Kidneys are essential for your survival. And Kidney Disease is a major cause of sickness & death worldwide. But if diagnosed early on, and necessary treatment procedures are initiated on time, some of these conditions could be reversed to normalcy, while for others, the progression of the condition to frank kidney failure can be effectively delayed. However, early diagnosis & treatment are not always implemented in reality. And some existing Myths around Kidney Disease have a significant role in hampering this process.
It is imperative, that you pro-actively educate yourself on this front to combat any ignorance, apprehension or confusion on this topic and choose a better quality of life for yourself, today and tomorrow!
So, here’s busting the commonest Myths around Kidney Disease with established facts. Read on to empower yourself!
Myth 1: Kidney disease is a rare condition.
Quite the opposite. Kidney Disease is a major cause of morbidity and mortality prevalent worldwide. Global Burden of Disease (GBD) studies by the World health organization (WHO) estimates that around 5-10 million people die because of some form of kidney disease either due to lack of access to treatment or due to the irreversible nature of the disease process itself. This number is potentially the same as the number of lives claimed by Cancer, Diabetes or Respiratory Diseases. In addition, it occupies a significant chunk of the healthcare budget for any country. So, what puts you at risk? Research evidence points to the following as common risk factors for developing permanent kidney damage in future:
- Untreated, long-term high blood pressure
- Sustained high blood glucose in Diabetes mellitus
- Chronic smoking
- Family History of kidney disease
- Low-birth-weight (less than 2.5 kilograms at birth)
- Ethnicity – Members of African-American, Hispanic, South Asian, South-east Asian or Maori ethnicities have a greater prevalence of Kidney Disease as compared to Caucasians.
Myth 2: If you feel fine, there is no chance of your having kidney disease
In most cases, Kidney Disease is an insidious entity, meaning we do not realize if there is any ongoing kidney damage. By the time we get symptoms and seek treatment, the disease usually progresses to an advanced stage and some form of permanent, irreversible damage already sets-in. In fact, that is exactly what makes kidney disease dangerous.
The best way to avoid such a situation is to educate yourself about the risk factors stated above and get a simple urine routine examination (URE) done. If there is any trace of Albumin (protein), Blood, Glucose, Crystals, Casts or WBCs in urine, seek medical consultation immediately. These could be early signs of kidney disease. Early diagnosis is the best-case scenario for delaying permanent kidney damage. Most medicines prescribed in present-day allopathy are effective in delaying permanent kidney damage when taken regularly.
Myth 3: Testing for kidney disease is a long and costly process.
No, it isn’t. Kidney disease can be initially traced with two simple and pocket-friendly tests as prescribed by your healthcare provider (Doctor):
- A Urine Routine Examination (URE): Presence of Albumin (protein), Red Blood Corpuscles (RBCs), Glucose or Casts (certain types) in urine could indicate kidney disease. Best to follow-up with medical consultation.
- A Blood Test to calculate your eGFR (estimated glomerular filtration rate): The value of your eGFR tells you how well your kidneys are working. If you are aware of your Serum Creatinine levels from your bloodwork, you can calculate your eGFR here.
Find a basic interpretation chart below for your reference: –
If your initial tests above indicate kidney damage, your consultant may want to diagnose the exact disease affecting your kidneys by advising a more specific blood test, imaging scan and if needed, a kidney biopsy. Determining the exact diagnosis will help your consultant plan your treatment specific to your condition.
Myth 4: If you are at risk of kidney disease, there is nothing you can do about it.
Of course, you can!
Being at-risk does not mean that you will get Kidney Disease for sure. Rather learning about whether you are “at-risk” and educating yourself on how important your kidneys are for your survival takes you a notch ahead with helping yourself avoid kidney damage in future.
Generally, follow the tips below to ensure a healthy kidney function and avoid the development of kidney disease due to preventable causes: –
Eat healthy food. Stick to the principle of “moderation”.
Stay hydrated (2.5 litres of water intake daily unless you have heart disease or on Dialysis already)
Maintain a healthy weight for your height, daily activity and metabolic needs.
Get moderate exercise regularly (at least 3-4 days a week). This ensures good blood circulation throughout your body and infuses your organs with life-saving oxygen!
Control your blood pressure. If you are on medication, take them regularly as prescribed by your doctor.
Keep a tab on your blood glucose levels. If you are a known Diabetic on meds, do not miss your dose and consult a registered dietician for Diabetic-friendly meal-plans.
Quit smoking. It spells doom not just for your kidneys, but lungs, eyes, liver, heart and brain as well.
Avoid overuse of painkiller meds like Aspirin, Ibuprofen and all their allied brand names. These have been proven to cause something called “Analgesic Nephropathy” (in your kidneys) with chronic overuse. This condition is incurable.
Myth 5: No one knows the cause of kidney disease.
Kidney disease is not a single entity. There are various forms and multiple factors that may cause kidney damage.
High Blood Pressure and Diabetes (High blood glucose) are the two dominant conditions that are responsible for the majority of cases of kidney disease encountered in the clinic. These conditions damage the delicate blood vessels going into your kidneys thereby cutting their supply of life-saving oxygen. This leads to extensive damage and premature death of your kidney tissue over time. Additionally, there are some kidney diseases where the exact root cause is unknown such as IgA nephropathy. Clinical variations of this condition are extremely common in South Asia, South-East Asia and North America.
Apart from the above, kidney damage can potentially set-in with:
Prolonged heart disease
Conditions where your immune system attacks your kidneys (various forms of nephritis)
Hereditary conditions running in families like polycystic kidneys.
Kidney defects by birth as seen in Low birth weight or structural defects.
Intake of drinking water laden with heavy metals like arsenic or lead.
