Fighting a silent killer: Chronic Kidney Disease

The kidneys are a very important pair of organs in the body. They are primarily responsible for removing excess fluid and filtering the blood free of toxins that may enter the body through food or medicine. They also play a vital role in producing red blood cells, in addition to regulating the levels of minerals in the body, such as calcium, phosphorus, potassium, and sodium.

The kidneys can be affected by a variety of diseases and health problems. Kidney disease is more likely to develop in patients who suffer from diabetes, high blood pressure, and obesity.

However, the advanced treatments, the possibility of a kidney transplant, and the success of many operations in this field around the world offer hope in treating many cases of CKD and other diseases. In this regard, early diagnosis is important because kidney disease kills silently and develops with no symptoms or signs, and many people don’t realize they have it until the disease is advanced. 

The doctor’s goal of advanced-stage treatment is to prevent further progression. The first steps of the diagnostic process are checking the level of creatinine in the blood, measuring the level of protein in the urine, in addition to performing an ultrasound of the kidneys to assess their structure and size.

Kidney Stones: Advanced Treatment Options

Many factors contribute to the formation of kidney stones, such as frequent urinary tract infections, diabetes, high blood pressure, obesity, a very high or very low urine pH (which may be caused by ureteral disorders), and inflammatory bowel diseases, such as Crohn’s disease, ulcerative colitis, and other diseases and surgeries that cause chronic diarrhea.

Kidney stones are also caused by gout, high levels of uric acid in the urine, drinking too little water and low-sugar and low-calorie fluids daily, which reduces the amount of urine to less than 2 liters per day and increases the concentration of some salts and minerals, causing them to build up. Excessive sugary drinks consumption can cause high amounts of calcium in the urine.

Doctors stress on the need to drink water frequently throughout the day and not wait to feel thirsty, and to consume water-rich foods, such as fruits and low-salt soups. Also, excessive salt intake (more than 5 g of salt or more than 2 g of sodium daily) may increase the amount of calcium in the urine, which may facilitate the formation of stones. In addition, excessive animal protein intake (more than 150 g of meat, chicken, or fish daily), excessive calcium intake, and excessive vitamin C intake (more than 1 g daily) increase the amount of calcium in the urine. However, calcium should be consumed daily in moderation.

Lithotripsy

Kidney stone treatments have become somewhat easy today due to the development in this field, as most of them use a laser to avoid traditional surgeries and their risks.

In addition to surgical intervention, the majority of doctors today resort to percutaneous ultrasonic lithotripsy for large stones, especially those in the kidney or the upper part of the ureter. Laser lithotripsy is often used for small stones that can be reached by a cystoscope. 

Before deciding on the surgery, doctors may resort to conservative treatment for small stones. This includes the use of some dissolving medicines, changing the quality of food, and drinking a lot of water in order to give the patient the chance of getting rid of the stones. However, if this method fails, the alternative solution must be laser lithotripsy or the other techniques, knowing that in some cases, severe symptoms and pain appear late and can only be treated with these techniques.

Kidney Failure: Excessive Use of Painkillers: One of the Main Risk Factors

Kidney failure occurs when the kidneys lose the ability to function properly, and it progresses gradually over time when kidney function declines to 10%, then 30%, until it reaches 100%. There are two types of kidney failure: acute and chronic.

Acute kidney failure is a temporary problem that occurred for some reason and will quickly disappear when the causative factor is gone. This type of kidney failure occurs as a result of a sudden fall in blood pressure (causing a decrease in the blood supply to the kidneys that will stop functioning), bleeding, dehydration, the presence of serious bacterial infection in the body, or blood poisoning. Taking painkillers for a long time also destroys the kidneys, except for those prescribed by the doctor. Once these factors are removed, the kidneys will recover well.

CKD is considered the most dangerous because it affects the cell tissue itself. The kidney cells begin to die gradually. The disease is categorized into 5 stages that occur gradually over periods of up to 5 years. CKD usually begins at the age of 30 and lasts 6 or 7 years. The patient then starts dialysis.

The seriousness of kidney failure is that the symptoms do not usually appear until a lot of damage to the kidney has already happened.

Diabetes and Its Impact on Kidneys: Difficulty in Maintaining Kidney Function and Controlling Diabetes is a Necessity

Diabetes is one of the main causes of chronic kidney disease (CKD) and accounts for more than 50% of the cases, according to the latest international medical studies.

High blood sugar levels affect the filtering units of the kidneys. Over the years, the kidney blood vessels become gradually damaged without showing any symptoms. 

Consequently, the disease does not manifest itself until the late stages, that is, years after being diagnosed with diabetes, which leads to difficulty in maintaining kidney function and thus having CKD.

 Therefore, it’s important for diabetics to regularly see the doctor and monitor their condition. Diabetes affects the kidneys firstly by limiting their function and reducing their ability to remove urea from the blood. In the late stages, it leads to complete failure of the filtration systems of the kidneys.

