Kidney disease a silent killer

Published 9:52 am Friday, February 17, 2012

by Dr. Robert Harrell III

Approximately 26 million American adults have chronic kidney disease – and millions of others are at risk, but may not know it.

Kidney disease is often called the “silent killer” because it has no symptoms until the advanced stage of the disease. In fact, one in nine Americans has chronic kidney disease, but many are unaware that they have it because they do not feel ill.

The kidneys help our bodies remove waste, fluid and toxins; regulate the body’s supply of water and certain chemicals in the blood such as calcium, sodium and potassium; and release hormones into the bloodstream that help to regulate blood pressure, create red blood cells, and produce vitamin D that in turn, helps maintain strong bones.

According to the National Kidney Foundation, the kidneys perform their life-sustaining job of filtering and returning to the bloodstream about 200 quarts of fluid every 24 hours.

Chronic Kidney Disease happens when the kidneys are damaged and unable to perform their cleansing and restorative functions. Over a period of time, this can lead to a build-up of waste matter in the bloodstream, which makes us sick. CKD complications include high blood pressure, anemia, weak bones, nutritional deficits and nerve damage.

Many health conditions can contribute to CKD, but the primary causes are diabetes and high blood pressure. Diabetes and the accompanying high levels of blood sugar can damage the organs in the body, including the kidneys and heart. High blood pressure, or hypertension, can damage blood vessels throughout the body, including those in the kidneys.

When these blood vessels are damaged, the kidneys are less effective at removing waste and extra fluid from the body. The excess fluid, in turn, raises blood pressure even more, which then increases the risk of chronic kidney disease — a vicious cycle. Sometimes, chronic kidney disease may progress to kidney failure, requiring dialysis or kidney transplantation.


Many people will have no symptoms in early stages of the disease. However, some people may experience the following in later stages:

• Excessive fatigue and lack of energy
• Difficulty concentrating
• Poor appetite
• Difficulty sleeping
• Muscle cramping at night
• Swollen feet and ankles
• Puffiness around the eyes, especially in the morning
• Dry, itchy skin
• Increased need to urinate, especially at night

If you are experiencing symptoms or have any of these risk factors, contact your doctor for a screening.


CKD can develop in anyone, at any age, but certain individuals have greater risk. In addition to having diabetes and high blood pressure, other risk factors include advanced age, a family history of the disease, or certain ethnic backgrounds that tend to have a high rate of diabetes or high blood pressure (African Americans, Hispanic Americans, Asians, Pacific Islanders and American Indians).


Early detection of CKD can be diagnosed through simple tests such as blood pressure measurement; a blood test for creatinine levels, which tells how effectively your kidneys are removing waste from the blood; and a urine test to measure protein levels in the urine. High levels of protein in the urine may indicate kidney disease.

The first step in treatment is to determine the cause of CKD. Although many causes remain unknown, there are other reasons for kidney problems, many of which are treatable. These include kidney problems caused by medications that impair kidney function, a kidney stone, obstruction in the urinary tract, urinary tract infection, or decreased blood flow to the kidneys. Treatment of these causes may stop or slow the progression of CKD.

Managing diabetes and high blood pressure can help prevent kidney disease, or keep it from getting worse. Treating high blood pressure with special medications called angiotensin converting enzyme inhibitors or angiotensin receptor blockers often helps to slow the progression of chronic kidney disease.

Learn more at by clicking on “Health Resources” and “Interactive Tools,” and taking one of more than 30 quizzes, including the Diet Quiz, Diabetes Quiz, Kidney Stones Quiz, and more.

DR. ROBERT R. HARRELL III received his degree from the Medical College of Virginia and has extensive training in the field of urology. He is the principal practitioner at Southampton Urology Clinic at Southampton Memorial Hospital and can be reached 562-2568.