The kidneys are as essential to life as the heart yet do not get as much appreciation and love.
The left and right kidneys are organs that are located under the lower part of your ribcage on the right and left sides of your spine. They are fist sized, bean shaped and are made up of millions of tiny filters. These tiny filters, called nephrons, allow blood in, filter out toxins, waste products and water; then releasing them as urine. The cleansed blood then leaves the kidney and goes on to the rest of the body.
When the kidney stops working (as a result of loss/death of these tiny filters), this causes toxins, waste products and water to build up in the body causing illness and disease. The early stages of kidney disease usually have no symptoms. Chronic kidney disease (CKD) has a global prevalence of 11-13%. It is the 4th leading cause of death in T&T. It has a high economic cost with countries like the US spending 6.7 per cent of their Medicare budget on treating just the final stage of the disease.
Kidney disease is both a risk factor for, and a contributor to, many non-communicable diseases. Causes of chronic kidney disease include:
Diabetes
Hypertension (high blood pressure), Heart disease
Smoking
Diabetes and hypertension are the two leading causes of CKD. Diabetic patients with high blood pressure appear to have the highest prevalence rate of chronic kidney disease when compared to other non-communicable diseases. Other common causes of kidney disease worldwide include diarrhoeal illness, HIV and autoimmune disorders like Lupus (SLE).
Patients with chronic kidney disease generally have no symptoms until late in the disease where the damage is already permanent and will only get worse over time. While there are medications to slow, but not cure, the progression of early stages of chronic kidney disease, the treatment for end stage kidney disease is kidney transplant or dialysis (where a machine/other structure does the job of the kidneys).
However, getting a transplant can be very difficult and requires lifelong medication that weakens the immune system. Dialysis can be expensive (costing approximately $1000 per session with most end stage kidney patients requiring 12 sessions a month), time intensive (necessitates spending three hours or more, three times per week at hospital/dialysis centre) and can have serious life threatening complications (such as infection, bleeding, stroke, heart dysfunction and shock).
While the early stages of the disease are asymptomatic, kidney disease can be detected inexpensively through screening urine and getting a blood test. At risks groups that should be screened include those with hypertension, diabetes, family history of kidney disease, old age, obese individuals, smokers and those with HIV. When it comes to promoting kidney health and slowing the progression of CKD, it is best to ensure:
1. Eating a healthy balanced diet with adequate portions of fruits and vegetables.
2. Keeping a healthy weight.
3. Drinking adequate water.
4. Stopping smoking /alcohol/cocaine use.
5. Keeping tight control of blood sugars.
6. Keeping tight control of blood pressure.
7. If you suffer from autoimmune diseases like SLE, it is important to take your medications.
8. Keep regular follow up with your doctor or clinic if you suffer with diabetes, hypertension or heart disease.
9. Getting a kidney function test (a simple blood test) at least every six (6) months especially if you are diabetic or suffer with high blood pressure.
Bluntly, and in conclusion, take care of your kidneys today because getting a transplant is too hard and dialysis is too expensive.
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Dr Jawwaad Mohammed
MBBS (UWI)
Medical House Officer,
Eric Williams Medical Sciences Complex
(On behalf of the T&T Society of Nephrology)
