How a Kidney Specialist Lives With Chronic Kidney Disease
A specialist shares his personal experience of living well with the condition.
What happens when a nephrologist—a kidney specialist—is diagnosed with chronic kidney disease (CKD)? As you might expect, they learn a thing or two about living every day with the condition.
Stephen Fadem, MD, is a nephrologist who has been treating patients since 1978. He was diagnosed with CKD in 1998, after cancer treatment with large doses of a chemotherapy ingredient that can lead to kidney issues. When his cancer doctor started sending him patients who had developed CKD after the same cancer treatment, Dr. Fadem had a revelation.
“I noticed a lot of them were doing very, very poorly, yet my disease wasn’t progressing,” says Dr. Fadem, who has a private practice in Houston, Texas, and is chair of the National Medical Advisory Board for the American Association of Kidney Patients.
“When I found out some of the things these patients were doing compared to what I was doing, I started practicing what I preach more than ever.”
A Closer Look at Chronic Kidney Disease (CKD)
Your kidneys filter all the blood in your body around the clock, removing waste, toxins, and excess fluid. In people with CKD, the kidneys are damaged and can’t filter blood as well as they should. Excess fluid and waste from the blood stays in the body and can cause other health problems, including heart disease and stroke.
CKD can be a “silent disease” because it may have no symptoms in its early stages, explains Kumar Dharmarajan, MD, MBA, cardiologist, geriatrician, and Associate Chief Medical Officer at Clover Health.
As a result, it tends to be underdiagnosed. In fact, the Centers for Disease Control and Prevention (CDC) says that 40 percent of people with severely reduced kidney function don’t know they have CKD. That’s why regular checkups and talking with your doctor is essential.
Kidney disease is diagnosed with blood and urine tests. Some primary care physicians do these tests as part of a routine exam. But especially if you may be at risk, ask your doctor about getting tested. The most common risk factors are diabetes, high blood pressure, heart disease, a family history of CKD, and being overweight.
How quickly kidney disease progresses depends largely on how well you take care of your health, so it’s important to diagnose it early and make good lifestyle choices.
Caring for Your Kidneys
“Blood pressure control is key, as is avoiding certain drugs that can worsen your kidney disease, the most common being nonsteroidals, ibuprofens, and naproxen,” says Sophia Chang, MD, MPH, internist, and Chief Clinical Informatics Officer at Clover Health.
Dr. Fadem agrees, and also points out that kidney disease can lead to high blood pressure. This makes it very important to keep an eye on your blood pressure. He also emphasizes the importance of a low-sodium, kidney-friendly diet and regular exercise.
“You cannot stay healthy if you don’t exercise, so I exercise every day—walking, using the rowing machine, lifting weights, or stretching” he says. “I also recommend not smoking and I very rarely drink alcohol. As soon as I learned I had kidney disease, I decided to protect them as best I can. My kidney disease has progressed very slowly and I’m really pretty healthy.”
Physical activity helps control both blood pressure and blood glucose levels, reducing two of the main risk factors for CKD. Exercise is also a great way to lose weight if you need to, or maintain a healthy weight.
In addition, Dr. Dharmarajan says, there are medications that can help delay the progression of CKD. It’s something to talk to your doctor about, along with other lifestyle changes you should make and how often you should have your kidney function tested. In some cases, an ultrasound may be a good idea to show just how much damage there is to the kidneys, Dr. Fadem says.
CKD progresses in stages, and some patients may eventually need a kidney transplant or dialysis. But according to Dr. Fadem, dialysis can be done at home to make it much easier to maintain your daily routine. Even so, taking steps to prevent CKD’s progression, as he has, is ideal.
“I don’t think about kidney disease every day—I just stay as healthy as I can,” Dr. Fadem says. “Even patients on dialysis or who have kidney transplants can exercise and live a very good life. If you have kidney disease, take a positive stance.”
Kidney-Friendly Foods
Good nutrition can help protect the kidneys and prevent or delay any health problems related to chronic kidney disease (CKD), says Jinan Banna, PhD, RD, a practicing registered dietitian. Here are a few of her recommendations.
Consider working with a dietitian to learn exactly which foods are best for you and which ones to avoid.
Plant-based sources of protein—such as tofu, legumes, and quinoa—have been linked to better outcomes for people with kidney disease. Some alternative meat products are high in sodium, so be sure to check labels.
You may need to eat fewer foods high in phosphorus or potassium, which includes some fruits and vegetables. People with CKD may have a decreased appetite and lose weight as a result. If this happens, try eating smaller meals at regular times throughout the day.
Know Your Kidneys
Working closely with your primary care physician or nephrologist is the best way to stay on top of your health if you have chronic kidney disease (CKD).
For additional support, check out these two organizations: American Association of Kidney Patients and National Kidney Foundation.
This article was originally published in the spring issue of Clover Living magazine. Want to see more articles like this? Subscribe to Clover Living magazine for free (if you aren’t already subscribed) here.
This article was medically reviewed by Dr. Kumar Dharmarajan and Dr. Sophia Chang.
Published 3/15/22
Illustration by Chiara Zarmati
