March is National Kidney Month, a time when the general public can gain a better understanding of how their kidneys work and why they’re so important.
Paul Drawz, MD, a 2003 alumnus of the University of Minnesota Medical School and now an Associate Professor of Medicine in the Division of Nephrology and Hypertension at the University of Minnesota Medical School, originally became interested in the kidneys because they are impacted by so many disparate conditions.
“Pretty quickly in medical school I realized that I was fascinated by pathophysiology, in particular renal pathophysiology, so that drew me into internal medicine. I broadly enjoy internal medicine and the fact that the kidneys can be affected by pulmonary conditions, cardiovascular conditions, rheumatology conditions and people with infectious disease, it means I can specialize but also take care of people across a wide spectrum of internal medicine. It’s challenging and the variety of patients that we see is what I enjoy most about it,” Dr. Drawz said.
Although they are small, the kidneys perform many complex and vital functions that keep the rest of the body healthy. Kidneys help remove waste and excess fluid, filter the blood and regulate blood pressure, in addition to many other crucial services in the body. When the kidneys begin to lose their function, this is known as Chronic Kidney Disease (CKD).
“As people get older, like most other organs in the body, their kidney function gets worse. Older individuals, especially people with chronic conditions–diabetes and hypertension–or people who take a lot of ibuprofen, Aleve or Advil, can be more likely to develop acute kidney injury or kidney disease,” Dr. Drawz said.
Not everyone needs to have their kidney function addressed, but for older individuals, people with conditions like diabetes or hypertension, or for those starting new medications, assessing kidney function is a wise decision.
“The kidneys are a primary regulator of blood pressure in a number of different ways. It’s bi-directional, the kidneys are predominantly involved in controlling blood pressure, and when they’re dysfunctional, people get hypertension. Also, people with hypertension are more likely to get kidney disease. Unfortunately, there’s not a lot you can do to prevent progression of kidney disease as far as lifestyle modifications. It’s difficult in the clinic because almost every single patient will ask ‘What can I do? What diet can I do to stop the progression?’ In general, there’s very little they can do,” Dr. Drawz said.
This is troubling, but it’s not the end of the road. Nephrologists like Dr. Drawz can assess each individual case and determine the best path forward. Patients with mild CKD will need to be managed by their primary care physician over time. They can see a nephrologist initially to determine a cause, but after that, it usually isn’t necessary.
Patients with moderate to severe CKD will see a nephrologist much more often, with the frequency of those visits increasing over time as they move closer to dialysis. Dialysis is still the most common modality for end-stage kidney disease, but transplantation and home hemodialysis are preferred options.
To learn more about kidney health, visit the National Kidney Foundation’s website.