Kidney Disease and Our Community: What You Need to Know for Better Health Today

More than likely, you may know someone who has had kidney disease, or you may have experienced kidney issues yourself. Even some of our greatest entertainers, like Tina Turner and Natalie Cole, have publicly shared their kidney concerns. Our kidneys play an important role in keeping our bodies healthy. When they become damaged or unable to work properly, you may develop chronic kidney disease (CKD). CKD greatly impacts Black people. In fact, we have a higher rate of developing kidney failure, and are less likely to receive equal treatment when it comes to CKD.^1,2

Understanding CKD

People typically have 2 kidneys and they each help to filter out waste from your blood, kind of like a water filter. Once your kidneys filter out the waste, this “cleaned” blood is returned back into your body, and the waste gets sent out of your body when you pee.³

When there is damage to your kidneys, this filter stops working properly. Damage can happen to your kidneys as a result of several things such as: a high-sodium diet, high blood pressure, diabetes, smoking, and obesity.^4,5

Chronic kidney disease happens when you begin to lose kidney function over time.³ Losing kidney function means that your kidneys are less likely to properly filter out waste from your bloodstream.³ 

Taking care of your kidney health before it progresses to CKD is important because once kidney disease is developed, it cannot be reversed.

What else should you know about your kidneys? 

Your kidneys are not like other organs. For example, your liver can regenerate, or regrow, after damage.⁶ If your kidneys reach end-stage renal disease (ESRD), there is no coming back.⁷   That means you may have to be on dialysis or need a kidney transplant for your body to function properly. ⁷

Dialysis is a procedure that uses a machine to remove waste from your blood if your kidneys stop working.⁷

This is why it is important to stay on top of any symptoms and look for signs that kidney disease may be developing. Managing any symptoms and taking care of your kidneys can be one of the most important steps in preventing chronic kidney disease from reaching end-stage renal disease.

 Learn More About CKD

What are the signs of chronic kidney disease? 

Chronic kidney disease is often called the “Silent Killer” because signs and symptoms can go unnoticed until CKD has reached a severe stage. 

It is important to know the signs to look out for, so you can prevent your kidney function from worsening. 

Symptoms of CKD can include:

• Fatigue
• Swelling in the legs and ankles
• High blood pressure
• Poor appetite
• Changes in urination frequency or amount
• Nausea and vomiting
• Itching⁸

Learn More About Possible Symptoms Here

The Stages of CKD

There are 5 stages of chronic kidney disease, and each stage depends on how much of your kidney function is still available. Stage-1 is the first, going all the way to stage-5, which is “end-stage.³”

Unequal Outcomes in CKD

When it comes to chronic kidney disease, the outcomes have not been equal across all backgrounds. Things like your access to healthy foods, healthcare facilities, and even the amount of stress present in your daily life, can all impact how your kidneys function.^2,9
On top of these individual and society-level factors, your genetics, or family health history, can also play a role. For Black people who may have any African ancestry, changes in a gene called APOL1 can impact your kidneys.¹⁰

All About APOL1

Have you ever heard of APOL1? Most people haven’t- but it can be helpful to your kidney health to know why it’s so important. 

APOL1, short for ‘Apolipoprotein L1’(pronounced: “a-po-li-po-pro-tein L-1″) is a gene that tells your body which proteins to create, and these proteins allow your body to fight off certain illnesses.  Everyone has APOL1. However, people with African ancestry can be more likely to have changes in the APOL1 gene that increase your chances of developing kidney disease and having it develop at a faster rate.¹⁰

Approximately 13% of the U.S. Black population have the APOL1 gene changes (mutations) that make kidney disease more likely to develop.¹⁰ Meaning if you have certain APOL1 gene changes, you have about a 1 in 5 chance of developing kidney disease.¹⁰

If you have this APOL1 gene mutation, you can develop what is called APOL1-mediated kidney disease.¹⁰ 

To find out if you are at risk for or have APOL1-mediated kidney disease, you can get a genetic test to find if you have these specific changes in your genes. Talking with your doctor is a great first step in finding out more about genetic testing and if you have a higher risk of developing kidney disease.¹⁰

Learn more about genetic testing here.

CKD and Diabetes 

Your chances of getting CKD can also increase if you have diabetes. Around 1 in 3 people with diabetes will develop kidney disease.¹¹

If you have diabetes and your body is unable to control its blood sugar, this can cause damage to the blood vessels in your kidneys which can cause them to not work as well.¹¹

Diabetes has also been found as the leading cause of kidney failure, which makes it especially important for those with diabetes to stay on top of how well their kidneys are functioning.¹²

CKD and Heart Disease

Having CKD can increase your risk of getting heart disease- and having heart disease can increase your risk of getting CKD.¹³ For people with CKD, there is a higher risk of heart failure because the kidneys can’t properly get rid of excess fluid.¹⁴ For people with heart disease, there is a higher risk of CKD because the heart can’t get enough blood flow to the kidneys.¹⁴

Heart disease is the leading cause of death for people who are on dialysis, so it is important to be aware of how your heart health can impact your kidneys.¹³

What should you do to stay on top of your kidney health?

