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Chronic Kidney Disease – An Emerging Threat

by Dr. Vishal Saxena

What is chronic kidney disease (CKD)?

  • Chronic kidney disease means long standing irreversible kidney damage. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage. Also, kidney disease increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long period of time. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.
  • Chronic kidney disease is commonly caused by diabetes and high blood pressure and worldwide about 500 million people have some form of kidney disease. In India an estimated 100 million people suffer from kidney disease. A study from the All India Institute of Medical Sciences (AIIMS) in 2005 demonstrated that the prevalence of chronic renal failure is about 7800 people per million population. This is a very troubling scenario for India as there has been a recent sharp rise in the incidence of diabetes and high blood pressure in the urban population and over the next two to three decades we can expect to see an explosion in the number of patient with chronic renal failure. This is something developing countries like India can ill afford. The economic burden this places on the country’s already stretched healthcare infrastructure will be tremendous. It is estimated that less than 20 % of all patients with kidney disease in India are able to afford dialysis or transplant.
  • The present focus is therefore on early detection of kidney disease and initiating steps to prevent the progression to the stage of dialysis or kidney transplantation. This allows developing countries to save considerably on treatment costs and prevents further complications of the disease process.
What are the symptoms of CKD?

Most people may not have any severe symptoms until their kidney disease is advanced. However, you may notice that you:
  • have swollen feet and ankles
  • have puffiness around your eyes, especially in the morning
  • need to urinate more often, especially at night
  • feel more tired and have less energy
  • have trouble concentrating
  • have a poor appetite
  • have trouble sleeping
  • have muscle cramping at night
  • have dry, itchy skin
The risk factor for developing Chronic kidney disease are:
  • Long standing Diabetes (Uncontrolled)
  • Prolonged high blood pressure
  • Genetic factors like family history of kidney disease
  • Heavy pain mediation intake
  • Obesity (Overweight people)
  • Old age (more than 50 years)
  • Smoking
  • Checking for kidney disease
  • People with these risk factors can have their kidney function checked regularly and any kidney disease can be detected at an early stage by doing the following simple tests:
  • Routine urine analysis
  • Spot urine protein / creatinine ratio
  • Serum creatinine

Management

  • Patients who already have early kidney damage can slow progression of the kidney disease by
  • Strict BP control
  • Control of blood sugars with HbA1C < 7 %
  • Control anemia – which prevents heart disease
  • Control lipids
  • Cessation of smoking
  • Increase physical activity and control body weight
  • Medications prescribed by their nephrologist.
  • Avoiding self medication with pain killers
The key to preventing kidney disease is awareness of the common risk factors causing this condition and to ensure blood pressure and blood sugar control. If you already have kidney disease then regular visits to a nephrologist are important to prevent progression of the disease and also to prepare for the future need for dialysis and transplant.

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