Are you worried about chronic kidney disease (CKD)? You might be surprised to learn that it’s usually the result of kidney damage caused by other conditions. The 2 most common are diabetes and high blood pressure, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).  

What’s the connection? Both conditions can damage your blood vessels, including the ones inside the kidneys. That reduces blood flow to the kidneys. As a result, the kidneys have a harder time doing their job of filtering waste from your blood. Over time, waste and fluid can build up in your blood. That causes damage and raises your blood pressure even more. It can become a vicious cycle. 

So it makes sense that having healthy blood pressure can help prevent CKD — or stop it from getting worse. Step 1 is staying on top of key tests and understanding what your results mean. That way you can take the best actions. 

Testing for high blood pressure 

High blood pressure is usually a silent disease, meaning it has no symptoms. Many people don’t know they have high blood pressure until something bad happens, such as a heart attack or stroke. That’s why it’s important to regularly have your blood pressure checked. 

If you’re 40 or older, you should have yours checked every year. If you’re between ages 18 and 39 and don’t have any high blood pressure risk factors, get checked every 3 to 5 years. Risk factors include: 

• A family history of high blood pressure. 
• Being overweight. 
• Drinking too much alcohol. 
• Not exercising enough. 
• Race — Black Americans are more likely to have high blood pressure than other races. 

Blood pressure is considered normal if it’s less than 120/80 mmHg. High blood pressure is defined as regularly having a reading of 130/80 mmHg or higher. Fortunately, blood pressure can often be controlled through medication and/or healthy lifestyle changes, such as: 

• Maintaining a healthy weight. 
• Getting regular exercise. 
• Eating fewer processed foods and focusing on fruits, vegetables, and low-fat dairy. 
• Cutting back on salt. 
• Consuming alcohol and caffeine in moderation. 
• Keeping your stress levels low. 

(Find out if you’re due for a blood pressure test or other heart health-related screenings through Wellframe, your digital health advocate. Log in or download the Wellframe app today.) 

Testing for kidney disease 

It’s not common to check for chronic kidney disease. But like blood pressure, CKD often doesn’t have symptoms until it’s more advanced. Once it gets worse, symptoms can include chest pain, headaches, dry and itchy skin, loss of appetite, nausea, and weight loss. Ask your doctor to test you for kidney disease if you have 1 or more of these risk factors: 

• Diabetes. 
• High blood pressure. 
• Heart disease. 
• A family history of kidney failure. 

If you have diabetes, you should be tested for CKD every year. In the other cases, talk to your doctor about how often you should be tested.  

To test for CKD, your doctor will likely order blood and urine tests that measure kidney health. Common tests include:  

• A blood test for creatinine: Creatinine is a waste product. It’s created during the natural breakdown of your muscles. When your kidneys are working well, they successfully remove creatinine from your blood. High levels of creatinine point to problems with kidney function.  
   
  The amount of creatinine in your blood is used to figure out your glomerular filtration rate (GFR). GFR measures how well your kidneys are filtering your body’s waste products and excess fluid. Here’s how to read your GFR results: 
   
• 60 or more: Your GFR is normal.  
• Below 60: You might have kidney disease and should see a specialist called a nephrologist.  
• 15 or less: This is a sign of kidney failure. At this stage, you would need dialysis or a kidney transplant.  
   
• A urine test for albumin: This test checks your urine for a protein called albumin. Albumin is created by the liver. Normally, your kidneys filter it out. But if your kidneys are damaged, they let proteins like albumin spill into urine. The more albumin you have in your urine, the worse your kidney damage likely will be. Your doctor may want you to repeat the urine test a few times to confirm the results.  
   
  One way to measure albumin is through a urine albumin-to-creatinine ratio. This test compares how much albumin and creatinine your urine has. A ratio higher than 30 mg/g may be a sign of kidney disease.   

(Need help understanding your test results? Wellframe, your digital health advocate, can connect you with your care team to get answers to all your questions. Log in or download the Wellframe app today.)

How to treat kidney disease 

If you find out you have CKD, your doctor will work with you to treat it and help prevent more damage. That often means treating the factors that can cause CKD, like diabetes and high blood pressure.  

If you’re not already taking medications for high blood pressure, you will probably start. The 2 types often prescribed for people with CKD are: angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs). These drugs reduce and restrict the body's supply of angiotensin. That’s a chemical that narrows arteries, especially in the kidneys. Less angiotensin means blood vessels can open up, which lowers blood pressure. 

Exercising and staying at a healthy weight can help stop kidney damage from getting worse. So can limiting the amount of protein you eat. That makes for less protein waste your kidneys must remove, which puts less stress on your kidneys. 

Going forward, your doctors will use your GFR score to see if your treatments are working. You can’t raise your GFR score. But if your score stays roughly the same in future tests, it shows that the treatment is effective. 

(Trying to lose weight or lower your stress levels can feel hard, but you don’t have to go it alone. Wellframe, your digital health advocate, gives you access to free programs for weight loss, stress management, physical activity, and more. Learn more now.)  

SOURCES:

“High blood pressure & kidney disease.” NIH: National Institute of Diabetes and Digestive and Kidney Diseases, www.niddk.nih.gov/health-information/kidney-disease/high-blood-pressure. Accessed July 15, 2021.  

“What is chronic kidney disease?” NIH: National Institute of Diabetes and Digestive and Kidney Diseases, www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/what-is-chronic-kidney-disease. Accessed July 15, 2021.