Latest / Heartwise / HW 2026-07-23 Understanding Kidney Function - Nathan Chamberlain

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HW 2026-07-23 Understanding Kidney Function - Nathan Chamberlain · Heartwise

• 0:11
  Speaker 1: This is Heartwise, offering practical tips and time proven guidelines
• 0:16
  Speaker 1: to make your life healthier, happier, and more fulfilling. Today
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  Speaker 1: you'll learn simple, Bible based principles for building and maintaining
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  Speaker 1: optimum mental and physical health, all while deepening your relationship
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  Speaker 1: with your creator. Here's your Heartwise host, doctor James Markham.
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  Speaker 2: Welcome to Heartwise. Everyone. We have a very interesting topic
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  Speaker 2: we're going to talk about today and everyone has hopefully
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  Speaker 2: everyone has two of these and these are kidneys. I
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  Speaker 2: guess some people don't have but one, but hopefully most
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  Speaker 2: of us have two kidneys. And we have a renowned
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  Speaker 2: specialist with us today that specializes in nephrology, and his
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  Speaker 2: name is doctor Nathan Chamberlain. Doctor Chamberlain, thank you for
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  Speaker 2: joining us today on Heartwise.
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  Speaker 3: My pleasure. Thank you, Doctor Markham.
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  Speaker 2: Well, what we've done, doctor Chamberlain, is we collect questions
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  Speaker 2: that come into our website, and whenever we have a
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  Speaker 2: certain volume of questions, what I try to do is
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  Speaker 2: group the questions that are similar and I bring a
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  Speaker 2: specialist in that knows a lot about the subject, and
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  Speaker 2: then we answer that question. Because if one person has
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  Speaker 2: that question, many persons has that questions so I'm going
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  Speaker 2: to jump right in if it's okay with you and
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  Speaker 2: this this person writes us and he says, I'm on dialysis,
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  Speaker 2: and this person wants to know what would make me
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  Speaker 2: transplant eligible. But before we talk about transplantation and dialysis,
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  Speaker 2: let's talk about things about the kidney that might cause
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  Speaker 2: us for the kidneys to go bad, so we would
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  Speaker 2: need those things.
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  Speaker 3: Yeah, you know, I guess starting off real basic, all
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  Speaker 3: of the everything's driven by lab when we talk about
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  Speaker 3: the kidney. Okay, so yeah, a lot of times people
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  Speaker 3: don't even have symptoms. I'd say most of the time
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  Speaker 3: people don't have symptoms, and they may find out that
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  Speaker 3: they have what's called chronic kidney disease, and that is
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  Speaker 3: diagnosed off of lab work that's routine and drawn usually
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  Speaker 3: by a primary care physician on an annual checkup. And
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  Speaker 3: what we look at is called the creatinine and it's
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  Speaker 3: one of the basic blood work tests. And once they
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  Speaker 3: have the creatinine, they do a calculation called the GFR.
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  Speaker 3: And the GFR is the glomerular filtration rate, which is
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  Speaker 3: the amount of blood that is filtered by the kidney.
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  Speaker 3: It's measured in milli liters per minute, and once we
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  Speaker 3: have the GFR, we can diagnose someone with chronic kidney disease.
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  Speaker 2: Now, what might cause a chronic kidney disease.
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  Speaker 3: And what causes that? In our country, most of the
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  Speaker 3: time you're talking about hypertension and diabetes. The long standing
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  Speaker 3: high blood pressure can result in some wear and tear
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  Speaker 3: on the kidney filters, and then long standing diabetes as
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  Speaker 3: it affects your eyes and your nerves other parts of
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  Speaker 3: your body, also causes problems in the kidneys where you
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  Speaker 3: lose protein and get some damage to the kidneys from that.
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  Speaker 2: Okay, so sorry you interrupted you. So you check your
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  Speaker 2: creatin and that's a filtration rate, that's right.
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  Speaker 3: And once you have the GFR, you can stage your
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  Speaker 3: level of kidney function, and the definition of chronic kidney
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  Speaker 3: disease would be a GFR less than sixty millimeters per
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  Speaker 3: minute for more than three consecutive months, okay. And stage
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  Speaker 3: three CKD or chronic kidney disease is what we have
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  Speaker 3: when your filtration rate is thirty to sixty. And as
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  Speaker 3: the filtration rate goes down, the three of your CKD
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  Speaker 3: goes up, it gets worse. And when you're talking about
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  Speaker 3: the patient who had a question about that, and they
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  Speaker 3: were on dallasis. Dallasis is when the GFR gets down
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  Speaker 3: in the ten to fifteen range.
