World Kidney Day is a global campaign aimed at raising awareness of the importance of our kidneys to our overall health and to reduce the frequency and impact of kidney disease and its associated health problems worldwide. It is a joint initiative of the International Society of Nephrology (ISN) and the International Federation of Kidney Foundations – World Kidney Alliance (IFKF-WKA). This year’s theme is ‘Kidney Health for All – Preparing for the unexpected, supporting the vulnerable!’
KIDNEY FACTS
The kidneys are complicated and amazing organs that do many essential tasks to keep us healthy. The main job of your kidneys is to remove toxins and excess water from your blood. Kidneys also help to control your blood pressure, to produce red blood cells and to keep your bones healthy. Each roughly the size of your fist, kidneys are located deep in the abdomen, beneath the rib cage. Your kidneys control blood stream levels of many minerals and molecules including sodium and potassium, and help to control blood acidity. Every day your kidneys carefully control the salt and water in your body so that your blood pressure remains the same.
GLOBAL AND INDIA FACTS ABOUT KIDNEY DISEASE:
10% of the population worldwide is affected by chronic kidney disease (CKD), and millions die each year because they do not have access to affordable treatment. The number of deaths attributable to CKD in India rose from 0.59 million in 1990 to 1.18 million in 2016. According to a 2012 report from the Indian CKD Registry, the most commonly identified causes of kidney failure were diabetes, hypertension, and GN, whereas the cause was not discernible in about 16% of patients. Early detection can help prevent the progression of kidney disease to kidney failure.
CAUSES OF CHRONIC KIDNEY DISEASE:
Diabetes and high blood pressure, or hypertension, are responsible for two-thirds of chronic kidney disease cases.
Diabetes: Diabetes occurs when your blood sugar remains too high. Over time, unmanaged blood sugar can cause damage to many organs in your body, including the kidneys and heart and blood vessels, nerves, and eyes.
High blood pressure: High blood pressure occurs when your blood pressure against the walls of your blood vessels increases. If uncontrolled or poorly controlled, high blood pressure can be a leading cause of heart attacks, strokes, and chronic kidney disease. Also, chronic kidney disease can cause high blood pressure.
Glomerulonephritis: Glomerulonephritis is a group of diseases that cause inflammation and damage the kidney’s filtering units. These disorders are the third most common type of kidney disease.
Inherited diseases: Polycystic kidney disease, or PKD, is a common inherited disease that causes large cysts to form in the kidneys and damage the surrounding tissue.
Kidney and urinary tract abnormalities before birth: Malformations that occur as a baby develops in its mother’s womb. For example, a narrowing may occur that prevents normal outflow of urine and causes urine to flow back up to the kidney. This causes infections and may damage the kidneys.
Autoimmune diseases: When the body’s defence system, the immune system, turns against the body, it’s called an autoimmune disease. Lupus nephritis is one such autoimmune disease that results in inflammation (swelling or scarring) of the small blood vessels that filter wastes in your kidney.
Other causes: Obstructions caused by kidney stones or tumours can cause kidney damage. An enlarged prostate gland in men or repeated urinary infections can also cause kidney damage.
RISK FACTORS OF CHRONIC KIDNEY DISEASE:
Anyone can get chronic kidney disease at any age. However, some people are more likely than others to develop kidney disease. You may have an increased risk for kidney disease if you:
– have diabetes
– have high blood pressure
– have a family history of kidney failure
– Belong to a population group with a high rate of diabetes or high blood pressure, such as African Americans, Hispanic Americans, Asian, Pacific Islanders, and American Indians.
SYMPTOMS OF CHRONIC KIDNEY DISEASE:
Most people may not have any severe symptoms until their kidney disease is advanced. However, you may notice that you:
– feel more tired and have less energy
– have trouble concentrating
– have a poor appetite
– have trouble sleeping
– have muscle cramping at night
– have swollen feet and ankles
– have puffiness around your eyes, especially in the morning
– have dry, itchy skin
– need to urinate more often, especially at night
– the urine is foamy
– see blood in your urine
TREATMENT FOR KIDNEY FAILURE:
Dialysis and kidney transplant are the two treatments for kidney failure. The dialysis treatments or transplanted kidneys will take over some of the work of your damaged kidneys and remove wastes and extra fluid from your body. This will make many of your symptoms better.
Dialysis: There are two types of dialysis- hemodialysis and peritoneal dialysis. Both remove waste produces and extra fluid from your blood. Hemodialysis uses an artificial kidney machine, while peritoneal uses the lining in the abdomen.
Kidney transplant: A kidney transplant is an operation that places a healthy kidney in your body.
DIETARY TIPS FOR PATIENTS WITH CHRONIC KIDNEY DISEASE (CKD):
If you already have kidney disease you can control your problems up to great extent by keeping track of these tips.
