does not have hypertension or diabetes be considered at risk for kidney failure or disease?

If you have a strong family history of kidney disease, are overweight, or have heart disease, you may be at increased risk of kidney disease.

How do you test kidney function? Blood test?

Yes; simple blood and urine tests available at any medical laboratory or through your primary care physician’s office.

What A1C # is considered diabetic?

Generally, greater than 6.

Are little dry bumpy patches, little bumps on your skin associated with maybe a kidney issue?

Not necessarily; there many different causes of this, usually not due to kidney disease.

Doctor, what foods or drinks can we consume to help our kidneys?

The same foods and drinks for a heart-healthy diet– lots of fruits and vegetables, moderate intake of red meat, low sodium, water instead of soft drinks or sugary drinks.

I have high levels of protein in my urine. What does that mean?

It means that there some sort of damage in your kidneys that is calling them to spill out protein; this should be evaluated by a doctor.

Can drinking Diet Coke as a diabetic harm your kidneys?

There is not good evidence that his harms the kidneys, but I always recommend people substitute water for soft drinks in general.

Dr. Orlando, Can diet and exercise modifications alone manage diabetes without insulin if your pancreas is the culprit?

If you have type 1 (juvenile) diabetes, you have to have insulin to survive; if you have type 2 diabetes (adult onset), diet and exercise can be effective for managing without insulin.

Hello Doc, my mom was just told yesterday that her kidneys have gotten a little worse. She’s hypertensive with thyroid disorder. What can she do to stop or slow down the progression?

Often times, certain medications can help to slow progression of kidney problems depending on the cause.

What steps, if any, can be taken to lower the creatine level? I know someone whose levels have been high for a few years.

It depends on the cause of the high creatinine levels; sometimes, certain medications or lifestyle changes can help lower creatinine.

Does high blood pressure medication damage my kidneys?

I have a question for the doctor. I have kidney disease. What can I do to prevent my creative level from going up?

It depends on the cause of the kidney disease; for certain conditions like diabetes, medications and lifestyle changes can help keep the creatinine down.

 What does it mean when you have a cyst on your kidney? It’s been there for several years.

This is usually a benign finding (not something to worry about); simply a sack of fluid in the kidney

Good morning. Can a kidney exam be given by a primary physician?

Yes.

Good morning. Other than hereditary, high blood pressure, diabetes, or overweight, what causes kidney failure? Does drinking too many sodas?

Certain other conditions like hepatitis B/C, HIV infection, taking medications like  ibuprofen can cause kidney failure; sodas alone normally do not cause kidney disease.

I have 1 kidney, but I drink a lot of diet Pepsi. Will that effect the other one? I have high blood pressure as well.

I always advocate substituting water for soft drinks; soft drinks have sodium (salt) in them you probably don’t need to be drinking.

Doctor, what are the numbers we should be concerned with when looking at blood pressure?

In general, a blood pressure > 140/90 should be evaluated by a doctor.

Question for the Doc: I’ve been diagnosed with polycystic kidney disease. Genetically inherited from unknown parents, will it skip through my children and grandchild, then eventually be gone?

Depends on the type of inheritance; for certain types of polycystic kidney disease (autosomal dominant) it will not skip generations.

Doctor, my blood pressure is 145/80 and there is blood in my urine. Are they related?

They may be; this should definitely be evaluated by a doctor.

I have diabetes. How do you test for kidney disease?

Simple blood and urine tests that can be done at a primary care physician’s office.

Good morning! I was diagnosed with kidney disease and was told I may need dialysis. At my last doctor”s appointment, my creatinine level went down. My question is what can I continue to do to help keep my level down? I changed my eating habits significantly and I’ve always been active as far as exercise & jogging.

Great job with changing your risk factors (diet, exercise); this is so important and most likely, the biggest thing that will help your kidneys. More specific advice depends on the cause of your kidney problems.

Do frequent UTIs mean that you have a kidney disease?

Not necessarily; this often happens without any problems in your kidneys

Doctor, when you take pain meds, do the pain meds cause kidney issues?

It can; certain medications like ibuprofen can cause kidney problems if you take lots of them over a long period of time.

Hello. I had been having chills nausea and felling weak. No appetite. I went to the doctor and they detected microscopic blood in my urine. They sent me to the urologist. I had an ultrasound done where cysts on my kidneys were discovered. I then had a CT scan on my kidneys where they discovered that they were slightly swollen. They checked my bladder and said everything was fine. They never gave me any reason for the symptoms and said I had nothing to worry about.

Cysts are a common finding in the kidney and often are benign (not to worry about); it would be good to talk to your doctor to make sure that is the case for you.

I get kidney stones often, although I’ve never been told that I have kidney problems. Should I be alarmed?

Kidney stones can be prevented!  You should talk to your doctor about your specific risk factors so that you don’t get them anymore.

Yes, doctor I was told I have a case of kidney disease but was told mine started from pain pills for my back problems, he have me on amlodipine to protect my kidneys, anything else that I can do?

Depends on the specific cause of you kidney disease; from what you write above, stopping the pain pills seems to be the best first step.

What are the benefits of pure coconut water to your kidneys?

None to my knowledge.

How long can a person live in dialysis?

There is no specific time; each person is different.  I have known individuals who have lived greater than 20 years on dialysis, though this is not the norm.

What’s the # 1 cause of high blood pressure?

Usually a combination of being obesity and diet.

How can you stop taking blood pressure medication?

Depends on the cause; for many people, exercise, losing weight and lowering diet sodium (salt) intake can lower the need for blood pressure medications.

I have Crohn’s disease. Does that effect my kidneys?

Sometimes; people with Crohn’s disease are at higher risk of getting certain forms of kidney stones.

Is there any correlation between taking Lipitor and getting diabetes? How helpful is Losartan for the kidneys?

The data on cholesterol-lowering medications and diabetes is murky right now; nothing definitive. Losartan is fine of the kidneys.

I had microscopic blood in my urine when I took my Department of Transportation physical Sunday. What might be going on with my kidneys?

There are many different things that might be going on, and not necessarily in your kidneys. This should definitely be evaluated by a doctor.

Will kidney disease cause hepatitis C and is hepatitis C the worst case of hepatitis one can get?

Hepatitis C can cause kidney disease, yes.  But hepatitis C is curable now– talk to your doctor.

Does a full body cleanse help with blood pressure?

Not necessarily.

Here’s what you should know about how to prevent kidney disease and failure:

• Diabetes is the #1 cause of kidney failures among African Americans.
• High blood pressure is the #2 cause of kidney failure among African Americans.
• African Americans with kidney disease are more likely to progress to kidney failure than any other group.
• African Americans are nearly four times more likely to develop kidney failure than Caucasians.
• Even though African Americans comprise only 13% of the U.S. population, they account for almost 1/3 of kidney failure cases.
• There are 195,000 African Americans living with kidney failure. To put this in perspective, if those individuals formed a line, it would be more than 70 miles long.

March is National Kidney Month. For more information on your risks and how to prevent kidney disease, click HERE.

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