How to take good care of your kidneys

Chronic kidney disease (CKD) is rising in South Africa to the point where even potential donors are rejected as a result of unhealthy living.

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An unhealthy lifestyle not only harms your own kidneys but also lessens your ability to save the lives of others.

The South African Medical Journal estimates that 10% of people worldwide suffer from some degree of CKD, meaning it is likely that about 5 million South Africans over the age of 20 may be affected by CKD, which significantly impacts their quality of life.

Cardiovascular (CVS) product manager for Pharma Dynamics, Solomon Fadhl, said roughly two thousand patients are currently awaiting a kidney transplant in the country.

For some, the chance of being matched with a suitable donor while still healthy enough to undergo a transplant is slim.

With World Kidney Day on March 9, countries around the globe are redoubling their efforts to raise awareness of kidney health and the factors that contribute to the disease.

Solomon says diabetes and uncontrolled hypertension (high blood pressure) are leading causes of kidney disease, which over time can impair the function of one or both kidneys.

“Hypertension causes damage to blood vessels and filters in the kidney, making it difficult to remove waste from the body.

“Kidneys are responsible for balancing water and mineral levels in your body by filtering waste products and excess fluids from your blood into urine for excretion. If your kidneys don’t function optimally, it leads to fluid build-up and harmful waste products in your body,” said Fadhl.

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“Once diagnosed with end-stage renal disease, a blood-cleansing process called dialysis or kidney transplantation is necessary,” said Fadhl.

He said it is critical to managing the danger of kidney disease.

The best way to control blood pressure is by making healthier lifestyle choices.

Those who already have hypertension and/or kidney disease should use prescribed medications that lower blood pressure to protect the kidneys from further damage.

Preventative measures that can slow disease progression and protect against kidney and cardiovascular disease include:

• Maintaining a healthy blood pressure, achieved by eating healthy, exercising regularly, limiting alcohol intake and quitting smoking.

• Combination therapies, such as an angiotensin II receptor blocker and a diuretic (water pill) or an angiotensin–converting enzyme (ACE) inhibitor with a calcium antagonist, be effective in patients who do not respond to monotherapy (treatment of disease with one medication).

• Reducing salt intake.

• Maintaining a healthy body weight.

Fadhl said there has been some controversy over whether taking anti-hypertensive therapy over the long term can affect your kidneys.

“It’s important to keep in mind that you cannot take certain medications like blood pressure-lowering medication or strong anti-inflammatories when you are constantly dehydrated, as this puts additional strain on your kidneys.

“Adequate hydration is key,” he said.

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“Some of the symptoms related to kidney disease include high or worsening blood pressure, a decrease in the amount of urine or cloudy or foamy urine, muscle cramps or spasms, dry and itchy skin, unexplained weight loss, oedema (fluid retention), especially in the lower legs and a need to urinate more often, especially at night.

Many of these symptoms may go unnoticed. Similar to hypertension, kidney disease is also described as a silent killer.

“Check the health of your kidneys with a laboratory test if you are obese, have high blood pressure, diabetes or chronic inflammation of the filtering units (glomeruli) in the kidney or the tubules or surrounding structures.

“Several blood and urine tests can show if your kidneys are working properly.

“These tests include serum creatinine and blood urea nitrogen (BUN) tests.

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“Elevated levels of either can indicate kidney damage. Proteinuria, an excess of protein in the urine, is also a sign of kidney disease.

“Given the rise in risk factors, it’s important to identify kidney disease early by going for regular screenings, especially in people who are at risk,” said Fadhl.