Chronic Kidney Disease and the Veteran Population

According to the  United States National Institute of Diabetes and Digestive and Kidney Diseases, the occurrences of chronic kidney disease (CKD) are estimated to be 34% higher in the veteran population when compared to the general population in the health care system.  This is due to the significant number of diagnoses among U.S. veterans of diabetes mellitus and hypertension which are directly related to CKD. In an effort to better treat existing cases and prevent new ones, significant research is being conducted by a number of organizations including the Department of Veterans Affairs.

What Are Kidneys?

Kidneys are a sized bean-shaped organ about the size of a fist located in the back of your body. They are the body’s filtration system. They perform a number of very important functions that are necessary for healthy living. They work to filter toxins from your blood, balance electrolyte levels, and control the fluid balance in your body. The waste they filter later becomes a component of urine. They are important in balancing your hormone levels. One type of hormone they work with helps control your blood pressure.

What is Chronic Kidney Disease?

CKD is the result of kidney damage accumulating over time. It can lead to kidney failure (also known as renal failure), which is a total loss of kidney function. As CKD progresses, it is described in 5 stages. Stages 1 and 2 are characterized as your kidneys still working but there is protein detected in your urine (also known as urine albumin or albuminuria). Symptoms start to become apparent in stages 3 and 4. This is when most people are diagnosed. Finally, in stage 5 the kidney function has decreased significantly and this is the beginning of renal failure also known as end-stage.  Once kidney function reaches end-stage renal disease there is no way to make them function optimally again.

Symptoms of Kidney Disease:

A diagnosis of kidney disease is made through the results of blood and urine tests.  Here are some symptoms to look out for:

·        Feeling cold all the time

·        Tiredness

·        Swollen hands and/or feet

·        Shortness of breath

·        Feeling dizzy

·        Nausea

·        Itchy

·        Puffy face

·        Breath that smells like ammonia

·        Foggy mind

What Can I Do To Prevent or Slow Down CKD?

There are a few simple things you can do to lower your risk of CKD. Staying active and eating healthy are the most important. Manage your protein intake. Avoid non-steroidal anti-inflammatory pills also called NSAIDS as much as possible. Avoid smoking and drugs. Additionally, you should manage other health conditions you have closely and under the supervision of a doctor. The two main culprits in the progression of kidney failure are diabetes and hypertension. These conditions should be treated continuously as those with diabetes and hypertension are at higher risk and comorbidity with these is common.

Diabetes care is crucial as it can cause damage to blood vessels by making them more and more narrow if left untreated. The kidneys are filled with small blood vessels that work as part of the filtration system. A narrowing of those already small blood vessels requires the kidneys to work overtime. High blood sugar can cause the vessels to become clogged, rendering them useless. When enough of them are damaged, the kidneys begin to fail. As we learned before, once they damaged there is no repairing them.

Hypertension can cause damage to those small blood vessels as well and can also lead to cardiovascular disease and heart failure. Continuously high blood pressure is a significant risk factor and will cause the small blood vessels to weaken and harden over time. The damaged vessels can no longer supply blood to the kidneys. Additionally, the kidneys produce a hormone, aldosterone, which assists in regulating blood pressure. Once the kidneys begin to fail there is less of this hormone present in the body. If the kidneys fail, there is none left at all.

Treatment of CKD:

There is a treatment for CKD, however, you have to be an active participant in your medical care and available healthcare services. Chronic kidney disease in veterans can be managed. As a veteran, you have access to VA medical centers and the VA health system.; you can get started on VA.gov. Take the steps outlined earlier to slow the progression of CKD. Follow up with your doctor and get urine tests to monitor your protein levels and albumin creatinine ratio. Manage your co-existing conditions fully. Sometimes it is necessary to undergo advanced treatments such as transplant, renal replacement therapy, dialysis, etc. With a kidney transplant, you are given one brand new healthy kidney. It is important to take care of it in order for it to work to the best of its ability. Dialysis is another type of treatment. There is hemodialysis which manually filters your blood. There is also peritoneal dialysis in which sterile fluid is injected into the body to gather the waste products and then drained. Both types are easy to do at home without a doctor. CKD isn’t a death sentence with proper care, people live long and healthy lives.