Kidney health
Awareness of kidney disease and beliefs about possible causes
Public awareness and media coverage of kidney disease is relatively low compared to other conditions, such as heart disease or cancer. Many people we spoke to knew that the kidneys are a vital organ, that they act as a filter to remove waste products from the blood stream and that they are somehow connected to ‘the waterworks’. However, the term ‘kidney disease’ may make people think of kidney failure, transplants and dialysis. As Jim put it, “I knew you could get kidney failure and things like that, but I didn’t realise you could just get something small wrong with them”. Some people thought there should be more advertising of kidney disease, especially what causes it, why kidneys are important for the body to stay healthy and what people can do to keep their kidneys healthy.
Joanne thinks there should be more promotion in GP surgeries of the function kidneys have in your body and how to keep them healthy.
Joanne thinks there should be more promotion in GP surgeries of the function kidneys have in your body and how to keep them healthy.
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I think GPs, I mean they promote a lot about don’t smoke, healthy living… keep fit… you know, in surgeries. I do… and in like mental health – you name it, they promote sort of… have posters and things up but there's never… I've never ever seen anything that I recall about kidneys and why kidneys are important. Now I know about kidneys, I mean did kidneys in biology A level, you know O level and A level so I do know a bit about... But it's not promoted like your lungs are. Well if you don’t have kidneys you're going to die unless you can get a transplant or whatever and yet people know about oh if your, you know, lungs pack up you're going to die, but people don’t understand that kidneys are a very, very important organ of your body. Yeah you can afford to lose one – that’s fine – most people can afford to lose one. Some people only have one, most people have two, but… if they are diseased and don’t work then it will affect your overall health and people don’t understand that.
People mentioned several factors that they thought were likely to harm the kidneys, including medicines, high blood pressure, genetics, alcohol and lifestyle. However, several felt uncertain when it came to possible causes for their own kidney impairment and a few people were concerned whether they could have done something to bring it on. Some had received information about causes from health professionals but others hadn’t, or weren’t satisfied with the explanations they had been given.
Bernard doesn’t know why his kidney function should be impaired, but his wife, who has a nursing background, suspects it is to do with ageing, not helped by his diabetes.
Bernard doesn’t know why his kidney function should be impaired, but his wife, who has a nursing background, suspects it is to do with ageing, not helped by his diabetes.
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Bernard: I’ve no idea. I haven’t got a clue! Apart from the fact that, according to the wife, I don’t drink enough but in terms of alcohol and all that sort of thing, which I would expect… to have a little bit of trouble with, I don’t drink.
You don’t drink any alcohol at all.
Bernard: No. So… why they should be as they are, I’ve no idea.
And what about you [addressing Shelley]? What are your ideas about why he has developed problems with his kidneys?
Shelley: Well, the diabetes doesn’t help, although he’s not on any treatment for diabetes. I just think it’s his organs are wearing out. Due to his age. But anything more technical than that, no, I don’t know.
And are those the kinds of questions that you have discussed with either the nurse or the doctor? Have you asked questions about why it might be that you have developed kidney problems?
Shelley: No, not really.
Bernard: No.
Jackie Z thinks long-term use of Voltarol (diclofenac), which she was taking to cope with joint pain, may have damaged her kidneys but she hasn’t discussed this suspicion with her GP.
Jackie Z thinks long-term use of Voltarol (diclofenac), which she was taking to cope with joint pain, may have damaged her kidneys but she hasn’t discussed this suspicion with her GP.
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And how long ago was that that your GP asked to test your kidneys?
I'm guessing now, how long have I had the… naproxen? One or two years, let's say two years, it's not long term. …It was- basically it was when the Voltarol was withdrawn.
So that was the explanation you got from your GP, it's to make sure that your kidneys haven't been damaged by taking the Voltarol?
They didn’t mention the Vol- no.
No
No they just said, "Let's make sure everything's alright, let's have a kidney check," so I did.
So it's just that is your assumption that it might have been to do with that?
Yes. Yes, that’s my assumption.
Hm mm. So you didn’t really get any explanation in particular of why this particular test needed to be done?
No, No. I didn’t but then I didn’t ask for one particularly.
Mm so it didn’t actually concern you at the time?
No! [laughs]
Joanne doesn’t know whether her decrease in kidney function is due to age or her medication or both – she is not too concerned to know the exact cause at this point in time.
Joanne doesn’t know whether her decrease in kidney function is due to age or her medication or both – she is not too concerned to know the exact cause at this point in time.
