Healthy lifestyle key to prevention of kidney diseases

• Managing Factors That Predispose Women
Ahead of World Kidney Day coming up on Thursday, Nigerians have been advised to live healthy lifestyle, as this would help to prevent diabetes, high blood pressure and such kidney diseases as kidney failure, chronic kidney disease (CKD).

It has been estimated that each year, 17,000 new cases of kidney failure are diagnosed in the country, with only 2,000 having access to life-saving dialysis.

Diabetes and high blood pressure are the most common causes of CKD. So, it is important that an individual with diabetes or high blood pressure works with his doctor to keep blood sugar and blood pressure under control, as that is the best way to prevent kidney disease.

Health professionals say there is also need to have kidney-friendly dietary plan.

Professor of Medicine, Honorary Consultant Physician and Nephrologist, Renal Unit, Department of Medicine, Obafemi Awolowo University and Teaching Hospitals Complex, Ile-Ife, Fatiu Arogundade, explained that this year’s World Kidney Day theme, ‘Kidneys and Women’s Health’ was chosen because women are exposed to most kidney diseases that men also have, except the obstructive uropathies.

He said: “They may, however, have additional burden of kidney disease by virtue of the fact that they carry the burden of pregnancy, which exposes borderline kidney function to further insults, aside pregnancy-related complications that may cause kidney disease. Some women engage in practices that are injurious to the kidneys, such as skin bleaching, commercial sex practices and analgesic consumption.”

He explained that women are more predisposed to developing connective tissue diseases, which could manifest as kidney disease.

“When they develop kidney disease, they are unable to support their care, hence, many may not even present to the hospital on account of lack of funds. Some of them may not have their spouses’ support to attend hospital or even seek care. Improving women’s kidney health would involve health education on harmful practices; good antenatal, labour and postnatal care, as well as avoidance of nephrotoxins and support for kidney care, when they develop one,” he said.

Arogundade noted that government should help by ensuring that individuals visiting hospitals are screened for kidney diseases, hypertension and diabetes. And this should apply to all tiers of health care provision, i.e. primary, secondary and tertiary healthcare centres, as it would ensure early detection of these ailments, which would engender early and appropriate treatment.

“Government could also support or significantly subsidise renal support treatment – haemodialysis, peritoneal dialysis and kidney transplantation. Again, by providing free medications for Nigerians that are unable to get a kidney transplant,” he said.

Explaining that kidneys are two bean shaped organs located in the loins beside the backbone, one on either side, he said each weighs about 150 grams.

He said: “The kidneys excrete waste products of metabolism from the body. They also maintain acid–base balance in the body, as well as regulate water content of the body. The kidneys produce erythropoietin, a hormone that stimulates production of red blood cells from bone marrow and also take part in the metabolism of vitamin D to its active form that ultimately aid calcium absorption from the gut. However, the kidneys’ major function is that of excretion of waste products of metabolism.

“There are several kidney diseases, but they are broadly grouped into two: acute and chronic. Acute kidney disease (AKD) is that type of kidney disease that evolves within 48 hours or seven or more days of an insult, but resolves within 3 months.

“On the other hand, chronic kidney disease (CKD) is the one that persists for longer than three months with implications on health. It usually manifests with pathologic abnormalities in the blood, urine or abnormalities in imaging tests.

“Acute kidney diseases are potentially reversible with up to 60 and 80 percent of the patients recovering fully without any significant long-term adverse consequences. However, CKD cannot be cured, but can only be controlled. Its progression to end stage renal disease (ESRD) can be delayed before the final stage, when renal replacement therapy would become inevitable. At this final stage, mortality from uraemia and cardiovascular diseases are high and less than 10 percent of the patients are able to support their renal support care.

“Primordial prevention of kidney disease entails providing good antenatal care, ensuring good and balanced nutrition for pregnant mothers, prevention of childhood infections, as well as good immunisation record.

“Primary prevention of kidney disease entails maintenance of healthy lifestyle and health-seeking behaviour, avoidance of childhood and adult obesity, as well as regular exercise. There is also need for avoidance of alcohol consumption, smoking, nephrotoxins, bleaching creams and soaps and unregistered local herbs or products, among others.

“Secondary prevention entails providing good care and support for individuals with conditions that could result in kidney disease. For example, those with hypertension and diabetes mellitus should ensure regular consultation with experts to control blood pressure and sugar with appropriate medications, ensuring good and balanced nutrition, prevention of infections, as well as take steps for primary prevention.

“Tertiary prevention has to do with providing good care for those that have developed kidney disease and include control of hypertension, anaemia, bone and mineral diseases, blood lipids and oedema. Offering renal support treatment, when there are indications for it.”

Dr. Chukwuma Ogunbor, a Consultant Family Physician and Chief Operations Officer with Cedar Group Hospital, Festac Town, said kidney failure is a situation, where the kidney is unable to eliminate waste products in the body systems.

Ogunbor said: “For instance, the urine is a waste product. All the waste products in the body pass through the kidneys, which filter out waste products and leave healthy ones. So, a kidney is said to fail, when it’s unable to perform these functions. When waste products are not eliminated, it causes toxins to the body systems. Kidney diseases are on the increase these days, as it is estimated that one in every five patients has kidney diseases.

“There are several causes of kidney diseases that may lead to kidney failure. These include uncontrolled hypertension, chronic inflammation of the kidneys from infections, diabetes, use of skin bleaching and lightning cream or soap, use of herbal concoctions, unprescribed medications such as antibiotics and painkillers, HIV infection, polycystic kidney disease, birth defects, urinary obstruction from fibroids and prostrate enlargement, among others.”

He explained that signs and symptoms of kidney diseases include excessive passage of urine, especially at night.

“When you pass urine and you notice that it is foamy, you should go for kidney check ups. In some cases, people’s faces, arms and legs, including other parts of the body start to swell. Some people would have diarrhoea, vomiting, weight loss, body weakness and sleeping problems, among other issues.

“If one has these symptoms, the next step is to see doctor, who would conduct some special tests. The patient should go for medical check ups, which include kidney function test and also the urine test. The patient should go for blood pressure and diabetes check ups”.

“To prevent kidney diseases, there is need to stay hydrated at all times. People should drink a lot of water, as it helps kidney to filter out waste products in the system. When one takes a lot of water, the kidney functions optimally, and the person would stay healthy. Again, people should avoid unhygienic foods, because most of them contain unhealthy ingredients, which are not good for the body.

“We advise smokers to stop the habit and reduction in alcoholic intake. Bleaching creams contains heavy metals that damage the kidney.

“The obese are advised to shed weight. They should engage in exercises at least 30 minutes daily. Staying healthy and fit is essential.”

“People should avoid oily and fatty foods. Too much salt is not good for the body. Not more than 5.8 grams of salt should be consumed daily. It is also not healthy to eat too much meat. Too much protein in the diet is harmful to kidneys. Protein digestion produces ammonia toxins that are very destructive to kidneys.”