RM: Hey there! Long time no chat!

JH: You’re so right – we haven’t chatted on our blog in ages. That’s because of all those “disease-a-month” topics we’ve had to cover.

RM: But aren’t we doing that with today’s blog anyway?

JH: Sure are. We’re talking about kidney disease in older women. But I thought it might be more fun for both of us to chat about it.

RM: Ok, then. What do we older but cooler ladies need to know about kidney disease?  Are you going to start by telling us how to stay leak-free?

JH:  That’s a big one at this age, but no, we’re not talking about urinary incontinence today.  (We do have an entire chapter on it and its treatment in our book though). We’re going to move higher up the urinary tract and talk about the main organs of that system – the kidneys.

RM:  You mean, the mothers of the urinary system?

JH:  Good analogy! The kidneys in fact do create the urine, by removing the toxins and waste matter from our blood, while maintaining the body’s fluid and electrolyte balance, and then send that urine on down the rest of the urinary tract and out into the world. So, they do the same type of work, and every bit as important, as mothers do.

RM:  Cool. So at this age, what are the main things that can go wrong with the kidneys?

JH: At our age, and as we continue to get older, the most common of the kidney diseases are chronic kidney disease and kidney failure. 

RM:  And exactly what do you mean by chronic kidney disease and failure?

JH:  Exactly as they sound. Chronic disease of the kidneys is a term indicating that the kidneys are not functioning as well at their job of removing toxins and waste products, and maintaining the body’s fluid and electrolyte balance.  Kidney failure occurs when neither kidney is functioning at all.  When someone has kidney failure, the next step is dialysis to, in essence, perform the job of the kidneys. And eventually, many people on dialysis can get kidney transplants.

RM:  Then those kidneys just get pooped out after all those years of disease?

JH:  That’s right.  What’s even more frightening about chronic kidney disease is that it is silent, or has no symptoms; so most people with it don’t know they have it.   There are an estimated 26 million people in this country with it, and most are unaware of it.  Also, it is the 9th leading cause of death in this country.

RM: Do we know of any risk factors for kidney disease, since we know risk factors for heart disease and many other diseases?

JH:  This may surprise our readers, but the three major risk factors for kidney disease  are also risk factors for heart disease and stroke:  high blood pressure, diabetes, and a family history of the disease in question, in this case – kidney disease.   In addition, smoking cigarettes and weight gain may increase the risk for chronic kidney disease.

RM:  Is there are a difference between men and women in how often they get it?

JH:  Great question.  Yes there is.  Women have what’s been called “the female advantage” regarding chronic kidney disease; that is, they get it much less frequently than men do.  The only group of women who do not have this advantage are diabetics.

RM:  So, are you saying that our not getting kidney disease has something to do with our hormones?

JH:  It’s a real possibility since postmenopausal women tend to be diagnosed more frequently with chronic kidney disease than are younger women, but still less than men.  But that needs to be studied further.

RM: Any difference between ethnic groups as to who gets chronic kidney disease?

JH:  Yes. African Americans, Hispanic Americans, and American Indians are more than twice as likely to develop this disease than are CaucasianAmericans.

RM: So, what can we do to prevent kidney disease?

JH:  The better our high blood pressure and diabetes are controlled, the less likely it is that we will get chronic kidney disease and kidney failure.  For those of us with a family history, the best thing we can do is to be proactive: take good care of ourselves, and make sure our clinician knows there is a family history of kidney disease, so we can be screened for it regularly.  Since diabetes and high blood pressure can often have no symptoms, we should have our healthcare provider check us regularly for those diseases.  And I know I’ll sound like a broken record here, but women who smoke need to stop!  Also, we need to try to maintain a healthy body weight.

RM:  Aren’t those tests you just mentioned checked for routinely anyway? And, another question, how is kidney disease diagnosed?

JH:  Easy – kidney disease can be diagnosed most often by labwork done on the blood – specifically, the creatinine and BUN levels. In addition, oftentimes, a urinalysis can help with the diagnosis. And yes – both of these studies, as well as a test for blood sugar and checking the blood pressure and weight should be a routine part of health screening.

RM:  Ok then, so we need to get a check up regularly, keep our blood pressure and blood sugar under control, stop smoking, and try to maintain a healthy weight. Nothing really new here!

JH: You got it.

RM: Oh yeah – and one other thing: be good to our mothers!

JH: And our kidneys!

For more information, go to:http://kidney.niddk.nih.gov/kudiseases/pubs/chronickidneydiseases/