Take care of your kidneys

Every year, the campaign highlights a particular theme.

This year’s theme is “Kidney health for all”.

Chronic kidney disease (CKD) is a progressive loss in kidney function over a period of months or years.

Each of your kidneys has about a million tiny filters, called nephrons. If nephrons are damaged, they stop working. For a while, healthy nephrons can take on the extra work. But if the damage continues, more and more nephrons shut down. After a certain point, the nephrons which are left cannot filter your blood well enough to keep you healthy.

When kidney function falls below a certain point, it is called kidney failure. Kidney failure affects your whole body, and can make you feel very ill. Untreated kidney failure can be life-threatening.

The main indicator of kidney function is your blood level of creatinine, a waste product of the body produced by muscles and excreted by the kidneys. If kidney function is reduced, creatinine accumulates in the blood leading to an elevated level when a blood is tested.

Kidney function is best measured by an indicator called Glomerular Filtration Rate (GFR) which measures the blood filtration rate by kidneys.

This indicator allows doctors to determine if the kidney function is normal, and if not, to what level the reduced kidney function has deteriorated. In everyday practice, GFR can easily be estimated, from measurement of the blood creatinine level, and taking into account, age, ethnicity and gender.

Causes

High blood pressure (hypertension) and diabetes are the most common causes of kidney disease. The high blood pressure causes just over a quarter of all cases of kidney failure.

Diabetes has been established as the cause of around one-third of all cases, and is the most common cause of End Stage Renal Disease (ESRD) in most developed countries.

Other less common conditions include inflammation (glomerulonephritis) or infections (pyelonephritis). Sometimes CKD is inherited (such as polycystic disease) or the result of longstanding blockage to the urinary system (such as enlarged prostate or kidney stones).

Some drugs can cause CKD, especially some pain-killing drugs (analgesics), if taken over a long time. Often doctors cannot determine what caused the problem.

Treatment

There is no cure for chronic kidney disease, although treatment can slow or halt the progression of the disease and can prevent other serious conditions developing.

The main treatments are a proper diet and medications, and for those who reach ESRD, long term dialysis treatment or kidney transplantation. In the early stages of kidney disease, a proper diet and medications may help to maintain the critical balances in the body that your kidneys would normally control.

However, when you have kidney failure, wastes and fluids accumulate in your body and you need dialysis treatments to remove these wastes and excess fluid from your blood.

Dialysis can be done either by machine (haemodialysis) or by using fluid in your abdomen (peritoneal dialysis).

In suitable patients, a kidney transplant combined with medications and a healthy diet can restore normal kidney function. Dialysis and kidney transplantation are known as renal replacement therapies (RRT) because they attempt to “replace” the normal functioning of the kidneys.