Kidney Disease: Global Impact
Patients with kidney failure are immunocompromised(less ability to fight diseases) and hence prone for infection and recurrent hospitalizations, the treatment of which adds to the cost of care and not to mention the time factor associated with it.
These are the few important and sufficient reasons among many others why we should care for our kidneys.
It has been estimated that 10% of the global population has some form of kidney disease more so in the older population and certain percent of these lead to End stage kidney disease where they require dialysis and the impact of which has been discussed in the previous issue.
According to records, the people on dialysis and other forms of renal replacement therapies are more among African origin. There may be many reasons for this education, poverty, nutrition, genetic make-up to name few.
What is a kidney failure and how can it be detected?
Like any other organ of the body kidneys are also prone for number of abnormalities. Conditions like increase in blood sugar (diabetes), increase in blood pressure (hypertension), stones and infections are the major causes of damage to the kidney. Drugs (like pain killers), toxic chemicals in water or spurious medicines or any inborn defect constitute a minor conditions that can result in kidney failure over a period of time.
Most of the time patient is asymptomatic. Few might present with swelling in ankle and feet, lethargy and fatigue, vomiting, etc. To begin with symptoms are very negligible but as the disease progresses the gravity of the disease gets obvious. What is relieving is the fact that by proper screening from time to time, kidney failure can be detected at the very inception and hence the treatment or rather prevention can be started before these appear making a dent on your economic conditions.
What are the forms of kidney disease?
If the failure occurs in hours and days, it can be called as Acute Kidney Failure but if it occurs over a period of time which can be months, then it is known as Chronic Kidney failure. Most of the time, it has been seen that diabetes and hypertension (among others) are the two major causes of chronic kidney failure in developing as well as developed nation.
Acute kidney failure-
2. Malaria (common in African and Asian countries)
3. Schistosomiasis (common in African countries)
4. Severe infection (Sepsis)
To prevent kidney going into failure first aid the patient with lots of fluids when he or she has loose stools and immediate medical care. Never try for common home remedies which may lead to complications and you may end up paying more price. Same with other infections take immediate medical help.
Kidney disease develops slowly and the patients might not know the onset till he develop the complications. The common myth associated with general population is that they believe passing good amount of urine is an indicator of healthy kidneys. But this belief is wrong and it is often the last stage of kidney failure where urine ceases to form.
What are the potentially preventable causes of chronic kidney failure?
Various causes of chronic kidney failure can be enumerated but those relevant to common public will be enlightened here.
1. Diabetes mellitus (9%-30% of cases in various developing nations)
2. Hypertension (high blood pressure 13% to 21%)
These 2 are the most common diseases prevalent in the population and most of the time undetected and often neglected. But these 2 along with causing health problem like stroke, heart attack, form a major bulk of causes for chronic kidney failure and the ensuing problem as enlisted in previous issues hence prevention is better than cure.
Many a times, it is seen that these 2 are the neglected and many forms of home remedies are tried.
Get regular health check up done more so at age more than 40 years to detect the onset of diabetes and high blood pressure.
What are the other causes?
Other common are smoking, infections, malnutrition, long term drug abuse and possibly enviromental pollution with heavy metals. Infections causing kidney disease and potentially preventable are Hepatitis B and C and HIV by safer sex practices and policy regarding usage of blood and blood products. Many infections like throat and skin infections can lead to kidney problems and hence such infections seemingly minor should not be neglected. Various herbal products used as food can cause kidney and liver damage like Chappparral tea used and as herbal medicine, djengkol beans, fruit of hard wood tree areknut, aristolochic acid used as slimming medicine and various laxative herbals like senna, cascara sagrada, rhubarb. The use of these should be avoided. If these simple steps are followed then most of the kidney diseases can be prevented for a better and productive life.
Take home message:
1. Regular health check up for diabetes and high blood pressure.
2. Immediate medical attention even for problems which can appear minor to prevent progression of these into major health issues.
3. Proper balance diet, hygiene avoidance of alcohol, smoking and safe sex practices.
* Dr. Sandeep G Huilgol and Dr. Sabahat Zaidi are both undergoing their Masters in Nephrology at Sheffield Kidney Institute at The University of Sheffield, UK