Courting A Rise In Kidney Disease

Longer Lives Bring More Age-Related Ills

By Surekha Vajjhala

San Antonio Spurs forward Sean Elliott knew during the 1999 NBA championship series that his kidneys could fail at any time because of a disease called focal glomerulosclerosis, ending his career and maybe his life. Two months after the Spurs captured the title, Elliott's kidneys did succumb, and last August he had a transplant. Only seven months later he returned as a starter and averaged more than 20 minutes in each of the 19 games remaining in the season.

This year kidney disease becomes the 17th specialty in America's Best Hospitals. Kidney ailments from stones and cysts to serious disease affect more than 3 million people, and kidney failure killed nearly 58,000 in 1997, with both numbers expected to soar in the next decade. Better treatments for conditions that damage the kidneys, such as diabetes and high blood pressure, are lengthening lives-and that in turn exposes the rising tide of elderly people to kidney disease.

The kidneys filter water and toxins from the blood to form urine, regulate blood pressure, and control blood levels of minerals such as sodium and potassium. Infection, inflammation, and prolonged use of medications can stop the kidneys from doing their job. The damage can be silent for years, as it was for Elliott. "Until the kidneys come really close to failing, you may not have any symptoms," says Raymond Harris, professor of nephrology and hypertension at Vanderbilt University Medical Center in Nashville.

Damage Control

A routine physical often can reveal kidney disease. A nephrologist can then limit damage by managing diet, controlling high blood pressure, and regulating the blood levels of certain substances. Medications like ACE inhibitors can help by lowering blood pressure and by acting directly on the kidneys in unexplained ways.

Left untreated, toxins and fluid that build up if the kidneys fail can kill in as little as three weeks. More than 300,000 U.S. patients undergo dialysis several times a week to cleanse their blood. A transplant is the best answer for patients lucky enough to find a suitable donor. Newer and better antirejection drugs mean that transplants should last at least five years before another transplant or dialysis becomes necessary.

Web-based help is offered by

• The American Society of Nephrology (www.asn-online.com)
• National Kidney Foundation (www.kidney.org)
• United Network for Organ Sharing (www.transplantliving.org).

For healthy kidneys, nephrologists advise plenty of fluids, regular exercise, no smoking, maintaining proper weight, and a regular check for diabetes and high blood pressure. Drinking a few extra glasses of water is about as easy as prevention can get.

Copyright © U.S.News & World Report Inc.

This article posted July 17, 2000.