how can people with a reduction in kidney function ward off future serious health issues?
the first [recommendation] is to monitor, have things repeated, talk to your doctor, get urine tests done. the second is, if you fall into this category, it would be good sound advice to have a healthy lifestyle. so if you’re a smoker, quit, if you drink alcohol, cut back, try to have a good diet and exercise. those are easy interventions that can be done while you figure out if a medication would help.
based on the study showing that even a modest drop in function is concerning, is the message different now?
yes. that traditional message [that it was not a concern until it dropped to 50] was based on studies that were done, all meaningful but not as big, and the age cut off was not that granular. it clumped 18-to-50-year-olds together [so you couldn’t] see a signal. we broke them down into smaller groups and looked at detailed decreases in kidney function — 5 per cent, 10 per cent, 20 per cent — and that’s how we found these signals. so yes, now the message has to change. a decline of even 25 per cent or more is meaningful and has consequences.
what do most people misunderstand about kidney disease?
that it’s silent, and silent right to the end. a lot of people think they’ll wait until they see symptoms, but they don’t get it. when i tell patients they have chronic kidney disease based on blood work, they say, ‘well, i don’t have back pain.’ that shows you that awareness is very low. back pain is not associated with chronic kidney disease. it could be a urinary tract infection or kidney stones. blood work is the only [way to confirm].
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