This blog aims to make "evidence-based medicine" understandable to the lay person
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Monday, May 27, 2013

Who needs to be tested for kidney disease? What are the causes of kidney disease?

I often get the question, "hey doc, do I need to be tested for kidney disease"? The answer would depend on whether you have the risk factors to develop serious kidney disease. Kidney disease is often called a "silent killer", because all too often, patients do not have any symptoms, period. A common misconception is that if you "make urine", your kidneys are healthy. This is not true. As you might have noticed in my previous post, the amount of urine you make is not necessarily considered a valid test of your kidneys' function. In fact, I personally have a lot of patients who are on dialysis due to kidney failure; yet they continue to pee out a liter of urine daily! I will talk about the symptoms of kidney disease later, but for now let's focus on who needs testing; knowing that you may or may not have the relevant symptoms.

Based on observational studies, we know that certain individuals are more likely than others to develop kidney disease. Physicians thus tend to focus on these specific groups when testing for kidney disease. One of the most common of these risk factors is diabetes. This is also one of the commonest reasons why people end up on dialysis. High blood pressure, or hypertension, is another big cause. Other risk factors include people with heart disease, history of smoking, and obesity. Over the counter non-steroidal pain medications like ibuprofen and diclofenac, when taken for prolonged periods (especially in these high risk groups) can sometimes cause kidney disease. People older than 65 years of age are also a high risk group since everyone does tend to lose a certain percentage of kidney function with aging. Older people also tend to have more of the co-morbidities (diabetes, hypertension, etc.) that cause kidney disease. They could also be more susceptible to dehydration that can interfere with the kidneys function. Smokers tend to have diseased blood vessels and high blood pressure that can cause kidney damage. If you have a family history of kidney disease or someone needing long term dialysis or kidney transplantation, you might want to get yourself checked as well. Finally, certain ethnic groups like African-Americans, Asians, and Native Americans tend to develop kidney disease at a higher rate due to multiple reasons. I will discuss how these different diseases cause kidney disease in the posts to follow. For now, suffice it to say that, should you have any of the above mentioned risk factors, you should talk to your physician about getting tested for kidney disease

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