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Kidney & Kidney diseases

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The main job of your kidneys is to remove toxins and excess water from our blood. Kidneys also help to control our blood pressure, to produce red blood cells and to keep our bones healthy.

Each roughly the size of your fist, kidneys are located deep in the abdomen, beneath the rib cage.

Your kidneys control blood stream levels of many minerals and molecules including sodium and potassium, and help to control blood acidity. Every day your kidneys carefully control the salt and water in your body so that your blood pressure remains the same.


Your Kidneys:
  • Make urine
  • Remove wastes and extra fluid from your blood
  • Control your body's chemical balance
  • Help control your blood pressure
  • Help keep your bones healthy
  • Help you make red blood cells

Kidney Diseases are Common, Harmful and Treatable

The prevalence of kidney disease is increasing dramatically and the cost of treating this growing epidemic represents an enormous burden on healthcare systems worldwide.

Common

Between 8 and 10% of the adult population have some form of kidney damage, and every year millions die prematurely of complications related to Chronic Kidney Diseases (CKD).

Harmful

In both developed and developing countries diabetes, hypertension and heart disease are the most common causes of CKD, especially in the aging populations. 

The first consequence of undetected CKD is the risk of developing progressive loss of kidney function, eventually leading to kidney failure and thus the need for dialysis or a kidney transplant to survive. The second consequence is the high risk of premature death from associated cardiovascular disease. Individuals who appear to be healthy who are then found to have CKD have an increased risk of dying prematurely from CVD regardless of whether they ever develop kidney failure.

Treatable

Early Detection: Kidney disease can be detected early. Simple laboratory tests are done on small samples of blood (to measure creatinine content and estimate GFR) and on urine (to measure creatinine and albumin excretion). The majority of individuals with early stages of CKD go undiagnosed because there are few or no symptoms. The early detection of failing kidney function is crucial because it offer the window to implement treatment before end-stage kidney damage or cardiovascular problems occur.

Screening: Screening is critical for those people considered to be at high risk of kidney disease, namely:

  • Patients with diabetes and hypertension.
  • Individuals who are obese or smoke.
  • Individuals over 50 years of age.
  • Individuals with a family history of kidney disease, diabetes mellitus or hypertension.
Did you know?

The majority of individuals with early stages of CKD go undiagnosed. On WKD we are calling on everyone to check if they are at risk for kidney disease and encouraging more people to take a simple kidney function test.


 
Secondary Prevention - slowing disease progression disease: Key preventative measures have been defined and proven successful in those with early stages of CKD as secondary prevention measures, which help slow disease progression and protect against both kidney and cardiovascular disease, such as:
  • Reduction of high blood pressure -the lower the blood pressure, the slower the GFR decline
  • Specific medications to reduce proteinuria as well as lower blood pressure - ACE inhibitors/ARBs
  • Reduce salt intake to lower blood pressure
  • Control of glucose, blood lipids and anemia
  • Smoking cessation
  • Increased physical activity
  • Control of body weight

Treatment: Clinical research over the last decade has shown the potential benefit of blockade of the renin-angiotensin system by ACEs and ARBs to significantly reduce the burden of disease from CVD, diabetes, hypertension and CKD at relatively low cost.

Importance of Early Detection

Screening is essential for people considered to be at-risk of kidney disease. The early detection of kidney impairment is essential and allows suitable treatment before kidney damage or deterioration manifests itself through other complications.

Testing for Kidney Disease

Kidney diseases develop slowly and the symptoms only appear at a late stage when the patient already has kidney failure and may even need dialysis. Renal Replacement Therapy (RTT) requires major burdensome lifestyle changes for the patient and is extremely costly for any country’s healthcare system. A routine test of urine, blood and blood pressure can reassure or detect if there are any early signs of kidney problems. The needed laboratory tests are done on small samples of blood and urine. When your kidneys are damaged, proteins leaks into your urine.

A simple test can be done to detect protein in your urine. Persistent protein in the urine is an early sign of chronic kidney disease. Your doctor uses the results of your Serum Creatinine measured in the blood to calculate your overall kidney function, or Glomerular Filtration Rate (GFR) and your blood sugar to be sure you do not have diabetes.