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  Speaker 2: Okay, So so let me simplify this. So when it
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  Speaker 2: goes down that low, if the kidneys can't filter the
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  Speaker 2: things that are bad, then the bad things build up
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  Speaker 2: in us. Is that right? Yes?
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  Speaker 3: And the you know it's simplified analogy is that your
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  Speaker 3: body is a bathtub, and if your body is a
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  Speaker 3: bathtub and it's full of dirty water that you should
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  Speaker 3: normally filter, and if your kidneys or the drain of
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  Speaker 3: the bathtub is not filtering, those toxins and the dirty
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  Speaker 3: water and poisons kind of build up over time and
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  Speaker 3: can make you feel bad.
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  Speaker 2: Okay, Now, what might be some of the symptoms as
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  Speaker 2: if it gets really worse and worse kidney disease.
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  Speaker 3: Yeah, again, most of the time you're not going to
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  Speaker 3: have symptoms when this is discovered, okay, But when you
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  Speaker 3: get to the point where you have euremia, which is
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  Speaker 3: when the toxins build up to a level where you
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  Speaker 3: need to start dialysis, you would have usually nausea in
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  Speaker 3: the morning, you would have vomiting, low appetite, fatigue, not
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  Speaker 3: feeling well, and sometimes we see itching osprous level builds up.
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  Speaker 2: Okay, so get those all those toxins build up. Now,
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  Speaker 2: how do you get your patients if most people don't
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  Speaker 2: know that they that they have.
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  Speaker 3: This Well, almost exclusively as a nephrologist, I get my
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  Speaker 3: patients from primary care physicians who refer patients who are
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  Speaker 3: found to have chronic kidney disease on their lab work.
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  Speaker 2: So should everyone have some lab work done at some
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  Speaker 2: point in their life to see how their kidneys are doing?
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  Speaker 2: Is that a routine thing or should you start it
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  Speaker 2: like on your twenties or when should you have that checked?
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  Speaker 3: Well? Definitely if you have a family history of chronic
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  Speaker 3: kidney disease or know someone on dalysis or even hypertension
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  Speaker 3: or diabetes, I would recommend teen checking of blood work,
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  Speaker 3: starting you know, in early adulthood. As far as I
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  Speaker 3: think everyone should be regularly seeing a doctor and getting
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  Speaker 3: their creating checked. Of course that's what I do every day.
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  Speaker 3: But you're not going to know you have c k
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  Speaker 3: D if you don't have your CRATNY check.
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  Speaker 2: Now, getting back to our question, this patient is on dialysis.
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  Speaker 2: That means as kidneys have not filtered the toxins out
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  Speaker 2: and they want to know specifically about transplant. What makes
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  Speaker 2: a person eligible for transplant or not eligible for a
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  Speaker 2: transplant of the kidneys.
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  Speaker 3: Yes, and that's a that's a very good question we
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  Speaker 3: have we really want. We have a long list of
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  Speaker 3: people who are waiting on transplants in our country. We
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  Speaker 3: have a lot of people on dialysis and a lot
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  Speaker 3: of people are waiting for a kidney. Uh. And this
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  Speaker 3: is uh, it's a quality of life issue. People do
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  Speaker 3: okay on dallass, but when they get a transplant, they
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  Speaker 3: get normal kidney function back, even with the one kidney,
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  Speaker 3: and that results in improved quality of life and in
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  Speaker 3: you know, longer survival for a dalyasis patient. And things
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  Speaker 3: that would make someone not a DALLASIS candidate would be
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  Speaker 3: a severe heart disease that maybe is not fixable, and
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  Speaker 3: then someone who's had cancer, depending on the type, within
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  Speaker 3: the last few years. And then maybe somebody who had
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  Speaker 3: like an Alzheimer's or a dementia type illness.
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  Speaker 2: What about diabetes.
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  Speaker 3: Uh, we have a lot of people with diabetes get
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  Speaker 3: transplant every day.
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  Speaker 2: And how about you know, you ask about you know,
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  Speaker 2: other things, how about age? Is age a factor at
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  Speaker 2: all or.
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  Speaker 3: Age is not a factor as far as getting a transplant.
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  Speaker 3: There are a new criteria called extended criteria donor kidneys.
