DIARY OF A KIDNEY LOVER

Just a quick entry to say I’ve checked off one exciting thing from my life’s to-do list.  I finally visited one of those traveling anatomy exhibits showcasing real bodies and organs at the LA County Fair last weekend. I couldn’t believe my luck when I saw the poster at the entrance gates to the fair.  I had no idea something like that would be there.  Two of my friends made sickly noises – no way they were going – but Mom and I beamed as we bought our special tickets to “Our Body: The Universe Within”. We waited in a long line to get in, analyzing the reactions of people leaving the exhibit.  Young cool boys smiled. Older people and children looked pensive or bewildered.

It was pretty crowded inside and I must say, I was disappointed at the 20-somethings giggling and pointing at the bodies. What did they think they were going to see? But when I told my friend, the grade school teacher, she said, “Oh, don’t feel so bad.  They’re just laughing because they’re uncomfortable. They haven’t faced their mortality before.” And of course, she was right. Even with the somber lighting, there was a strange carnival atmosphere – life and death side by side, as they must be. There was music and cheering from the Selena Gomez concert outside, but I managed to focus after a while. I perused the muscles of the legs, the spinal column, the brain, the surprisingly large lungs and what looked like a coral reef of dried-out blood vessels surrounding them.  I found the kidneys mid-way through the show. It’s strange seeing lifeless organs that are meant to be filled with blood and activity.  They were miraculous nonetheless, and much smaller than I thought – even smaller than my tiny fist.

By that time, Mom was feeling queasy and it was time to go.  It was a fascinating show and I do recommend it, despite the jeering kids. (You can learn more about the exhibit here.) There were plenty of people interested in the science of it all, reverent as they stared at a lung shriveled by smoking or a liver damaged by alcohol abuse.  Perhaps some contemplated a lifestyle change…starting tomorrow.  Until then, they had things to check off their personal to-do lists. Chocolate-covered bacon and fried Snickers maybe. It was a day at the fair, after all.

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DIARY OF A KIDNEY LOVER

OK.  Time for a change.  After a very tasty Chinese dinner last week, I had one of the worst heart-burn episodes I have ever had (and I don’t even get heartburn).  I felt like I was going to die.  Thinking about it, I’m sure that yoga move my Mom told me to try didn’t help any.  There is a time and a place for yoga and this wasn’t it.

But here I am, alive and eager to turn over a new leaf, literally!  I am a vegetarian, so I wouldn’t say that I am really unhealthy, but I do need more balance in my diet, less stress, less sodium, less restaurant meals, more exercise – the usual healthy stuff.  And I should confess that I have had a few moderately high blood pressure readings at the doctor’s office.  I attributed these to “white-coat” hypertension – blood pressure that’s only high when you’re in the doctor’s office.  You can read more about that here. http://www.winnipegfreepress.com/life/ignoring-white-coat-pressure-dangerous-102324989.html.  Although I really like medicine and enjoy talking to doctors if we’re talking about kidneys, I don’t like talking to doctors if I’m the patient.  The possibility of pain, illness, the reminder of the high cost of my health insurance, not to mention the cost of the visit – no wonder my blood pressure is a little high! The whole doctoring experience makes me nervous.  But I shouldn’t dismiss my previous readings, given what I know about high blood pressure and kidney disease.  Kidney filtration is driven by our blood pressure and higher BP “slams” the kidneys, forcing them to work much harder. It can cause permanent scarring and damage.

I’ll be making my doctor’s appointment very soon (still need to work up to that, but it’s on the task list for Monday) and in the meantime, I’ll be making changes to my diet. The DASH diet (“Dietary Approaches to Stop Hypertension”) – a healthier way of eating that’s safe for nearly everyone – has caught my eye lately. I’ve seen news articles all over the web and even in the research project pages on the UKRO site.  Check out this USA Today article for more info http://www.usatoday.com/yourlife/food/diet-nutrition/2010-09-03-dash-heart_N.htm and this research project abstract if you’re feeling a bit more ambitious http://ukrocharity.org/research/john-mckay-fellowship-grant/yang-full-project-summary/. The first few paragraphs describing the connection between low blood pressure and an optimal diet of more potassium vs. sodium are particularly interesting to me.

I can’t wait to dig into the DASH book on my desk.  Once I’ve read the book (it’s quite short!), I’ll get out to the pharmacy for a few free blood pressure checks, and on to the farmer’s market for some leafy greens and other veggies, fruits, nuts.  Now that the weather’s fine, there’s nothing stopping me from adding daily walks to my kidney lover regimen. Then, it’s on to the doctor’s office.  I’ll let you know how it all goes.

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Welcome to our second Q & A session with Dr. Yu! You’ll notice that we’ve added a cool new glossary feature to this blog.   Mouse over any underlined medical term here (and throughout the website) and you’ll see a pop-up with the definition.

By the way, this thought-provoking question comes to us from one of our Facebook followers.  Many thanks to him for suggesting it!

Q: Why isn’t there a permanent cure for Chronic Kidney Disease (CKD), since it is on a par with cancer and is very costly to treat.  What are the main obstacles to a cure?

A: What a great question!

There are both scientific and socioeconomic obstacles:

Scientific:
CKD is not a single disease, but a common disease process caused by many different underlying diseases, such as diabetes, hypertension, glomerulonephritis, etc.  By the time CKD ensues, the damage to the kidney is already done, and is very difficult to reverse.  The best that can be expected at that point is to slow down further deterioration of the kidney, for which there are, in fact, some quite effective treatments.

There is active research going on to find a cure for some of the underlying diseases, with some minor successes. For example, some patients with Type I diabetes have received pancreatic cell transplants that allow the pancreas to function normally, effectively “curing” their diabetes.  Some types of hypertension are curable and some types of glomerulonephritis can be cured with steroids and other immunosuppressant drugs.  Obviously though, there is a very long way to go!

Socioeconomic:
CKD is extremely common (more than 10% of the adult population suffers from it), but it does not have the visibility of cancer.  This is because few patients with CKD actually  die from it.  In fact, it is estimated that less than 10% ever reach end-stage kidney disease and need dialysis or a transplant.  The remaining 90+% die of cardiovascular diseases (heart attacks, heart failure, strokes).  CKD is the major risk factor in these deaths, but most people do not know to attribute them to kidney disease.  Thus, the general public is not fully aware of how common or how serious CKD is, and consequently, the amount of money available for kidney disease research is tiny compared to that devoted to cancer research.  Conclusion: we need to get the word out!

Michelle, is there any way to research how much money goes to cancer research vs kidney research in this country? I predict that the disparity will be shockingly large.

A quick search on the web turned up many articles with conflicting numbers for dollars spent on cancer research – estimates of $10 to 12 million yearly for the American Cancer Society and $5 to 6 million for the National Cancer Institute.  (This doesn’t even account for all the dollars raised by organizations devoted to specific types of cancer.) Yet, I found it very difficult to find any information on how much money is spent on kidney research.  This could have had something to do with the search terms I was using (I’ll be sure to refine them and try another web search soon), but it’s more likely evidence that Dr. Yu is right.  We really must get the word out about CKD and the need for more research!

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