Women More Likely to Get Kidney Disease than Breast Cancer
How often do you check your plumbing?
Not very often, right? Usually only when the toilet won’t flush, the faucet won’t work, or the bathtub drain becomes clogged beyond what Drano can fix.
Unfortunately, most of us treat our own plumbing system—the kidneys—much the same way. As long as we don’t notice a problem, we ignore them, completely.
A new report published in the American Journal of Kidney Diseases tells us that’s a very bad idea. Using data from the National Health and Nutrition Examination Surveys, researchers estimate that more than half of U.S. adults aged 30 to 64 years will develop chronic kidney disease (CKD) during their lifetime.
Compare that to current estimates of lifetime incidence of breast cancer at 12.5 percent, and between 33-38 percent for diabetes.
In fact, rates of kidney disease in both men and women have doubled between 1974 and 2002, and they’re expected to continue to increase, particularly among those over the age of 60.
Kidney disease is no picnic. Disease progression can be delayed with medications and other therapies, but meanwhile symptoms may include fatigue and weakness, muscle twitches and cramps, swelling in the feet and ankles, high blood pressure, and more. As the disease gets worse, kidneys may shut down completely, after which patients face dialysis and, if they’re lucky, transplantation.
The National Kidney Foundation states that 26 million Americans have CKD, and millions of others are at risk.
How can you avoid being one of them?
What is Kidney Disease?
The kidneys are the body’s plumbing system. Like giant filters, they remove all the excess waste and extra water from the bloodstream and flush it out through urine. That waste includes byproducts of metabolism, chemicals ingested through food and from the environment, medications or drugs you’re taking, alcohol, and more.
It’s a little more complicated than that, though, as the kidneys are also responsible for maintaining balance in the body of several chemicals, including sodium, potassium, and certain hormones. In doing so, they help to control blood pressure, support production of red blood cells, and release hormones that maintain healthy bones.
When kidneys begin to malfunction or become damaged somehow, the person may be diagnosed with CKD. The official definition of the disease states that the kidneys have some type of abnormality for three months or more.
Some people can get by for years with sub-par kidney function, but others eventually progress to all-out kidney failure. At that point, the kidneys can no longer do their job, and dialysis or transplant are the only options left.
What Causes Kidney Disease?
Like heart disease, kidney disease is usually the result of other health problems that exist for several years. By far, the biggest risk factors are diabetes and high blood pressure. These two diseases, if not controlled, greatly increase the changes that a person will develop CKD.
High blood pressure, for example, can damage the small blood vessels in the kidneys, while diabetes can damage the “nephrons,” or filtering units, inside the kidneys.
Other risk factors include the following:
- Age—those over 60 are more at risk
- Cardiovascular disease
- Family history of kidney disease
- Glomerulonephritis (inflammation of the kidneys)
- Polycystic kidney disease (kidney cysts)
- Birth defects that affect the kidneys, and low birth weight
- Kidney stones
- Frequent urinary tract infections
- Street drugs like heroin
- Large amounts of over-the-counter pain relievers
- Race: African Americans, Hispanics, Pacific Islanders, and American Indians are at increased risk
Kidney Disease is Sneaky—Keys to Making a Diagnosis
Like high blood pressure, kidney disease is sneaky. It can exist for years without you knowing it. Meanwhile, the damage gets worse.
You may have no symptoms at all for years. Eventually, you may feel fatigued, or suffer from frequent headaches. As the diseases progresses, you may need to go to the bathroom more often, find your appetite waning, experience swelling in your hands and feet, suffer from muscle cramps, and lose your appetite.
If you have any of the risk factors above, it’s important to keep an eye on your kidneys. Specifically if you have high blood pressure or diabetes, you want to keep these diseases under control.
If you go to your doctor for testing, he or she is likely to look at the following:
- Blood test: Signs that your kidneys aren’t working right include too much of certain waste substances in the blood. One of these is creatinine, which is a byproduct of muscle breakdown during activity. Others include urea, calcium, proteins, and hormones.
- Urine test: This shows how well your kidneys remove creatinine. You simply collect your urine for 24 hours, and an analysis will show whether levels of creatinine and other waste products are normal.
- A1C test: This test is used to measure long-term blood glucose levels. It’s usually given to people with diabetes, but high levels can also signal potential kidney disease, since high blood sugar can damage kidneys.
- Blood pressure test: Since blood pressure increases risk of kidney disease, this test may also be used to make a diagnosis.
- Renal imaging: This is simply a scan of the kidneys themselves. Doctors may use ultrasound, a CAT scan, or MRI.
- Renal biopsy: The doctor retrieves a small piece of kidney tissue for examination.
Through these tests, an examination of any symptoms you may be having, and a look at your medical history, a doctor can make a diagnosis of CKD.
According to a recent study, urine and A1C tests were the best for diagnosing and managing kidney disease. Researchers suggested that additional tests may be unnecessary.
How is Kidney Disease Different in Women?
Though we have less information on how kidney disease differs between the genders than we do heart disease, there are some things we know:
- CKD is more common in women overall: Several studies have shown that overall, women are more likely than men to have chronic kidney disease.
- Women aren’t treated with dialysis as often as men: According to a 2014 study, fewer women than men receive dialysis treatment for advanced kidney disease (often called “end-stage renal disease”). Researchers analyzed data from over 200,000 patients looking for any inequalities between the genders, and found that more men than women were receiving dialysis (59 percent versus 41 percent). Men were also more likely to get kidney transplants. This raises concerns that women aren’t being treated as aggressively as they should be for the good of their long-term survival. Researchers recommended further study, and stated they didn’t know what was causing the discrepancy.
