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Commentary: Treat your one million nephrons with TLC

Pain pills should be used with caution, as longterm use can lead to chronic kidney disease.
Over the counter pain medication comes with cautions, and can contribute to kidney disease. Photo: Metro Creative Connection

Why don’t we learn from history? Years ago, Australians began to use mixtures of powders containing Aspirin, codeine, phenacetin and caffeine to ease pain. By the 1970s, 25% of those dying of kidney disease had consumed too much of this powder. They also suffered hardening of arteries (atherosclerosis) and heart attack. Now, Dr. Richard Glassock, Emeritus Professor of Medicine at the University of California, Los Angeles, says that more than half of North Americans over 75 have chronic kidney disease (CKD). Kidneys, he says, need tender loving care (TLC) to avoid this avoidable common problem.

One must never forget the wise counsel of Sir William Osler who remarked, “The one thing that separates man from animals is man’s desire to take pills.” North Americans are too quick to devour pills for every ache and pain. Think twice if you feel you need a painkiller for a headache or other minor pains. Time and nature cure many ills.

Careless use of over-the-counter (OTC) non-steroidal drugs such as ibuprofen (Advil) and naproxen (Aleve) increase the risk of damaged kidneys.

There’s another problem. Recent research found that those who regularly use proton-pump inhibitors (PPIs) such as esomeprazole (Nexium), lansoprazole (Prevacid) and omeprazole (Prilosec) are more than 28 times more likely to develop CKD than those who use histamine-2 receptor antagonists (Pepcid and Zantac). PPIs are designed for the short-term, not extended use.

Never forget another wise remark from Sir William Osler, that “alcohol is for the elderly what milk is for the young.” The key here is moderation. In other words, sip smart. According to the Clinical Journal of the American Society of Nephrology, too much alcohol harms kidneys. In general, two drinks a day for men and one for women are OK.

Should our diets be lighter on roast beef and mashed potatoes? The California reports says no, but it’s a prudent move to limit the intake of meat. Dr. Glassock claims that those who eat 1.7 ounces daily have a higher risk of severe kidney disease. He suggests that plant sources of protein, such as soybeans, can decrease the risk.

Remember that kidneys are the master glands of our bodies. They control water balance, keep our blood neither too acid nor alkaline, and help to control blood pressure.

They also have a filtering system that contains one million nephrons. If placed end to end, this system would stretch 70 miles.  Kidneys filter every drop of blood in our body every three minutes. They need lots of TLC.

Protect kidneys by maintaining a healthy weight. Remember extra weight puts added stress on kidneys and is a major cause of Type 2 diabetes, atherosclerosis and hypertension.

CKD is the price we pay for progress. Today more diagnostic invasive procedures require the use of catheters and injections of dyes. These procedures are done with great care, but hovering over them is always the risk of infection. And if infection occurs following by-pass coronary surgery or a hip operation, it may require long-term use of antibiotics. They too can injure kidneys.

Don’t wait to get smart. CKD is a silent killer. Symptoms, which appear only after significant damage, may be feet and ankle swelling, nausea, weight loss, and shortness of breath.

Learning from history could save many lives.

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