A call for creating more awareness on kidney diseases

World Kidney Day is a global awareness campaign that aims at raising awareness of the importance of our kidneys. In 2019, we are celebrating the 14th anniversary of the World Kidney Day on 14th of March 2019 and the theme for this year is “Kidney Health for Everyone Everywhere”.

Kidney is one of the most important organs of the body. It maintains the balance of our body’s internal environment and excretes all toxins through urine. It also sustains our acid – base balance of our blood. By controlling blood pressure our kidney preserves normal haemoglobin level and strengthens our bones with electrolyte balance.

Around 850 million people worldwide are now estimated to have kidney diseases due to various causes. Chronic kidney diseases (CKD) cause at least 2.4 million deaths per year and are now the 6th fastest growing cause of death. Acute kidney injury (AKI), an important driver of CKD, affects over 13 million people worldwide and 85 per cent of these cases are found in low and middle-income countries (LMICs). The theme of this year “Kidney Health for Everyone Everywhere” spreads 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.

Experts feel that there is a lack of awareness amongst Indian population as far as prevention of kidney diseases is concerned.

“There is a complete lack of awareness amongst Indian population about prevention of kidney diseases. Every year, number of patients diagnosed with CKD is rising, with over 20 per cent new cases being registered last year. This trend is up not only due to better detection, but is largely attributed to sedentary lifestyles, unhealthy eating habits, rising obesity, smoking and other drug abuse,” informs Dr Ramesh Jain, HOD – Centre for Kidney Transplant and Renal Sciences, Saroj Super Speciality Hospital, Delhi.

Earlier considered to be a health problem only in developed countries, four out of five chronic kidney disease deaths now occur in low- and middle-income countries. With rising prevalence of various lifestyle diseases in India, prevalence of kidney disease has also almost doubled in the last decade and is expected to rise further.

In line with this, Dr Garima Aggarwal, Consultant Nephrologist, Max Hospital, New Delhi, says, “One of the major contributing factors include high sodium intake (salt) which results in hypertension and in turn kidney damage. Often it is difficult to diagnose renal failure in the early stages. The masses need to be educated to improve their lifestyle for preventing renal failure. The young corporates due to their time-deficient schedules and lack of availability tend to binge on processed food which is the highest source of sodium and also have sedentary desk jobs. They should focus on eating fresh fruits and vegetables, exercising regularily, staying well-hydrated, and stop smoking. These habits not only help in maintaining healthy kidneys, but also overall health. People in India tend to take over the counter pills without prescription, especially pain killers, these can also harm the kidneys.”

Dr Gaurav Thukral, Critical Care expert and Chief Operating Officer at HealthCare atHOME (HCAH) says, “Studies have pegged the burden of chronic kidney diseases (CKD) in India to 800 per million people – which is a significant number considering our population. Treatment and management of CKDs is a long process made painful by long admissions to the hospitals – which leads to mental, physical and economical discomfort to patients and their families. Quality home healthcare solutions are striving to reduce this discomfort by providing a comprehensive health education plan, developing and executing a special care plan for CKD patients and ensuring patient adherence to a healthy lifestyle – all at the comfort of the patient’s home.”

He adds, “Home healthcare solutions are a more convenient and cost-effective option for patients and their families as well. For instance, HCAH provides hospital quality peritoneal dialysis to patients at their homes at 30 per cent lesser cost and also reduces stress of care givers by eliminating bi-weekly visits for patients to the hospital for dialysis.”

A study conducted by SBI General Insurance reveals that kidney ailments continue to shoot up for millennials. It further tells that the total number of claims made by males is higher as compared to women. In FY 15-16, there were 39 per cent claims for women, whereas for men, it were 61 per cent; in FY 16-17, it stood at 43 per cent for women and 57 per cent for men; in FY 17-18, it was 44 per cent for women and 56 per cent for men. Last year (FY 18-19), the claims stood at 44 per cent for women and 49 per cent for men.

