Look after your kidneys
By Dr Harold Gunatillake FRCS, FICS, FIACS, AM (Sing), MB BS – Health writer
The two kidneys you have are so valuable for your health and survival. You tend to think of safeguarding your heart by reducing the risk factors that can give you heart disease, such as control of cholesterol numbers in your blood among other precautions. Do you ever think of the risk factors that harm your kidneys?
When you suffer from asthma you tend frequently to use the puffers to get relief. Do you know how many people die of kidney failure by using those puffers too frequently, too long? You need to learn and find out the triggering factors that cause your asthma rather than using the puffers every time you get slightly breathless. There are allergists who can help you to find the triggering factors to cause those symptoms, and taking the relevant vaccines to de-sensitise against such allergens will help you to use those harmful puffers less frequently. There are tests you do on a sample of blood (Rast studies) or a drop of various allergens is injected under the skin of your forearm to check for reaction in the form of red patches.
By the way, all parents must know that asthma in children is preventable.
Those who suffer from diabetes needs to be aware of how it can affect your kidneys. Diabetes is not a disease that you can take lightly and continue a lifestyle like a nondiabetic. Strict control of diet and taking anti-diabetic medication is essential to lead a life without diabetic complications ending up such as amputations of your limbs, as was so frequent in the past before the glucometers came to the market.
Uncontrolled diabetes affects your kidneys causing a disease called CDK (chronic Kidney Disease. Your doctor will do certain tests annually to check on your kidneys.
The common tests are – blood urea and other electrolyte levels in your blood, creatinine level and eGFR, and check on the presence of albumen in your urine (micro-albuminuria). These tests will indicate whether you are tightly controlling your blood sugar levels. If you neglect your control of diabetes there will be permanent damage of your kidneys that may get worse over time to need dialysis. The last stage of damage is referred to as the ‘end-stage renal disease (ESRD) when you will notice retention of fluid in your body, appearing early in your legs (oedema) progressing to strain your heart and lungs. Fluid collections in the lungs are called pulmonary oedema and the heart shows signs of failure. This is because your body holds on to more salt and water than it should, and there’s more waste in your
system.
Do not allow yourself to progress and deteriorate to this stage. Keeping your blood sugar controlled you could live a healthy life like the non-diabetics.
In diabetes the small blood vessels that filter the blood are damaged (vasculitis) due to uncontrolled diabetes and the normal functions of excretion of waste material and toxins, deteriorates.
Hypertension
Your blood pressure should always be kept as low as possible. The upper pressure should be kept at 120mm.Hg and the lower pressure could vary between ranges of 60-70 mm.Hg. Increased BP weakens your blood vessels, including the ones in your kidneys. This will prevent getting rid of waste and extra fluids from the body. Daily exercise, less salt and a balanced diet, keeping your weight controlled, are all important to maintain a normal blood pressure. If the BP cannot be controlled the natural way you need to take anti-hypertensive medication. The common types of drugs prescribed are the ACE inhibitors and angiotensin receptor blockers (ARBs) to reduce the inflammation (vasculitis) and dilate the renal blood vessels.
High cholesterol
Just like in the coronary blood vessels, the renal blood vessels also can be blocked by having increased bad cholesterol in your blood. Controlling your blood cholesterol helps a good blood supply to all the organs including the heart, brain and the kidneys.
Lupus
This is an autoimmune disease where your own body proteins attack parts of your body, including the kidneys and it’s called lupus nephritis. It causes scarring and narrowing of blood vessels that filter waste out of your kidneys. This condition is treated with cortisone therapy to minimise the immune response
Cancer of white blood cells (Myeloma)
This kind of cancer attacks the white blood cells that fight to control infections (T cells). The cancer builds up in the bone marrow, causing anaemia and loss of protective white cells. Abnormal proteins that are created cause kidney problems.
Unknown CKD
Farmers working in the North Central regions in Sri Lanka and also in many other countries seem to suffer from chronic renal disease (CKD) supposed to be due to the exposure to pollutants and pesticides, in the soil and drinking water. Up to now the causative factors have not been found, though arsenic and chromium are suspected.
Medications
Your kidneys can get damaged due to using many over-the counter drugs, such as aspirin, Panadol (acetaminophen) and ibuprofen among others. These drugs should not be taken regularly for long periods. There are other prescription drugs including statins that can cause kidney damage. Always consult your family doctor before taking any medicine that could affect your kidneys. Antibiotics can also be dangerous if they are not taken correctly. Some diabetic medications like metformin can damage already damaged kidneys. Some medical tests called “imaging tests’ contain a type of dye called “contrast dye” used in tests like MRIs and CT-scans can harm to people who have kidney disease
Alcohol
Heavy drinking can hurt your kidneys and your liver.
There are many other diseases that can cause kidney damage not discussed in this article. Such diseases are not preventable, and only those situations where you can control your kidney health are discussed. Look after your kidneys
