Dr. Anjay Rastogi, the clinical chief of nephrology and director of the Clinical excellence, Outreach, Research and Education Kidney Health Program for UCLA Health, sat down with science and health contributor Tia Ketsan to discuss kidney disease awareness.

The kidney health program, which was founded in 2016, aims to help patients self-advocate, Rastogi said. Rastogi, who has practiced medicine for over two decades, received his medical degree from the Rajasthan University of Health Sciences in India and completed his doctoral degree in molecular and medical pharmacology at the David Geffen School of Medicine.

This interview has been edited for length and clarity.

Daily Bruin: Why is Kidney Awareness Month so important? What are some of the key messages you hope to convey to the public, specifically college-aged students?

Anjay Rastogi: One in three adults in the U.S. are at risk (for kidney disease). When you go to your class – let’s say 300 students – 100 of those students are at risk, and one in seven have it. About 15% of the adults in the U.S. have kidney disease, but only one in 10 know it; nine out of 10 people don’t know they have any kidney illness, and these are the patients who have the worst outcomes because they end up on dialysis.

We want kidney health awareness because unless you really test yourself, which is (a) simple blood and urine test, you would not know if you have kidney disease.

Kidney disease is a spectrum. There are five stages of chronic kidney disease. Stage one is the earliest, stage five is the most advanced and that stage needs dialysis or transplants. The biggest fear is ending up on dialysis. That’s a very reasonable fear because what they don’t know (is that) there’s a higher risk of them dying in stage three, not even stage five.

DB: How do you recommend getting tested for kidney disease? Are there any signs and symptoms to look out for?

AR: There are signs and symptoms – your eyes could be swollen, your legs could be swollen, you can feel headaches. If your blood pressure is really high, you might have nausea, vomiting, you might even have numbness, tingling and obviously fluid overloaded that can give shortness of breath. A lot of times symptoms are not that significant – if you have those symptoms, you need to go and get it checked out.

My concern is asymptomatic (patients). A lot of these symptomatic patients might have been asymptomatic a while ago and it was never caught, so we could have prevented it from becoming symptomatic. If you go for your physicals, asking for a urine and blood test should suffice.

DB: What are the primary functions of the kidney, and why are they important for our overall health?

AR: Kidneys act as a filter. They purify blood, they get rid of waste products from your body, and then those products are excreted in the urine. That’s one of the primary functions, but it does a lot more than that. It maintains your acid-base (levels), maintains electrolytes and fluids. It has hormonal functions, so it activates vitamin D. The vitamin D that you ingest is inactive unless it goes to the kidneys. Patients who have kidney disease become vitamin D-deficient because they don’t have the active form of vitamin D.

It produces a hormone called epogen which works on bone marrow and produces red blood cells. If you have kidney disease, that patient becomes anemic (and) also has impaired iron absorption. Finally, it secretes renin that has a central role in (maintaining) blood pressure.

DB: What are some of the misconceptions people might have about kidney disease?

AR: The biggest one is that it’s not common. How many times do you see an ad for colon cancer or dementia? How many times do you see it for kidney disease? There are a few, but not as many as there should be. The myth is that kidney disease is not common when it is very common. That’s why we had a float in the Rose Parade.

The other big myth is, “I don’t care if I have kidney disease because I’m going to get transplanted or get dialysis.” The transplant is not your kidney, and you have to be on a lot of medications. Over time, the transplant might fail. Dialysis barely provides 10% of what your kidneys do, and the filtration and all of the other hormonal functions it doesn’t do.

The other myth is that there’s nothing you can do about that. There’s a lot of stuff you can do. Healthy living, being proactive, early diagnosis and treatment. For me, the entire spectrum is pre-diagnosis. When I have family members with kidney disease, I get them involved with the kids and other family members, screening at-risk family members.

DB: What are some simple lifestyle changes individuals can make to protect their kidney health and prevent the disease?

AR: One is avoiding damage to the kidneys. Simple drugs as ibuprofen and Motrin that you take over the counter in excessive doses can cause kidney damage. Smoking is a big risk factor for cardiovascular disease and kidney disease. Hydration is key, avoiding very high-protein diets. A lot of people go to these protein shakes that can cause kidney damage. Healthy living, eating well, drinking well – what’s good for your heart is good for your kidneys.

DB: Are there specific foods or other diets that are harmful or beneficial?

AR: Eating a heart-healthy diet like avoiding fried foods, not too much carbs, controlling your blood sugar and blood pressure.

One thing we have to keep in mind is a diet specific for kidney disease, when your kidneys are not working properly. You have to avoid high-phosphorus foods, high-potassium foods, high-sodium foods. The other one is how you can prevent or slow down kidney disease, and that is avoiding fried foods and high carbs that can cause blood sugar worsening.

DB: How can kidney disease, whether stage one or stage five affect a person’s quality of life? Are there any resources you’d like to point out for students?

AR: Most of the patients, there’s fatigue. There’s also a lot of depression and anxiety that go with it, fear of the unknown when they’re diagnosed with kidney disease, so we do focus a lot on mental health. We also focus on meditation, mindfulness – UCLA has a PAC (patient-animal connection) team. We have patient ambassadors that come and talk with patients and share their journey, that, “You’re not alone. We have been through this, and you’ll get through this as well.” We send them the right resources depending upon what the disease is.