Kidney and urinary health Archive

Ask the doctors

Q. My bad cholesterol has been rising, and my doctor suggested that I start taking a statin. I've read that red yeast rice has many of the cholesterol-lowering benefits of a statin, and I would rather go the natural route. However, I recently heard on a newscast that red yeast rice can have adverse effects on the kidneys. Is it still safe for me to take this supplement?

A. It's true that red yeast rice, which contains monacolin K, a chemical that's identical to the active ingredient in the cholesterol-lowering drug lovastatin (Mevacor), may reduce your LDL (bad) cholesterol and lower your total cholesterol. However, an independent analysis of a dozen 600-milligram (mg) capsules of red yeast rice products conducted a few years ago found that the actual monacolin K content varied widely — from 0.1 mg to 10.9 mg. (The lowest dose of lovastatin is 20 mg.) In addition, one-third of the products were contaminated with a potentially toxic compound called citrinin, which can damage the kidneys. The Food and Drug Administration (FDA) has blocked the sale of red yeast rice supplements that contain enough of the active ingredient to make them as effective as lovastatin because they haven't undergone the drug approval process. Unlike FDA-approved drugs, supplements can be sold without proof of effectiveness and purity.

Fatty plaque in the arteries that feed the kidneys poses a danger to the heart and brain.

Controlling blood pressure and blood sugar will help both your heart and your kidneys.

On the surface, it's difficult to see how coronary artery disease and kidney damage might be related. But on the cellular level, the two conditions often go hand in hand. A closer look reveals the key. Underlying both conditions are two powerful risk factors: high blood pressure and diabetes, each of which damages the heart and kidneys independently.

If your weather forecaster warns about a heat wave this summer, take it seriously. A study by Harvard researchers found that people with certain conditions were at an increased risk of winding up in the hospital during periods of high heat. Their work was published Dec. 23, 2014, in The Journal of the American Medical Association.

Researchers analyzed hospitalization rates for specific diseases among 23 million Medicare beneficiaries between 1999 and 2010. What sent older adults to the hospital most often during a heat wave? Heatstroke, fluid and electrolyte disorders, kidney failure, urinary tract infections, and sepsis (a dangerous blood infection). For some diseases, the risk of hospitalization was elevated for up to five days after a heat wave day, suggesting that preventing and treating heat-related illnesses is crucial both during and after a heat wave.