Why kidney health is vital for overall well-being
Understanding kidney health is essential for early detection and management of kidney diseases. The kidneys are vital organs responsible for filtering waste and excess fluids from the blood to form urine. They play a crucial role in maintaining overall health and well-being.
In Kenya, there is a steady rise in the number of people with significant kidney problems. Therefore this article seeks to provide concise, accurate and actionable information for better kidney health.
Understanding the Kidneys and Their Functions
The kidneys are bean-shaped organs located on either side of the spine, just below the rib cage. Each kidney is about the size of a fist and contains millions of tiny filtering units called nephrons. These nephrons filter blood, remove waste and excess fluids, and produce urine.
The kidneys’ primary functions include:
- Filtration of blood to remove waste products, such as urea, creatinine, and uric acid, as well as excess fluids
- Regulation of electrolyte levels, such as sodium, potassium, and calcium, which are essential for nerve and muscle function
- Control of blood pressure through the renin-angiotensin-aldosterone system
- Production of erythropoietin, a hormone that stimulates red blood cell production in the bone marrow
- Activation of vitamin D for bone health
- Maintenance of acid-base balance in the body
How common are Kidney diseases in Kenya?
According to the Kenya Renal Association, an estimated 4 million Kenyans have kidney disease, and that number is expected to increase to 4.8 million by 2030. However, a 2022 study from NCBI estimates that the prevalence of chronic kidney disease (CKD) in Kenya is 4%, which is lower than the 14% prevalence in sub-Saharan Africa.
Common Kidney Diseases and Risk Factors
Several kidney diseases can affect kidney function, including:
- Chronic kidney disease (CKD): a gradual loss of kidney function over time, often due to underlying conditions such as diabetes and hypertension
- Diabetic kidney disease (DKD): kidney damage caused by uncontrolled diabetes, which can lead to protein leakage in the urine and a decline in kidney function
- Hypertensive kidney disease: kidney damage caused by high blood pressure, which can put strain on the blood vessels in the kidneys
- Glomerulonephritis: inflammation of the kidney’s filtering units, which can be caused by autoimmune disorders, infections, or unknown factors
- Polycystic kidney disease: an inherited disorder characterized by the growth of numerous cysts in the kidneys, leading to kidney enlargement and damage
- Kidney Stones – Also called nephrolithiasis
- Kidney infections – Pyelonephritis due to mainly bacteria and mycobacteria.
- Nephrotic Syndrome
- Nephritic Syndrome
- Tumours of the Kidneys – Clear cell carcinoma and nephroblastoma being the commonest.
Common risk factors for kidney disease include:
- Diabetes: high blood sugar levels can damage the kidneys’ filtering units (Diabetic Nephropathy)
- Hypertension: high blood pressure can put strain on the blood vessels in the kidneys (Hypertensive nephropathy
- Obesity: excess weight increases the risk of developing diabetes and hypertension, both of which can lead to kidney disease
- Family history of kidney disease: certain genetic factors may increase the risk of developing kidney disease
- Advancing age: the risk of kidney disease increases with age
- Smoking: can accelerate the progression of kidney disease
Diagnosing Kidney Disease
Diagnosing kidney disease involves various tests, including:
- Urea, creatinine, and electrolytes (UECs) test: measures levels of urea, creatinine, sodium, potassium, chloride, and carbon dioxide in the blood. Urea is a waste product of protein metabolism, while creatinine is a waste product of muscle metabolism. Elevated levels of urea and creatinine can indicate kidney dysfunction. The UECs test is used to assess kidney function and detect kidney disease.
- Estimated glomerular filtration rate (eGFR): calculates how much blood the kidneys can filter per minute, based on the creatinine level in the blood. eGFR is used to stage CKD, with lower values indicating more severe kidney disease.
- Urine albumin-to-creatinine ratio (UACR): measures the amount of albumin, a type of protein, in the urine. Normally, albumin is not present in the urine, but kidney damage can cause albumin to leak into the urine. The UACR is used to detect and monitor kidney damage.
- Kidney biopsy: in some cases, a small sample of kidney tissue may be taken for analysis under a microscope to determine the cause of kidney disease.
- Complete blood count with Peripheral blood Film. Kidney disease can affect various blood parameters leading to conditions such as anaemia.
- Urine Microalbumin Test. This test checks for the presence of minute quantities of protein albumin in urine, which is an early indicator of kidney damage, especially diabetic nephropathy
- Urinalysis. Checking urine for amounts or concentrations of different components such as proteins and electrolytes plays a central role in the evaluation of kidney health
Learn More⏭️Urine test (Urinalysis) in Disease screening and diagnosis
4. Preventing and Slowing Progression of Kidney Disease
Preventive measures to maintain kidney health and slow disease progression include:
- Controlling diabetes and hypertension through medication and lifestyle modifications, such as a healthy diet, regular exercise, and weight management
- Medications such as ACE inhibitors and ARBs (angiotensin II receptor blockers) can help lower blood pressure and reduce the risk of kidney disease progression
- SGLT2 inhibitors and GLP-1 agonists are newer medications that have been shown to have kidney-protective effects in people with diabetes
- Maintaining a healthy lifestyle with a balanced diet, regular exercise, and weight management can help reduce the risk of developing kidney disease
- Avoiding excessive use of over-the-counter pain medications, such as ibuprofen and naproxen, which can cause kidney damage if taken for prolonged periods
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5. Managing End-Stage Renal Disease (ESRD)
In cases of end-stage renal disease, where the kidneys have lost most of their function, treatment options include:
- Dialysis: hemodialysis or peritoneal dialysis to filter waste and excess fluids from the blood. Hemodialysis involves using a machine to filter the blood, while peritoneal dialysis uses the lining of the abdomen (peritoneum) as a filter.
- Kidney transplantation: replacing a failed kidney with a healthy donor kidney, either from a living or deceased donor. Kidney transplantation can improve the quality of life and reduce the need for dialysis.
- Palliative and conservative care: in some cases, when dialysis or transplantation is not an option, palliative and conservative care may be used to manage symptoms and improve quality of life. This may involve managing pain, nausea, and other symptoms, as well as providing emotional and spiritual support.
By understanding the functions of the kidneys, recognizing common kidney diseases and risk factors, utilizing diagnostic tests like the UECs test, and implementing preventive measures, individuals can take proactive steps to safeguard their kidney health and overall well-being.
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Disclaimer
The information provided on this medical blog is for general informational purposes only and should not be considered as a substitute for professional medical advice. Always consult with a qualified healthcare provider before making any healthcare decisions or taking any actions based on the information provided on this blog. The authors and publishers of this blog are not liable for any errors or omissions in the content or for any actions taken based on the information provided.