Prolonged blockage of your urine outflow pipe system from your kidneys due to strictures or tumours downstream
Some Cancer Chemotherapy medicines such as Cisplatin.
Extensive over-use of painkiller medication such as Aspirin and Ibuprofen.
Exposure to radioactive substances [radiation exposure damage]
Blunt-force trauma (kicks, punches etc.) on your flank (waist).
The process by which all the above conditions mediate kidney damage has been delineated by researchers in the past years. Based on this, appropriate medication is available for use. Your physician will prescribe these, to delay disease progression to kidney failure as needed, provided you are diagnosed early on.
Myth 6: All kidney diseases are incurable.
That is untrue. Conditions such as Kidney Stones, Infections extending to the kidney from urine infection and some cases of Acute Kidney Injury (AKI) are clinically curable if diagnosed and treated as per approved protocols in good time. Hypertension (High Blood Pressure) and Diabetes that are responsible for about three-fourths of all cases of Kidney Failure worldwide can also be stopped from damaging your kidneys if you: –
Take your prescribed medicines regularly to control your blood pressure and blood glucose levels respectively
Follow the recommended diet restrictions
Avoid unapproved “therapies” promising miracle cures
Get moderate exercise at least 3-4 days per week and maintain a healthy weight for your height. For the remaining causes of kidney damage that lead to “Chronic Kidney Disease” and subsequent “Kidney Failure”, there are medicines to delay the disease progression by as much as is possible, followed by Renal Replacement Therapies such as Dialysis and Kidney Transplantation.
Myth 7: Kidney failure can occur if even one out of two kidneys is affected.
That is not true.
Patients experience symptoms of kidney failure only when both of their kidneys are adversely affected. However, if somebody is born with just one kidney (known as “Congenital solitary kidney”) instead of two, damage to that single kidney will lead to end-stage kidney disease.
It is the compromise of overall kidney function in your body that determines whether you will have end-stage kidney disease or not. Compromise of overall kidney function causes progressive buildup of waste products such as Creatinine and Blood Urea-Nitrogen in our bodies which also show up in our blood tests accordingly.
Myth 8: The presence of swelling of face and/or feet due to fluid accumulation (Oedema) automatically suggests kidney disease & failure.
Oedema (fluid accumulation beneath the skin in certain body parts) is a result of altered fluid movement & distribution in our body. It is a dominant symptom in advanced kidney disease and kidney failure, but could also be present with a healthy kidney function as listed below:
Sitting for prolonged durations hanging your legs (as in a long-haul flight) (swollen feet)
Wearing socks with tight elasticated bands for a prolonged period. (swollen feet)
As a benign side effect of taking certain blood pressure medication [such as Amlodipine (generic name)] (swollen feet)
As a side effect of taking steroidal medicines like Prednisone and Prednisolone for conditions other than kidney disease (facial swelling)
It is only when Oedema is present in combination with blood, urine & imaging tests suggestive of kidney disease that you should consider it a possible sign of advanced kidney damage.
Myth 9: Oedema is present in all patients with kidney failure
Kidney Failure is diagnosed when your blood tests show your kidney function / eGFR value to be less than 15 ml/min.
This calculation is based on your Blood (serum) Creatinine levels, your height and body weight.
Development of Oedema in kidney disease depends on:
Whether your unwell kidneys fail to remove enough fluid in urine along with waste products (Fluid Retention)
The extent of decrease in blood albumin (protein) levels due to protein-loss in the urine. (Low albumin protein levels promote fluid retention and oedema).
It is not necessary that excess fluids will start accumulating or low albumin levels will set-in as soon as your kidney function falls below the 15ml/min mark. This is especially true if patients are already on medicines to help prevent excess fluid build-up in the body.
However, patients with eGFR values well below this mark usually do present with oedema of the face and feet.
Conversely, patients with immune-system mediated kidney damage, who are on steroidal medicines like Prednisone and Prednisolone will present with facial oedema (swollen face) despite early-stage kidney damage. This appearance also called a “Moon Face” is not a result of Kidney Failure but entirely, the side effect of the steroid medicine mentioned.
Myth 10: All patients with kidney disease should drink a lot of water
It is alright for patients with Kidney Stone(s) and Urinary Tract Infection with normal kidney function parameters to drink more water than their usual intake.
In CKD patients, maintaining a good hydration status (drinking about 2 litres of water daily) is helpful in the initial stages of kidney disease. However, as the kidney disease enters advanced stages, your kidneys lose their ability to eliminate sufficient fluid in urine. Instead, they start retaining excess fluids in your body, that manifests as Oedema (swelling).
It is important to follow your doctor’s advice at this stage and restrict your daily water intake as advised by your medical team based on your individual requirement. This is necessary to avoid burdening your already unwell kidneys with water overload. Not following water intake restrictions when advised will only aggravate your kidney damage.
Myth 11: My blood (serum) Creatinine level is slightly above normal. But I am perfectly well so there is nothing to worry about.
Creatinine is a metabolic waste product derived from muscles in your body. Our kidneys normally eliminate it efficiently to maintain safe limits of 0.6-1.2 mg/dl in our blood (serum). Therefore, Creatinine levels can vary both with conditions that affect your muscles or in conditions that affect your kidneys. In the context of kidney disease, blood (serum) Creatinine levels only begin to rise beyond the safe limit (06-1.2 mg/dL) once significant kidney damage (over 40%) sets-in and your kidneys are unable to eliminate sufficient quantities of Creatinine via Urine. So, DO NOT ignore even a mild increase in this value at any cost. It could potentially be a sign of Kidney dysfunction that may need urgent medical attention. Receiving proper treatment from a kidney specialist (Nephrologist) at this stage will allow protection of the rest of your kidney from extensive damage for many more years to come.
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