For people with diabetes, kidney disease has to be carefully tracked
More than 30 years ago, Louis Foranoce was diagnosed with diabetes. In 2012, after topping the scales at 400 pounds, he had lap-band surgery.
After the surgery, in which a surgeon places a gastric band around the upper part of the stomach to create a smaller stomach pouch, Foranoce’s weight dropped to 190 pounds.
“I was a walking time bomb,” said Foranoce, 73, of Boynton Beach, who moved to South Florida after retiring as a correctional officer at Rikers Island in New York. “I was obese with high blood pressure and diabetes. Even though I lost all the weight, my kidneys were ruined. One kidney wasn’t working at all.”
DIABETES IS LEADING CAUSE OF KIDNEY FAILURE
Chronic kidney disease is a leading cause of death in the United States, according to the Centers for Disease Control and Prevention (CDC). Diabetes and high blood pressure are the leading causes of kidney failure, representing about 3 out of 4 new cases. Approximately 1 in 3 adults with diabetes has chronic kidney disease.
Kidney failure is caused by damaged kidneys that can’t filter blood effectively. Excess fluid and waste remain in the body and cause other health problems, including heart disease and stroke.
About 37 million adults are estimated to have chronic kidney disease and most are undiagnosed, with 40 percent of those with severely reduced kidney function not aware they have chronic kidney disease, according to the CDC. Kidney disease often develops slowly and with few symptoms.
NOT REALIZING IT’S KIDNEY DISEASE
“Kidney disease isn’t painful, so people don’t seek medical attention,” said Dr. Alessia Fornoni, chief of nephrology at the University of Miami Health System.
Many people don’t realize they have the disease until it’s advanced and need dialysis, a treatment that filters the blood, or a kidney transplant to survive. A transplant is preferred because patients live longer with a transplant.
“The name of the game is to slow kidney disease progression so patients won’t be on dialysis or need a transplant,” said
Dr. Ruchir Chokshi, nephrologist at Broward Health Medical Center. “Dialysis is a bridge therapy for a patient until they can get a transplant.”
In 2018, Foranoce began receiving dialysis due to his remaining kidney not functioning well.
“Once you get on dialysis, it is four to six hours every other day,” Foranoce said. “It is very limiting because after dialysis, you are constantly weak.”
In 2019, after his health improved, he became eligible to be a candidate for a kidney transplant. That same year, he underwent transplant surgery at the Cleveland Clinic Florida in Weston. He developed Hepatitis C, a virus that affects the liver, from the transplanted kidney but was cured with medication.
“I was amazed myself at how quick it was and everything went well,” Foranoce said. “I’ve gotten better. The kidney is working really well. I feel strong.”
KEEPING BLOOD SUGAR IN CHECK
Not all patients with kidney disease progress to kidney failure; proper treatment can slow the disease. Patients with diabetes should have their kidneys checked regularly for early detection of kidney disease. Controlling blood sugar levels, keeping blood pressure in check and eating healthy and exercising can help prevent kidney disease.
“Once you have diabetes, there are things you can do to slow down having sugar in the urine and decreasing blood pressure, “said Dr. Shane Bobart, a nephrologist at the Cleveland Clinic.
Blacks, Hispanics, and American Indians, three groups that have high rates of diabetes and elevated blood pressure levels, are at high risk for developing kidney failure, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Blacks are almost four times as likely as whites to develop kidney failure. Blacks comprise 13 percent of the U.S. population, but account for 35 percent of people with kidney failure in the United States.
EDUCATING CHILDREN ABOUT DIABETES
Prevention of diabetes should begin in school with education and reduction of sugary drinks and foods with high carbohydrates, Fornoni said.
“Obesity drives diabetes through lifestyle and diet,” Fornoni said. “Instead of treating it, we can prevent it through educating children in schools about diabetes.”
Since his kidney transplant, Foranoce said he is “almost functioning like a normal person” but doesn’t have an immune system because of the anti-rejection drugs he takes.
“I was wearing a mask before it was fashionable,” Foranoce said. “People would look at me like what’s wrong with me. It’s not what’s wrong with me [that I’m worried about]. It’s what’s wrong with you.”
Foranoce credits Linda, his wife of 51 years, for helping him throughout his health journey. Currently, he takes 30 pills daily and insulin twice a day. Together, they have two sons and six grandchildren.
“Without her, I wouldn’t be here,” said Foranoce.