This one suffers itself?from an acute shortage of public awareness. While most people today know about the increasing incidence of strokes, heart diseases and its associated risk factors, very few know that chronic kidney disease (CKD) is on the rise too. ?We are amidst an epidemic of kidney diseases,? says Dr Sanjiv Gulati, nephrologist at Fortis Healthcare, Delhi.
It is a case of simple logical deduction ? one epidemic leads to another. India is already the diabetes capital of the world and diabetes, experts say, is one of the most common causes of kidney diseases. The other is high blood pressure. The link between the heart and the kidneys is particularly worthy of mention. ?Associated with it is a huge direct and indirect economic loss to the country.
Most cardiologists and physicians only fix the temporary problem of the heart and do not look at the kidneys,? adds
Dr Lloyd Vincent, senior consultant, nephrology, and director, dialysis services, Narayana Hrudayalaya Hospitals, Bangalore. Chronic kidney disease, he maintains, is very similar to other common diseases that are silent in the early stage and that lead people to be at an increased risk for heart diseases. ?People suffering from kidney diseases are at an increased risk of heart diseases.
Unfortunately, the cause-effect relationship between the two is not exactly known. It?s like a vicious cycle. CKD leads to high BP, which can affect the heart. Similarly, a person suffering from kidney disease tends to accumulate more fluid in the body, a factor that can lead to more pressure on the heart. Death from cardiovascular diseases is 10 times more likely in patients on dialysis,? says Dr ZS Meharwal, director, department of cardiovascular surgery, Escorts Heart Institute & Research Centre.
Many renal insults leading to chronic kidney disease in later life begin in the paediatric age group,? says Dr Sanjeev Bagai, senior consultant pediatrician and nephrologist, Batra Hospital. Acute kidney injury (AKI) is known to be commonly precipitated by acute gastroenteritis, blood loss, shock and inflammation of the liver. In fact, various painkillers and anti-inflammator drugs, antibiotics, herbal and alternative medicines may also cause kidney injury, as can urinary tract infection (UTI). Renal stone disease in children is not uncommon either, he further explains.
?There are five stages of kidney diseases. So far, no study has been done to know what these are. We have evidence that approximately 2.5 to 3 lakh peoples suffer from stage 5 kidney disease each year. More than often the diagnosis happens at stage 3,? says Dr Suresh C Tiwari, director, Fortis Institute of Renal Sciences. And, it is this delay that actually costs the patients dear. ?If detected well in time, the problem can be treated with simple medication.
The problem is that there is little awareness. Popping a simple pain killer can be fatal for someone with 30% reduced kidney function. A single pill can take down the kidney function from 70-80% to 10%. And once that happens, we have to resort to dialysis or kidney transplant,? adds Dr Gulati.
This is where the major challenge lies. ?Though prevention of kidney disease is the best option in India, weekly dialysis followed by kidney transplant most often forms the major modality of treatment for end-stage kidney failure. Of the 1,50,000 new patients who need dialysis annually in the country, 1,35,000 people die without any kind of treatment due to financial constraints. Of the remaining 15,000 patients who are started on dialysis, 9,000 patients discontinue dialysis treatments within a month due lack of resources,? shares Dr Vincent.
It is, therefore, essential to screen the high-risk population. People with diabetes, high BP, people over the age of 50, people with family history of kidney diseases, those who smoke or are overweight qualify for this category. ?An eGFR (estimated glomerular filtration rate) test as part of your routine annual health examination is advisable,? says Dr Gulati.
A decline in kidney function of 30-40% is hardly noticeable by way of symptoms. The test primarily determines how efficiently the kidneys are filtering wastes from the blood. That?s the bottom line, a simple test can, indeed, help.
