Doc's Tips Kidney Disease

Sandra Gadson, M.D.: Kidney Disease—Start Treating Early

Black folks are three times more likely than whites to suffer kidney failure

Black folks are setting records—for all the wrong reasons when it comes to chronic health problems, and kidney disease is no exception. We are three times more likely to suffer kidney failure than whites. We make up more than 32 percent of all patients in the United States receiving dialysis for kidney failure, though we represent only 13 percent of the population.

Sandra Gadson, M.D., of the Northwest Indiana Dialysis Center, shares some of the reasons for this disparity and talks about ways to stop the progression of kidney disease.

Black Health Matters: What’s going on with African Americans and kidney disease?

Sandra Gadson, M.D: Nineteen million people (in this country) have chronic kidney disease, 372 thousand are on dialysis. Eighty-two thousand are awaiting transplants. But health disparities aren’t new. We take the top ranks when it comes to kidney failure and being on dialysis. We also develop chronic kidney disease at a younger age.

How does kidney disease happen?

The kidney is damaged from high blood pressure or diabetes. Sometimes it’s congenital. With HIV there can be nephropathy, where some who have the virus end up with end-stage kidney disease. Cocaine and heroin can cause kidney failure. But the two major reasons: high blood pressure and diabetes—both not well controlled. High blood pressure is a silent disease. And in diabetes, elevated blood sugars harden blood vessels in kidneys and you’re not able to filter and get rid of wastes well.

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What’s something we may not know about kidney disease?

People who have kidney failure tend to have more cardiovascular risks. Also, dialysis is performed three times per week. Transportation to dialysis is becoming a big problem. One of the worst things is people who have to have dialysis, but don’t have transportation.

What’s the difference between peritoneal dialysis and hemodialysis?

Peritoneal dialysis is better. You can eat what you want and don’t have to worry about diet restrictions because it’s daily (at night). The patient has control, takes ownership. Hemodialysis is basically every other day. There are diet and fluid restrictions. Some people don’t want to take ownership.

What can be done to slow kidney disease—or prevent it?

Staging chronic kidney disease helps people not progress to dialysis or transplant. Many years ago, nephrologists wouldn’t see people until they progressed to dialysis. Now we want to see them earlier. Educate patients. Talk about weight loss. Look at their diet, limit salt, eliminate processed foods. Tell them to get blood sugars checked. If i can take care of you at stage one, perhaps you won’t get to stage five, when there’s no return. Starting early really does make a difference.

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