Defusing the dread of kidney disease

BY CHANDANI Jayatilleke

KIDNEY related diseases are posing a severe threat to people all over the world. A high proportion of people in Sri Lanka is also falling victim to various kidney-related illnesses each day. Kidney failure is often a complication of critical illness.

Kidney damage can go unnoticed and detected only through medical tests. Blood tests will show whether the kidneys are removing wastes efficiently. Certain kidney issues are recoverable and certain others not.

Many Sri Lankans suffering from kidney ailments come from remote areas and poor families who cannot afford to bear high costs involved in medication and detecting tests.

We spoke to Consultant Nephrologist at Apollo Hospital, Colombo, Dr Surjith Somaih to ascertain his views on kidney patients of Sri Lanka, the causes behind kidney issues and prevention methods.

Dr. Somaih said that the increase in the number of patients could be attributed to many different reasons. But one of the major reasons for this increase is the high number of people with diabetes, high blood pressure and hypertension.

"The entire world is affected by such illnesses and the situation is becoming worse each year," he explained.

Each person having diabetes or high blood pressure has a tendency to develop a cardiac problem or a kidney illness. And cardiac issues are easily attended to, as they can be diagnosed easily in many patients. But, kidney issues have not received that much of attention yet.

Therefore, it is important for all such patients to be aware of their kidneys - by going through a medical check-up and seeking early treatment to avoid kidney illnesses.

Some of the other reasons which cause kidney troubles could be environmental toxins, water with high mineral content, strong medicine given for various illnesses, fluoride, pesticides, salt and other chemical substances.

Snake bites can also cause kidney failure. Cooking in aluminium pots and pans can also be dangerous since aluminium can cause anaemia and kidney diseases.

Kidney failure detection

However, kidney related issues among children are quite low. Many develop kidney issues after the 40s. After 40s, the function of kidneys would start deteriorating as a result of ageing.

However, it happens at a rather low pace. Therefore, it is difficult to diagnose the disease until it reaches a critical stage unless, you go for regular medical check-ups. Hence, at 40 people should start concentrating more on their health, specially the kidney issues.

It can be detected through many ways: hypertension, decrease in amount of urine or difficulty in urinating, Edema (fluid retention), especially in the lower legs, swelling of feet and face, a need to urinate more often, especially at night. Ninety per cent of the kidney patients get these symptoms.

As with hypertension, a person may not realise that he has kidney disease. Certain medical tests can indicate whether the person's kidneys are eliminating waste products properly. Proteinuria, an excess of protein in the urine, is also a sign of kidney disease.

In countries such as Japan, there is a compulsory diagnosis test on an annual basis, through which the doctors there diagnose kidney patients easily.

Hypertension is a major cause of kidney disease and kidney failure (end-stage renal disease). Hypertension can cause damage to the blood vessels and filters in the kidney, making removal of waste from the body difficult.

Therefore, people who have diabetes and people with a family history of hypertension and kidney disease should take care of their health.

Blood pressure

High blood pressure can also cause kidney failure, as it makes a patient's heart work harder and, over time, can damage blood vessels throughout the body. If the blood vessels in the kidneys are damaged, they may stop removing wastes and extra fluid from the body.

High blood pressure is one of the leading causes of kidney failure, also commonly called end-stage renal disease (ESRD).

People with kidney failure must either receive a kidney transplant or go on dialysis.

People with diabetes also have a substantially increased risk for developing kidney failure. People who are at risk because of diabetes should have early management of high blood pressure.

Prevention

Prevention is the main thing as far as kidney issues are concerned. To prevent hypertension kidney disease, the patients should keep their blood pressure below 130/80, get their blood pressure checked on a regular basis and eat a proper diet.

To control high blood pressure, people should follow health guidelines such as; maintain your weight at a level close to normal.

Choose fruits, vegetables, grains, and low-fat dairy foods. Limit your daily sodium (salt) intake to 2,000 milligrams or lower if you already have high blood pressure.

You need to get plenty of exercise, which means at least 30 minutes of moderate activity, such as walking, most days of the week, avoid consuming too much alcohol and limit caffeine intake.

Kidney stones are also a major problem among Sri Lankans. Kidney stones are collections of mineral salts combined with calcium.

They can lodge anywhere in the urinary tract and cause intense pain. To prevent kidney stones, people should eat less meat, drink plenty of fluids (one study has shown that people who drink more than 2 1/2 litres of water everyday have almost a 40 per cent decrease in the risk of developing a stone than those who drink less water).

They should limit consumption of fruits and drinks that can increase the risk of developing stones and should adopt a diet high in potassium and magnesium - these minerals decrease the likelihood of kidney stones and also reduce their salt intake.

However, the doctors treating kidney patients should advice each patient on her/his diet, depending on the patients other health issues.

Chronic Kidney Disease (CKD) could be caused by diabetes, high blood pressure and other disorders. Early detection and treatment can often keep Chronic Kidney Disease from getting worse.

When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.

However, both these treatments are costly and many people would not be able to meet required finances to continue their treatment.

In the case of dialysis, a patient will have to take the treatment about three times a week. Each session, running for about three hours would cost nearly Rs. 7,500.

In the case of transplant, the operation alone is costly and it involves much responsibilities such as finding a suitable kidney from a donor. Even after the operation, the patient will have to spend substantial amount of money for post-surgery treatment.