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  Speaker 3: So anyone of any age should be looked at to
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  Speaker 3: get a transplant because those people, as they were transplanted,
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  Speaker 3: would actually live longer and do better than they would
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  Speaker 3: on dallases. And it's case by case, like I said,
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  Speaker 3: but if somebody if someone's not going to get a
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  Speaker 3: kidney transplant based on their age, I'll leave.
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  Speaker 2: It like that now. So, doctor Chamberlain, if a patient
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  Speaker 2: comes to you on dialysis, do you routinely say you
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  Speaker 2: would be eligible transplant or is that a patient does?
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  Speaker 2: Who initiates that discussion for someone on dialysis, Well.
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  Speaker 3: It should be the Dallass clinic. The Dallas Clinic should
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  Speaker 3: be looking at each patient and everybody should be asked
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  Speaker 3: whether or not they're interested in transplant, and if they're
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  Speaker 3: interested in transplant at least be referred for education. Now,
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  Speaker 3: they're of course people who will not qualify the people
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  Speaker 3: we talked about before. Another one maybe like a hepatitis right,
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  Speaker 3: hepatitis C or hepatitis B, depending on the liver biopsy.
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  Speaker 3: A lot of people still do get transplants with those diseases.
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  Speaker 3: But again it's it's a case by case situation.
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  Speaker 2: So if you're interested in eligible, the next step would
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  Speaker 2: be to go to a transplant center or what's this
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  Speaker 2: next step?
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  Speaker 3: Yeah, you would be referred by the Dallas's unit to
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  Speaker 3: a transplant center and then you would, depending on where
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  Speaker 3: you are, you would go through an evaluation process that
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  Speaker 3: usually takes a couple of days.
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  Speaker 2: Yeah. So it sounds like there's a lot of a
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  Speaker 2: big process that there's a lot of people are waiting
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  Speaker 2: to get kidneys. Huh.
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  Speaker 3: It's very involved, and I think the average weight time
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  Speaker 3: for a kidney in our area is three to five years.
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  Speaker 2: Wow. Wow, you know.
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  Speaker 3: That's on the cadaver list. Oh okay, and you're talking
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  Speaker 3: about when you go to a transplant center and get
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  Speaker 3: on the list. We're talking about cadaver or to cease
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  Speaker 3: donor transplant.
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  Speaker 2: Okay. These are not other people.
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  Speaker 3: Who have died in a car accident or forever whatever reason.
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  Speaker 2: It's not a family member or anything like that.
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  Speaker 3: Right, And if you can get a living donor whether
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  Speaker 3: it's a relative or not, you can get your kidney
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  Speaker 3: usually much quicker than.
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  Speaker 2: Well, I'm gonna stop you there. We're about ready to
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  Speaker 2: go to break, and I hope you're learning a little
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  Speaker 2: bit about your kidneys with doctor Nathan Chamberlain. After break,
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  Speaker 2: we're gonna talk some ways about how to keep your
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  Speaker 2: kidneys well. We'll be right back after this break.
• 10:43
  Speaker 1: In his book The Ultimate Prescription, now available from Tendale
• 10:46
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• 11:22
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• 11:25
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• 11:36
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• 11:42
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• 12:01
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• 12:23
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• 12:28
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• 12:31
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• 12:34
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• 12:39
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• 12:52
  Speaker 2: Welcome back to Heartwise. I'm talking today with nephrologists, doctor
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  Speaker 2: Nathan Chamberlain. And for those who don't know what a
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  Speaker 2: nephrologist is, it's a doctor that's trained in internal medicine
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  Speaker 2: that specializes in the care of kidneys. And doctor Chamberlain
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  Speaker 2: worked with Nephrology Associates out of Chattanooga, Tennessee, and he's
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  Speaker 2: a great nephrologist. We get to work with him and
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  Speaker 2: his group. They are all great every day. And in
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  Speaker 2: the last segment, we were talking about someone that needed transplantation,
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  Speaker 2: doctor Chamberlain, and this next question is a little bit different.
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  Speaker 2: This is a person that has a history of polycystic
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  Speaker 2: kidney disease in his family. And this person does not
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  Speaker 2: have polycystic kidney disease in his family. But here's wanting
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  Speaker 2: to know some ways that he might protect his kidneys
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  Speaker 2: and keep his kidneys happy. And I guess, is there
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  Speaker 2: anything you can do to protect your kidneys from a
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  Speaker 2: genetic defect?
