{"product_id":"show-1482-are-your-kidneys-in-trouble-two-tests-could-tell-you","title":"Show 1482: Are Your Kidneys in Trouble? Two Tests Could Tell You","description":"\u003cp\u003eOur kidneys do an incredible job filtering our blood every hour of every day. Most of us have two kidneys, and each one has about a million microscopic filters called glomeruli. Unlike the filters in our HVAC system, though, these filters cannot be replaced. But they do their work so well and unobtrusively that most of us don’t even think about our kidney function. Although 37 million Americans have kidney trouble, the majority are unaware of their situation. Two tests could reveal how well the kidneys are working. What are they, and how often should you ask about them?\u003c\/p\u003e\n\u003cp\u003e\u003cem\u003eAt The People’s Pharmacy, we strive to bring you up‑to‑date, rigorously researched insights and conversations about health, medicine, wellness and health policies and health systems. While these conversations intend to offer insight and perspective, the content is provided solely for informational and educational purposes. Please consult your healthcare provider before making any changes to your medical care or treatment.\u003c\/em\u003e\u003c\/p\u003e\n\u003ch2\u003eWhat Are the Two Tests That Reveal Kidney Trouble?\u003c\/h2\u003e\n\u003cp\u003eChronic conditions like high blood pressure and diabetes put a strain on the kidneys. They are very common problems that signal the need for kidney function monitoring. Our guest expert, Dr. Samir Parikh, suggests that all of us should know our numbers. One is derived from the level of creatinine in the blood. This is normally part of a basic metabolic panel. Usually, the panel results will include a number for the estimated glomerular filtration rate (EGFR) calculated from the value for blood creatinine. The other crucial test is a urine test for protein.\u003c\/p\u003e\n\u003ch2\u003eKeeping Kidneys Healthy by Staying Properly Hydrated\u003c\/h2\u003e\n\u003cp\u003eOne of the simplest tactics to keep kidneys healthy is to provide them with enough liquid. We get some fluid from the food we eat, which may be one reason eating fruits and vegetables seems to be good for us. They are full of water! We also need to drink fluid, and plain water is probably the best choice. It would be smart to use thirst as a guideline and make sure to drink when thirsty. We do avoid overdoing water consumption, though, as overloading the kidneys with more fluid than they can handle is dangerous as well.\u003c\/p\u003e\n\u003ch2\u003eMedicines That Are Hard on the Kidneys\u003c\/h2\u003e\n\u003cp\u003eWe mentioned to Dr. Parikh the experience of an older friend, a devoted runner, who discovered that taking ibuprofen after a run reduced the likelihood of having to get up overnight to urinate. He reminded us and our listeners that nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, naproxen, celecoxib or meloxicam can be hard on the kidneys. That doesn’t mean we shouldn’t ever take such pain relievers, but perhaps we should try not to make it a habit.\u003c\/p\u003e\n\u003cp\u003eWhen we asked about other medicines that might be tough on the kidneys, he mentioned PPIs. Proton pump inhibitors such as omeprazole (\u003cstrong\u003ePrilosec\u003c\/strong\u003e) or esomeprazole (\u003cstrong\u003eNexium\u003c\/strong\u003e) are often used to treat heartburn or other digestive symptoms. Regular use can put a strain on the kidneys, although the gastroenterologist recommending the medicine might not warn you of that side effect.\u003c\/p\u003e\n\u003cp\u003eWe asked about environmental toxins and learned that heavy metals such as lead or arsenic can harm the kidneys along with other organs. We should make sure that the food we eat and the water we drink are not contaminated with such compounds.\u003c\/p\u003e\n\u003ch2\u003eThe Possible Benefits of Vitamin B\u003c\/h2\u003e\n\u003cp\u003eDr. Parikh has been studying how the kidneys respond to the B vitamin nicotinamide. The preliminary work he and his colleagues have done so far is promising. However, they have not conducted clinical trials to find out whether the vitamin could help people with early kidney disease.