Many countries, including Anguilla, use the month of March to focus on kidney diseases and focus attention on how we can prevent kidney disease and kidney failure. The large number of individuals receiving dialysis at the Princess Alexandra Hospital is an indication of how serious a problem kidney disease is in Anguilla.
What are some of the functions of the kidneys?
The kidneys are two bean-shaped organs that extract waste from blood, balance body fluids, form urine, and help in other important functions of the body.
They reside against the back muscles in the upper abdominal cavity. They sit opposite each other on both sides of the spine.
Some of the core functions of the kidneys include:
• Waste excretion: There are many things your body does not want inside of it, and the kidneys help get rid of some of them. The kidneys filter out toxins, excess salts, and urea, a nitrogen-based waste created by cell metabolism.
• Water level balancing: As the kidneys are key in the production of urine, they react to changes in the body’s water level throughout the day. As water intake decreases, the kidneys adjust accordingly and leave water in the body instead of helping excrete it.
• Blood pressure regulation: The kidneys need constant pressure to filter the blood. When it drops too low, the kidneys increase the pressure. One way is by producing a blood vessel-constricting protein (angiotensin) that also signals the body to retain sodium and water. Both the constriction and retention help restore normal blood pressure.
• Red blood cell regulation: When the kidneys do not get enough oxygen, they send out a distress call in the form of erythropoietin, a hormone that stimulates the bone marrow to produce more oxygen-carrying red blood cells.
• Acid regulation: As cells metabolize, they produce acids. Foods we eat can either increase the acid in our body or neutralize it. If the body is to function properly, it needs to keep a healthy balance of these chemicals. The kidneys do that, too.
Most people are born with two kidneys, but many people can live on just one. Kidney transplant surgeries with live donors are common medical procedures today. Because of all of the vital functions the kidneys perform, and the toxins they encounter, the kidneys are susceptible to various problems.
Acute kidney failure is a condition in which the kidneys suddenly lose their ability to function properly, but the vast number of individuals in Anguilla with kidney disease, have chronic kidney disease which will be the focus of this article.
Chronic kidney disease
Many individuals in Anguilla have chronic kidney disease, especial those who have diabetes mellitus or high blood pressure. It should be noted that early chronic kidney disease has no sign or symptoms but you can help delay or prevent kidney failure by treating kidney disease early. If you have high blood pressure, suffer from diabetes, have a family history of kidney disease, overweight and smoking, or if you over 50 years, you should see your doctor to be investigated for kidney disease.
What can you do to protect your kidneys?
The following are recommended to help prevent chronic kidney disease:
Get plenty of regular physical activity
Keeping fit helps to reduce your blood pressure and therefore reduces the risk of Chronic Kidney Disease. The physical activity could include a number of activities such as backyard gardening, swimming, dancing or even walking.
If you are a pre- diabetic or diabetic – Keep regular control of your blood sugar level
About half of people who have diabetes develop some form of kidney damage, so it is important for people with diabetes to have regular tests to check their kidney functions.
Kidney damage from diabetes can be reduced or prevented if detected early. It is important to keep control of blood sugar levels with the help of doctors or healthcare providers.
Maintain healthy blood pressure and cholesterol
Although many people may be aware that high blood pressure can lead to a stroke or heart attack, few know that it is also the most common cause of kidney damage.
The normal blood pressure level is 120/80. Between this level and 129/89, you are considered prehypertensive and should adopt lifestyle and dietary changes. At 140/90 and above, you should discuss the risks with your doctor and monitor your blood pressure level regularly. High blood pressure is especially likely to cause kidney damage when associated with other factors like diabetes, high cholesterol and Cardio- Vascular Diseases.
Eat healthy and keep your weight in check
This can help prevent diabetes, heart disease and other conditions associated with Chronic Kidney Disease.
Eat more fruits and vegetables, and cut back on foods high in salt. The recommended sodium intake is 5-6 grams of salt per day (around a teaspoon). In order to reduce your salt intake, try and limit the amount of processed food and do not add salt to food. It will be easier to control your intake if you prepare the food yourself with fresh ingredients. Many tinned foods have large amounts of salt.
Maintain a healthy fluid intake
Although clinical studies have not reached an agreement on the ideal quantity of water and other fluids we should consume daily, to maintain good health, traditional wisdom has long suggested drinking 1.5 to 2 litres (3 to 4 pints) of water per day.
Consuming plenty of fluid helps the kidneys clear sodium, urea and toxins from the body which, in turn, results in a “significantly lower risk” of developing chronic kidney disease, according to researchers in Australia and Canada. Intake, around two litres daily, may reduce the risk of decline in kidney function. It’s important to keep in mind that the right level of fluid intake for any individual depends on many factors including gender, exercise, climate, health conditions, pregnancy and breastfeeding.
Do not smoke
Smoking slows the flow of blood to the kidneys. When less blood reaches the kidneys, it impairs their ability to function properly. Smoking also increases the risk of kidney cancer by about 50 percent.
Do not take over-the-counter pills on a regular basis
Common drugs such non-steroidal anti-inflammatory drugs like ibuprofen are known to cause kidney damage and disease if taken regularly.
Such medications probably do not pose significant danger if your kidneys are relatively healthy and you use them for emergencies only, but if you are dealing with chronic pain, such as arthritis or back pain, work with your doctor to find a way to control your pain without putting your kidneys at risk.
If you take any medications, do so as the label and your doctor prescribe.
Certain antibiotics, and other medications, are known to be nephrotoxic or kidney damaging. Talk to your doctor if you have concerns over your medications.
Treatment
Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause. Chronic kidney disease can progress to end-stage kidney failure which is fatal without artificial filtering (dialysis) or a kidney transplant.
Conclusion
The kidneys are important organs of the body. Many individuals who have diabetes, hypertension or other disorders go on to develop chronic kidney disorders. In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body and this can be fatal if not treated. Taking care of your kidneys can help prevent kidney disease and end-stage renal failure.
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 is an Obstetrician/Gynaecologist and Family Doctor who has over thirty years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
