Prevention of Kidney Disease

What is Kidney Disease?

A kidney disease does not occur overnight but develops over a period of time and in stages. Kidney disease commonly goes unnoticed due to the slow occurrence of mild symptoms and is called as chronic kidney disease (CKD). Generally, both the kidneys are affected by the disease. Most patients do not show any symptoms in the initial stages, hence it is usually detected only once severe symptoms are visible in the advanced stages. The degeneration can be slowed down or controlled if detected early.

When kidneys are damaged, waste gets accumulated inside the body and can cause various problems like high blood pressure, low red blood cell count, swelling, weak bones. When CKD advances or is left untreated, it can lead to kidney failure or end-stage renal disease (ESRD). The treatment for kidney failure is dialysis or a kidney transplant.

What is the Prevalence of Kidney Disease?

Approximately 10% of the global population is reported to be affected by CKD. According to the Global Burden of Disease study, CKD was ranked 27^th as the cause of total number of deaths worldwide. However, this rank rose to 18^th in 2010. The number of cases of CKD is expected to increase disproportionately in developing countries like India and China.

What are Kidneys?

The Kidneys are a pair of small bean shaped organs present on the either side of the spine just below the ribs, near the back. The main function of the kidneys is to work as a blood filter, thus eliminating extra fluids and waste from the body. This metabolic waste is eliminated through the urine.

What are the Causes of Kidney Disease?

Anyone can suffer from kidney disease and at any age; however, the most common causes of chronic kidney disease are as follows:

• Diabetes: In cases of uncontrolled or poorly controlled diabetes, chances of kidney problems are high. High sugar levels can also affect other organs like muscles, nerves, eyes, heart, blood vessels as well as Kidneys.
• High blood pressure: In people with very high blood pressure there are high chances of developing chronic kidney disease, heart attack, and stroke.

Many other health conditions can harm the kidneys and trigger CKD.

• Glomerulonephritis: an autoimmune disease that damages the kidney's filtering unit.
• Inherited diseases: Diseases like polycystic kidneys cause cyst formation in the kidneys.
• Urinary Tract Obstruction: Any blockage caused by kidney stones, abnormally shaped ureters, tumors and enlarged prostate gland in males.
• Repeated urinary tract infection.

Other risk factors include obesity, heart diseases, high cholesterol, and lupus disease. High risk groups include people over the age of 60 years with a family history of kidney disease and persons that have been taking medications for other diseases for a long period of time.

What are the Early Signs of Kidney Disease?

Unfortunately, early stages of CKD do not show any visible signs and symptoms. Our body can cope with a significant loss in kidney function, and the problem usually goes undiagnosed. The following signs can be seen in later stages CKD.

• Weight loss and poor appetite
• Tiredness
• Difficulty sleeping
• Swelling in ankles, feet, and hands
• Muscle cramps
• Shortness of breath
• Erectile dysfunction
• Increased frequency of urination

How to Prevent/Avoid Kidney Disease?

Get Yourself Tested

The key to prevent CKD is getting tested at regular intervals. The above mentioned various reasons and risk factors increase the chances of developing CKD. Thus, if you have one or more risk factors mentioned above, get yourself tested. Most people with early stage kidney disease do not show any symptoms, but the following two simple tests can help to detect if any damage is occurring inside.

• Routine Urine test: Urine is tested for the presence of proteins to detect kidney function. Presence of protein in urine is called 'albuminuria,' which is suggestive of kidney's hampered filter mechanism.
• Blood tests: Blood is tested to detect creatinine levels. Creatinine is a waste product that comes from broken muscle tissue. When kidneys are damaged, they have trouble clearing creatinine from blood. The blood creatinine level is used to assess the glomerular filtration rate (GFR). Your GFR value will help in assessing how well your kidneys are working. Below normal GFR levels indicate kidney damage that needs intervention.

• In addition to these tests, get your blood pressure and sugar levels checked at regular intervals of 3 months if you are diagnosed with hypertension and diabetes.

Get Healthy

• Make sure to keep your cholesterol, blood pressure, blood sugar under control by living a healthy lifestyle. If these triggering factors are under control, there are less chances of developing kidney problems in the future.
• Eat 5-7 portions each day of fresh vegetables and fruits, whole grains, and low-fat dairy products. Maintain alcohol consumption to 1-2 times a week. Don't smoke. Exercise at least 30 mins for 5 days a week and be physically active everyday as far as possible. Maintain a healthy weight for your height and age.

Be careful about Medication:

• Avoid taking herbal supplements, which are used for body building, treating other diseases without consulting a certified health expert first. E.g. Siddha, These products may contain certain heavy metals like cadmium, mercury, lead compounds that can be hazardous for the kidneys. Hence, it's recommended to consult your nephrologist (doctors specialized in kidney treatment) before taking any alternative medication.
• Some over-the-counter drugs such as pain killers are known to have harmful effects on the kidney if consumed for a long period of time. Examples of pain killers are NSAIDs (non-steroidal anti-inflammatory drugs) such as aspirin, ibuprofen, and naproxen. Talk to your doctor if you have questions regarding their consumption.
• Dyes used to make the blood vessels or organs visible on X-rays or other imaging tests can also damage the kidneys. Talk to your healthcare provider before undergoing such tests.

Foods you should avoid:

• Avoid salt: In order to control blood pressure, along with taking medication you are advised to eat less salt (under 2.6 grams each day). If you are diabetic, cut down on your sugar intake- cut down on high sugar foods like milkshakes, colas, and frozen yogurt
• One must avoid taking fatty and fried foods that can increase blood cholesterol and blood sugar leading to worsening of kidney health.

• Some people with kidney disease have a mineral and bone disorder associated with it. Hence, it's recommended to avoid foods rich in calcium and phosphorus such as nuts, dairy, dried beans, seeds, and peas. Check with your doctor if you need to follow this.

Foods you should eat:

• Consult a dietitian specialized in kidney disease; she can help plan your meals so that you eat the right foods in appropriate amounts.
• If you plan to eat out for dinner, plan your breakfast and lunch accordingly.
• Consult your doctor for the amount of fluid you can have all day. 2 liters is a must have amount of fluids each day.
• Grilled or boiled foods are good choices.
• Have foods with high fiber content- raw fruits and vegetables, whole grains and cereals, and less of processed foods. The more a food is processed, lesser its fiber content, higher is its sodium/sugar content.
• Some easy tips to follow are to use lemon or vinegar or use little pepper to spice up food instead of using too much salt.

References:

1. CKD Is Common Among Adults in the United States - (https://www.cdc.gov/diabetes/pubs/pdf/kidney_factsheet.pdf)
2. About Chronic Kidney Disease: A Guide For Patients - (https://www.kidney.org/sites/default/files/11-50-0160_patientguideCKD.pdf)
3. The kidneys and kidney disease - (https://www.health.govt.nz/system/files/documents/topic_sheets/kidneys-and-kidney-disease.pdf)
4. Use of alternative medicine by patients with stage 5 chronic kidney disease - (https://www.ncbi.nlm.nih.gov/pubmed/16010646)

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