Bhagwan Dass
On the occasion of World Kidney Day the author has attemped to create awareness among massage about some important points regarding functioning of kidneys.
What is the main function of kidneys?
They remove waste products from body by making urine. They help control blood pressure and maintain acid base balance in the body, also play a big role in keeping your bones healthy.
What is the Prevalence ofCKD (Chronic Kidney Disease)?
Kidney disease is a global public health problem, affecting over people worldwide.Compared to rest of the world kidney disease is more prevalent in south Asia. In country like India very high prevalence is due to high rate of diabetes and high blood pressure.It is more common as weget olderbut it can start at any age.
Diagnosis of Kidneydisease
Blood test for serum creatinine , urine test for albumin and measurement of Glomerular Filtration Rate (GFR): Normal GFR is about 100 ml/min , it declines with decrease in kidney function.
Natural Course of kidney disease.
Kidney disease is a slow andsilent killer.Disease starts slowly and keeps on progressing unless detected early and treated effectively under physician supervision , If untreated can lead to high incidence of heart disease and also leads slowly towards dialysis .
What is the cost of treatment.?
It becomes expensive once you reach advanced stage of the disease especially in dialysisphase.In the US, treatment of kidney disease is likely to exceed $48 billion per year., and the dialysis program consumes 6.7% of the total Medicare budget to care for less than 1% of the covered population, In India only 10 % of the population who need dialysis gets the treatment as treatment becomes very expensive. In later stages of disease it becomes unaffordable over a long period of time .
How about kidney transplantation and risks with Kidneydonation.?
No major riskat all.
Life span of kidney donors is similar to that of persons who have not donated a kidney. The risk of kidney disease does not appear to be increased among donors..Transplants from deceased donors have an 85 to 90% success rate for the first year. Live donor transplants have a 90 to 95% success rate.Kidney transplantation should be highly encouraged.
What is the level of awareness about the kidney disease?
Awareness about disease is very poor. In USA about48% of people with severely reduced kidney function and not on dialysis are not aware of even having kidney disease , I think this percentage may be higher in India although I don’t have latest data on this.
In most of the cases diabetes and high blood pressure are main cause of kidney failure, representing about 3 out of 4 new cases. Approximately 1 of 3 adults with diabetes and 1 of 5 adults with high blood pressure may have kidney disease.
Awareness campaign – Goals
Early detection, prevention and Risk Management, one of the strategies is to Managing Risk Factors.
“Get your BP checked often, monitor your diabetes and get your A1C test at least twice a year, but ideally up to four times a year, Get your cholesterol checked regularly
“Certain dyes (contrast agents) used for diagnostic purposes as imaging tests., ask doctor about them.
“Kidney infections get them treated promptly. Get your kidney function monitored on regular basis by your physician if you have diabetes and hypertension.
“Eat foods lower in salt. Losing weight if you are obese and doing at least 150 minutes of physical activity each week.
“Herbal supplements (always talk to your doctor before taking any supplements).
“Pain killers – Be aware of the drugs having potential of causing kidney damage if taken over a long period of time unsupervised for example use of over-the-counter NSAIDs (Non steroidal anti inflmatory drugs ) commonly used NSAIDS.are ibuprofen, naproxen and diclofenac. About9.% of people with kidney disease stages 3-4 used prescription NSAIDs,most of the time without the supervision of the physician.
(The author is Associate Professor Medicine, University of Florida,USA.)
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