Ask Your Doctor: CHRONIC KIDNEY DISEASE
The increasing number of individuals living in Anguillla, developing hypertension and diabetes, has led to more individual ending up with chronic kidney disease also called chronic kidney failure. There is no cure for chronic kidney disease, but various treatments are available that can help relieve the symptoms of chronic kidney disease and stop it getting worse. More importantly, more is needed to prevent some of the individuals from developing this chronic disease.
What is chronic kidney disease?
As the name implies, it is a long-term disease of the kidneys where the kidneys cannot function normally. The kidneys filter waste and excess fluids from the blood, which are then excreted in the urine. In chronic kidney disease, there is a gradual loss of kidney function over time. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.
As the kidney disease gets worse, wastes build to high levels in the blood and make individual feel very sick. Several complications can occur, like high blood pressure, anaemia (low blood count), weak bones, poor nutritional health and nerve damage. Also, kidney disease increases the risk of having heart and blood vessel disease. These problems may happen slowly over a long period.
What are some signs and symptoms of chronic kidney disease?
There are usually no symptoms of kidney disease in the early stages. It may only be picked up if blood or urine tests carried out for another reason detect a possible problem with your kidneys.
When chronic kidney disease reaches a more advanced stage, symptoms can include:
• swollen ankles, feet or hands
• shortness of breath
• feeling sick
• blood in your urine
You should see your doctor if you have persistent or worrying symptoms that you think could be caused by kidney disease.
What causes chronic kidney disease?
Any condition or disease that damages blood vessels or other structures in the kidneys can lead to kidney disease. The most common causes of chronic kidney disease in Anguilla are diabetes mellitus and uncontrolled high blood pressure (hypertension).
Other causes include kidney diseases and infections such as polycystic kidney disease, pyelonephritis and glomerulonephritis. Having a narrowed or blocked renal artery. Long-term use of medicines that can also damage the kidneys. These include nonsteroidal anti-inflammatory drugs (NSAIDs) such as celecoxib and ibuprofen, and certain antibiotics.
At this time, there is no cure for chronic kidney disease. Treatment is directed at relieving symptoms and preventing progression of the disease. Treatment will vary from one individual to another, and on how severe the disease is at time of diagnosis. Treatment options also vary, depending on the cause.
Individuals are encouraged to peruse lifestyle changes so that they remain healthy. Any underlying medical disorders should be addressed and managed adequately. Diabetes and hypertension should be well controlled. If your kidneys cannot keep up with waste and fluid clearance on their own, and you develop complete or near-complete kidney failure, you have end-stage kidney disease. At that point, you need dialysis or a kidney transplant to prevent imminent death.
In some cases of chronic kidney disease there is not much you can do to prevent it. In other cases, you can take steps to reduce the chances of getting the condition.
The following might prove beneficial in preventing chronic kidney disease:
• If you have a long-term condition that could potentially lead to kidney disease, such as diabetes or high blood pressure, it is important that this is managed carefully. Have regular medical checkups and take mediations as directed.
• If you smoke, stop smoking. Smoking increases your risk of cardiovascular disease, including heart attacks or strokes, which is associated with a higher risk of kidney disease.
• Have a healthy diet. A balanced diet to include lots of fruit and vegetables, low levels of saturated fat, salt and sugar. Do not abuse alcohol.
• Exercise regularly.
• Regular exercise should help lower your blood pressure and reduce your risk of developing kidney disease. Cycling, swimming, brisk walking and any other aerobic activity should be done on a regular basis.
• Be careful with painkillers. Kidney disease can be caused by taking too many non-steroidal anti-inflammatories (NSAIDs), such as aspirin and ibuprofen, or taking them for longer than recommended. If you need to take painkillers, make sure you follow the instructions that come with the medication and follow the recommendations from your doctor.
More and more individuals are being diagnosed with chronic kidney disease in Anguilla recently. This might be due to the increase incidence of diabetes mellitus and hypertension in our community today compared to fifty years ago, but other factors might be involved. Better control of high blood pressure, and diabetes mellitus, might help reduce the incidence of chronic kidney disease. Adopting healthy lifestyles are being encouraged by all, but especially those with diabetes and hypertension. If you have signs and symptoms suggestive of kidney disease, see you doctor for and evaluation. Early treatment of the signs and symptoms of chronic kidney disease might help relieve symptoms and prevent the progression of this chronic disorder.
Ask Your Doctor is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG, is an Obstetrician/Gynaecologist and Family Doctor who has over thirty-two years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).