Kidney disease and renal failure is an epidemic of recent time not only in our country but also throughout the world. If kidney disease is not addressed in right time, this would ultimately progress to End Stage Renal Disease (ESRD). It is not possible to provide advanced kidney disease care to all the people who are suffering from kidney disease. India is known to be diabetic capital of the world and 4th in place for hypertension. These are considered as the two major causes of kidney disease.
There are few nephrologists but day by day kidney disease is increasing rapidly. So, prevention of kidney disease is not so easy.
Therefore, we should know some basic knowledge about kidneys and its function and some tips to keep kidney healthy.
Kidneys:-
Kidneys are bean shaped excretory organ located just below the rib cage. We have two kidneys and both work simultaneously to remove toxins out of the body.
Functions of kidneys:-
· As excretory organ kidneys remove metabolic waste products from our body.
· Kidneys maintain the water balance of our body.
· Kidneys control the acid base balance of our body. Kidneys are most important buffer organ for maintaining acid base balance.
· Kidneys are also produce one important hormone erythropoietin which is essential for keeping our hemoglobin level in normal range.
· Kidneys are important site for the production of 1, 25 dihydroxycholecalciferol, which is the active form of vitamin- D. If kidney not function properly, it can lead to bone diseases.
· Kidneys also maintain calcium and phosphorus in our body.
· Kidneys are the most important organ to control our blood pressure.
· Kidneys maintain the electrolyte balance of our body.
Types of kidney disease:-
Kidney disease is classified in mainly two types. These are-
i) Acute renal failure
ii Chronic renal failure
§ Acute renal failure:-
Acute renal failure is a sudden shut down of renal function including reduction of the ability of the kidney to excrete waste products.
In this condition patient needs medical emergency and nutritional support.
CAUSES
Ø Loss of blood can cause acute renal failure as flowing of blood to kidney decreases during ulcers, internal hemorrhage, at the time of delivery, surgical operation etc.
Ø Loss of fluid during diarrhea, vomiting, excessive urination and excessive sweating.
Ø Hypocalcaemia (low calcium) is also the cause of renal failure.
Ø Destruction of red blood cells due to some diseases.
Ø Some nephrotoxins that damage the cells of kidneys.
SYMPTOMS
There are many different symptoms of acute renal failure. Most possible symptoms include-
Ø Low urine volume. The output of urine as little as 20 to 200 ml/day.
Ø Accumulation of waste products of protein metabolism in blood serum urea nitrogen and creatinine levels is increased.
Ø There is also increased potassium, phosphate level.
Ø Shortness of breath.
Ø Drowsiness or fatigue.
Ø Nausea and vomiting.
Ø Loss of appetite.
§ Chronic renal failure:-
Chronic renal failure is also known as uremia (The level of urea is very high in the blood). When 90 % of functioning renal tissue is destroyed uremia occurs.
CAUSES
Ø There is a progression of nephrotic syndrome.
Ø Urinary tract infection and chest infection.
Ø Kidney stone.
Ø High blood pressure.
Ø Diabetes mellitus.
Ø Polycystic kidney disease(Multiple cysts in the kidneys)
Ø Gout.
Ø Exposure to toxic substances.
SYMPTOMS
Since the renal failure progress more severe and more nephrons die, the kidneys can no longer compensate for this loss and symptoms become appear.They include-
Ø Oedema (Swelling of eyes, hands and feet).
Ø High blood pressure.
Ø Hiccups.
Ø Convulsions and coma.
Ø Anaemia.
Ø Itchy skin.
Ø Electrolyte imbalance (e.g. High levels of potassium in the blood).
Ø Mineral imbalance (e.g. High levels of calcium in the blood).
Ø Acidosis (Increases calcium resorption from bones leading to osteomalacia).
Ø Mental confusion (As toxins build up in the kidneys)
How to know about your kidneys health?
If kidney disease is found and treated early, we can help slow or even stop it from getting worse. As kidney disease remains silent in early stage so it is important to know about your kidney health by testing.
Kidney’s health can be assessed by checking the GFR (Glomerular Filtration Rate) in the lab.
Normal GFR ranges between 90ml/min to 120ml/min.
There are 5 stages in chronic kidney disease (CKD).Your GFR will determine what stage of kidney disease you have. The disease gradually progress from stage 1 to stage 5.
Testing of creatinine is only the first step to know your GFR. If you know serum creatinine you can find your GFR by a math formula with your age, sex and race.
GFR number helps to know how well your kidneys are working. So, check it and consult with your nephrologist.
· Different stages of kidney disease
STAGE |
DESCRIPTION |
GFR(ml/min/1.73m2 |
1
|
Kidney damage with normal GFR
|
≥
90
|
2
|
Kidney damage with mild GFR
|
89-60
|
3a
|
Mild to moderate GFR
|
|
3b
|
Moderate GFR
|
45-30
|
4
|
Severe GFR
|
30-15
|
5
|
Kidney failure
|
< 15
or dialysis
|
§ Here are some health tips to keep your kidneys healthy
- Eat healthy foods and avoid junk foods. Protein should be taken according to your GFR rate. So, you should consult with a renal dietitian.
- Monitor blood sugar and blood pressure regularly specially after age of 30.
- ·Monitor your weight. You should maintain optimum body weight as per your height.
- Quit smoking, drinking, chewing gutkha, masala since they are harmful for kidney.
- Stop taking over the counter medications common non- prescription pills like painkillers, naphroxen, slimming pills etc as they can cause kidney damage if taken regularly over a prolonged period.
- Before taking any medicine consult with your nephrologist.
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