Metro cities have reported 69 per cent of claims, whereas non-metros have reported 31 per cent. This may be due to specialised treatment and dialysis facility available at metros and a lack of health resources within access in smaller cities.

The study also highlights some emerging trends. It says that four per cent of the total health insurance claims paid are for kidney-related claims. Second highest disease settled for renal diseases is usually associated with heart-related complaints with one of the complications with renal diseases. Besides, 70 per cent of claims settled for kidney-related ailments over the last four years are under non-surgical category, where most of the diseases are managed with dialysis. There has been an year-on-year increase in this since FY 15-16 to FY 18-19.

Sukhesh Bhave, Head, – Accident & Health Claims, SBI General Insurance, says, “In its early stages, chronic kidney disease can lurk silently in the body, showing fewer or no symptoms at all. However, as time passes, it starts affecting vital organs leading to impairment and failure. The end stage renal disease may result in renal failure or kidney failure and can be life threatening.”

He added, “Most women often tend to hesitate in getting a health check-up done as they fear the cost of treatment that may come with a possible diagnosis and tend to ignore the symptoms. We are aiming to encourage women to change this behaviour by offering products like SBI General’s Simple Health Insurance Policy that has an affordable premium of Rs 1,300 per year and offers a wide coverage from Rs 50,000 up to Rs 5,00,000. Furthermore, the policy offers free medical check-ups for every four claim-free years up to a maximum limit of Rs 2,500.”

Dr Anupam Majumdar – Consultant and Dr Dilip Kumar Pahari, Senior Vice Chairman, Director and Senior Consultant – Nephrology, Medica Superspecialty Hospital suggest a few steps to stay away from kidney diseases:

Stay away from air pollution: Apart from traditional risk factors, such as hypertension and diabetes, an increasing body of evidence demonstrates that air pollution is a novel environmental risk factor for CKD.

Avoid junk food and stressful life: A new study has warned that a diet that relies mostly on junk food or processed food may cause long-term damage to our kidneys and trigger diabetes. Stress and uncontrolled reactions to stress can also lead to kidney damage. As the blood filtering units of our body, our kidneys are prone to problems with blood circulation and blood vessels. High blood pressure and high blood sugar can place an additional strain or burden on your kidneys.

Drink enough water: Dehydration can cause a build-up of wastes and acids in the body, and it can clog the kidneys with muscle proteins (myoglobin). All these things can hurt the kidneys. Dehydration can also contribute to the formation of kidney stones and urinary tract infections, both of which can lead to kidney damage if not treated quickly.

Stay away from obesity: Obesity has become a worldwide epidemic, and its prevalence has been projected to grow by 40 per cent in the next decade. This increasing prevalence has implications for the risk of diabetes, cardiovascular disease, and for chronic kidney disease (CKD).

Maintain proper diet: Choose and prepare foods with less salt and sodium and phosphorus. Kidneys still work well in stage 1 and stage 2 of CKD. The focus of this type of kidney diet is to make changes that may preserve kidney function, reduce blood pressure and, in people with diabetes, control blood glucose. Alcohol and other addiction to be controlled.

Symptoms of kidney disorder

• Early morning facial puffiness
• Swelling of legs, ankles, and feet
• Decreased appetite
• Recent diagnosed high blood pressure
• Anemia
• Tiredness after some physical activity
• Unexplained shortness of breath and
• Reduced amount of urine.

Process of diagnosis

• Regular health check-up for kidney disease: Kidney function tests find out the level of waste products, such as creatinine and urea, in our blood.
• Urine examination: Analysing a sample of our urine may reveal abnormalities that point to chronic kidney failure and help identify the cause of chronic kidney disease.
• Blood urea level, haemoglobin, calcium and uric acid should be within the normal parameters
• Ultrasonography is necessary to see the structure and size of kidney, it also helps to diagnose cyst in the kidney
• Removing a sample of kidney tissue for testing. A kidney biopsy must be done to remove a sample of kidney tissue.