Professor (Dr.) MA Samad :
After knowing some information, you will understand why it is so important to be aware of kidney health or why the theme for this year’s World Kidney Day has been declared ‘Kidney Health for All-Bridge the knowledge gap to better kidney care’. There is no substitute for knowledge in improving kidney health. Whether you are an ordinary citizen of the country or involved in the medical profession and healthcare or a policy maker of the country, you need to know about kidney.
Kidney disease was the 27th cause of death two decades ago. It has now risen to the 7th leading cause of death and by 2040 it will occupy 5th place. Kidney disease, as the leading cause of death, is moving forward at the pace of Usain Bolt.
According to the World Health Organization, by 2040, more than 5 million kidney failure patients will die prematurely due to lack of medical treatment. At present more than 85 crore people are suffering from kidney disease in the world. Unfortunately, about 90 percent of these patients are not aware that the deadly disease is silently damaging their kidneys. Every year, 13 million people are diagnosed with acute kidney failure, of which 85pc are in developing countries like ours. In developed countries, the government is struggling to provide kidney failure treatment. In 2019, the United States spent 57 billion on dialysis and kidney transplants alone, which is almost equal to our national budget.
According to various statistics, more than 20 million people in Bangladesh suffer from kidney disease. The end result of kidney disease is kidney failure. The only way to survive after kidney failure is kidney transplantation or dialysis but this treatment is so expensive that even 10pc of kidney failure patients cannot afford it. That is why in developing countries like Bangladesh, India, Pakistan and Nepal almost 90pc of patients die without treatment or partial treatment. On the other hand, if everyone is aware of the prevalence, severity, consequences and causes of kidney disease and leads a healthy life, it is possible to prevent fatal kidney failure in 60pc of cases. Where the country is struggling to provide treatment to the 10 percent, families are becoming destitute, 60 percent prevention could be considered as a great achievement.
Why is the kidney so important?
Our bodies are a combination of thousands of complex machines which are constantly interacting. As a result, many types of toxic chemicals are produced. The kidneys purify the blood by expelling these toxins through urine. Kidneys help produce red blood cells, keep bones strong, regulate blood pressure and maintain water balance in the body. Our kidneys are called the master chemists. There are many types of chemical elements in our body like sodium, potassium, calcium, iron, zinc etc. If any one of them loses its balance, we may die. The kidneys perfectly balance these elements. So the kidney is one of the most important organs for our survival.
What is kidney failure?
When the kidneys fail to function properly or completely due to any reason, it is known as kidney failure.
Acute Kidney Injury (AKI)
If the kidneys lose function suddenly, within a few hours to a few days, it is called acute kidney failure. For example, diarrhea, vomiting, bleeding, acute inflammation, painkillers, adulterated food, or obstruction of urine flow can cause acute kidney failure. In this case, the kidneys can be completely cured by early detection and treatment.
Chronic Kidney Disease (CKD)
When the kidneys begin to deteriorate slowly and lose function, month after month, year after year, it is called Chronic Kidney Disease. Depending on the level of kidney function, CKD is divided into five stages. The first stage is the onset of the attack and the fifth stage is when the capacity of the kidneys drops below 15 percent. If the disease is diagnosed between stages one to four, then the kidneys can be kept healthy for a long time through treatment, diet, and a healthy lifestyle. Complications related to the disease can also be prevented.
What is the end result of Chronic Kidney Disease?
If left untreated at the early stage, the kidneys can be completely destroyed, and death is inevitable if dialysis or kidney transplants are not performed. However, the alarming aspect of CKD is that this disease generates other life-threatening diseases by many times. Patients with CKD were found to have several times higher chance of heart disease and brain stroke. That is why kidney disease is called disease-multiplier.
What Causes Chronic Kidney Disease?
A closer look reveals that the root causes of CKD are intertwined with our lifestyle practices, which can be controlled by ourselves. CKD can be caused by many reasons. However, the main reasons are – uncontrolled diabetes, high blood pressure, obesity, smoking, inactive lifestyle, unhealthy food consumption, etc.
On the other hand, lack of knowledge about the kidneys can lead to kidney failure. For example, taking pain-killers in large quantities, adulterated food, neglecting treatment of sore throat and scabies of children and lack of awareness among parents of congenital kidney problems may cause damage to kidney. It is often seen that due to minor birth defects in children, kidney failure occurs later. However, if these diseases are identified in the early stages, they can be treated.
There are many other causes of kidney failure; such as hereditary, kidney stones, urinary tract infections, urinary incontinence and age-related kidney disease. If any kidney disease is detected at an early stage by regular kidney examination, kidney failure can be prevented. The disease can be detected at an early stage by simply estimating eGFR from blood creatinine and testing urine albmin. In most cases there are no symptoms before the kidneys lose 80 to 90 percent of their capacity. So those who are at risk of kidney disease should check their blood and urine at least once a year.
If we follow a healthy lifestyle, it is possible to prevent fatal kidney failure in 50 to 60 percent of cases.
Ways to keep your kidneys healthy:
01) Engaging in physical work, sports and regular exercise,
02) Keeping high blood pressure and diabetes under strict control,
03) Measuring blood pressure regularly to control latent high blood pressure,
04) Eating a healthy diet consisting of vegetables and fruits every day to keep the body weight under control,
05) Drinking enough water, avoid artificial, colorful drinks
06) Abstinence from smoking,
07) Refraining from taking any medicine without prescription,
08) Avoiding negligence in the treatment of other diseases,
09) Leading a stress free orderly life,
10) Regular testing of kidney function
How to ensure kidney health for all?
To prevent kidney disease, one needs to be health-conscious, practice a healthy lifestyle. However, it is a matter of concern for those whose kidneys have been damaged, who have no option but dialysis or kidney transplantation to survive. 90pc of patients die without treatment or partial treatment. Just as food, clothing, and shelter are basic human rights, so is survival. Therefore, to prevent premature death, all kidney failure patients should be brought under health insurance. Introducing “Kidney Protection Insurance” under universal health coverage can ensure kidney health for all.
(The author is Kidney Disease and Medicine Specialist President, Kidney Awareness Monitoring and Prevention Society (KAMPS) Professor and Head of Department, Department of Nephrology Anwar Khan Modern Medical
College Hospital).
