• Thank you for participating in my education session today. I am a Kidney Health Coach, certified by the American Kidney Fund. I took an online course that certified me to teach this material today. • Introduce yourself. Talk about your background, and why you became a Kidney Health Coach. • Informally survey the audience about how much they know about kidney disease, and why they chose to participate in the education session. 1
First, we’re going to begin with the basics of kidney disease. And to do that, you need to know what the kidneys do. • The kidneys are vital organs, and are as critical to life as the heart, lungs and other organs. • The kidneys are a pair of bean shaped organs, about the size of a fist located near the lower middle part of the back, on either side of the spine. • Most people have two kidneys, but some are born with just one. It is possible to live with just one kidney. • Each of the kidneys is connected to the bladder by a thin tube called a ureter, as you can see in the picture. 2
• The main job of the kidneys is to filter waste and extra fluid out of the blood to make urine. • You may not realize it, but the body makes waste all the time. • The waste comes from food we eat, and from using the muscles in the body. • The kidneys have thousands of tiny little filters. As the blood goes through the kidneys, these filters take out the waste, and it goes into the urine. • Then the cleaned blood flows out of the kidneys and through the rest of the body. • This waste builds up in the urine, so when one urinates, this waste exits the body. • Think of the kidneys as a shower drain. As you take a shower the water flows to the drain, and your drain cover catches anything you don’t want going down the drain but allows water to pass. • Similarly, when blood flows through the kidneys, the kidney filters remove waste from the blood so it doesn’t build up in the body. The clean blood then flows back through the body. • Imagine if your drain cover came off, or was broken. All that extra hair and fuzz would go down the drain and clog it, and water would build up in the shower. • If the kidney filters are damaged or stop working, they let things the body needs – like blood and protein - escape through their filters, and things the body doesn’t need – like waste and extra water - start to build up in the body. • This will cause serious illness including problems for the heart, lungs, blood, and bones. • The kidneys have other important jobs that keep the body working the way it should. Some of the other jobs of the kidneys are to: • Help keep the right amount of minerals in the body. Minerals include things like sodium, potassium, and calcium, which we get from food. • The kidneys help to control blood pressure. • They help to keep bones healthy. • And they help the body make red blood cells. 3
• Chronic kidney disease means permanent damage to the kidneys, meaning the damage cannot be reversed. • This damage can get worse over time. • Unfortunately, chronic kidney disease will not get better. There isn’t a medicine or a treatment that can fix damage to the kidneys. • Once the kidneys reach a certain level of damage, they will not get better. • It’s possible to keep the damage from getting WORSE, but the damage to the kidneys won’t get better. 4
• There are 5 stages of kidney disease. The stage of kidney disease can be determined by a blood test. • Stages 1-3 usually don’t have symptoms, and so many people don’t know they have it at that point. • Stage 4 means the damage to the kidneys is already very severe, but still may not show very obvious symptoms. • By stage 5, the kidneys are nearing failure or have completely failed, and this may come as a surprise to certain people. • The dangerous thing about kidney disease is that many people with kidney disease don’t know that they have it until it’s become pretty bad. • In fact, some people end up in the emergency room with what seems like a serious illness, and find out that they have had kidney disease, and are close to kidney failure! • This happens because chronic kidney disease usually gets worse slowly, and symptoms may not appear until the kidneys are badly damaged. • In the late stages of chronic kidney disease, nearing kidney failure, some may notice symptoms that are caused by waste and extra fluid building up in the body. • These symptoms can be severe, and are definitely noticeable at this point. These symptoms are what bring people into the ER. • The only way to diagnose chronic kidney disease is to get tested. That’s why it’s so important to be tested regularly. 5
• Kidney failure, or end-stage renal disease (ESRD), is the last stage of kidney disease. • Kidney failure happens when the damage to the kidneys gets worse, to the point that they completely stop working. • Once a person reaches kidney failure, they will need to start dialysis or have a kidney transplant to live. 6
• In order to beat kidney disease, you need to understand what causes it. • I will now be going over the causes and risk factors for kidney disease. 7
• Anyone can get kidney disease, but some people are more at risk than others. • Diabetes and high blood pressure are the most common causes of kidney disease and kidney failure. 8
• Diabetes is the leading cause of kidney disease and kidney failure. • Almost half of all kidney failure cases are caused by diabetes. 9
• Diabetes is a disease that causes the body to have trouble making or using insulin. • Insulin is a hormone that helps the body turn the sugar one eats into energy. • So when the body doesn’t make or use insulin the way it should, too much sugar stays in the blood. • When there is too much sugar in the blood, it can damage the tiny blood vessels in the kidneys. • Let’s go back to the shower drain analogy. • Since the main job of the kidneys is to filter the blood, you can imagine what would happen when these filters stop working. • Just like if the drain cover of a shower came off or was broken, it would allow extra stuff to go down the drain that would cause problems. • Similarly, if the kidney filters stop working, the extra waste in the body stays in the blood and causes major health problems. • The extra sugar that stays in the blood because of diabetes can cause damage to the kidney filters. • And damage to the kidney filters leads to permanent kidney damage, meaning chronic kidney disease. • To check for diabetes, one would need to have a blood glucose test which looks at the level of sugar in the blood. • A healthy blood glucose level after fasting is between 70 and 99. A healthy level when not fasting is between 100 and 140. 10
• High blood pressure is the second leading cause of kidney disease and kidney failure. • You may have heard the word, “hypertension.” This is just another word for high blood pressure. High blood pressure and hypertension mean the same thing. • High blood pressure causes about 1 in 4, or 25 percent of all cases of kidney disease. 11
• High blood pressure can cause kidney disease, and it can also be caused by kidney disease. We’ll explain both of these ways separately. • First we’ll start with how high blood pressure can cause kidney disease. • Having high blood pressure means the heart is working too hard to pump blood. • When someone has high blood pressure, blood flows through blood vessels very forcefully, and since kidneys are made of tiny blood vessels, this can harm these blood vessels and cause kidney disease. • Think of the kidneys as a colander (or strainer). You can imagine water from the sink gently flowing through the colander. This is what it’s like when the blood flows through the kidneys when a person has a healthy blood pressure. • Now imagine a firehose aimed at a colander. The strong pressure from the firehose would cause damage to the colander over time. This can be compared to the damage high blood pressure will cause when blood is flowing too forcefully through the kidneys over time. • Keeping a healthy blood pressure can help prevent kidney disease. A healthy blood pressure is considered 120 over 80 or below. • 140 over 90 and higher is considered high blood pressure. • A blood pressure test is an easy way to check one’s blood pressure numbers. Blood pressure is measured using a cuff that tightens around the upper arm. • One can get a blood pressure test at their doctor. • Sometimes pharmacies or grocery stores have free automatic blood pressure machines. It’s also possible to buy your own blood pressure cuff in order to check your blood pressure at home. 12
• Kidney disease can also cause high blood pressure. • The kidneys make a hormone called renin that helps the body control blood pressure. • When the arteries that deliver blood to the kidneys are damaged, the kidneys make too much renin. This causes an increase in blood pressure. • Whenever someone gets their blood pressure checked, they should keep in mind that a high reading could be connected to kidney disease. • They may already have kidney disease, which makes their blood pressure high. • Or if their blood pressure is high for another reason, they are at risk for getting kidney disease. • This is why checking blood pressure regularly, especially for those with high blood pressure, is so important. 13
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