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Kidney Health: Preparing for the unexpected

•Check blood sugar, bp, and avoid concoctions, unprescribed medications –Experts
•‘Embrace prevention as the best treatment and take adequate water daily’

Annually, World Kidney Day is observed on the second Thursday in March. It is a global health awareness campaign focusing on the importance of the kidneys and reducing the frequency and impact of the disease and its associated health problems worldwide. Although many are treatable, there are secondary medical concerns for the greater population, reports Isioma Madike

World Kidney Day, observed on the second Thursday of March, is to create awareness about kidney health. The theme for this year’s celebration is: “Kidney Health for All – Preparing for the unexpected, supporting the vulnerable.” The 2023 campaign focused on raising awareness about disastrous events, natural or man-made, international or local, and their impact on people living with kidney disease whose access to appropriate diagnostic services, treatment, and care is hindered. A Professor of Veterinary Medicine and Clinical Virology at the Michael Okpara University of Agriculture, Umuahia, Maduike Ezeibe, in an interview with Saturday Telegraph, advised Nigerians to embrace prevention as the best treatment for kidney problems. Ezeibe, while speaking at the 2023 World Kidney Day celebration, said that kidney disease has become a huge burden all over the world and Nigeria was not left out.

Dr. Rotimi Adesanya, a Fellow, Academic of Public Health (FAPH) and Head, Medical services, College Medical Centre, Federal College of Education (Technical) Akoka, in his contribution, also said that the prevalence of chronic kidney disease, is rising, but under diagnosed in the country. Adesanya, who spoke with this reporter, said that many Nigerians who had CKD did not know they had the disease until it was in an advanced stage. The good news, according to him, is that the earlier one finds out he or she has kidney disease, the sooner he or she can take steps to protect his or her kidneys from further damage.

The physician believes that protecting the kidneys would allow a person to continue to work, spend time with their family and friends, stay physically active, and do other things. Ezeibe says Kidney is a vital organ for all mammals because it is responsible for eliminating nitrogenous wastes from the body. He, however, added that it is only in human beings and in dogs that kidney diseases attract enough attention. Apart from filtering wastes from the body, kidneys, he said, help to maintain composition and volume of blood and density of bones.

He said: “They also regulate water balance and blood pressure. Dysfunction of the kidney is usually referred as kidney failure and this becomes noticeable only when both kidneys fail. “Signs of kidney failure include loss of appetite, lack of sleep, weakness, abnormality in urination (frequent urination or less urination than normal), loss of memory, high blood pressure, dry skin, swelling of feet and ankles. “There is no known cure for kidney failure once it has occurred. Efforts are to do work of the kidneys as management of the p a – tient. Such management includes dialysis to wash out wastes from the body of patients.

Risk factors for kidney failure include heart diseases, diabetes mellitus, smoking, obesity, old age and bad medication. “Infections of the kidneys and conditions that cause blockage of flow of urine such as kidney stones and prostate enlargement/cancer also lead to kidney failure. “So, such conditions should be promptly treated while habits that predispose to kidney failure such as taking medicines without prescription by qualified physicians, eating too much salt or sugar, taking excess alcohol, taking too much red meat and failing to drink enough water should be avoided.”

He added: “For men who are over fifty years of age, there should be regular prostate-checks. Good news is that prostate enlargement or prostate cancer (which, if not treated, can lead to kidney failure) is now treatable. “When cells become abnormal (enlarged or cancerous), they acquire negative electrical charges while normal cells remain neutral (without charges). This information is already in literature.” For Adesanya, the first thing is to take an adequate amount of water in a day, about three liters of water is recommended in the 24 hours period for everyone.

“Then you need to eat a balanced diet, you need to avoid herbs, concoctions, unprescribed medications, over the counter painkillers, and avoid using them indiscriminately. We need to have our blood checked, check for blood sugar, blood pressure because high blood pressure and high blood sugar are some of the things that affect our kidneys. “High blood pressure leads to hypertension, which is one of the major causes of kidney failure just the same as diabetes is also one of the major causes of kidney failure.

“The first function of kidneys is that it removes waste from the body. It also helps in the production of red blood cells; produces a hormone called erythropoietin that helps blood to build up. It produces another hormone that helps to regulate blood pressure.

