An expert opinion on Chronic kidney disease

Human kidneys have vital functions such as controlling the balance of acid-base and water, maintaining electrolytes, removing toxins and waste products, controlling blood pressure and others. However, a "silent" long-term condition, which may continue, at times without the patient knowing about it, can cause complications. This condition, known as chronic kidney disease, or CKD in short, can persist over a period during which the kidneys do not function as they should or cannot filter blood the way they should.

"It is the silent nature of CKD that is a cause of concern. Over and above, the symptoms of CKD are non-specific," consultant nephrologist, Dr Dhruvajyoti Choudhury says.

As it is, CKD is a global public health problem with an estimated prevalence of over 13.4 per cent. According to reports, patients with kidney failure needing renal replacement therapy are estimated between 5 and 7 million.

"It is a common problem. As we get old, our kidneys get older and from the age of about 40, there is a progressive loss of kidney function, albeit at a marginal rate. But of course, CKD can affect any age group," the doctor says.

Causes of CKD: 

Doctors say that the main risk factors for developing kidney disease are diabetes, high blood pressure, heart disease, and a family history of kidney failure.

A diabetic might have comorbid conditions which can have a negative impact on kidneys, even if the patient controls sugar levels

"A diabetic might have comorbid conditions which can have a negative impact on kidneys, even if the patient controls sugar levels. Then again, uncontrolled blood pressure/hypertension increases the chance of developing CKD. In a country like India, research hints that dehydration, exposure to heat, pollution can take a toll on the kidneys," Dr Choudhury says.

Moreover, random and at times, excessive use of painkillers, antibiotics and drugs such as anti-acidity medication such as pantoprazole/omeprazole for long periods can lead to kidney injury.

Diagnosis: 

In the absence of specific symptoms, tests may be the only way to know if a person has developed kidney disease.

Managing CKDThe most important step a patient can take to treat kidney disease is to control blood pressure."Consumption of six to eight glasses of plain water every day is vital for hydration. Curbing saturated fats and junk food and instead of adhering to healthy habits by eating the right food, being physically active, controlling weight, can help manage kidney diseases," says Dr Choudhury.

According to reports, procedures used in the management of kidney disease include chemical and microscopic examination of urine (urinalysis), measurement of kidney function by calculating the estimated glomerular filtration rate using the serum creatinine; and kidney biopsy and CT scan to evaluate for abnormal anatomy.

Dialysis and kidney transplantation are used to treat kidney failure; one (or both sequentially) of these are almost always used when renal function drops below 15 per cent.