Chronic kidney disease is scary. The kidneys play so many roles – filtering waste from our blood, regulating fluid levels and releasing hormones – and their function is related to high blood pressure and diabetes.
“When we show patients the two conditions are related, they tend to understand the path forward,” said Robert Allison, MD, Avera Medical Group Internal Medicine. “We use blood and urine testing to determine the level of kidney function. We then consider the different options for treating their blood pressure or diabetes so we can help prevent chronic kidney disease from going further.”
Lifestyle, Medication and Kidney Disease
Chronic kidney disease has five stages. When patients progress through the stages, treatment may include medication. It often includes, coaching, too.
“Prevention is our goal, especially when people have tough blood-pressure situations, where they might be taking several medications,” said Allison. “If diabetes is also a factor, then the management can become more complicated.”
Our kidneys release hormones that affect many other organs, including the heart. The regulation of blood pressure is part of their work. Since they’re also cleaning our blood, when blood sugar (glucose) levels are too high, which happens with diabetes, they’re under stress.
“Chronic kidney disease is, in many ways, a math problem,” Allison said. “Figuring out the equation is the hard part – how to keep the kidneys functioning by controlling the blood pressure, as well as reducing glucose levels in our diabetic patients. Our goals are to ensure that the blood pressure and/or diabetes are well managed, that way the kidney can do its work. That’s why annual exams are important for adults, be they 18 or 108 years old. We can find the problem during that visit.”
Weight loss, sensible diets and exercise, not smoking and tracking blood pressure all can help prevent the triad or lessen their impact.
“Lifestyle changes, even losing as little as 10 pounds, can help make the chronic kidney problems easier for both me and my patients,” he said.
Management of Conditions Can Change Everything
Seeing a doctor regularly can help anyone who might face problems with blood pressure and new kidney problems and catch them in time to get on the right track.
“I see patients every day who have success making lifestyle choices. Too often we think of significant lifestyle changes as impossible – that’s a myth,” said Allison. “If you want to be there for your kids and grandchildren, you’ll have to work at it.”
A coordinated care team supports patients.
“Internal medicine is a specialization, like nephrology, and when patients need specialists, we are there to work with them, ready to help them as they work with us to solve the problems that can come with blood pressure, diabetes and kidney issues,” he said. “We see people who go from that initial fear of their condition to living long lives that avoid diabetic amputation, dialysis and kidney transplants. These are serious conditions – but together we can manage them.”
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