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I don’t know. From talking to people and reading stuff it could be my age… because I understand that late forties, early fifties your kidney functions naturally decrease, so it could be my age and it's just, over the last few years, gone down to due to that and it could be that my kidney function stays where it is now in which case there’s not much point to worry about it. It could be that; it could be as a result of long term taking lithium…it could be a combination of those. So I don’t know.
Would it be important for you to know?
No because what's happened in the past has happened so you can't go back and turn the clock back. I would hope that my- my kidney function is continued to be monitored and if it does change then maybe they would do a review of my drugs and maybe decide what we're going to do from there. I think at the moment it's… you know, it's within a range that people could naturally get to my age so don’t panic, we'll just monitor and if things do change then we'll make a decision about what we're going to do.
From a GP perspective, controlling high blood pressure, possibly with the help of blood pressure lowering medicines, is the main clinical target for patients with a mild kidney impairment to prevent further decline. Not everyone we talked to seemed to be aware of the links between high blood pressure and decline in kidney function (see also ‘How and why is kidney function monitored?’).
Kidney function may be damaged through the long-term use of certain prescription drugs. For Simon, kidney damage has been caused by taking lithium for bipolar disorder since he was a teenager. Kath and Lesley knew that their anti-inflammatory medication for arthritis had affected their kidneys, and Peter’s kidneys had been affected by high dose diuretics (water tablets) he had needed for his heart. But others, who had not been given such a clear-cut explanation, also wondered whether medicines they had taken in the past could have had a negative effect on their kidney health. Margaret knew that high blood pressure can damage the kidneys but hadn’t known that the very drugs prescribed to lower blood pressure could also cause kidney function to decline in a small minority of patients, as had happened in her case, so close monitoring of people taking certain medicines is essential (see ‘Controlling blood pressure’).
People with family members who had also experienced kidney problems often wondered whether there was an underlying genetic condition running in their family. Mike, at age 36 - the youngest amongst the people we talked to - wondered whether there was a risk of passing on his kidney and thyroid problems to future children. Jill and Jackie, who had a history of kidney or urinary tract infections, wondered whether this had made their kidneys more vulnerable to decline.
Jackie wonders whether an untreated kidney infection was the trigger for her decline in function or whether there was an underlying familial problem that caused her to have recurrent infections in the first place.
Jackie wonders whether an untreated kidney infection was the trigger for her decline in function or whether there was an underlying familial problem that caused her to have recurrent infections in the first place.
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Well, that was never really established. There was two schools of thought, one was that I may have been born with some problem that made me prone to get the infections. The other, the sort of school of thought is that I, my kidneys were fine, I got an infection that wasn’t treated, and that caused the problem. I know my kidneys were damaged with the infection. I may have been born with perfectly healthy kidneys and ureters and all the rest of it but I’ve never actually found out what it was, and I don’t know whether it was known at the time, I mean whether, I think it would be different today because often they can pick up things a lot sooner with ultrasound scans and things like that.
More recently, I have wondered if I did have a problem, because one of my sons has subsequently had to have a kidney removed because he had a problem with the junction, the valve in his ureter. He was getting back flow, as an adult this this was, so part of me wonders whether I did have something and it was passed onto him and didn’t manifest itself until later years in him. But as I say… I don’t know.
Eric wonders whether heavy drinking during his time in the military may have contributed to the development of a mild kidney impairment. He hardly drinks at all now.
Eric wonders whether heavy drinking during his time in the military may have contributed to the development of a mild kidney impairment. He hardly drinks at all now.
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I used to be a party animal. Being in the military it's very easy to be a party animal. The drinking may have had something to do with it but I'm not sure. I think drinking would more likely affect your liver than your kidneys. I think this is just something with my kidneys which is that they're not functioning as they should do, but at seventy-nine years of age I accept that.
Has your GP ever offered you any lifestyle advice?
No [laughs]. I was a party animal long before I knew my GP.
Do you still drink a lot now?
No, no I hardly drink at all now. See I've gone from… I stopped my drinking heavily in… when I was fifty-five - twenty-four years ago – and now I don't even go out to pubs. I go out to pubs to have a meal but I don't physically say, "I'm going down the pub to drink". But I'm not sure whether drinking had anything to do with my kidneys; as I say, I think if my liver had failed I would say, "Yeah I know what caused it", but I'm not sure what caused the kidney problem. You know, if doctors can't tell me how can I fathom it out?
Last reviewed August 2017.
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