Kidney Health

Kidney Health for All – Bridge the gap to better Kidney care

Functions of kidneys

  • To keep the balance of water and minerals (such as sodium, potassium, and phosphorus) in blood.

  • To remove waste products from blood after digestion, muscle activity, and after taking medicines.

  • To make an enzyme named renin which helps to maintain blood pressure especially when it is low.

  • To make a hormone named erythropoietin which is needed by our body to make red blood cells.

  • To make an active form of Vitamin D which is needed for making our bone strong.

 

Chronic Kidney Disease (CKD)

It is a progressive and long-term loss of kidney functions over a period of months or years due to damage/injury to the filters present in kidneys called nephrons. Each kidney possesses about a million of those filters. Nephrons stop working when damaged and after a certain period of time, the nephrons that are left after continuous damage are not adequate to filter the blood well. Thus, the kidneys are unable to function properly and when their function falls below a certain level, kidney failure occurs which affects the whole body. Kidney failure when not treated can be life-threatening. 

 

Prevalence:

About 1 in every 10 persons have some degree of chronic kidney disease. It becomes more common with increasing age and is also more common in women than in men. Most of them are mild or moderate.

The prevalence of chronic kidney disease (CKD) has increased dramatically over the past two decades, with 13.4% of the population affected worldwide; the majority of the cases are CKD stages 3–5.4

 

 Symptoms

Usually, no symptoms of kidney disease occur in the early stages.

At the advanced stage, the following symptoms may occur:

  • Tiredness

  • Swollen ankles, feet, or hands

  • Shortness of breath

  • Blood in urine

  • Poor appetite

  • Weight loss

  • Dry, itchy skin

Consult a doctor if the symptoms reflect kidney disease are persistent.

 

Causes

  • Diabetes

  • High blood pressure

  • Old age: About half of people aged 75 or more have some degree of CKD.

  • Certain medications, including non-steroidal anti-inflammatory drugs, (if they are used long-term, especially at high doses (such as ibuprofen, naproxen, diclofenac, high-dose aspirin), may also cause CKD.

 

Other conditions include

  • Disease involving the immune system (such as kidney disease due to lupus where the body’s immune system attacks our own tissue and organs).

  • Long-lasting viral illnesses, such as HIV and AIDS, hepatitis B, and hepatitis C

  • Pyelonephritis is a urinary tract infection involving kidneys.

  • Inflammation in the tiny filters (glomeruli) in kidneys. This can happen after a streptococcal (bacterial) infection.

  • Polycystic kidney disease is a genetic condition where fluid-filled sacs form in the kidneys.

 

Diagnosis

Chronic kidney disease (CKD) can be diagnosed with blood and urine tests.

In many cases, when routine blood or urine test is done for another problem shows that kidneys are not working properly and then CKD is diagnosed.

 

Prevention

CKD cannot always be prevented but following the advice below can reduce the risk.

 

  • Manage underlying conditions: Other long-term diseases such as diabetes or high blood pressure should be managed. Regular medicines prescribed by doctors should be taken.

 

  • Stop smoking: Smoking increases the risk of cardiovascular (heart-related) disease, which is associated with a higher risk of CKD.

 

  • Healthy diet: A healthy, balanced diet can reduce the risk of kidney disease by keeping blood pressure and cholesterol at a healthy level.

Diet consisting plenty of fruit and vegetables, meals that include starchy foods (such as potatoes, wholegrain bread, rice or pasta), some milk products and its alternatives, some beans or pulses, fish, eggs, or meat as a source of protein, low levels of saturated fat, salt and sugar should be taken.

 

  • Manage alcohol intake: Drinking excessive amounts of alcohol can cause blood pressure and cholesterol levels to rise to unhealthy levels.

 

  • Exercise regularly: Regular exercise helps to lower blood pressure and therefore, reduces the risk of developing kidney disease.

At least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity (such as cycling or fast walking), every week is recommended.

 

  • Careful while taking painkillers: Kidney disease can be caused by taking too many non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, or taking them for longer than recommended.

 

Treatment

There is no cure for chronic kidney disease, although treatment can slow or stop the progression of the disease and can prevent other serious conditions from developing.

