1-7 February 2013 #641

Keep your kidneys running

If you are 55-years or older, have diabetes or hypertension or family history of renal failure, get checked for chronic kidney disease immediately
Dhanvantari by Buddha Basnyat, MD
Forty-year-old Ram Maya has been feeling queasy for the last three months. She is easily exhausted and has trouble sleeping. Recently she noticed some swelling in her ankles. She was not pregnant, but when the doctor checked her serum creatinine (an index of kidney function) it was clearly abnormal. She was also noted to be anemic.

Although she had been diagnosed with high blood pressure fifteen years ago, she took her medicines for a few months and stopped because the symptoms had disappeared. Also as the pills were quite expensive, she was quite happy to be saving money.

Ram Maya is suffering from chronic kidney disease (CKD), an increasingly common problem in Nepal as evidenced by the growing number of patients lined up outside dialysis centres like the one in Bir Hospital (pic, below).

Healthy kidneys perform a number of duties to help the body function normally. Besides getting rid of waste, they keep a good balance between water and electrolytes. They even function as glandular organs to make erythropoietin, a hormone (the same one that cyclist Lance Armstrong took for doping) which helps produce red blood cells.

No wonder Ram Maya was anemic and tired because she lacked erythropoietin. In majority of cases, chronic kidney disease is strongly associated with uncontrolled hypertension as in Ram Maya’s case or diabetes, another escalating health problem among Nepalis (in fact, South Asia has more diabetics than anywhere else in the world). Many patients with CKD also die of heart attacks because the important risk factors (diabetes and hypertension) are similar for both CKD and cardiovascular diseases.

It’s not possible to completely ‘cure’ CKD, but there are ways to slow the progress of the disease and prevent cardiovascular complications.

If you are 55-years or older, have diabetes or hypertension or family history of renal failure, get checked for chronic kidney disease immediately. Once diagnosed, you will need to make some major changes in your diet and lifestyle to prevent kidney failure. The DASH diet (Dietary Approaches to Stop Hypertension) is high in fruits, vegetables, and dairy products containing little saturated fat, and cholesterol. Lowering sodium intake, quitting smoking, exercising regularly, and keeping blood pressure and blood sugar level under control are also critical.

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