These are all the functions of the kidney. Kidney also helps us to regulate the body fluids. For example when we take too much water the kidney will help us to regulate it so that it will not harm us,” he said. A Consultant Nephrologist at the University College Hospital, Ibadan, Dr. Yemi Raji, in an interview with the News Agency of Nigeria (NAN) in Ibadan, had said that chronic kidney disease accounts for eight to 10 per cent of all medical admissions. He had said: “I have observed over the last decade that the burden of the disease has increased more in our environment.

So, as part of reducing this burden all over the world, every year, world kidney day is commemorated on the second Thursday of every March. “The purpose is to create awareness about kidney disease, the problem and causes and how to prevent it. We have a lot of vulnerable people in our community, such as the motherless, refugees and Internally Displaced Persons. “We are taking the message to them to educate them on kidney disease and how they can prevent it. In our environment, kidney disease is a big burden, particularly, if the kidney has been damaged completely. People need to start going for dialysis or kidney transplantation, which is very expensive. “So, how many people can afford this? That is why we must find a way to prevent rather than treat. This is why prevention is quite important.” He, therefore, admonished sufferers of diabetes and hypertension or other ailments that could cause kidney disease to go to appropriate places where they could get treatment. Raji said that there were a lot of things people indulge in that could cause kidney disease, including the abuse of painkiller drugs. He, however, advised people to avoid packaged foods and to visit hospitals regularly and not only when they are very sick. “People go to the pharmacy and chemists to buy all sorts of painkillers and this has a bad effect on their kidney or damages it. People should avoid self-medication. “They should go to hospital, whenever they are sick. People should also learn to take a lot of water because it helps the kidney. They should also reduce their salt intake and as much as possible take lots of fruits. “Government is not doing enough and, of course, can’t do it alone. That is why it is good to do preventive care. If the government comes to support, they should make dialysis free to reduce the burden suffered by people with the disease,” he further said. Dr. Thomson Nduka, a public health expert, also said that every 30 minutes, the kidneys filtered all the blood in the body. According to him, about 800 million people worldwide suffered from a progressive and often fatal deterioration of the organs. He urged Nigerians to protect their kidneys by getting tested; stating that early kidney disease usually had no symptoms. He said getting tested was, therefore, the best way to know how their kidneys were working. He said that even if people felt healthy; if they were over 60 or had risk factors like diabetes, high blood pressure, or heart disease, they should consider speaking with their doctor about getting tested for kidney disease. “Finding out if your kidneys are struggling before you have symptoms gives you the opportunity to make changes to help keep your kidneys healthier for longer. Even if you have symptoms, you can take steps to slow the disease. “Your doctor can use your test results to work with you to develop a kidney care plan. Having a plan may reduce your risk for serious health problems, like heart attack and stroke, and give you more healthy moments,” he explained. According to Nduka, high blood glucose levels could cause your kidneys to work harder, increasing the risk of chronic kidney disease. He said those who had type 2 diabetes should talk to their doctors about regular kidney screenings which he described as the key to early detection and treatment. Non-communicable diseases like diabetes, hypertension and kidney disease, Nduka said, have taken the lead in the causes of death worldwide, especially in developing countries. This group of people, he also said, is vastly affected by incidents of disasters. In this regard, he advised Nigerians to take care of their kidneys by imbibing kidney-friendly habits, which includes good hydration, routine kidney function tests, avoiding excessive consumption of salts, and unjustified use of medications. Another Consultant Nephrologist in Mumbai, India, Dr. Vaibhav Keskar, while emphasizing the benefits and challenges of dialysis for chronic Kidney disease, said that the kidneys are responsible for removing waste products that are produced in human bodies. He, however, said that in people with the chronic disease, the kidneys cannot function properly and waste products start to accumulate. This can cause various health problems, he said, adding that people with advanced kidney failure need artificial support to remove waste products and extra water that the body doesn’t need. He called the support, dialysis, which, according to him, is of two types – hemodialysis and peritoneal dialysis. Peritoneal dialysis uses the lining of the abdominal cavity to remove waste products, while hemodialysis uses artificial filters to remove waste products from the bloodstream. Hemodialysis is a life-saving therapy for people with chronic kidney disease, as it removes waste products and helps all the organ systems work properly, thus increasing the longevity of these people. It can also help improve the quality of life of patients by treating symptoms like fluid retention, loss of appetite, nausea, and vomiting. He said: “People on hemodialysis can lead a productive life as the therapy enables them to continue activities of daily life. It makes them feel better and has more energy. People on dialysis can continue working, travelling, and engaging in other activities they enjoy which can improve their overall quality of life. “However, hemodialysis is not without its challenges. Patients need to have something called vascular access to perform hemodialysis, which is the site from where the blood leaves for the filter and is returned to the body from the filter. “Without vascular access like a catheter or AV fistula, hemodialysis is not possible. Creating and maintaining such access is challenging for many patients. “Patients on hemodialysis also face higher risks of complications like infections and cardiovascular diseases, as well as challenges like malnutrition, anemia (low hemoglobin level), vitamin deficiencies, and bone disease. It can put a lot of strain on the patients and their families, owing to its complex nature. “However, with a multidisciplinary team consisting of nephrologists, dialysis nurses and technicians, dietitians, physical therapists, and primary care professionals, hemodialysis can make a difference in the lives of people with advanced kidney disease. “It can sustain life for several years, but it is best used as a bridge therapy to kidney transplantation, which is a desirable modality of treatment for most patients. “Although hemodialysis cannot match the natural kidneys, it does offer hope to patients with advanced kidney disease. “Peritoneal dialysis on the other hand is a way to remove waste products from one’s blood when the kidneys can’t adequately do the job any longer. This procedure filters the blood in a different way than does the more common blood-filtering procedure called hemodialysis.”