  • Serum Creatinine: Creatinine is a waste product in your blood that comes from muscle activity. It is normally removed from your blood by your kidneys, but when kidney function slows down, the creatinine level rises. Your doctor can use the results of your serum creatinine test to calculate your kidney function, or GFR.
  • Glomerular Filtration Rate (GFR): Your GFR tells how much total kidney function you have. It may be estimated from your blood level of creatinine. Normal is about 100 ml/min, so lower values indicate the percentage of normal kidney function which you have. If your GFR falls below 60 ml/min you will usually need to see a kidney disease specialist (called a nephrologist), If the treatment you receive from the nephrologist does not prevent a further reduction in GFR, your kidney doctor will speak to you about treatments for kidney failure like dialysis or kidney transplant. A GFR below 15 indicates that you may need to start one of these treatments soon.

THE 8 GOLDEN RULES

What can you do for your kidneys?

Kidney diseases are silent killers, which will largely affect your quality of life. There are however several easy ways to reduce the risk of developing kidney disease.

Keep fit and active

Keeping fit helps to reduce your blood pressure and therefore reduces the risk of Chronic Kidney Disease.

Keep regular control of your blood sugar level

About half of people who have diabetes develop kidney damage, so it is important for people with diabetes to have regular tests to check their kidney functions.

Kidney damage from diabetes can be reduced or prevented if detected early. It is important to keep control of blood sugar levels with the help of doctors or pharmacists, who are always happy to help.

Monitor your blood pressure

Although many people may be aware that high blood pressure can lead to a stroke or heart attack, few know that it is also the most common cause of kidney damage.

The normal blood pressure level is 120/80. Between this level and 129/89, you are considered prehypertensive and should adopt lifestyle and dietary changes. At 140/90 and above, you should discuss the risks with your doctor and montior your blood pressure level regularly. High blood pressure is especially likely to cause kidney damage when associated with other factors like diabetes, high cholesterol and Cardio- Vascular Diseases.

Eat healthy and keep your weight in check

This can help prevent diabetes, heart disease and other conditions associated with Chronic Kidney Disease.

Reduce your salt intake. The recommended sodium intake is 5-6 grams of salt per day (around a teaspoon). In order to reduce your salt intake, try and limit the amount of processed and restaurant food and do not add salt to food. It will be easier to control your intake if you prepare the food yourself with fresh ingredients.

Maintain a healthy fluid intake 

Although clinical studies have not reached an agreement on the ideal quantity of water and other fluids we should consume daily to maintain good health, traditional wisdom has long suggested drinking 1.5 to 2 litres (3 to 4 pints) of water per day.

Consuming plenty of fluid helps the kidneys clear sodium, urea and toxins from the body which, in turn, results in a “significantly lower risk” of developing chronic kidney disease, according to researchers in Australia and Canada. The findings, the researchers said, do not advocate “aggressive fluid loading”, which can cause side effects, but they do provide evidence that moderately increased water intake, around two litres daily, may reduce the risk of decline in kidney function. It's important to keep in mind that the right level of fluid intake for any individual depends on many factors including gender, exercise, climate, health conditions, pregnancy and breast feeding. In addition, people who have already had a kidney stone are advised to drink 2 to 3 litres of water daily to lessen the risk of forming a new stone.

Do not smoke

Smoking slows the flow of blood to the kidneys. When less blood reaches the kidneys, it impairs their ability to function properly. Smoking also increases the risk of kidney cancer by about 50 percent.

Do not take over-the-counter pills on a regular basis

Common drugs such non-steroidal anti-inflammatory drugs like ibuprofen are known to cause kidney damage and disease if taken regularly.

Such medications probably do not pose significant danger if your kidneys are relatively healthy and you use them for emergencies only, but if you are dealing with chronic pain, such as arthritis or back pain, work with your doctor to find a way to control your pain without putting your kidneys at risk.

Get your kidney function checked if you have one or more of the 'high risk' factor

  • you have diabetes
  • you have hypertension
  • you are obese
  • one of your parents or other family members suffers from kidney disease
  • you are of African, Asian, or Aboriginal origin

( Courtesy: http://www.worldkidneyday.org/ )

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Refer: http://nihseniorhealth.gov/alpha.html  

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