Flipping through the book of anatomy, you will see how amazing the human body was created. Everything is well coordinated and perfectly structured to fit one another. The vessels running through every possible slit to reach from one station to another, sometimes joining with the other vessel to form a larger one. Each functioning organ is special in their own way, and today let us focus on the magical bean-shaped organs which provide filtration of the fluid in the body, produce components important for red cells, contribute indirectly to the bone density, and a lot more.
Did you know?
Chronic kidney disease (CKD) is a worldwide public health problem and the amount of people on dialysis increases tremendously each year. CKD implies long standing (more than 3 months), progressive impairment of the kidney function. Common causes of CKD are hypertension, diabetes mellitus, congenital and inherited kidney disease, inflammatory disease as well as vascular disease.
When do you have to worry?
Among all the causes of CKD, diabetes mellitus and hypertension are the two most common causes of CKD. High blood pressure increases the chance that kidney disease will get worse due to the pressure effect on the kidney structure, which reduces the filtration rate. The relationship between high blood pressure and CKD is vice versa.
Diabetes mellitus at the initial stage does not have an impact on the kidneys, but when the complications arise, the kidneys will be affected. The high levels of blood glucose make the kidneys filter too much blood, thus the extra strain on the kidneys causes protein leakage and eventually kidney damage.
Are you anywhere near the stage for dialysis?
The stages of CKD depend on the filtration rate of the kidney, termed as glomerular filtration rate (GFR).
Stage 5 CKD is known as kidney failure, where the glomerular filtration rate has declined to less than 15mL/min/1.73m2, and that is when dialysis is required.
Symptoms of CKD
Initially, the CKD patient does not show any symptoms until the glomerular filtration rate falls below 30mL/min/1.73m2.
- early symptoms
- loss of concentrating ability of the urine, thus bed wetting (nocturia)
- body itching
- loss of weight
- nausea/ vomiting
- late symptoms
- muscular twitching
- increased bleeding tendency (bruising area)
- increased susceptibility to infections, especially lung infection (pneumonia)
- poor nutrition
- restless leg syndrome (jumpy leg at night)
- alterted sensation of the foot
- heart problems
How do I assess my kidneys condition?
- Blood test
- full blood count
- urea and creatinine levels
- calcium, phosphate, parathyroid hormone levels
- lipids and glucose level
- urine test
- liver function test
- albumin level
- hepatitis and HIV screening (if dialysis or transplant is planned)
- ECG electrocardiogram
- cardiac disease
- kidney ultrasound scan
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The management of chronic kidney disease is another complex world of drugs and symptoms control. However, the first approach is to treat the underlying cause aggressively. Also, depends on the stage of the disease, the treatment varies as stage 1-3 is reversible.
Below are the few examples of treating CKD:
- Antihypertensive therapy
- lowering blood pressure helps to slow the rate at which the kidney function declines.
- Lipid lowering therapy
- reducing cholesterol and triglyceride levels not only slow the course of the disease, it can also help reduce cardiac disease.
- Diet and lifestyle intervention
- prevent excessive consumption of protein
- ensure adequate calorific intake
- stop smoking
- exercise and weight loss
- Medication to treat anemia
- Vitamin D for maintaining bone density
Renal replacement therapy
It is definitely not easy for the patient himself and the family members to accept that one has been diagnosed with end-stage kidney failure. They will have to consult the specialist to assess the patient’s condition and to decide whether to go on dialysis or kidney transplant, or neither one.
There are 2 types of dialysis.
Hemodialysis is the one people visit the dialysis centre 3 days a week, and peritoneal dialysis is the one in which the patient insert a catheter into the abdomen to filter out the fluid. You would know by the time you see one.
- Shorter duration of time, fewer days compared to peritoneal dialysis.
- Done by trained health professions.
- Do not have to self-handle the entire procedure.
- Requires visits to hospital or dialysis centre.
- Requires adequate venous circulation for vascular assess.
- Infections related to vascular assess.
- (low blood pressure causing fainting episodes, sometimes chest pain)
- Careful compliance with diet and fluid restrictions required.
- Performed at home.
- Usually asymptomatic.
- Diet and fluid less restricted.
- Full responsibility for treatment.
- Less efficient.
- Daily treatment. Few hours between each treatment.
- Abdominal infections or catheter-related infections.
- Inadequate clearance of toxic metabolic products.
To have healthy kidneys, start from your daily life care.
by Angie Loh
A medical student with nothing but passion and a pen. Poems and novels never fail to make me feel alive. I'm inspired to make the world a better place and fill it with a little bit more love. But first, where's my coffee? View all articles by Angie Loh.