Certain activities like limiting your sodium intake, managing your diabetes, exercising regularly, and keeping your blood pressure in a healthy range (below 130/80) can all work to keep your kidneys healthy.¹⁶

If you have access, getting an at-home blood pressure monitor can also help you to notice any changes in your blood pressure that can potentially impact your kidneys.

You can ask your doctor for a blood or urine test to check how your kidneys are functioning. Your doctor can measure your eGFR (estimated glomerular filtration rate) to see how well your kidneys are working.

There are many parts to preventing and managing CKD, but keeping a healthy diet and lifestyle, having regular check-ins with your healthcare provider, and considering genetic testing can all work to best protect your kidneys.

References

1. National Kidney Foundation. “Race, Ethnicity, & Kidney Disease.” National Kidney Foundation, 2020, https://www.kidney.org/atoz/content/minorities-KD. Accessed 12 July 2023.
2. Tucker, J. Kevin. “What’s Behind Racial Disparities in Kidney Disease?” Harvard Health Publishing, 3 February 2021, https://www.health.harvard.edu/blog/whats-behind-racial-disparities-in-kidney-disease-2021020321842. Accessed 12 July 2023.  
3. American Kidney Fund. “Stages of Kidney Disease.” American Kidney Fund, 26 October 2022, https://www.kidneyfund.org/all-about-kidneys/stages-kidney-disease. Accessed 12 July 2023.
4. Mayo Clinic. “Chronic Kidney Disease.” Mayo Clinic, 3 September 2021, https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521 Accessed 12 July 2023.
5. National Kidney Foundation. “10 Common Habits That May Harm Your Kidneys.” National Kidney Foundation, 27 June 2016, https://www.kidney.org/content/10-common-habits-that-may-harm-your-kidneys. Accessed 12 July 2023. 
6. NIH Research Matters. “Cells That Maintain and Repair the Liver Identified.” National Institutes of Health, 9 March 2021, https://www.nih.gov/news-events/nih-research-matters/cells-maintain-repair-liver-identified#:~:text=The%20liver%20has%20a%20unique,the%20liver%20isn’t%20invincible. Accessed 12 July 2023. 
7. UCLA Health. “End-Stage Renal Disease (ESRD)” UCLA Health, https://www.uclahealth.org/medical-services/urology/conditions-treated/adult-conditions/end-stage-renal-disease-esrd#:~:text=End%2Dstage%20renal%20disease%20(ESRD)%20occurs%20when%20the%20kidneys,with%20a%20functioning%20transplanted%20kidney. Accessed 12 July 2023.
8. National Kidney Foundation. “10 Signs You May Have Kidney Disease.” National Kidney Foundation, 17 December 2020, https://www.kidney.org/news/ekidney/august14/10_Signs_You_May_Have_Kidney_Disease. Accessed 13 July 2023. 
9. Cains-Shiels, L., et. al. “The Association Between Goal-Striving Stress and Rapid Kidney Function Among African Americans: The Jackson Heart Study.” National Library of Medicine, National Center for Biotechnology Information, 20 April 2021, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8057281/#:~:text=Ethnic%20and%20racial%20disparities%20in,may%20lead%20to%20kidney%20disease. Accessed 12 July 2023.
10. American Kidney Fund. “APOL1- Mediated Kidney Disease.” American Kidney Fund, 5 May 2023, https://www.kidneyfund.org/all-about-kidneys/other-kidney-diseases/apol1-mediated-kidney-disease. Accessed 27 June 2023. 
11. CDC. “Chronic Kidney Disease.” Centers for Disease Control and Prevention, 30 December 2022, https://www.cdc.gov/diabetes/managing/diabetes-kidney-disease.html. Accessed 12 July 2023. 
12. National Kidney Foundation. “Diabetes and Chronic Kidney Disease.” National Kidney Foundation, January 2016, https://www.kidney.org/news/newsroom/factsheets/Diabetes-And-CKD. Accessed 12 July 2023.
13. American Kidney Fund. “Heart Disease and Chronic Kidney Disease (CKD)). American Kidney Fund, https://www.kidneyfund.org/all-about-kidneys/risk-factors/heart-disease-and-chronic-kidney-disease-ckd. Accessed 12 July 2023. 
14. National Kidney Foundation. “Heart Failure and CKD: What You Need to Know.” National Kidney Foundation, 2016, https://www.kidney.org/sites/default/files/Heart_Failure_and_CKD_2018.pdf. Accessed 12 July 2023. 
15. National Kidney Foundation. “High Blood Pressure and Chronic Kidney Disease: For People with CKD Stages 1-4.” National Kidney Foundation,  2010, hbpandckd.pdf (kidney.org). Accessed 12 July 2023.