While a new procedure for hypertensive patients who are labeled as “resistant” to medical therapy may show promise in ongoing trials, the standard of care remains aggressive lifestyle modification and appropriate combination of medical therapy.
“After we eat, the kidneys help the body eliminate anything that’s not needed,” says the College of Medicine’s Dr. Abdo Asmar, a board certified nephrologist at UCF Pegasus Health, the medical school’s physician practice. “They also maintain your fluid, salt and mineral balance; regulate blood pressure; maintain healthy bones; and produce hormones to control the production of red blood cells.”
The two leading causes of kidney disease in the United States are diabetes and high blood pressure. When these conditions are under control, kidney damage can be prevented or at least slowed down.
An estimated one in nine adults in the U.S. has kidney disease, with more than half the people with chronic kidney disease have high blood pressure, and about 20-30% of them are labeled as resistant or difficult to control. Over time, high blood pressure can damage small blood vessels in the kidneys leading to renal failure.
The new procedure on the horizon, renal nerve ablation, uses radio frequency energy to disrupt crosstalk between the kidney and the brain from triggering hormones that increases the heart rate, constricts blood vessels and raises blood pressure.
"This procedure will be good news for appropriately selected patients who are on proper medical therapy, yet their blood pressure remains high,” says Dr. Asmar, who serves on the Board of the National Kidney Foundation of Florida. “However, this procedure is still investigational in the United States, and appropriate lifestyle modifications (primarily salt restriction to levels well below 2.0 g/day) and aggressive pharmacotherapy should always be the first step”
Dr. Asmar specializes in caring for patients with kidney disease, high blood pressure, kidney stones and disorders of electrolyte and mineral metabolism.
In addition to keeping diabetes and high blood pressure under good control, here are a few other ways to keep your kidneys in good working order:
- Avoiding unnecessary non-steroidal anti-inflammatory medications (NSAIDs). Don’t just pop a pain reliever for every little ache and pain.
- Staying hydrated by maintaining a healthy fluid intake
- Quit smoking, and if you do not smoke never start
- Get your kidney function checked if you have one or more of the high risk factors (diabetes, hypertension, obesity, family history or you are of African origin)
- Eating a low-salt diet and checking the salt content in prepared foods.
“Everything that goes into our mouth will eventually be dealt with by the kidneys, and most of us take our kidneys for granted,” he says.
According to the National Kidney Foundation, the third leading cause of kidney failure is glomerulonephritis, a disease that damages the kidneys' filtering units. This may be inherited or triggered by an autoimmune disease or infection.
Dr. Asmar cautions that kidney disease is mostly a “disease without complaints,” noting that even when kidneys are not functioning at 100 percent, they will still do their job. Unfortunately, symptoms generally ensue when the majority of the organ’s function has been lost.
Everyone is encouraged to join Dr. Asmar on Sunday, April 14 at the National Kidney Foundation Orlando Walk to help increase awareness of the silent epidemic of kidney disease. Check-in begins at 8:30 a.m. at the College of Medicine. For more information about the event visit http://donate.kidney.org/site/TR/Walk/Florida?pg=entry&fr_id=5702.