Monday, November 23rd, 2009

Protect Your Kidneys

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Sixty-year-old Sudhir Gupta has to go for dialysis thrice a week. It started as once a week, but in six months time, it grew to three times a week because his kidneys had damaged beyond repair. Needless to say, dialysis was a huge burden on his finances. This was a result of diabetes, a metabolic disorder, with which he had lived for twenty years and had tried to keep it in control. Yet, this disorder had corroded his kidneys and he wasn’t aware of the early signs of failing kidneys.

The kidneys contain millions of tiny blood vessel clusters that filter waste from your blood. Diabetes can damage this delicate filtering system. Severe damage can lead to kidney failure or irreversible end-stage kidney disease, requiring dialysis or a kidney transplant. In the early stages of chronic kidney failure, you may have few signs or symptoms. Many people with chronic kidney failure don’t realize they have a problem until their kidney function has decreased to less than 25 percent of normal.
Chronic kidney failure can progress to end-stage kidney disease, which is fatal without artificial filtering (dialysis) or a kidney transplant.
Signs and symptoms may include some or many of the following:
• High blood pressure
• Decreased urine output or no urine output
• Darkly colored urine
• Anaemia
• Nausea or vomiting
• Loss of appetite
• Sudden weight change
• A general sense of discomfort and unease (malaise)
• Fatigue and weakness
• Headaches that seem unrelated to any other cause
• Sleep problems
• Decreased mental sharpness
• Pain along your side or mid to lower back
• Muscle twitches and cramps
• Swelling of the feet and ankles
• Bloody or tarry stools, which could indicate bleeding in your intestinal tract
• Yellowish-brown cast to your skin
• Persistent itching

Save your kidneys

Dr Vijay Kher, Director—Nephrology and Renal Transplant Medicine with Fortis, says, “Forty percent of diabetics are at higher risk of developing kidney disease within 15-20 years of diabetes. However, kidney disease can be arrested through diet modifications and early diagnosis of failing kidney through tests.”

1. Go for regular tests—Regular tests can help detect the status of your kidney health long before any symptom of deterioration of kidneys happen.

2. Maintain normal blood pressure–Hypertension (high blood pressure) is a common cause of chronic kidney disease. Have your blood pressure checked regularly. “As far as control of blood pressure is concerned. It should be 120/80 mm of Hg. Some times 3-4 antihypertensive drugs are used for BP control. ACE inhibitors are seen as more appropriate for managing hypertension when diabetes is present,” says Dr Q Hasnain, senior consultant and HOD Nephrology with Dr B.L Kapur Hospital.

3. Lose Weight–Being overweight or obese can lead to high blood pressure and diabetes. Exercise regularly.

4. