EVERY year in Serbia between 600 – 700 patients start medical treatment of dialysis due to definitive (permanent and irreparable) loss of kidneys functions. In order to understand the importance of kidney regular function, it is necessary to answer a several very simple questions.
Every human being has two kidneys situated in the lower part of back abdomen and every kidney is approximately the size of a hand, shaped as a bean. Kidneys have numerous roles, crucial for human organism: they purify and process blood while leading the surpluses of water and unusefull materials out of the body, regulate water and chemical materials such as sodium and kalian in blood, clean and remove the medications and poisons from blood. Every single day, kidneys filtrate about 200 liters of blood in order to secrete about two liters of refuse products and unnecessary water
HOW TO KNOW WHEN KIDNEYS FUNCTION IS WEAK?
Most patients who start with dialysis did not know they had kidney disease nor did they take previous steps in order to have medical treatment, but they faced the kidney insufficiency only a month or two before it was already time for haemodialysis or peritoneal dialysis. Chronic kidney disease does not cause pain, but it quietly damages kidneys and shows signs only when the kidneys are completely ‘destroyed’. An average patient starting the dialysis is 66, more often male, suffers from overweight, diabetes, increased blood pressure and fats in blood. Just before he got sick, he felt well.
. WHY DO THE KIDNEYS FAIL/DETERIORATE?
The loss of kidney function which leads to permanent dialysis or kidney transplantation is most often caused by diabetes. What once was called diabetes in elderly persons or benign diabetes, is not benign at all. One third of such patients lost their kidney function caused by the mentioned diabetes.
Kidneys (as well as other organs) are being destroyed by diabetes which does not show obviously huge problems, even the level of sugar in blood can be low enough not to be treated by insulin, or even not to be treated at all by medical substances. It happens sometimes in some patients that the kidney failure is diagnosed at the same time as diabetes, without previous knowledge of the patient that the disease ever existed. This does not mean that diabetes did not exist earlier, but the signs and symptoms did not show at all or these were ignored or not recognized in time. It takes about 20 years for diabetes to destroy kidneys.
Long term (several years period) increased blood pressure, especially in case if not treated at all, gradually damages the smallest blood vessels of a kidney which disables its normal function. High blood pressure does not cause visible problems or obvious disorders, nor warns the patient to take steps into direction of medical treatment until it causes permanent damage on kidneys, heart and brain. Being painless, hypertension goes unnoticed and ignored for a very long period of time without the necessary treatment. Very few persons apply the recommendations for healthy lifestyle, as it is the key part in hypertension treatment. There are more and more people suffering from obesity and overweight is the main cause of high blood pressure. Patients suffering from hypertension start taking medicines only when they already suffer from heart and brain damage or blood vessels problems.
Arthrosclerosis (the narrowing of artheries caused by fats) is causing the decreased flow of blood which results in heart infarction, brain stroke, or damaging of legs parts leading to amputations, etc. The narrowing of renal arteries prevents normal kidney function, kidneys become smaller and smaller and finally stop their function. This is also hardly noticeable disease; the only sign may be sometimes worsening of hypertension.
. IS IT POSSIBLE TO PREVENT KIDNEY DETERIORATION?
In case the kidney damage is detected in early phase, it is possible to start medical treatment that may slow or stop further damaging of kidneys, or even repair the damage. Chronic kidney disease and loss of kidney function may be discovered in early stage by simple urine and blood tests. The presence of albumen in blood show the risk of kidney function, while creatinine from blood show the degree of kidney damage. Basic aim of medical treatment is to decrease absorption of albumen into urine by the appropriate choice of medicaments for blood pressure regulation, or by changing the lifestyle. In patients where the kidney damage was caused by diabetes, it is necessary to correct the therapy of hyperglycemia (by introducing insulin) and anemia (by introducing eryrtopoetine).
. WHAT IS THE RISK OF LETHAL OUTCOME?
Chronic renal disease is not only risk for kidneys and necessity of dialysis. Much higher risk lies in the premature death probability. Kidney disease causes worsening of the heart, brain, blood vessels diseases and decreases the quality of life (in case of heart infarction, brain stroke or amputation) while increasing the risk of lethal outcome by more than ten times.
. WHOSE KIDNEYS SHOULD BE CHECKED?
Persons with already detected kidney disorders demand regular treatment and checks. All persons with diabetes and hypertension, persons whose relatives are on dialysis and persons with heart diseases or blood vessels disorders must check blood and urine in order to test kidneys condition and function.
In order to point out the increasing problem of kidney diseases and in order to raise the awareness of the population related to the importance of this organ protection, The World Health Organization declared 13th of March as the Day of Kidney.
MD Natalija Damnjanović,Internal medicine specialist
CRUEL STATISTICS
Diabetes and high blood pressure are the main cause of kidney diseases. About 150 million people in the world suffer from diabetes and this number might be doubled in the period of next twenty years. High blood pressure hits almost a billion people in the world. These diseases damage kidney function by gradual destruction of blood vessels in kidneys.
At the same time, chronic renal disease increases the risk of heart attack and stroke. Chronic kidney disease functions as the ‘trigger’ for other diseases.
FREQUENCY
One out of ten adults suffers from some form of kidneys damage – in total, about 500 million people in the world. Chronic kidney disease is defined as kidney damage or kidney function decrease lasting for more than three or more months. Chronic kidney disease has five phases, from moderate to very severe one.