 

The main treatments are a proper diet and medications, and for those who reach ESRD, long term dialysis treatment (to remove wastes and excess fluid accumulated in the body which kidneys are no longer able to remove) or kidney transplantation (an operation to replace an unhealthy kidney in patient’s body with the healthy/donor kidney).

 

Hemodialysis

It is the method of removing waste products from the blood when kidneys no longer work, with the help of a dialysis machine connected to a patient’s body through a needle in a vein.

Blood is removed from the body, circulated through the dialysis machine for cleansing, and then return to the body. It is generally done three times a week and takes between three to five hours per session.

 

Kidney transplantation

It is considered the best treatment for many people with severe CKD because the quality of life and survival are often better than in people who use dialysis. However, there is a shortage of organs available for donation. Many people who are candidates for kidney transplantation are put on a transplant waiting list and require dialysis until an organ is available.

 

A kidney can come from a living relative, a living unrelated person, or from a person who has died (deceased or cadaver donor); only one kidney is required to survive. In general, organs from living donors function better and for longer periods of time than those from donors who are deceased.

 

Overall, transplant success rates are very good. Transplants from deceased donors have an 85 to 90% success rate for the first year. That means that after one year, 85 to 90 out of every 100 transplanted kidneys are still functioning. Live donor transplants have a 90 to 95% success rate. Long-term success is good for people of all ages.

 

Diet and chronic kidney disease

A diet containing high animal protein (such as meat especially red meats and processed meat, dairy products, eggs) and low fruit and vegetable content, can cause many chronic diseases, including chronic kidney disease.

Reducing animal protein intake and egg yolk and increasing intake of fruits and vegetables and fiber may prevent or delay end-stage kidney disease.6

 

An increased risk of colon cancer, coronary heart disease, and impaired kidney function is seen when red meat is excessively consumed. Kidney function decline was observed with people consuming animal protein-rich diets but not those consuming plant protein-rich diets (tofu, peanuts, soybean).

 

References

  1. WebMD. Kidney Disease [Internet]. [place unknown]: Khatri M; 2020 Aug 08 [Cited on 2022 Mar 09]. Available from: Kidney Disease (Chronic & Acute) - Causes, Risk Factors, Stages (webmd.com)

  2. International Society of Nephrology- Global Operations Center. World Kidney Day [Internet]. Brussels, Belgium: [publisher unknown]; [Cited on 2022 Mar 09]. Available from: Chronic Kidney Disease - World Kidney Day

  3. Jarvis S. Chronic Kidney Disease [Internet]. England and Wales: Patient; 2021 Oct 08 [Cited on 2022 Mar 09]. Available from: Chronic Kidney Disease (CKD) | Stages, Symptoms and Treatment | Patient Leaflet | Patient

  4. Hill NR, Fatoba ST, Oke JL, Hirst JA, O’Callaghan CA, Lasserson DS, et al. Global Prevalence of Chronic Kidney Disease–A Systematic Review and Meta-Analysis [Internet]. PLoS ONE. 2016 [Cited on 2022 Mar 09];11. pmid:27383068. Available from: Global Prevalence of Chronic Kidney Disease – A Systematic Review and Meta-Analysis (plos.org)

  5. National Health Service. Chronic Kidney Disease [Internet]. England: [publisher unknown]; 2019 Aug 29 [Cited on 2022 Mar 09]. Available from: Chronic kidney disease - NHS (www.nhs.uk)

  6. Kramer H. Diet and chronic kidney disease. Advances in Nutrition [Internet]. 2019 Nov 01 [Cited on 2022 Mar 09];10(Supplement_4):S367-79. Available from: Diet and Chronic Kidney Disease | Advances in Nutrition | Oxford Academic (oup.com)

Odermatt A. The Western-style diet: a major risk factor for impaired kidney function and chronic kidney disease. American Journal of Physiology-Renal Physiology. 2011 Nov;301(5): F919-31. Available from: The Western-style diet: a major risk factor for impaired kidney function and chronic kidney disease | American Journal of Physiology-Renal Physiology

 

By Bipsana Shrestha

Registered Nurse

Danphe Care