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  Speaker 3: That's a very good question. Polycystic kidney disease has a
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  Speaker 3: lot of variation, and I would assume that this person
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  Speaker 3: would be talking about autosomal dominant polycystic kiinney disease, which
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  Speaker 3: is the most common form that we see, and that
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  Speaker 3: is a fifty chance of inheritance. And if I understood
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  Speaker 3: the question right, the family has yes and.
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  Speaker 2: He wants to know. Well he doesn't know, so what
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  Speaker 2: should he do? What should he do? But he does
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  Speaker 2: want to keep the skidney's happy.
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  Speaker 3: Yeah, well, I think the it depends on your age,
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  Speaker 3: first of all. But what we what we talk about
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  Speaker 3: with autism wal dominant is that if you have the gene,
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  Speaker 3: it is expressed, so you have a fifty chance of
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  Speaker 3: getting that gene from the affected parent. So there's a
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  Speaker 3: fifty percent chance you don't have polycystic kidney disease. But
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  Speaker 3: you won't know unless we do an ultrasound or some
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  Speaker 3: or cat skin or some type of imaging pictures of
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  Speaker 3: the kidneys.
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  Speaker 2: So you couldn't pick it up on a blood test.
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  Speaker 3: Right, you can have normal kidney function and still have
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  Speaker 3: polycystic kidneys, Okay, And it depends upon your age because
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  Speaker 3: as you age, as people age, you can get on
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  Speaker 3: your kidney even normal people who don't have polycystic kidney disease.
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  Speaker 3: So there are criteria and I think, depending on the
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  Speaker 3: person's age, they would need an ultrasound and probably maybe
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  Speaker 3: a yearly ultrasound to see if CYS develop at some point. Now,
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  Speaker 3: assuming the patient in question does not have polycystic kidney disease,
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  Speaker 3: things that could keep your kidneys healthy, of course, would
• 15:27
  Speaker 3: be to control of your blood pressure, and as a nephrologist,
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  Speaker 3: we like you to be in the one to twenty
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  Speaker 3: over seventy range that's low, and we like that to
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  Speaker 3: keep it on the low end to prevent further damage.
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  Speaker 3: And then we want your diabetes under very good control
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  Speaker 3: if you have diabetes, and that would be keeping that
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  Speaker 3: hemoglobin a one C level down in the six to
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  Speaker 3: seven range. And then we want to drink plenty of
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  Speaker 3: water unless there's a reason not to, and avoid medications
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  Speaker 3: like the nonstroidal anti inflammatory drugs, which can over time
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  Speaker 3: cause kidney damage in and of themselves if taken in
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  Speaker 3: high doses.
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  Speaker 2: Now can antabotics hurt the kidneys.
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  Speaker 3: Antabotics can, especially if you have some chronic kidty disease,
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  Speaker 3: But basically any drug you take is filtered to some
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  Speaker 3: degree by the kidneys, and not just antibotics, but other
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  Speaker 3: medications can cause an allergic reaction sometimes in the kidney.
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  Speaker 3: That would be more of an acute kidney injury rather
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  Speaker 3: than a chronic kidney disease process.
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  Speaker 2: So we're writing this down. So what about testing? Is
• 16:48
  Speaker 2: there anything you know? Testing? Why is it can hurt you?
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  Speaker 2: Occasionally hear about certain contrasts things. Does that really damage
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  Speaker 2: the kidneys or not?
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  Speaker 3: It certainly can, especially again and someone with chronic kidney disease.
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  Speaker 3: And one of the things we tell our patients regularly
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  Speaker 3: is to avoid IV contrast. Okay, so if you go
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  Speaker 3: to the hospital and get a cat scan and you
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  Speaker 3: drink contrast oral contrast that has, in our best knowledge,
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  Speaker 3: does not cause kidney damage. But if you were to
• 17:21
  Speaker 3: get ivy contrast or a cat scan, then that is what.
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  Speaker 3: Or for cardiac cathey or coronary angiogram, those that type
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  Speaker 3: of die can damage kidneys.
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  Speaker 2: Yeah, now you know, we are, you know, and at
• 17:36
  Speaker 2: least in the heart world, we're using you know, lower
• 17:39
  Speaker 2: ionic and we're using safer dies now. So I don't
• 17:41
  Speaker 2: see it quite as much as we used to.
