The expert spoke about the dangers and insidiousness of chronic kidney disease
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It occurs in approximately 10 percent of the world’s inhabitants
World Kidney Day is celebrated on the second Thursday of March. “Awareness of disease risk factors, preventive measures and diagnostic capabilities helps people maintain health and notice the symptoms of the disease in the early stages,” says Associate Professor of the Department of Nephrology at Moscow State Medical University. A.I. Evdokimova, Chairman of the Supervisory Board of the Association of Medical Organizations for Nephrology and Dialysis Valery Shilo. The expert told MK what symptoms you should pay attention to and when you need to contact a specialist.
As Valery Shilo notes, one of the most common chronic non-infectious diseases is chronic kidney disease (CKD). It affects approximately 10 percent of the world’s population, or more than 850 million people worldwide. In Russia, this figure is even slightly higher: according to experts, based on studies conducted, 16 percent of the population of our country has signs of CKD. In 2019, CKD was responsible for more than 3.1 million deaths. By 2040, kidney disease may take fifth place in the structure of mortality.
The term “chronic kidney disease” refers to irreversible kidney damage that can develop for various reasons, for example, due to chronic diseases such as diabetes mellitus or arterial hypertension, acute kidney disease (glomerulonephritis), damage to the kidney vessels, urolithiasis and/ or urinary tract infections, hereditary kidney diseases. Due to these progressive damages, the kidneys can no longer function as well as healthy organs, which can ultimately lead to almost complete loss of their function and the need for dialysis or transplantation, life-saving renal replacement therapy. In previous years, the main efforts in the treatment of CKD were concentrated on preparation for and implementation of renal replacement therapy.
The insidiousness of chronic kidney disease is that this disease most often does not have specific symptoms, especially in the early stages. Because of this, most patients (9 out of 10!) do not even suspect that they have CKD, do not undergo examinations, do not take tests, and consult a doctor only in the later stages, when kidney function is lost irrevocably and the patient requires renal replacement therapy: dialysis or kidney transplantation. That is why it is important to be aware of the risk factors for this disease and, if they exist, undergo regular examinations and consult with specialists. This will help catch the disease at an early stage and prevent or significantly delay the need for renal replacement therapy, a very burdensome procedure for patients, since they need to visit a dialysis center several times a week.
At risk for the development of CKD are patients with diabetes mellitus and cardiovascular diseases, primarily with arterial hypertension, which is diagnosed in almost half of the adult population. There is a clear link between cardiovascular disease, diabetes and CKD. In the presence of CKD, the incidence of heart attacks and strokes increases by 3–4 times, and mortality also increases significantly in diabetics. Other risk factors for developing CKD include smoking, alcohol abuse, old age, obesity, hereditary factors, previous acute kidney injury due to disease or injury, long-term use of certain medications, especially analgesics, and urinary tract infections.
Patients in high-risk categories should be seen by a doctor and undergo tests that can detect chronic kidney disease (CKD) in the early stages. To do this, you need to regularly take a biochemical blood test and monitor creatinine in the blood and protein in the urine. Based on the results of these studies, the doctor will calculate the glomerular filtration rate (GFR), the main indicator by which the condition of the kidneys is assessed and its dynamics are monitored. Based on the glomerular filtration rate, five stages of chronic kidney disease are distinguished. Patients with stage CKD-3 and beyond should especially closely monitor this indicator, since such a diagnosis already indicates serious damage to the organ.
The basis of CKD prevention is to reduce or eliminate exposure to risk factors. Among the basic measures that are relevant not only for the prevention of kidney disease, but also other chronic diseases, first of all, one should consider stopping smoking and excess alcohol, stopping the uncontrolled use of analgesics, moderate and regular physical activity is useful, control of blood pressure and glycemia is necessary in diabetics, as well as body weight control. The latter implies a diet that includes plenty of vegetables, fruits, legumes, whole grain bread and lean protein foods, such as poultry, fish, and seafood. The Mediterranean diet is quite suitable. If you have high blood pressure, you should limit your salt intake, and those who are prone to developing kidney stones, live in a hot climate, or work in a hot shop should drink more fluids.
Patients already diagnosed with CKD need to take steps to slow the progression of the disease. First of all, they need regular clinical observation and calculation of the trajectory of the glomerular filtration rate, as well as drug therapy, which can be selected by a general practitioner, endocrinologist, cardiologist or nephrologist. Recent breakthrough discoveries of new classes of drugs provide new opportunities to prevent or delay disease and minimize cardiovascular complications and kidney failure, ultimately extending the length and improving the quality of life for people living with CKD. In order for such nephroprotective therapy to be available to everyone from the early stages, chronic kidney disease should be recognized as a socially significant disease, which nephrologists around the world have been unanimously talking about for many years.
Newspaper headline:
Not a day without a kidney
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