Early diagnosis of chronic kidney disease can help manage it in its initial stages, significantly improving the prognosis for slowing down its progression, while late detection increases the risk of kidney failure, Cimas Health Group doctor Tafadzwa Mungiria has warned.
Late detection could also increase the likelihood of complications such as cardiovascular disease and anaemia. It also limits the treatment options, Dr Mungiria said.
The importance of early detection of kidney problems and protecting your kidney health is emphasised in the theme for this year’s World Kidney Day, which was marked yesterday (Thursday).
The theme this year of World Kidney Day — which takes place every year on the second Thursday of March — is “Are Your Kidneys Ok? Detect Early, Protect Kidney Health”.
Chronic kidney disease is estimated to affect approximately 850 million people worldwide. Unfortunately, in Zimbabwe it remains underestimated, he said.
“Zimbabwe records approximately 1 000 cases of kidney failure each year. However, only about 700 patients can access dialysis treatment, leaving many without the necessary care. The availability of dialysis services is primarily concentrated in urban areas such as Harare, making it difficult for patients in rural regions to receive timely treatment,” he said.
Kidney functions
Kidneys play a crucial role in maintaining overall health by performing several vital functions. Their primary function, Dr Mungiria said, is to filter waste products and excess substances such as water, salt and toxins from the blood to form urine.
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“Blood enters the kidneys through the renal arteries and is filtered in tiny structures called nephrons. Each kidney contains about a million nephrons. As blood flows through the nephrons, useful substances such as glucose, amino acids and certain ions are re-absorbed back into the bloodstream. Waste products and excess substances are secreted into the forming urine,” Dr Mungiria said.
“The filtered waste and excess substances form urine, which flows through the ureters to the bladder, where it is stored until excretion. Kidneys also help regulate blood pressure by controlling the volume of blood, which they do by adjusting the amount of water excreted and releasing the enzyme renin, which helps manage blood pressure.
“They maintain the balance of electrolytes such as sodium, potassium and calcium, which are essential for muscle function, nerve function and overall cellular health. They also produce hormones such as erythropoietin, which stimulates red blood cell production, and calcitriol, the active form of vitamin D that helps maintain bone health.”
There are several things that can go wrong, he pointed out. There can be a sudden loss of kidney function due to injury, infection or toxins. This is known as acute kidney injury.
Chronic kidney disease can occur, with a gradual loss of kidney function, often due to diabetes or high blood pressure.
Hard deposits of minerals and salts can form kidney stones. The kidneys can also be affected by infections such as pyelonephritis, which is a type of urinary tract infection that reaches the kidneys.
Causes
High blood sugar levels can damage the kidneys over time, if diabetes is not well-managed. High blood pressure can damage the blood vessels in the kidneys. Certain infections and toxins can damage the kidneys, Dr Mungiria said.
He said another possible cause of kidney damage is glomerulonephritis, which is an inflammation of the kidney’s filtering units.
There is also a genetic disorder called polycystic kidney disease that causes cysts in the kidneys.
Symptoms
Symptoms of kidney disease, Dr Mungiria said, include fatigue, swelling in the legs and ankles, shortness of breath, nausea and vomiting and changes in urination patterns.
Risk factors
Risk factors, he said, were diabetes, high blood pressure, a family history of kidney disease, being over 60 years of age and obesity.
Protecting kidney health
Dr Mungiria said staying active and having regular exercise helps maintain a healthy weight and reduce blood pressure, both of which are beneficial for kidney health.
“If you have diabetes, keeping your blood sugar levels under control can prevent kidney damage. High blood pressure can damage your kidneys. So, regularly check your blood pressure and manage it through diet, exercise and medication, if necessary,” he said.
“Eating a balanced diet that is low in salt and processed foods and high in fruits, vegetables and whole grains supports kidney health. Drinking plenty of fluids to stay hydrated helps your kidneys function properly but avoid overhydration.
“Avoid smoking, as this can damage blood vessels, reducing blood flow to the kidneys and impairing their function. Limit over-the-counter medications, as some painkillers can damage your kidneys if taken too frequently. Always follow the recommended dosage. If you are at high risk, regular testing can help detect any issues early.”
Stages
Chronic kidney disease begins with some signs of kidney damage, but with normal kidney function, Dr Mungiria said.
The second stage is a mild reduction in kidney function.
The third stage is a moderate reduction in function. This may progress to a severe reduction in kidney function, which is the fourth stage. The fifth stage is kidney failure requiring dialysis or a kidney transplant.
Treatment
Acute kidney injury can sometimes be reversed with prompt treatment. Chronic kidney disease is generally not curable, although its progression can be slowed down, Dr Mungiria said.
Medication can be prescribed to control symptoms and underlying conditions, he said. Dialysis is needed when kidney function drops to between 10% and 15%.
A kidney transplant is an option for end-stage kidney disease.
“Kidney transplants are performed in Zimbabwe but availability and access may be limited,” he said.
He said there are several lifestyle changes that can be helpful in managing kidney disease and slowing its progression.
These include the lifestyle changes that help protect kidney health. Additional dietary changes were limiting phosphorous and potassium, as high levels of these minerals could be harmful to kidneys that are not functioning well. Limiting alcohol was also important.
“Excessive alcohol can strain your kidneys and worsen your condition,” he said. “Regular visits to your healthcare provider can help track the progression of kidney disease and enable treatment to be adjusted as necessary.”
- The information in this article is provided as a public service by the Cimas iGo wellness programme, which is designed to promote good health. It is provided for general information only and should not be construed as medical advice. Readers should consult their doctor or clinic on any matter related to their health or the treatment of any health problem. To contact the iGo team, email [email protected] or WhatsApp 0772 161 829 or phone 024-27730663.