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  Speaker 3: Yeah, I see it more, probably on my end because
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  Speaker 3: all of my patients already have some right chronic kidney disease.
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  Speaker 3: To start with.
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  Speaker 2: Okay, so you've really given us some good ways to
• 17:55
  Speaker 2: to keep our kidneys happy. Water, watch your medicines, watch
• 18:00
  Speaker 2: contrast agents, keep your diabetes and high blood pressure under control.
• 18:04
  Speaker 2: Those are some great suggestions. We have a time for
• 18:06
  Speaker 2: another question here, and let's get to that one. And
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  Speaker 2: this person says, my kidney function is not normal. Is
• 18:13
  Speaker 2: there anything or medicines I can do to help the
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  Speaker 2: filtration rate get better? So they want to is there
• 18:19
  Speaker 2: any medicines they can do to sort of help their
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  Speaker 2: kidneys get better?
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  Speaker 3: That's another very good question. I would not knowing the detail.
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  Speaker 2: Yeah, that's in general.
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  Speaker 3: Yeah, basically the things that we just talked about. In
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  Speaker 3: my opinion, if you've got chronic kidney disease, the patients
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  Speaker 3: I see, as long as they're not getting worse, I'm
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  Speaker 3: pretty happy, okay to meaning that I wouldn't expect an
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  Speaker 3: improvement in kidney function over the long term. But if
• 18:51
  Speaker 3: you can hold steady and not have your kidney function
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  Speaker 3: worse in over time, then we're pretty happy with that.
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  Speaker 2: Good.
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  Speaker 3: But what we normally do is people with high blood
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  Speaker 3: pressure or diabetes with protein in the urine, we like
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  Speaker 3: certain medications, particularly ACE inhibitors and ARBs which help slow
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  Speaker 3: down the rate of decline of kidney function in patients
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  Speaker 3: with chronic kidney disease, and of course what we talked
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  Speaker 3: about earlier by controlling blood pressure and diabetes and avoiding
• 19:24
  Speaker 3: those nonsteroidal anti inflammatory drugs.
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  Speaker 2: Okay, well let's talk a little bit now. We've had
• 19:29
  Speaker 2: several questions that come into a website about diuretics and kidneys.
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  Speaker 2: Do diuretics help the filtration, hurt the filtration, or what
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  Speaker 2: are the role is diuretics in kidney disease.
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  Speaker 3: A lot of times we have to use diuretics.
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  Speaker 2: And explain to our audience what they do.
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  Speaker 3: Actually, well, diuretics, you know, we're talking about water pits,
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  Speaker 3: uh huh, And there are several different classics, several different
• 19:56
  Speaker 3: kinds of diuretics. But what happens is the kidneys as
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  Speaker 3: they don't filter, a lot of times you will have
• 20:03
  Speaker 3: some water or fluid retention, sodium retention, and when that happens,
• 20:08
  Speaker 3: we can prescribe a diuretic which alters the kidney's ability
• 20:14
  Speaker 3: to hold on to salt and water, and therefore your
• 20:17
  Speaker 3: you'reine output will increase. Diuretics can increase the creating level
• 20:24
  Speaker 3: at times, but in and of themselves, I don't think
• 20:28
  Speaker 3: they cause any chronic kidney disease or worsening of chronic
• 20:32
  Speaker 3: kidney disease. They're a necessary part of a lot of
• 20:36
  Speaker 3: medical regimens in dealing with patients with KD and edema
• 20:41
  Speaker 3: or swelling.
• 20:43
  Speaker 2: Have you ever seen them hurt people.
• 20:46
  Speaker 3: If they're used appropriately? Usually not, but sometimes you get
• 20:53
  Speaker 3: You can get what we call dry or dehydrated from
• 20:57
  Speaker 3: over use of diuretics. And if you get that, then
• 21:00
  Speaker 3: your creatinine level or your kidney function will get worse.
• 21:04
  Speaker 2: Yeah. Well, I saw a patient recently in the hospital
• 21:06
  Speaker 2: that had swollen, swollen legs. You know, heart was fine,
• 21:10
  Speaker 2: kidney function was fine. They just had swollen legs and
• 21:13
  Speaker 2: probably from having bad veins. In retrospect. Well, they were
• 21:17
  Speaker 2: given a lot of diuretic, okay, and unfortunately that diuretic
• 21:21
  Speaker 2: wasn't smart enough just to take fluid out of the legs,
• 21:23
  Speaker 2: and it took fluid out the whole body, including potassium,
• 21:27
  Speaker 2: and that person got in a little bit trouble when
• 21:28
  Speaker 2: their potassium got down to two. So, you know, so
• 21:32
  Speaker 2: you got to you know, like I said, I try
• 21:34
  Speaker 2: to tell people if you can get at the cause.
