Kidney disorders: Silent trouble

Most kidney diseases are not accompanied by obvious symptoms. Here's how to understand the subtle signals

tired manTo mark the occasion of World Kidney Day [March 11, 2010], Nephrolife, a renowned renal disease managing centre, conducted a survey to gauge the awareness about renal diseases among urban Indians. The survey was conducted by Synovate, a global market research company in Delhi, Mumbai, Kolkata, Chennai, Bengaluru and Hyderabad. It included men and women in the age group of 20 to 50 years.

The results of the survey were surprising and concerning. It was found that most people across cities are not aware about the causes, symptoms and treatment options of renal diseases.With this in mind, we decided to dedicate an article to create awareness about renal diseases and their treatment options.

Before we begin, let us take a quick look at the major functions our kidneys perform.

Understand their importance

Kidneys serve the important functions of regulating the body’s fluid levels as well as releasing three important hormones in the body—erythropoietin, renin and calcitrol. Erythropoietin stimulates the bone marrow to make red blood cells; renin regulates blood pressure; and calcitriol, the active form of vitamin D, helps maintain calcium levels and normal chemical balance in the body.

The early warning signs of kidney trouble are very subtle and hence many people don’t know that they are living with a problem. Familiarise yourself with these symptoms so that you don’t become one of them.

Look for these symptoms

  1. Frequent urge to urinate
  2. Formation of foamy, bubbly, unusually pale or dark urine and presence of blood in the urine
  3. Strange swelling in ankles, feet, legs or hands
  4. Anaemia and fatigue
  5. Bouts of dizziness
  6. Nausea
  7. Altered taste
  8. Bad breath
  9. Shortness of breath
  10. Back pain or pain on the sides near the hip.

Know the disorders

There are three stages of kidney disease:

  • Acute Kidney Injury [ARF-Acute Renal Failure] is characterised by a sudden drop in kidney function, generally brought on by an accident that injures the kidneys, a sudden loss of blood or a poisonous toxin from a drug. ARF can lead to permanent loss of kidney function, if not treated immediately. However, if the kidneys are not severely damaged, renal failure may be reversed.
  • Chronic Kidney Disease [CKD] is the gradual loss of kidney function and is the most common form of kidney disease. If left untreated, it leads to permanent kidney failure, which can result in a heart attack or stroke. The early stage of CKD does not show any symptoms of improper functioning.However, as the disease progresses, the person may experience fatigue, dry and/or itchy skin, frequent urination, loss of appetite, nausea, swelling of the hands or feet, numbness in the hands or feet, trouble concentrating, darkening of the skin or muscle cramps. Other complications include anaemia, weak bones, nerve damage and heart disease.
  • End Stage Renal Disease [ESRD] is last stage of CKD i.e. total loss of kidney function. Once the kidneys have reached ESRD, the damage becomes permanent and irreversible. In such cases, the only way out is to undergo dialysis or opt for a kidney transplant. If detected early, progression of the disease may be slowed down.

Keep a check

Normally, protein and albumin do not get filtered through the kidneys. Hence, presence of these in the urine indicates early damage to the kidneys. It is also recommended that those with kidney disease follow a low-protein diet with low-salt intake to keep blood pressure under control. Along with this, it is also advised to eat a healthy diet and avoid too many spicy and fried foods.

Since two-thirds of all kidney diseases are caused by either high blood pressure or diabetes, controlling blood pressure and blood glucose levels goes a long way in keeping the kidneys healthy.

In case of hypertension or diabetes, a regular check of urine for presence of albumin is essential. It has also been found that in India diabetes and hypertension are responsible for 40 – 50 per cent of all cases of chronic renal failure.

Hence, it is of prime importance to understand the causes and symptoms of kidneys disorders to catch them at an early stage.

With inputs from Rajan Ravichandran, director of nephrology at MIOT hospital, Chennai.

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Ashwini Ranade, who holds a master's degree in biochemistry, was a staff member of the CW editorial team at the time of writing this article

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