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Diabetes is one of the most common causes of chronic kidney disease, which was previously called as "End-Stage Renal Disease (ESRD)". More than 50-60% of our population needs dialysis or kidney transplant, prime reason being - “Our Change in lifestyle”. In India, dialysis population is growing significantly and spreading its jaws to more people.
What is chronic kidney disease?
The kidneys are bean shaped organs probably the size of our fist, located in the middle of your back on both sides. Their foremost job is to filter the circulating blood and remove the waste products through urine. But this not the only thing they do. The kidneys perform a wide range of functions apart from filtering the blood, which includes assistance in the formation of red blood cells, control of blood pressure, strengthening of bones, aiding the sugar metabolism in the body and many more.
If you are suffering from kidney disease, it means that your kidneys are damaged and they cannot filter blood like they should, causing waste to build up in the body. It can also cause other problems that can affect your health. The term “Chronic” indicates irreversibility to normal state, as opposed to ‘acute kidney injury’- which is a temporary phenomenon. If not treated, it can lead to ESRD, implying that your kidneys may stop working. Once this happens, you may require a kidney transplant or dialysis to maintain your overall health.
How do I know if I have kidney disease?
Early kidney disease usually produces no signs and symptoms and the only way to know is blood and urine tests. In blood tests we measure ‘creatinine’ which gives an idea about the filtering function of the kidneys. Apart from this screening for kidney disease usually includes a urine test which often gets neglected. Urine tests are done to look for any protein leaking in the urine or any white blood cells in urine which is sign of infection. Ultrasound of the kidneys helps to ascertain the size and position of the kidneys.
It is only later in the stages of chronic kidney disease that one gets symptoms and signs like nausea, lack of appetite, swelling over body parts, and altered behaviour at times.
Can it be cured? What if I have chronic kidney disease ?
According to Dr. Dinesh Khullar, ‘Chronic’ kidney disease in its nature is irreversible, but its progression to end stage can be slowed or stopped if detected early. If tests show you have kidney disease, you can take steps to protect your kidneys from further damage. There are medicines you can take and other things you can do, such as controlling your blood sugar and keeping your blood pressure below the target set by your doctor to help delay or prevent kidney failure.
What are the options then?
The first measure you can take is to get your blood and urine tests done. In case the tests prove end stage kidney disease the one has the option of replacing the function of kidneys by either dialysis, which is a form of blood purification therapy or kidney transplant.
Dialysis requires blood to be artificially purified through a “hemodialysis machine” or through fluids instilled and removed from abdominal cavity called as peritoneal dialysis. Hemodialysis requires an access to ones blood stream and scheduled visits to the hospital at least thrice per week for dialysis sessions. Peritoneal dialysis contrary to this can be performed at home.
Renal transplant in the long run considered a better modality and requires a voluntary donor usually amongst the family members as per the organ donation laws in India.
Are there any precautions I can take? What diet should I take?
The general precautions involve a good blood pressure and blood sugar control along with regular blood tests done during visits to your doctor. The chronic kidney disease diet help kidneys preserve their function for as long as possible. It is best to follow such a diet on advice of your dietician.
By and large the diet should have sufficient calories but should be limited in protein if you are not on dialysis. During dialysis the diet gets modified considerably.
The diet should be limited in sodium, phosphorus and potassium.
The amount of fluid from food and drink also needs to be regulated according to individual requirements.
Is there a road ahead?
Kidney disease can be controlled and prevented if we understand the circumstances and risk factors which predispose to it. This goes a long way in preventing a patient ending up on dialysis or requiring a kidney transplant. A kidney patient even if on dialysis or after a transplant can lead a healthy life if adequate measures are taken. This would mean many people detected and prevented from the dangers of kidney failure and in long term inseparable from the others who don’t have it.