The global burden of Chronic Kidney Disease (CKD) has been progressively increasing. This is because of increasing incidence of diabetes, hypertension (high blood pressure), kidney stones, overuse of painkiller drugs and use of alternative therapy whose contents are not known. When poorly managed, CKD progresses to kidney failure for which the treatment options are limited (Dialysis & Transplantation) and very expensive. Even with the treatment, the quality of life and longevity of patients with kidney failure is significantly compromised.
Further, CKD significantly increases the risk of heart disease and many patients with CKD die of heart disease before their kidneys fail. Therefore, every effort should be to prevent CKD. For those who already have developed CKD, it should be detected at an early stage and aggressively treated to prevent or delay its progression to kidney failure or End-Stage Renal Disease (ESRD) as called in medical terms.
The most important point is that CKD can be prevented and by early detection in those who already have CKD, the progression to kidney failure can be delayed with appropriate treatment. To understand this one needs to know what causes CKD. Here are some of the most common causes of CKD explained by Dr Bharat Shah (Director, Institute of Renal Sciences, Global Hospital, Mumbai)
- High blood pressure
- Chronic glomerulonephritis (damage to filters of the kidney)
- Kidney stones
- Urinary infections
- Long term intake of pain killers /alternative medicines with unknown contents or containing heavy metals.
With this knowledge of causative factors of CKD one can understand that CKD and its progression to kidney failure can be prevented by taking the following measures:
- Control blood sugar and blood pressure (BP) if you have diabetes and high BP. This can only be achieved by regular monitoring of blood sugar and BP at home and adjusting the medicines. When uncontrolled, high blood sugars and high blood pressure can progressively damage different part of the body (kidneys, heart, brain, nerves and eyes). In the early period, there may not be any symptoms and often it is quite late by the time symptoms develop.
- Avoid taking unnecessary drugs. A common misconception is that non-allopathic drugs are harmless. Every drug will have some side-effects whether it is allopathic or non-allopathic
- Avoid taking pain killer medicines for a long time.
- If there is a kidney stone or any condition causing blockage to the flow of urine, it should be immediately treated even if there are no symptoms. Early intervention can prevent irreversible damage to the kidney.
- Hereditary kidney diseases can be passed on to children. This can be prevented by proper genetic counselling.
There are national policies and strategies for non-communicable diseases (NCDs) like diabetes and high blood pressure in many countries. For example, the National Diabetes Prevention Program (DPP) in The USA has been successful in achieving a decline in the incidence of type 2 diabetes.
But much more effort is required at the national level for prevention and early detection of kidney diseases. If that can be achieved, we will be able to reduce the incidence and provide equitable access to patients with CKD.
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