- Protein: When your body uses protein, it produces waste. This waste is removed by the kidneys. Too much protein can make the kidneys work harder, so people with CKD may need to eat less protein. However, patients with CKD on dialysis require a higher amount of protein in the diet in order to help maintain blood protein levels and improve health. Dialysis removes protein waste from the blood, so a low protein diet is no longer needed. Animal protein includes all of the building blocks that your body needs. Plant proteins need to be combined to get all of the building blocks that your body needs. Your dietician will tell you what amount and types of protein are right for you.
- Avoid excess Sodium: Sodium is a part of salt. Sodium is found in many canned, packaged, and “fast” foods. It is also found in many condiments, seasonings, and meats. Patients with CKD need to reduce overall salt intake. Sodium helps maintain the water level in the body but if the kidneys are not functioning well, extra Sodium can lead to water retention which can cause swollen ankles, high blood pressure, shortness of breath and more. Aim for less than 1,500 milligrams of sodium each day or as advised by your healthcare provider. (1 gm of salt = 396 mg of sodium)
How do I enhance the taste in my food?
You can make use of salt alternatives like amchur powder (dry mango powder), kokum (Garcinia indica), and unsalted tamarind to enhance the taste in your food.
- Avoid Excess Potassium: Potassium is a mineral that helps your nerves and muscles work the right way. In some people with CKD, the kidneys may not remove extra potassium from the blood. Some medicines also can raise your potassium level. The level of potassium in your blood should be between 3.5 to 5.0 mEq/L. Potassium is found naturally in almost all foods of both plant and animal origin. Salt substitutes in the market may contain potassium and labels should be checked. Leaching of food helps to reduce the potassium content. Wash, peel and cut vegetables into small pieces. Soak in warm water for 2-3 hours. Discard water. Add large volume of fresh water and cook vegetables. Discard water.
POTASSIUM CONTENT IN FOODS:
| Foods Low In Potassium | Foods Moderate In Potassium | Foods High In Potassium |
| Rice, semolina (rawa) | Rice flakes, corn flakes, bambino vermicelli. | Barley, ragi, wheat flour. |
| All dals after leaching | All pulses | |
| Egg whites, Chicken and meat-boiled in excess water twice and drained. | Curd | Milk, fish especially sardines |
| Vegetables such as cucumber, ridge gourd (turai), snake gourd (padwal), tinda, broadbeans, beetroot, fenugreek leaves (methi), green mango, pink radish, bottle gourd (dudhi). | Vegetables such as carrot, cauliflower, ladies finger, tomatoes, Bitter gourd, onions, cabbage, white radish, pumpkin, brinjal, French beans. | All leafy vegetables such as amaranth, coriander leaves, drumstick leaves, spinach; potato, colocasia, sweet potato, yam, drumstick, Green papaya, sword beans. |
| Fruits such as apple (1/4), pineapple (1/4), guava, papaya, pear. | Watermelon, grapes, banana, oranges. | Fruits such as sweet lime, mango, chickoo, apricots, dates, figs, melons. |
| – | Nuts such as cashewnuts, almonds, etc; oilseeds such as peanuts. | |
| – | Amchur, tamarind and kokum | Condiments and spices, jiggery. |
| – | – | Brown sugar, coffee, cocoa powder, chocolate, coconut water. |
- Avoid excess of phosphorus: Phosphorus is a mineral that helps keep your bones healthy. It also helps keep blood vessels and muscles working. In people with CKD, phosphorus can build up in their blood, making their bones thin, weak, and more likely to break. It can cause itchy skin, and bone and joint pain. Most people with CKD need to eat foods with less phosphorus than they are used to eating. A phosphate binder (advised by your physician) with meals also helps to lower the amount of phosphorus in your blood. Phosphorus is found naturally in foods rich in protein, such as meat, poultry, fish, nuts, beans, and dairy products. Phosphorus is also added to many processed foods. Therefore, look for phosphorus, or for word with PHOS, on ingredient labels. Choose a different food when the ingredient list has PHOS on the label.
| High-phosphorus foods to avoid or limit | Low – phosphorus foods that are allowed |
| Dairy foods | Fresh fruits such as apples, apricots, blackberries, grapes, tangerines, pears, peaches, pineapple, plums and strawberries. |
| Beans | Fresh vegetables such as cauliflower, cucumber, carrots, celery, green beans and broccoli |
| Lentils | Rice cereals |
| Nuts | Coffee or tea without milk, ginger ale, lime or lemon soda |
| Bran cereals | |
| Oatmeal | |
| Colas and other drinks with phosphate additives | |
| Some bottled ice tea |
Summary:
In order to prevent chronic kidney disease, the following preventive tips would be helpful:
- Keep fit and avoid a sedentary lifestyle.
- Have a healthy balanced diet.
- Check and manage the blood sugar levels.
- Check and maintain the blood pressure levels.
- Drink sufficient water (10 glasses, nearly 2 litres per day).
- Avoid tobacco consumption.
- Avoid regular intake of non-steroidal anti-inflammatory drugs (NSAIDs).