HOW WELL DO YOU KNOW YOUR KIDNEYS?

“I didn’t know I could look and feel fine while my organs were failing”, says Sheree, an Australian woman diagnosed with Chronic Kidney Disease at the prime age of 34. “Everyone needs to let go of the ‘it won’t happen to me’ mentality” — she added.

This is often the case with many individuals diagnosed with kidney disease. It shows no symptom until it progresses to end-stage damage and can be life-threatening, hence, the need to be conscious of one’s kidney health.

The kidneys are two bean-shaped organs about the size of a fist. They are located on either side of the spine below the rib cage and behind the abdomen.

FUNCTIONS OF THE KIDNEY

They filter blood in the body and thus perform the following vital roles in the process:

1. Elimination of waste products and toxic substances from the body.
2. Removal of excess fluids to form urine
3. Production of essential hormones — It secretes erythropoietin, a hormone that is responsible for the production of red blood cells in the bone marrow. Also, vitamin D gets converted to its active metabolite in the kidney.
4. Regulation of blood pressure and electrolytes

CHRONIC KIDNEY DISEASE (CKD)

CKD is now a leading public health burden. About 10% of the population worldwide has been estimated to be affected by this condition. In Nigeria, about 17 million Nigerians have some form of CKD. It is defined as kidney damage or decreased glomerular filtration rate (GFR) of less than 60 mL/min/1.73 m2 for at least three months.

RISK FACTORS OF CKD

1. Hypertension

2. Diabetes

3. Elderly

4. Family history of kidney disease

5. Cardiovascular disease

Symptoms of CKD

Most individuals may not exhibit any symptoms until the damage is severe. The symptoms include:

1. Loss of appetite

2. Weight loss

3. More frequent urination than usual especially at night

4. Anemia

5. Blood-stained urine

6. Muscle twitches

7. Swollen feet or body

Causes of CKD

Hypertension and diabetes have been considered the major causes of kidney disease. Other causes include polycystic kidney disease, infection of the glomerulus, nephrotoxic drugs, or herbal remedies. Herbal remedies accounted for 37.5% of cases of acute tubular necrosis in a Nigerian study.

Diagnosis of CKD

A blood test is a major test used in determining kidney function and the extent of the damage.

• Serum Creatinine — Creatinine is a waste product of the breakdown of muscles in the body. It is filtered from the blood by the kidney. When the kidney is not functioning well, the creatinine level rises in the blood.

• Glomerular Filtration Rate (GFR) — This is a measure of the amount of blood the kidney filters per unit of time. A GFR value less than 90ml/min may indicate an issue with the kidney.

• Blood Urea Nitrogen (BUN) — This measures the amount of nitrogen, which is from urea, in the blood. Urea is a waste product from the breakdown of proteins. The higher the BUN than normal, the more deficient the kidney function.

TREATMENT OF CKD

Management of CKD involves lifestyle changes especially dietary modifications, pharmacotherapy, and dialysis.

• Life Style Modification — It is important for patients to stop smoking and reduce alcohol intake. Dietary restrictions include low salt and low protein diet. Consumption of more fruits and vegetables are encouraged. The patients might be referred to consult with the dietician for expert counselling on diet.

• Management of Hypertension & Diabetes — Medications are prescribed to control blood pressure and blood glucose. Volume overload resulting from fluid accumulation is reduced with the use of loop diuretics. Dose adjustment in some oral hypoglycemics may be required. Nephrotoxic drugs like the non-steroidal anti-inflammatory drugs (NSAIDS) and herbal remedies containing aristolochic acid or anthraquinones should be avoided. Generally, drugs that are largely metabolized or excreted by the kidney should be avoided. Classes of drugs that require dose adjustments include most antibiotics, direct oral anticoagulants, gabapentin and pregabalin, oral hypoglycemic agents, insulin, chemotherapeutic agents, and opiates.

• Renal replacement therapy — Dialysis or kidney transplantation may be considered depending on the stage of CKD and the manifestations.

COMPLICATIONS OF CKD

1. Anemia

2. Electrolyte imbalance

3. Cardiovascular diseases

4. Mineral and bone disorder

TIPS FOR HEALTHY KIDNEYS

1. Keep your blood pressure and blood glucose under control

2. Eat healthily — eat more vegetables and fruit

3. Regular exercise or physical activity

4. Drink enough water

5. Stop smoking and reduce alcohol intake

6. Reduce your weight if you’re obese

7. Get enough rest and manage your stress well

8. Get tested today

Written by Rahmotallah Mosunmola B.

SOURCES:

Kidney Health Australia 2020. https://Kidney.org.au/your-kidneys/living-with-kidney-disease/kidney-stories/shere

Global Facts about Kidney Disease. ewww.kidney.org/kidneydisease/global-facts-about-kidney-diseas

II Ulasi et al. Towards prevention of chronic kidney disease in Nigeria: a community-based study in Southeast Nigeria

National Institute of Diabetes and Digestive and Kidney Diseases. ewww.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ck

Medscape. dhttps://emedicine.medscape.com/article/238798-overvie

Chen et al. Chronic Kidney Disease Diagnosis & Management: An overview. whttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7015670/