Kidney failure: A leading cause of death in African Americans

Most people don’t give their kidneys a second thought — until they fail. That’s probably because kidneys are associated with the indelicate task of waste production.

But kidneys do much more than manufacture urine. They filter blood to ensure certain nutrients, such as proteins and sugar, remain available to the body while removing metabolic waste. They keep a healthy balance of minerals, such as potassium and sodium, which work together for muscle contraction and normal heartbeat. They produce hormones that make vitamin D for strong bones. They stimulate the formation of red blood cells and they play a key role in regulating blood pressure.

The problem is that kidney disease is initially silent. Damage progresses slowly and quietly through five stages. Stage 5 is considered end-stage kidney failure. At that point, only two procedures — dialysis or transplantation — can keep a person alive.

Kidney failure is one of the leading causes of death in African Americans in this country. African Americans are almost four times as likely as whites to develop kidney failure, according to the National Kidney Disease Education Program. While blacks constitute only 13 percent of the U.S. population, they account for one third of those with kidney failure.

That’s because diabetes and high blood pressure — both of which are prevalent in the black community — are the two largest contributors to kidney failure. These diseases alone account for almost 71 percent of all cases, as noted by the National Institute of Diabetes and Digestive and Kidney Diseases.

Other contributors to kidney disease are lupus, prolonged use of NSAIDs (ibuprofen and naproxen), cardiovascular disease, obesity and family history of kidney disease, diabetes and high blood pressure.

What’s disturbing is that kidney failure is in many cases largely preventable. Strict adherence to blood pressure control and certain medications called ACE (angiotensin-converting enzyme) inhibitors or ARBs (angiotensin receptor blockers), can be critical. These medications are often kidney protective and a first line of attack.

In addition, lifestyle — healthy eating, exercise, weight control and not smoking — can often prevent kidney failure and may stop its progression.

As kidney disease advances, symptoms begin to appear. Painful or difficult urination, fatigue, muscle twitching or cramps, swollen feet and ankles and dry, itchy skin are common.

Those at risk should be screened regularly. Simple blood and urine tests can check how well the kidneys are working.

The GFR, or glomerular filtration rate, tests how well your kidneys are filtering, while urine tests check for albumin in your urine. Albumin is a protein that can pass into the urine when the kidneys are damaged.

The National Kidney Foundation has launched a new online portal on kidney disease geared specifically for African Americans. The portal offers healthy lifestyle tips, a Kidney 101 section, an online risk quiz and information about dialysis and transplantation.

The NKF’s new portal can be found at www.kidney.org/africanamericanhealth.