- Women less likely to be diagnosed than men: In 2009, researchers reported that women were more likely than men to have undiagnosed kidney disease. Researchers reviewed data for nearly 900 patients with known kidney disease and found that just over 52 percent of them did not have a diagnosis in their medical charts. Women were more likely than men to lack a diagnosis, except in the very end stages of the disease. Researchers cautioned that primary care physicians need to improve early detection.
- Women may live longer with the disease than men: Though women are more likely to have kidney disease than men, they also survive longer with it. Even with the inequality in dialysis treatments, women have a survival advantage.
- Kidney disease may increase risk of early menopause: According to a recent study, women with even mild kidney disease are more likely to experience early menopause—before the age of 45. It was a small difference (26 percent of women with kidney disease had early menopause vs. 23 percent of women without the disease), but it was significant.
Treatment for Kidney Disease
Kidney disease is not curable, but it can be treated so patients can continue to live their lives. If detected early, doctors can help control it so that it progresses more slowly. Treatment is also important to help patients reduce their risk of complications, like heart disease and stroke.
Treatment depends on the cause. If you suffer from high blood pressure, for instance, doctors may prescribe medications to help manage it, which can shield your kidneys from further damage. If you have diabetes, controlling your blood sugar becomes paramount. Depending on your symptoms, doctors may also prescribe medications to encourage production of red blood cells, relieve swelling, protect bone development, and minimize waste products in your blood.
Even with these steps, however, kidney disease is likely to get worse over time. If the kidneys deteriorate to the point that they’re functioning at only 10-15 percent of capacity, doctors are likely to prescribe hemodialysis. This treatment involves a machine that filters waste and fluids from the blood. The treatment must be done often, usually about three times a week, for the rest of the patient’s life, or until he or she can get a kidney transplant.
A kidney transplant can help patients avoid continued dialysis. Surgeons remove the malfunctioning kidney and replacing it with a healthy one from a “matching” family member or deceased donor. Not everyone is a candidate for transplants, however. It depends on overall health, age, and the availability of a matching kidney.
The good news it that according to a recent report released by researchers at the United States Renal Data System (USRDS), patients are doing better and living longer with treatment today than they were even just a few decades ago.
5 Ways to Lower Your Risk of Kidney Disease
Though treatments continue to improve, it’s best to avoid kidney disease in the first place. Check with your doctor, particularly if you have risk factors, and use the following five tips to increase your odds of retaining healthy kidneys for the rest of your life.
- Eat a Mediterranean diet: According to a 2014 study, this diet helped significantly reduce the risk of CKD. Researchers found that for every one-point increase in the Mediterranean “diet score,” participants experienced a 17 percent decreased risk of developing CKD. Overall, the diet was linked to a 50 percent reduced risk of CKD and a 42 percent reduced risk of rapid kidney function decline. Not sure what a Mediterranean diet is? Just think more fruits, veggies, fish, legumes, and healthy fats, with fewer red meats, processed foods and sweets.
- Control high blood pressure and blood sugar: Since these are two major risk factors for heart disease, it’s critical that you keep them under control. Getting a blood test at least once a year will show you and your doctor how you’re doing on both.
- Limit pain pills: Taking a lot of pain pills over the duration of your life can increase your risk of kidney disease. Even over the counter NSAIDs, like aspirin, acetaminophen, ibuprofen and naproxen sodium can damage your kidneys when taken for a prolonged period or at high doses. If you have a chronic pain condition that is causing you to turn to pain pills a lot for a long period of time, talk to your doctor about your risk and what you may be able to do to reduce it. There may be alternative pain treatments that don’t involve the medications, for instance.
- Get a urine test: It’s easy to do, and it will tell your doctor if you have any kidney trouble. This is the best way to detect kidney problems early.
- Don’t smoke: Smoking increases risk of kidney disease.
Thomas J. Hoerger, et al., “The Future Burden of CKD in the United States: a Simulation Model for the CDC CKD Initiative,” American Journal of Kidney Diseases, March 2015; 65(3):403-411, http://www.ajkd.org/article/S0272-6386(14)01363-8/abstract.
Kunitoshi Iseki, “Gender differences in chronic kidney disease,” Kidney International, (2008) 74: 415-417, http://www.nature.com/ki/journal/v74/n4/full/ki2008261a.html.
“How Your Kidneys Work,” National Kidney Foundation, https://www.kidney.org/kidneydisease/howkidneyswrk.
“Are Doctors Using Unnecessary Tests to Diagnosis Chronic Kidney Disease?” Brigham and Womens Hospital, [Press Release], March 2, 2015, http://www.brighamandwomens.org/about_bwh/publicaffairs/news/PressReleases/PressRelease.aspx?sub=0&PageID=2000.
Minesh Khatri, et al., “The Association between a Mediterranean-Style Diet and Kidney Function in the Northern Manhattan Study Cohort,” CJASN, November 7, 2014; 9(11):1868-1875, http://cjasn.asnjournals.org/content/9/11/1868.
Manfred Hecking, et al., “Sex-Specific Differences in Hemodialysis Prevalence and Practices and the Male-to-Female Mortality Rate: The Dialysis Outcomes and Practice Patterns Study (DOPPS),” PLoS Medicine, October 28, 2014; 11(10: e1001750; http://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1001750.
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