SAPIENS HEALTH FOUNDATION (Balaji Medical And Educational Trust)
| Chronic Kidney Failure is one of the Deadliest disease. Yet, it is least understood. |
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| Dr.Rajan Ravichandran MD,MNAMS,FRCP(Edin),FACP(USA) Nephrologist |
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Ki dney Failure - Facts & Myths
There has been a remarkable increase in the incidence of kidney disease in the last decade
because of both increasing detection and a true increase in the occurrence of the disease itself.
High occurrence of diabetes, hypertension, lack of physical exercise, use of drugs toxic to the
kidney are possible causes for the true rise that we see.
The basic functions of the kidneys are :-
Types of kidney Diseases - Acute and Chronic
Acute - It means a sudden reduction in the kidney function due to reduced blood supply following
dehydration due to conditions like gastroenteritis, heart attack, blood loss etc. If the underlying
disease is not rapidly corrected, the patient may die. On the contrary if the underlying disease is
corrected, the patient recovers fully and may require only temporary dialysis.
Chronic - The most important cause of this is diabetes in middle aged or the elderly population.
High blood pressure is also an important reason and can add with diabetes to produce a bad
outcome. Both the above conditions affect the kidney slowly over the years.
The body can adapt itself till ninety percent of the kidney is damaged and hence the patients do not
have any symptoms. The detection is done by laboratory testing of the urine and blood. Albumin leak
is the earliest parameter warning of kidney damage. Subsequently the urea and creatinine rise in the
blood indicates the severity of the kidney failure. It is unfortunate that still many patients are being
detected at this stage and not at the early stage of albumin leak when corrective measures can be
taken. An important marker of possible kidney damage in a diabetic individual is reduced vision due
to retinopathy.
Another curse of modern development is the excessive in take of drugs for example pain killers, so
called tonics and various other unstudied alternate or native medical preparations. Over a long
period of time, these drugs tends to damage the kidney. Needless to say patients are often
asymptomatic and only after a careful laboratory evaluation is the kidney disease deducted.
Myths about Kidney Diseases
There has been a remarkable increase in the incidence of kidney disease in the last decade
because of both increasing detection and a true increase in the occurrence of the disease itself.
High occurrence of diabetes, hypertension, lack of physical exercise, use of drugs toxic to the
kidney are possible causes for the true rise that we see.
The basic functions of the kidneys are :-
- Maintenance of the internal environment that is the pH, water content and electrolyte content of
the body so that each and every cell and organ in the body can function properly. That is why
when the kidneys are diseased, the symptoms and signs are sometimes found in different
organs.
- Excretion of various waste products of metabolism and drugs from the body. Again a very
important function which explains why drugs should carefully be used in kidney patients.
- Production of hormones responsible for the bone growth(Vitamin-D), blood production by the
marrow (Erythropoietin) and blood pressure (Renin).
Types of kidney Diseases - Acute and Chronic
Acute - It means a sudden reduction in the kidney function due to reduced blood supply following
dehydration due to conditions like gastroenteritis, heart attack, blood loss etc. If the underlying
disease is not rapidly corrected, the patient may die. On the contrary if the underlying disease is
corrected, the patient recovers fully and may require only temporary dialysis.
Chronic - The most important cause of this is diabetes in middle aged or the elderly population.
High blood pressure is also an important reason and can add with diabetes to produce a bad
outcome. Both the above conditions affect the kidney slowly over the years.
The body can adapt itself till ninety percent of the kidney is damaged and hence the patients do not
have any symptoms. The detection is done by laboratory testing of the urine and blood. Albumin leak
is the earliest parameter warning of kidney damage. Subsequently the urea and creatinine rise in the
blood indicates the severity of the kidney failure. It is unfortunate that still many patients are being
detected at this stage and not at the early stage of albumin leak when corrective measures can be
taken. An important marker of possible kidney damage in a diabetic individual is reduced vision due
to retinopathy.
Another curse of modern development is the excessive in take of drugs for example pain killers, so
called tonics and various other unstudied alternate or native medical preparations. Over a long
period of time, these drugs tends to damage the kidney. Needless to say patients are often
asymptomatic and only after a careful laboratory evaluation is the kidney disease deducted.
Myths about Kidney Diseases
- Kidney disease is Hereditary - Very few kidney diseases are hereditary like polycystic.
- Single or double kidney failure - All medical diseases affect both the kidneys. The word kidney
failure refers to both the kidneys not functioning. If a single kidney is not functioning the blood
urea will not go up.
- Dialysis once started has to be permanent - This depends on whether the patient has acute or
chronic kidney failure. Acute failure might require only temporary dialysis.
- It is not safe to donate a kidney - If the general health of the donor is normal without diabetes
or blood pressure, it is safe to donate a kidney. Donors have led a normal life including
marriage and childbirth, etc.
- Water should be consumed in large quantities by patients with kidney disease - Often
restriction in water consumption is required since maintenance of water balance in the body is
one of the functions of the kidneys.
- Beer drinking is good for the kidneys- Beer, because of its large content of water produces
increases urine output and does not improve kidney functioning.
- Salt substitutes can be used in kidney patients- Salt substitutes being potassium chlorides are
more dangerous in patients with kidney failure as potassium excretion is already affected.