If something "gets down to your kidneys" is not just proverbial, but actually, it often goes unnoticed at first: When you have kidney disease, you often only have symptoms later. How do you know that something is wrong with the organs? And is there any truth to the advice that drinking a lot is good for the kidneys?
The kidneys make urine, right? That's true, but it's by far not the only task that the organs have. They also regulate blood pressure, produce vitamin D and some hormones, stimulate blood formation and balance the body's water and acid-base balance.
Quite a lot of tasks for the two organs, which are located in the abdomen and are reminiscent of a bean in shape. For this reason, the kidney is also called "kidney" in English.
If something is wrong with the kidneys, the whole body can become unbalanced. But how do we even know that this is the case? And how do we keep our kidneys fit?
"Unfortunately, the kidneys only become noticeable very late," says Volker Lechterbeck, chief physician of the nephrology clinic at the Petrus Hospital in Wuppertal. Because kidney diseases often go hand in hand without pain and other symptoms. Anyone who only pays attention to symptoms will probably not recognize kidney disease until very late. This is why regular check-ups with your family doctor are important. A urine test strip can show whether protein has been excreted or whether there is blood in the urine.
"What we have been propagating very strongly lately is the determination of albumin in the urine," says Kai M. Schmidt-Ott, specialist in internal medicine and nephrology at the Charité Berlin. Albumin is a special protein that the kidneys excrete in the urine. These excretions are closely related to progressive renal dysfunction. They can therefore indicate chronic kidney disease.
The family doctor can also take blood and determine the blood creatinine value in the laboratory. This value provides an indication of how well the kidneys are performing their filtration function. An elevated value can be the first sign that kidney function is declining.
Most kidney diseases are chronic and slowly progressive. This often affects other diseases as well. The organ plays a decisive role in heart and vascular diseases, for example. There are a number of things you can do to prevent kidney disease. A healthy diet comes first, explains kidney specialist Schmidt-Ott.
This includes avoiding being overweight. The biggest risk factor for later kidney disease is diabetes. People of normal weight have a lower risk of developing diabetes and thus kidney disease. "30 to 40 percent of patients who have kidney disease so severe that they need dialysis or a transplant are diabetics," explains Schmidt-Ott, who is the medical site manager of the medical clinic with a focus on nephrology and internal intensive care medicine.
According to Schmidt-Ott, the same recommendations apply to people with healthy kidneys: "Mediterranean, low-meat diet, striving for a healthy body weight, low-salt foods." In the case of very advanced kidney diseases, a low-potassium diet can be useful - always in consultation with the kidney doctor. For people with healthy kidneys, however, this recommendation does not apply across the board.
High blood pressure, which according to Schmidt-Ott affects more than a third of the German population, is one of the risk factors for kidney disease. This is also the reason why a low-salt diet is recommended. Because high salt consumption can increase blood pressure. Treating high blood pressure with medication can prevent kidney disease. Therefore, the family doctor should also check your blood pressure regularly.
"We tell all patients in whom we identify a problem with the kidneys that they should definitely stop smoking," says Schmidt-Ott. Because nicotine is known to play a major role in vascular diseases - and they are closely linked to kidney diseases.
The link between alcohol and liver disease is well known to many. Heavy alcohol consumption can also damage the kidneys, according to the nephrologist. Directly, but also indirectly, because the alcohol changes the fluid balance, but also the liver function.
In addition, genetic factors or autoimmune diseases can promote kidney diseases. But taking painkillers such as ibuprofen or diclofenac can also trigger kidney disease - at least if you take them in very large quantities.
The most common folk wisdom is: Drinking a lot helps the kidneys. However, the rule should be viewed critically, according to Lechterbeck. Because it has not been scientifically proven that drinking large amounts prevents kidney disease from progressing. On the contrary - sometimes patients with advanced kidney disease are even encouraged to drink less - for example if water has accumulated in the body due to heart failure.
Kidney patients should drink more when it comes to counteracting kidney stones, for example, explains nephrologist and internist Lechterbeck. Effective drugs are now available for the treatment of progressive kidney disease. The earlier these are used, the better. But you can also influence how kidney disease develops with your own lifestyle.
(This article was first published on Sunday, June 05, 2022.)