There is no treatment for diabetic nephropathy or glomerulosclerosis, but there are procedures that help prevent further progression of the disease and delay kidney failure, such as regularly taking diabetes and high blood pressure medicines prescribed by the doctor, maintaining a healthy diet, and abstaining from smoking.

A raised level of albumin in the urine is the typical first sign that the kidneys have become damaged by diabetes. Urine samples provide the doctor with the necessary information on kidney function or the presence of a large amount of albumin in the urine. Albuminuria results from damage within the kidneys.

People with type 2 diabetes should be tested for microalbuminuria at diagnosis.On the other hand, patients with type 1 diabetes should be tested for microalbuminuria annually five years after diagnosis. Prevention is the best way to protect the kidneys from diabetic neuropathy.

 The most important step is to maintain a normal blood sugar level by following a diet, exercising or doing any kind of physical activity, and regularly taking medicines as determined by the treating doctor. 

High Blood Pressure: The First Indicator of Kidney Disease

High blood pressure is the first indicator of kidney disease, as it causes damage to blood vessels and over time causes kidneys to not filter blood well. When the arteries become damaged, the nephrons do not receive the essential oxygen and nutrients — and the kidneys lose their ability to filter blood and regulate the fluids, hormones, acids, and salts in the body.   Damaged kidneys fail to regulate blood pressure. Kidney damage and uncontrolled high blood pressure each contribute to a negative spiral. As more arteries become blocked and stop functioning, the kidneys eventually fail.

Damaged kidneys may produce an amount of renin that raises blood pressure. This is called renal blood pressure and represents 5-10% of blood pressure cases. Regular (non-renal) hypertension affects the function and filters of the kidneys, and albumin may be detected in the urine. This may result in kidney failure. The kidneys affect and are affected by blood pressure. Therefore, patients with high blood pressure must continue treatment and do the necessary tests regularly to monitor the condition of their kidneys.

Maintaining a normal rate of blood pressure over long periods carries with it many positive aspects for the patient’s health in general, due to the role of moderate blood pressure in the prevention of diseases, especially heart disease. Having a low blood pressure and keeping it within normal levels is an ideal opportunity to reduce the risk of developing cardiovascular disease by 32%, coronary artery disease by up to 27%, and having a heart attack by 36%.

Maintaining blood pressure also helps in preventing or delaying the progression of CKD and heart failure, relieving the existing symptoms, and reducing recurrence of heart attacks.

Doctors advise patients with high blood pressure to lose excess weight and avoid obesity, in addition to eating low-fat foods and unsaturated fats, such as corn oil, sunflower oil, olive oil, and soybean oil.

The most important advice is to reduce table salt to 2-3 g per day, equivalent to a teaspoon of salt, and avoid fast foods that contain significant amounts of salt.

It is no secret that doing a physical activity that the patient likes is very important, provided that it be done regularly for 20-30 minutes three times a week. Strenuous exercise should be avoided. Abstinence from smoking cigarettes and hookah is also important for patients with high blood pressure.

Obesity Causes Deteriorating Kidney Function

Obesity is a major risk factor for CKD, diabetes and high blood pressure. Extra weight forces the kidneys to work harder, filtering above the normal level, to meet the metabolic demands of the increased body weight. This increase in normal function is also associated with a higher risk of developing CKD in the long-term.

Studies in this field confirm that excess weight, especially abdominal fat, has been linked to metabolic disturbances that affect the kidneys. It can activate the sympathetic nervous system, which secretes hormones. This increases sodium retention and blood pressure and makes it difficult for the body to get rid of excess sugar in the bloodstream, which leads to diabetes. All of this negatively affects the kidneys. The inflammation associated with obesity and excessive abdominal fat also cause impaired kidney function and sometimes lead to kidney failure.

As an indirect cause, obesity increases the risk of the major CKD risk factors – type 2 diabetes and high blood pressure. These health problems have a negative impact on the albumin-to-creatinine ratio, leading eventually to kidney disease, unless care is taken and the extra weight is disposed of in time, that is, before the damage takes place.

Some of the obesity-related diseases that affect kidneys are:

• High blood pressure: obesity is associated with increased blood flow, which causes high blood pressure. Uncontrolled blood pressure can cause arteries around the kidneys to narrow, leading to decreased blood flow and thus kidney failure.
• Diabetes: obesity reduces the insulin’s ability to lower blood glucose levels. Kidneys then have to work harder to filter the blood free of toxins and glucose. This is accompanied by proteinuria, which may cause CKD.
• High cholesterol levels: the heart’s ability to pump blood is reduced due to the cholesterol buildup along the inside walls of blood vessels. This usually happens when the person has excess weight. The blood supply to the kidneys decreases, making the kidneys unable to function properly and filter blood.