\u003c\/p\u003e\n\u003cp\u003eBecause kidneys work so hard, they need a lot of energy to be produced by the mitochondria in their cells. Those mitochondria need NAD+ (nicotinamide adenine dinucleotide) to function at their best. Providing additional nicotinamide appears to help (\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/31673160\/\"\u003e\u003cem\u003eNature Reviews. Nephrology\u003c\/em\u003e, Feb. 2020\u003c\/a\u003e).  One to three grams a day appears to be safe and may be beneficial.\u003c\/p\u003e\n\u003ch2\u003eMedications That Can Promote Kidney Health\u003c\/h2\u003e\n\u003cp\u003eSome medicines initially developed for other conditions are proving to be helpful in treating kidney disease. In particular, these include diabetes drugs known as SGLT2 inhibitors like dapagliflozin (\u003cstrong\u003eFarxiga\u003c\/strong\u003e) or empagliflozin (\u003cstrong\u003eJardiance\u003c\/strong\u003e). They help slow the decline of kidney function (\u003ca href=\"https:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa2204233\"\u003e\u003cem\u003eNew England Journal of Medicine\u003c\/em\u003e, Nov. 4, 2022\u003c\/a\u003e). GLP-1 agonists may also be familiar because they too are used to treat diabetes. Medications such as semaglutide (\u003cstrong\u003eOzempic\u003c\/strong\u003e, \u003cstrong\u003eRybelsus\u003c\/strong\u003e, \u003cstrong\u003eWegovy\u003c\/strong\u003e) and tirzepatide (\u003cstrong\u003eMounjaro\u003c\/strong\u003e, \u003cstrong\u003eZepbound\u003c\/strong\u003e) have made headlines as weight loss and diabetes meds, but they also can reduce the risk of kidney failure and other bad outcomes (\u003ca href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/39608381\/\"\u003e\u003cem\u003eLancet. Diabetes \u0026amp; Endocrinology\u003c\/em\u003e, Jan. 2025\u003c\/a\u003e). The benefits of these types of drugs should give us hope that we can go from slowing the progression of kidney disease to stopping it in its tracks\u003c\/p\u003e\n\u003ch2\u003eTaking Care of Your Kidneys\u003c\/h2\u003e\n\u003cp\u003eWe asked Dr. Parikh what we should be doing to care for our kidneys and keep them healthy. He urged us once again to know our numbers: most importantly, the numbers from the two tests we discussed, blood creatinine and urine protein. Other numbers that are important for kidney are our blood pressure and, for those with diabetes, HbA1c. In addition to paying attention to all those numbers, we need to embrace a lifestyle that will help keep them where they belong. That means following a heart-healthy diet, staying physically active and getting adequate sleep.\u003c\/p\u003e\n\u003ch2\u003eThis Week's Guest\u003c\/h2\u003e\n\u003cp\u003eSamir M. Parikh, M.D., FASN, is Professor of Internal Medicine and Pharmacology and Chair of Internal Medicine at the University of Texas Southwestern. He holds the Donald W. Seldin Distinguished Chair in Internal Medicine and the Ruth W. and Milton P. Levy, Sr., Chair in Molecular Nephrology.\u003c\/p\u003e\n\u003cp\u003e[caption id=\"attachment_141020\" align=\"alignnone\" width=\"720\"]\u003cimg class=\"size-full wp-image-141020\" src=\"https:\/\/nyc3.digitaloceanspaces.com\/peoplespharmacy\/Parikh-photo-square-headshot.jpg\" alt=\"Dr. Samir Parikh, University of Texas Southwestern\" width=\"720\" height=\"725\"\u003e Dr. Samir Parikh, University of Texas Southwestern[\/caption]\u003c\/p\u003e","brand":"The People's Pharmacy","offers":[{"title":"MP3","offer_id":46359119757391,"sku":"pc1482","price":0.0,"currency_code":"USD","in_stock":true}],"thumbnail_url":"\/\/cdn.shopify.com\/s\/files\/1\/1208\/7442\/files\/Urologist-Pointing-Kidney-Model_26177cfc-95ed-4ef6-92b5-5392c58132fd.jpg?v=1786064197","url":"https:\/\/cp7dom-b3jtc8.myshopify.com\/products\/show-1482-are-your-kidneys-in-trouble-two-tests-could-tell-you","provider":"The People's Pharmacy","version":"1.0","type":"link"}