Winnipeg Free Press - PRINT EDITION

Don't fail your kidneys -- dump painkillers, weight

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Who are the master chemists that control water balance in our bodies, keep the blood neither too acid nor alkaline, rid us of dangerous waste, filter every drop of blood in our bodies every 30 minutes and weigh a mere five ounces? They're our kidneys. But millions of North Americans are so abusing this vital organ that their lives depend solely on renal dialysis. What lethal mistakes are they making?

History provides much of the answer. Fifty years ago in Australia, Switzerland and the Scandinavian countries, people developed a bad habit. They were using mixtures of Aspirin, codeine, phenacetin and caffeine not only for pain relief but also for their mood-altering qualities. In fact, at watch factories in Switzerland, workers were encouraged to take this combination and provided free samples. That resulted in injured kidneys.

The problem was worst in Australia. Due to powerful advertising, women began purchasing mixtures of powders containing Aspirin, phenacetin and caffeine along with their weekly groceries. It was a bad decision. By the 1970s, 25 per cent of those dying of kidney disease had consumed too much of this powder. They also suffered more atherosclerosis (hardening of arteries), narrowed renal arteries and coronary attacks.

Unfortunately, we do not learn from history. A report from Johns Hopkins University claims the number of people with advanced kidney disease has doubled in the past 10 years, and the number with end-stage kidney disease who require renal dialysis is growing at the rate of seven per cent a year. It's creating a huge economic problem.

Why is this happening? Some people develop chronic kidney infections or are born with polycystic kidneys, but today a vast amount of renal disease is due to one major factor.

Sir William Osler, a famous physician, once remarked, "The one thing that separates man from animals is man's desire to take pills." People are still using multiple pain medications. Go into any pharmacy and you'll see a huge number of painkillers available in various combinations. All these medications travel through the kidneys as they leave the body.

As I'm not related to our Maker, I have no first-hand knowledge to report from Him or Her. But I imagine the Creator designed our delicate renal tubules to filter natural products in our environment, not such a deluge of chemical prescriptions and over-the-counter drugs delivered to them day after day. They're overwhelmed.

Another big problem of recent years, the epidemic of obesity and diabetes, is destroying kidneys. These diseases cause atherosclerosis that decreases blood flow to kidneys. Diabetes also triggers hypertension and its increased pressure gradually affects renal function.

So how can you decrease the risk of renal failure and the need to be attached three times a week to a machine? First, act like animals who, when given a human pill, usually spit it out. Putting up with a little discomfort rather than reaching for a painkiller would save many kidneys.

But if it's necessary to take pain medication for arthritis and other conditions, use these drugs in the lowest possible dose for the least amount of time. The biggest concerns are NSAIDs (non-steroidal anti-inflammatory drugs) such as ibuprofen (Advil) and naproxen (Aleve) when used for prolonged periods. Cholesterol-lowering statin drugs can, in rare cases, damage muscles, releasing a protein into the blood stream that can injure kidneys.

Losing weight to prevent Type 2 diabetes would save many more kidneys. It's outrageous that every 40 seconds a new case of diabetes is diagnosed in North America. A huge public health issue is that one child in five born today is destined to develop this disease.

Arranging regular medical checkups is important, as kidney disease is symptomless for many years. A blood test that measures creatinine, a waste product in your blood that comes from muscle metabolism, can estimate renal function. If this detects early kidney disease, your doctor will suggest a lower protein diet, drugs to control blood pressure and steps to lose weight

Remember, it's not pleasant being attached to a machine three times a week for the rest of your life. So be sure to practice prevention.


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Republished from the Winnipeg Free Press print edition August 26, 2011 A21

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