Kidneys are one of the most important organs in the body. The main role of kidneys in our body is worked as a “body filter” that removes toxins, wastes and other impurities from the blood, and then flushes them out of the body through urination. Besides work as a “filter”, it also helps in balancing body fluid and electrolytes level, regulates the body pH (acid-base level), production of renin for maintaining blood pressure, and promotes erythropoietin for red blood cells production.
Kidney disease occurs when the kidneys are damaged and cannot perform its’ functions properly. Chronic kidney disease often turned into “the silent burden of life” because it can cause the gradual loss of kidney functions, toxins and waste build up in the blood, and lead to kidney failure. Kidney failure is also known as the end-stage renal disease (ESRD), which is the stage that the kidney has irreversible damage, and failed to perform functions. Patients with kidney failure often required to spend a lot of money for treatment such as artificial filtering (dialysis) or kidney transplant. The condition can be fatal if left without treatment, hence it is a lifelong effort for the patient who need dialysis treatment regularly.
- Diabetes and high blood pressure: Diabetes is the first leading cause of chronic kidney disease, followed by high blood pressure as the second leading cause. Both high blood glucose and high blood pressure can damage blood vessels and the filtering units of kidney (nephron), hence will affect the kidney’s function, and lead to the kidney disease.
- Aging: Aging increase the risk of developing kidney disease, especially when reaching the age of 60s. This is because aging will cause kidney to lose function gradually and might increase risk of high blood pressure and diabetes, hence increase the risk of kidney disease.
- Family History: The risk of kidney disease will be higher if having close relatives or family members with kidney’s problem.
- Smoking: Smoking is a risk factor for various non-communicable diseases (NCDs). It will increase the risk of kidney disease since it contains carbon monoxide which will thicken the blood and cause damage to blood vessels, leading to high blood pressure.
- Kidney injuries or others: Kidney injuries may affect kidney functions for temporary and some severe injuries may cause permanent damage to kidneys. However, there are other conditions such as kidney infection, polycystic kidney disease, kidney stones, glomerulonephritis, urinary tract infections, etc.
Signs and symptoms
- Fatigue, tired, hard to concentrate
- Sleep problems
- Nausea, vomiting, loss appetite
- Changes in urination: Urinate more, blood in urine, foamy urine
- Fluid or sodium retention: Swollen feet and ankles; swollen or puffy eyes
- Muscle cramp, Itchy skin
*Symptoms may be vary based on an individual’s health. However, it is usually no signs and symptoms in the early stage until irreversible damage occurred.
Diagnosis
- Blood test:
- Blood Urea Nitrogen (BUN) test: Urea nitrogen is a waste product formed when the liver breakdown protein. The BUN test measures the amount of nitrogen in the blood, which indicates the amount of waste in the body. The normal BUN level is between 7-20 mg/dL, higher value might be an indicator of kidney problems.
- Serum creatinine test: Creatinine is a waste product formed during the breakdown of muscle tissue. Creatinine should be filtered out from blood and excreted out through urination. Normally the amount of creatinine in men should not higher than 1.4 mg/dL and women should not higher than 1.2 mg/dL.
- Estimated Glomerular Filtration Rate (GFR): GFR test can be used to estimate kidneys filtering function. It is estimated with creatinine level, age, gender, height, weight, and race.
- Urine test: A urine test is performed to test the presence of albumin. Albumin is a protein that will be excreted out through urination when kidneys are damaged.
- Ultrasound or computed tomography (CT) scan: Clear image of kidneys and urinary tract structure can be obtained through these tests. Any structural abnormalities that will affect kidneys’ functions can be found out, while doctors can provide treatments based on the scanning result.
Prevention and management
1. Control and maintain blood pressure and blood glucose in a healthy range.
Maintaining blood pressure below 120/80 mmHg and fasting blood glucose below 100mg/dL could be the best way to prevent kidney disease. When blood pressure and blood glucose are maintained at the normal range, the risk of developing chronic disease (included kidney disease) is highly reduced.
2. Healthy diet. Drink plenty of water every day; Eat more fresh foods, consume more whole grains, vegetables, and fruits; Avoid processed foods, fast foods, canned and pickled foods, and foods that are high in salt (sodium), sugar, fat, cholesterol and trans-fat.
- Limit protein intake. Eat fewer protein foods such as meat, tofu, milk, cheese, beans, and nuts. Limit consumption of protein helps to protect kidneys. Waste products such as urea nitrogen can be formed when the body is digesting protein. When increasing protein intake, the digestion process creates more waste products. This might increase the burden of kidneys as it needs to work harder to remove the waste products.
3. Increase physical activity, do more exercise. You may increase your physical activity level by walking, jogging, cycling, running, or other simple activity. Just spend 30-60 minutes per day on these activities and do for at least 3 times per week. Besides, you may include other sports, dance, yoga, Tai-chi, and so on.
4. Maintain a healthy weight. Overweight and obesity have been found to increase the risk of various chronic diseases. Keep the body weight in healthy weight range is important. BMI is an indicator of the weight range, which is calculated using weight (kg) divided by the square of height (m2).
| BMI | Asian | International |
| Underweight | < 18.5 | < 18.5 |
| Normal | 18.5 – 22.9 | 18.5 – 24.9 |
| Overweight | 23 – 27.4 | 25 – 29.9 |
| Obesity | ≥ 27.5 | ≥ 30 |
5. Quit smoking and limit alcohol consumption. Smoking and drinking alcoholic beverages can cause high blood pressure and may increase the risk of chronic diseases. Limit alcohol intake to less than 2 drinks per day (men) or less than 1 drink per day (women). The portion size of a drink is 12 oz (355ml) of beer, or 4 oz (118ml) of wine, or 1.5 oz (44ml) 80-proof spirits.
6. Regular health checkup. Checking the blood pressure and blood glucose level can be important. High blood pressure and high blood glucose can be the lead factors for kidney diseases. Detection of kidneys’ problems before it worsens is very helpful for treatment and cure.
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References:
- American Kidney Fund, (2018). Causes and Risk Factors [online]. Available at: http://www.kidneyfund.org/prevention/are-you-at-risk/ [Accessed 1/10/2018].
- Kazancioglu R., (2013). Risk factors for chronic kidney disease: an update. Kidney Int Suppl., 3(4), pp 368-341. Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4089662/ [Accessed 2/10/2018].
- Light V., and Boskey E., (2017). Chronic Kidney Disease. Healthline. Available at: https://www.healthline.com/health/chronic-kidney-disease#causes [Accessed 1/10/2018].
- Mayo Clinic, (2018). Chronic Kidney Disease [online]. Available at: https://www.mayoclinic.org/diseases-conditions/chronic-kidney-disease/symptoms-causes/syc-20354521 [Accessed 27/9/2018].
- National Institute of Health (NIH), (2016). Eating Right for Chronic Kidney Disease. Available at: https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/eating-nutrition [Accessed 5/10/2018].
- National Kidney Foundation, (2017). 10 Signs You May Have Kidney Disease [online]. Available at: https://www.kidney.org/news/ekidney/august14/10_Signs_You_May_Have_Kidney_Disease [Accessed 28/9/2018].
- Stang D., (2018). Kidney Function Tests [online]. Healthline. Available at: https://www.healthline.com/health/kidney-function-tests#procedures [Accessed 5/10/2018].
- Wedro B., (2017). Kidneys Failure (Symptoms, Signs, Stages, Causes, and Treatment). MedicineNet.com. Available at: https://www.medicinenet.com/kidney_failure/article.htm#what_do_the_kidneys_do [Accessed 27/9/2018]
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