Chronic kidney disease can strike anyone at any time.
It can mean spending years on dialysis treatment or opting for an organ transplant that often involves a long journey to seek a suitable donor.
Patients often discover that they have kidney disease when they go for routine blood tests for insurance purposes, and it’s only when high levels of toxins and protein are found in the body that doctors are alerted to the fact that kidneys are dysfunctional or failing.
Durban physician and nephrologist, Dr Ismail Ranederee, says leading risk factors for kidney disease include Type 2 diabetes, high blood pressure and the abuse of medication such as painkillers, while the overuse of creatine containing protein supplements sold by gyms was now also an emerging problem.
‘Some people may not know at all that they have kidney disease, so it may be incidental and others may pick it up during routine examinations.
‘Kidney disease may be congenital, where a person may be born with polycystic kidney disease or they may be born with just one kidney, with a horse shoe shaped kidney or abnormalities of the renal tract,’ Ranederee says.
He adds that patients, especially those with a family history of kidney disease, may not even know they have been living with kidney abnormalities until an ultrasound has been performed.
‘People think ‘I feel well so my blood will be normal’. It’s like when diabetics think their sugar level is fine because they feel well or a person with high blood pressure doesn’t take their medication because they feel well.’
He says other causes include recurrent kidney stones, obstructive uropathy in men due to an enlarged prostrate, auto immune diseases such as systemic lupus erythematosis, gouty arthritis with uric acid stones and a propensity for patients to use non-steroidal anti-inflammatories.
Pregnancy related hypertension, diabetes and cortical necrosis, as well as glomerulonephritis/nephrotic syndrome in children and teenagers, were other potential causes.
Randeree advised patients who had experienced these conditions to check their blood pressure and sugar levels and have a urine analysis on a yearly basis.
Randeree said the symptoms of established chronic kidney disease – more than three months of kidney damage – were varied and ranged from nausea, appetite loss and tiredness, to excessive itching and awaking three or four times at night to pass urine.
Nausea is caused by an increase in the toxin urea in the blood, while itching was as a result of high phosphorous levels due to the kidneys’ failure to filter toxins. High levels of creatine in the blood could also indicate kidney disease.
‘The kidney is a filter and the filter has a membrane that is damaged if your forcefully push high protein through it,’ Randeree says.
Dialysis three times a week for four hours per session was recommended for chronic kidney disease patients, who sometimes remained on treatment for 10 to 15 years because an organ transplant was not an option.
Dialysis is an artificial process using a machine to perform the function of the kidneys to remove waste and water from the blood.
He said reasons patients did not consider transplants ranged from being in the late stages of other chronic illnesses, religious concerns, age, fear of the risks and the simple fact they had adapted their lives to the regular treatment.
Ten signs you could have kidney disease
1. Tiredness, lethargy and trouble concentrating.
2. Trouble sleeping as the kidneys are not filtering toxins properly.
3. Dry and itchy skin can be a sign of mineral and bone disease that often accompanies advanced kidney disease.
4. Feeling the need to urinate more often, especially at night.
5. Blood in the urine owing to damaged kidney’s ‘leaking’ blood cells.
6. Foamy urine can indicate protein in the urine.
7. Puffiness around the eyes
8. Swollen ankles and feet owing to sodium retention.
9. Poor appetite
10.Cramping muscles owing to electrolyte imbalances such as low calcium levels.
•Source: The National Kidney Foundation www.kidney.org
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