Chronic kidney disease (CKD) is on the rise and it has become a major public health problem. CKD is defined as damage or a decrease in kidney function that persists for longer than 3 months.

Although the exact numbers are hard to know, it is estimated there are 19 million people in this country living with kidney disease. CKD is divided in stages 1 through 5 depending on the severity of the dysfunction.

There are many causes of kidney disease, but by far the most common ones are diabetes and high blood pressure.

Most people diagnosed with CKD are instantly overcome by fears of ending up on dialysis. It is important to know that of the 19 mil people with CKD, 5.3 have stage 2, 5.4 have stage 3 and only 600, 000 end up requiring some form of dialytic intervention. The fear of dialysis is well justified, but one should look at CKD more as a marker for overall health and especially vascular health than dialysis risk. For instance being diagnosed with CKD stage 3 places you at higher risk of having a stroke or a heart attack, when compared to someone with normal kidneys.

CKD usually develops over years and years; it frequently can go undiagnosed for decades. High levels of blood sugar or blood pressure, gradually damage the kidneys, until they are unable to properly clear the toxins. While it would be nice to have a magic pill that can reverse all this damage, we do not have that option. But, early stages of CKD are excellent times to intervene with lifestyle changes and controlling the underlying etiology. That can delay or halt the progression of the disease.

In short, that means, if you have diabetes, control the blood sugar as tightly as possible, aiming for a Hb A1c<7.0. Try to impact diabetes not only through medication, but also proper nutrition and exercise. Eliminating processed foods and simple carbohydrates is a must. If you have been sedentary, enroll in an exercise regimen and set goals to improve your aerobic fitness; aim for at least half an hour of moderate exercise 5 days a week. If you are overweight, start losing weight; follow this link to find your ideal body weight using the BMI formula. Try to keep track of your intake using a food journal; there are many websites or phone apps that help you approximate calorie intake in food, so you can aim for a negative calorie balance.

Blood pressure should be controlled as well to levels of less than 130/80. In addition to medications prescribed by your physician, diet and exercise help lower your pressure. It is usually the aerobic exercise that has been linked to control of hypertension. A diet rich in vegetables and fruits and especially low in salt is associated with normal blood pressure and vascular health. I do not recommend using nutritional supplements, as they have not been studied and proven to work.

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