As if heart disease isn’t enough, kidney health for seniors is becoming a major focus. How many seniors are aware of their level of kidney health? I certainly wasn’t, until recently.
We know the importance of monitoring cholesterol and blood pressure numbers because of the risk for heart and blood vessel disease. But few of us know about the number that indicates the health of our kidneys: our GFR. I had never heard of it before, but there is such a thing as cardiorenal syndrome. Heart disease is wide-spread among seniors, and it can affect kidneys.
GFR and Kidney Health for Seniors
This important number is the glomerular filtration rate (GFR). GFR tells a lot about how well your kidneys are working.and it’s better to have early awareness as we age.
After a recent hospital stay for a bout of congestive heart failure, doctors revealed that my husband Rob also shows signs of kidney disease. Like the song that says “the hip bone’s connected to the leg bone,” it’s all connected and interdependent. People with heart disease often lose kidney function, measured by “GFR,” something else we didn’t know about.
According to Dr. Wikipedia, cardiorenal syndrome (CRS) is an umbrella term that defines disorders of the heart and kidneys whereby “acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other.”
We were first alerted to this by his lab results showing high creatinine levels along with a low GFR. Even when spelled out, we didn’t understand what the heck glomerular filtration rate actually means.
We lose optimal kidney functioning every year we age. For seniors, our other disease histories have an impact. GFR can’t be measured directly. It needs to be estimated using a mathematical formula from the amount of creatinine in your blood along with other factors like age, race and gender.
Creatinine is a waste product created by your body’s muscles. Your kidneys usually keep the level of creatinine just right. Serum creatinine (a blood measurement) is an important indicator of renal health because it is an easily measured byproduct of muscle metabolism that is excreted unchanged by the kidneys.
The creatinine level alone is not the best way to check kidney function, but it is an important blood test because it is used to estimate GFR.
Our Amazing Kidneys
According to the National Kidney Foundation:
The kidneys perform several important jobs. One job is to remove wastes and excess fluid from the blood. When your kidneys are working well, wastes and excess fluid are removed to become part of the urine your body makes each day. When kidneys aren’t working well, they don’t filter the way they should. Important substances that should remain in the body, for example protein, are filtered out, and wastes that should be removed build up in the blood.
People don’t always know if something is wrong with their kidneys. Early kidney disease can be silent, without pain or other symptoms. A person may not suspect that they have kidney disease. In more advanced kidney disease, some people notice problems such as swelling, high blood pressure, poor appetite and nausea and vomiting.
Who’s at Risk?
The two biggest risk factors for chronic kidney disease (CKD) are diabetes and high blood pressure. Rob has neither, so we were surprised when we were referred to a kidney specialist. In his case, since his heart attack, the heart isn’t functioning well and the kidneys suffer. But his symptoms of kidney deficiency are similar to his heart dysfunction.
People don’t always know if something is wrong with their kidneys. Symptoms may not show up until stage 3 or 4 when it becomes chronic and progressive.
Stages of Kidney Health for Seniors
The Kidney Foundation uses the following guidelines for stages of kidney functioning. Generally:
- In adults, the normal GFR number is 90 or higher
- Having a GFR between 60 and 89 may be normal for some people, including those over age 60. GFR tends to decline as we age even in people without kidney disease. These people may need to have GFR checked more often in the future. They may be asked to avoid medications that can damage the kidneys (such as ibuprofen and other non-steroidal anti-inflammatory agents) or reduce the dose of medicines that are removed by the kidneys
- A GFR below 60 is abnormal. The GFR test should be repeated. GFR below 60 that persists for 3 months or more means chronic kidney disease. Your health care professional may refer you to a nephrologist (kidney specialist) for evaluation and treatment. A GFR below 15 indicates kidney failure. Someone with kidney failure needs dialysis or a kidney transplant to survive
What to Do About a Low GFR
Fortunately, at early stages, following a kidney healthy diet will slow the progression. We are still finding out what to eat and what to avoid, but there are many sites with kidney health cookbooks. It won’t be easy for Rob, because he’ll have to forego red meat, chicken and most animal sources of protein. On the other hand, we love these kidney-healthy foods: greens, apples, cranberries, oats, whole bread, pumpkin seeds, radishes, and pepper.
How to Be KidneySmart
There is an online course called KidneySmart, so we can continue to be informed. Rob was told to continue his exercise because that will also help his kidney health. The fact he doesn’t smoke or drink alcohol, and no longer takes ibuprophen or other nsaids is also good.
In the War on Aging, we need to be informed about our bodies and aware of what we can do to stay healthy as long as we can. Even though we have two kidneys, we can’t live long if they aren’t functioning well. Be kind to your body, it’s been through a lot!
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