Need for kidney care

Among the many health conditions that can cause significant morbidity and mortality, chronic kidney disease (CKD) is a progressive disorder. It causes the kidney function to decline over time, eventually leading to end-stage renal disease. In India, about 17% people have some form of CKD and in one-third of them, the disease is in the advanced stages. Kidneys play a major role in maintaining homeostasis, and therefore, CKD can have a profound effect on other body systems as well.

This disease is usually the outcome of certain underlying problems such as diabetes and hypertension, which damage the small blood vessels in the kidney. Some other risk factors include cardiovascular diseases, age, ethnicity, some autoimmune disorders, and excessive use of over-the-counter medications. Although CKD is a serious issue, it is possible to prevent complications, improve outcomes, and at times even reverse it.

Symptoms & diagnosis

CKD is often a silent condition and the symptoms may not be apparent until much later. A regular blood and urine test, which shows the presence of the protein albumin, can indicate kidney disease. In youngsters, the signs include a puffy face, brownish urine, swelling of the legs, strep throat, and skin infections. Other symptoms, particularly in older people, could include nausea, itchy skin, weight loss, bad breath, and muscle twitching or cramps.

Managing complications

When CKD progresses, it can cause other complications as mentioned below:

* Anaemia: Kidneys have a major role to play in helping the body produce red blood cells. In patients with CKD, this process is hampered and can cause anaemia.

* Bone disease: Both calcium and vitamin D are essential for bone health. By regulating minerals and other vital nutrients, kidneys contribute to healthy bones. If you have CKD, the kidneys cannot do this effectively causing bone disease and an increase in phosphorus content.

* Heart disease: This is the most common cause of mortality in people who undergo dialysis for CKD.

* Hyperkalemia: Kidneys filter extra potassium from the blood, and this ability is reduced if you suffer from CKD.

* Fluid build up: Another important function of healthy kidneys is to remove excess fluid from the blood. CKD can cause fluid build-up and affect the ability of kidneys to filter it out. This, in turn, causes problems to the heart and lungs, as also high blood pressure.

The first step towards managing CKD is aggressive blood pressure and blood sugar control. Those with dyslipidemia are prescribed statin therapy in order to reduce the risk of cardiovascular disease. Some other ways to avoid chronic complications and end-stage renal disease are as follows:

* Quit smoking and alcohol as they can hasten the damage to blood vessels.

* Consume a diet that is rich in fruits, vegetables, and whole grains. Reduce the intake of salt and avoid consuming processed food.

* Follow the treatment regimen for diabetes, lupus, and hypertension to slow down the progress of CKD.

* Get treated for urinary tract infections or other such problems at an early stage.

While the above measures can help in prevention and management, awareness is the key to tackle this disorder.

(The author is head of the Clinical Advisory Board, healthi)

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