• 21:36
  Speaker 2: You know, the cause of the swelling wasn't a diuretic.
• 21:39
  Speaker 2: The cause was probably too much sodium and bad veins.
• 21:41
  Speaker 2: If you can help that out, maybe you can avoid
• 21:44
  Speaker 2: taking the risks of some of the diuretics.
• 21:47
  Speaker 3: And that's true. Yeah, every medication that you take does
• 21:51
  Speaker 3: have some side effect.
• 21:53
  Speaker 2: Everyone has.
• 21:53
  Speaker 3: Now.
• 21:53
  Speaker 2: Now, I know that you talk to people about kidneys
• 21:56
  Speaker 2: every day, and you have our audience just just waiting
• 21:59
  Speaker 2: for some great tips here. If you if you had
• 22:01
  Speaker 2: to talk to our audience here and want to leave
• 22:03
  Speaker 2: them with one or two things that they should take
• 22:06
  Speaker 2: home from this this talk today, what would what would
• 22:08
  Speaker 2: you leave that with them with Doctor Chamberlain, Well, I would.
• 22:11
  Speaker 3: First of all recommend everybody know their kidney number, and
• 22:15
  Speaker 3: that kidney number is the serum CREATNYA, and I would
• 22:19
  Speaker 3: encourage everyone to get to their primary care physician and
• 22:23
  Speaker 3: find out what their creat ney level is and whether
• 22:27
  Speaker 3: or not they have chronic kidney disease, because again, you
• 22:30
  Speaker 3: will not have symptoms from this, and if you can
• 22:34
  Speaker 3: catch it early enough, we can prevent problems down the road. Excellent,
• 22:39
  Speaker 3: know your kidney number, control your blood pressure, control your diabetes,
• 22:43
  Speaker 3: watch your salt intake and lay off of the nonsteroidal
• 22:48
  Speaker 3: anti inflammatory drugs and hopefully you'll have healthy kidneys from
• 22:53
  Speaker 3: here on out.
• 22:54
  Speaker 2: Well, that's great advice from doctor Chamberlain. If you'd like
• 22:57
  Speaker 2: to leave a question for doctor Chamberlain, you can go
• 22:59
  Speaker 2: to our website that's Heartwiseministries dot org and we'll have
• 23:05
  Speaker 2: him on again some time to answer your specific questions.
• 23:08
  Speaker 2: Doctor Chamblain, we want to thank you so much today
• 23:10
  Speaker 2: for taking time out of your busy schedule to be
• 23:13
  Speaker 2: with us on Heartwise.
• 23:14
  Speaker 3: My pleasure, enjoyed it.
• 23:16
  Speaker 2: Okay? Well, friends, if you have a question of concern
• 23:19
  Speaker 2: again go to our website and remember at Heartwise we
• 23:22
  Speaker 2: like to take a balance approach, remembering if there's a
• 23:24
  Speaker 2: place for modern medicine, especially in acute care injury, but
• 23:27
  Speaker 2: that doesn't fix everything. There's a place for lifestyle changes,
• 23:31
  Speaker 2: but it's in that unique relationship that you develop with
• 23:33
  Speaker 2: God that helps bring you to ultimate healing. We want
• 23:37
  Speaker 2: to thank you for joining us each and every week
• 23:38
  Speaker 2: on Heartwise. We would also thank our special guest, doctor
• 23:42
  Speaker 2: Nathan Chamberlain nephrologists at Chad Nephrology Associates here in Chad
• 23:48
  Speaker 2: Niggle for joining us, and thank you also for joining
• 23:50
  Speaker 2: us today on heartwise.
• 23:59
  Speaker 1: Thank you for joining us today on heartwise. If you'd
• 24:02
  Speaker 1: like more information on how to build and maintain optimum physical, mental,
• 24:06
  Speaker 1: and spiritual health, log onto Heartwiseministries dot org. Heartwise is
• 24:11
  Speaker 1: a listener supported program and your partnership with us would
• 24:15
  Speaker 1: be greatly appreciated. Once again, our web address is Heartwiseministries
• 24:19
  Speaker 1: dot org.