Each person normally has two kidneys, which are about the size of a fist and are located on either side of the spine at the level of waist. Each kidney is made up of one million (10 lac) functioning units called nephrons. A nephron is made up of a glomerulus, which filters out the waste products and a tubule which regulates the amount of water and chemicals in the body. Besides performing life sustaining function of removing the waste products and regulating the amount of water and chemicals in the body, kidneys perform the important function of maintaining normal blood pressure, produce a hormone called erythropoietin which helps in formation of red blood cells and activate vitamin D which helps in making our bones strong.
Kidneys may get damaged suddenly (acute kidney injury), or they may get damaged slowly and progressively (Chronic kidney disease). Acute kidney injury is often due to a treatable cause. Here, once the cause is treated, there is an almost complete recovery. There may be temporary requirement of dialysis until the kidneys recover.
According to Dr Bharat Shah , director, Institute of Renal Sciences, Global Hospitals, Mumbai, chronic kidney disease (CKD) is usually due to a disease process which is unknown or which cannot be eliminated.
Prevalence of CKD is estimated to be eight to 16 percent worldwide. Its incidence is increasing – particularly in developing countries because of increasing incidence of obesity, diabetes and hypertension. It is an increasing public health issue because of the morbidity and mortality associated with it and the economic burden resulting from its treatment, said Dr Shah.
Watch this also:
CKD increases risk of cardiovascular (heart) disease and mortality associated with it. In those who do not succumb to cardiovascular disease, it invariably progresses to End Stage Kidney Disease (ESKD) or kidney failure.
When kidneys fail, the treatment options are limited and include life-long dialysis and kidney transplant. Both the treatment options are very expensive and require an elaborate infrastructure which is available only in major cities. Thus, in the economically poor country like India, it is non-affordable and non-available for majority of patients. Less than 10 percent of patients with kidney failure get treatment due to limited affordability and availability. Even with treatment the longevity and quality of life is curtailed. Thus, the answer lies in preventing kidney disease. This is possible if we know the causes of CKD and prevent them from causing CKD.
Diabetes and hypertension (high blood pressure) are leading causes of CKD and account for almost 50 percent of all cases of CKD. They (diabetes and hypertension) are lifestyle diseases. They not only increase the risk of CKD but also increase the risk of heart attack and brain attack (stroke). Data from screening camps conducted by Narmada Kidney Foundation in residential societies and corporate offices and including 1855 adults showed that 66 percent were obese, 26 percent hypertensive and 23 percent diabetic.
Kidney stones affect approximately 12 percent of men and five percent of women by age 70. They are more common in coastal and desert areas. Prompt removal of kidney stone when it blocks flow of urine and preventing recurrence by treating the underlying cause can prevent permanent injury to the kidney. Those with tendency to form kidney stones should drink plenty of water.
Repeated use of pain killers of the class called non-steroidal anti-inflammatory drugs (NSAIDS) can cause irreversible kidney injury, particularly in those with pre-existing kidney disease. These drugs (ibuprofen, diclofenac, piroxicam, naproxen, indomethacin, aceclofenac, celecoxib etc.) are often taken for headache, backache and joint pain. Rather than taking these drugs frequently, one should try and find out the cause of pain and treat the cause of pain. A common misconception is that non-allopathic drugs are harmless. It must be understood that there can be no drug which can have only beneficial effects and no side effects. There have been several cases where a patient with early and stable CKD who could have done well for years has developed rapid worsening of kidney function after taking alternative therapy whose content is not known. It is very important to refrain from taking alternative therapy thinking that it is harmless.
Dr Shah sums up saying, the incidence and prevalence of CKD is increasing because of increasing incidence of obesity, diabetes, and hypertension. In a large majority of cases CKD can be prevented by preventing or controlling these lifestyle diseases.