Quick look

Symptoms

Signs and symptoms of chronic kidney disease develop over time if kidney damage progresses slowly. Loss of kidney function can cause a buildup of fluid or body waste or electrolyte problems. Depending on how severe it is, loss of kidney function can cause: Nausea, vomiting, loss of appetite, fatigue and weakness, sleep problems, urinating more or less, decreased mental sharpness, muscle cramps, swelling of feet and ankles, dry, itchy skin. Others are high blood pressure (hypertension) that’s difficult to control, shortness of breath, if fluid builds up in the lungs, and chest pain, if fluid builds up around the lining of the heart. Signs and symptoms of kidney disease are often nonspecific. This means they can also be caused by other illnesses. Because one’s kidneys are able to make up for lost function, one might not develop signs and symptoms until irreversible damage has occurred.

When to see a doctor Make an appointment

with your doctor if you have signs or symptoms of kidney disease.

Early detection might help prevent kidney disease from progressing to kidney failure.

If you have a medical condition that increases your risk of kidney disease, your doctor may monitor your blood pressure and kidney function with urine and blood tests during office visits. Ask your doctor whether these tests are necessary for you.

Factors that can increase your risk of chronic kidney disease include: Diabetes High blood pressure Heart (cardiovascular) disease Smoking Obesity Family history of kidney disease Abnormal kidney structure Older age Frequent use of medications that can damage the kidneys

Complications

Potential complications include: Fluid retention, which could lead to swelling in your arms and legs, high blood pressure, or fluid in your lungs (pulmonary edema) A sudden rise in potassium levels in your blood (hyperkalemia), which could impair your heart’s function and can be life-threatening Anemia Heart disease Weak bones and an increased risk of bone fractures Decreased sex drive, erectile dysfunction or reduced fertility Damage to your central nervous system, which can cause difficulty concentrating, personality changes or seizures Decreased immune response, which makes one more vulnerable to infection Pregnancy complications that carry risks for the mother and the developing fetus Irreversible damage to one’s kidneys (end-stage kidney disease), eventually requiring either dialysis or a kidney transplant for survival

Prevention

Maintain a healthy weight. If you’re at a healthy weight, maintain it by being physically active most days of the week. If you need to lose weight, talk with your doctor about strategies for healthy weight loss. Don’t smoke. Cigarette smoking can damage your kidneys and make existing kidney damage worse. If you’re a smoker, talk to your doctor about strategies for quitting. Support groups, counseling and medications can all help you to stop. Manage your medical conditions with your doctor’s help. If you have diseases or conditions that increase your risk of kidney disease, work with your doctor to control them. Ask your doctor about tests to look for signs of kidney damage.

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