Listen in or read from the partial transcript below as Eugene De Guzman, MD, Nephrologist at Skagit Regional Health, discusses the importance of kidney health, possible symptoms to look out for if things don't feel right and more.

Cheryl Martin Host: First, what are the kidneys main functions and why are they so vital to overall health?

Eugene De Guzman, MD: So, simply put the main functions of the kidney, essentially are to remove wastes and remove extra fluid, but it has host of other functions that people don't usually are aware of. And, some of them are regulating your electrolytes, your sodium, potassium in the body. And it also produces a hormone that stimulates your body to make blood.

Host: What are some of the early signs or symptoms of kidney problems that people should not ignore? 

Eugene De Guzman, MD: That's a difficult question to answer because the severe symptoms that can usually present are also only present towards the end stages of kidney disease. And because the kidney, I would say the kidneys are very much resilient a lot of the symptoms don't usually show up until your kidney function is like around, below like 20%.

Possibly the earliest, maybe most observable sign that it can associate with kidney disease would be an elevated blood pressure or leg swelling, but even for example, leg swelling, it can, can occur in early stages of kidney disease. If let's say you have an inflammation of the kidney, whether it be like a medication or on indium associated.

Host: Are there some blood tests that you can take that would indicate there may be a problem? 

Eugene De Guzman, MD: Oh, absolutely. So kidney disease primarily is diagnosed with lab tests. And if you go to your physician regularly, it can be as simple as a blood test and a urine test. Those are the two things that we at least check to identify individuals who have kidney disease or are at risk for kidney disease.

And it's a blood test called creatinine. And it's a waste product in the blood. It gets plugged into a formula and it gives us an estimate of the kidney function. And then the other test is a urine test for protein. Those are the two tests that we would usually require to say if one has kidney disease or not.

And it typically entails doing serial lab tests. You can't just diagnose kidney disease with one lab test. That abnormality should be at least present for at least three months. ,

Host: So, are these blood tests typically in that panel, or should a person ask the doctor for them, even if they don't have any symptoms?

Eugene De Guzman, MD: Oh yes, the creatinine is typically part of your basic metabolic panel. That's the most basic lab test that usually your physician would order, if, you present with different complaints. The urine test is something that's more specific. Typically, you would ask for it or your primary care physician would order it, let's say if you have leg swelling, for example, or if they already know that you have abnormal kidney function based on your lab tests. 

Host: What are risk factors for worsening kidney function?

Eugene De Guzman, MD: So the most common, risk factors for kidney disease are diabetes and hypertension. By far, they make up about at least almost two thirds of all the causes. Diabetes is by itself, almost 40 to 50 percent of all the risk factors, but certain conditions, chronic infections, things like HIV, hepatitis, which are not as common as, before. Also things like chronic use of some medications like ibuprofen or over-the-counter pain relievers, even over-the-counter medications for acid reflux, for example. So chronic intake of those medications have been linked to kidney disease.

Host: Okay, any other health problems that kidney disease can cause?

Eugene De Guzman, MD: I would say that health problems that can be, are associated with dysfunction. So because it regulates your body's regulation of salts and fluid, then if there's a kidney problem, you usually would develop hypertension and uncontrolled hypertension will eventually lead to more kidney disease.

Towards the late stages of kidney disease, people develop anemia because it's the kidneys produce that hormone that stimulates your body to make blood. And it also helps regulate bone health because the kidney plays a part in your calcium and phosphorous metabolism that if, let's say, when towards late stage of kidney disease, your phosphorous level builds up, which in turn leads to a state of weakening your bones.

Host: So, what treatments are available?

Eugene De Guzman, MD: Treatments in terms of if you reach end stage, of course, then of course dialysis is what we offer. Dialysis can take place in a center or at home. There are two forms of dialysis. There's hemodialysis, where you actually see your blood getting cleaned from a machine with a pump.

And there's peritoneal dialysis, where there's a catheter that will be put in the abdomen. And we teach you how to do this at home. Of course, kidney transplantation is also another option, although not everyone can get a kidney transplant. Still, the best treatment would be prevention.

Host: I'm glad you brought that up because we want to know how can healthy lifestyle choices impact kidney health and what are those choices?

Eugene De Guzman, MD: So, certainly, healthy lifestyle choice can slow down kidney disease, especially if you already have kidney disease. Making sure that you maintain close to your ideal body weight, your body mass index and that's something that you need to discuss with your primary care physician.

Quitting smoking, certainly is going to be helpful, not just for the kidney disease, but also for cardiovascular health in general. Because the kidneys are made up of very small blood vessels, that the smoking damages blood vessels, essentially. Limiting your sodium intake because it contributes to hypertension and the usual recommendation from the CDC is limiting it to less than two grams a day.

Making sure that you get a healthy and balanced diet, making sure that you have enough plant sources in your diet, not just animal protein. And of course, maintaining regular activity, staying active, engaging in exercise. Again, it's hard, but the CDC recommends at least 150 minutes of exercise per week, which a lot of us can't do, but we should always try to achieve.

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