-By Ibrahim Suleiman PhD
March is World Kidney Month, a time when communities across the world raise awareness about kidney health and advocate for care towards people living with kidney disease. The day serves as a day to drive conversations and communicate the benefits of healthy living. This year’s theme focuses on “living well with kidney disease”. The kidneys are a pair of fist-sized organs located at the bottom of the rib cage on the inner back. They are responsible for filtering waste products, excess water, and other impurities out of the blood. They also regulate body pH (acidity of body fluids) and salt levels in the body. They produce hormones that regulate blood pressure and control the production of red blood cells.
Damage to the kidneys can lead to kidney disease. This damage could be caused by diabetes, high blood pressure, and various other chronic (long-term) conditions. Kidney disease may result in other health problems, including weak bones, nerve damage, and malnutrition.
If the disease worsens, your kidneys may stop working completely, thereby relying on dialysis to perform the function of the kidneys. Dialysis is a treatment that filters and purifies the blood using a machine. It can’t cure kidney disease, but it can prolong your life. Examples of kidney diseases include chronic kidney disease (CKD), kidney stones, polycystic kidney disease, glomerulonephritis and urinary tract infection.
Acute kidney disease occurs when kidneys suddenly stop working or when the blood flow to the kidneys is not enough. It also happens when there is direct damage either by a physical injury or other diseases like diabetes, high blood pressure, or when urine accumulates in the kidneys without being properly expelled.
Chronic kidney disease (CKD) is the most common form of kidney disease and it affects over 20 million Nigerians. About 80% of CKD burden occurs in low-or-middle-income countries, and 75% of the burden occurs among people above 60 years. It is commonly caused by high blood pressure and diabetes. Often overlooked until symptoms appear, CKD is progressive and can put you at risk of serious health complications including kidney failure, which is life-threatening if left untreated.
Dialysis and kidney transplant are your two major treatment options for kidney failure depending on your circumstances. The cost of dialysis in a public health facility in Nigeria is about N20,000 to N30,000 per session. Most patients in Nigeria cannot afford the global standard recommendation of three sessions of dialysis per week. Similarly, the cost of a kidney transplant remains on the high side. Thus, taking necessary measures to maintain a healthy kidney is of paramount importance.
Kidney diseases can easily go unnoticed until the symptoms become severe. It is important to notice the early warning signs that you might be developing kidney disease. These include fatigue, difficulty concentrating, trouble sleeping, poor appetite, muscle cramping, swollen feet/ankles, puffiness around the eyes in the morning, dry scaly skin and frequent urination (especially late at night). Late-stage symptoms may include a swollen face, swollen hands, feet or legs, sudden pain, changes in urine appearance, and frequent urinary tract infections.
Having a family history of kidney disease and being hypertensive places you at higher risk of developing kidney disease. Other risk factors include age and race, which are uncontrollable factors. Nevertheless, you can modify controllable factors such as blood pressure and obesity. The current COVID-19 pandemic is noted to pose a significant risk of acute kidney injury, which can lead to serious illness, thereby contributing to an increased surge in the number of kidney diseases in Nigeria. Thus, protecting oneself from contracting COVID-19, will also enhance kidney function and overall health.
The best way to maintain kidney health is to adopt a healthy lifestyle and follow your doctor’s advice. Making changes to your diet is just as important as taking medication. Drink plenty of water and take diets that have less cholesterol, fewer animal proteins and less salts. It is also important that you take heart-friendly diets like whole grains, low-fat dairy products, fresh fruits and vegetables.
If you have diabetes, take control of your blood glucose level by adhering to your physician’s prescriptions/advice. Blood glucose is an important risk factor for high blood pressure, which ultimately increases the pressure in the kidneys and thereby damaging your kidneys.
Other important measures include limiting alcohol consumption, quitting smoking, increasing physical activity and losing weight. Aim for a healthy weight by creating a healthy meal plan and working with your health team to develop a weight-loss plan that works for you. You should also make time for sleep. Aim for 7 to 8 hours of sleep per night. Ensure you reduce stress and make physical activity part of your routine. Consider healthy stress-reducing activities and get at least 30 minutes or more of physical activity each day.
Another thing to be wary of is the over-the-counter medication. You should always follow the dosage instructions for over-the-counter medications. Taking too much aspirin or ibuprofen can cause kidney damage. Contact your physician if the normal doses of these medications aren’t controlling your pain effectively.
It is important that you discuss with your physician about getting a kidney function test at different time intervals. This involves urinalysis and checking the levels of electrolytes, urea and creatinine in the blood. Kidney problems generally don’t show symptoms until they’re more advanced. You should be tested once or twice annually if you have diabetes, heart disease, or high blood pressure.
Even if you are presumed healthy, meet regularly with your health care team. Staying connected with your physician, whether in-person or using telehealth (via phone or computer) can help you maintain your kidney health. This is extremely important for people with a family history of kidney disease.
Manage blood pressure and monitor blood glucose levels. Work with your healthcare team to develop a plan to meet your blood pressure goals and check your blood glucose level regularly if you have diabetes.
It may seem difficult, but these few lifestyle modifications can go a long way in keeping your kidneys healthy and more effective. Living with kidney disease is not a death sentence. Nigerians with kidney disease can leave a normal life devoid of social stigma.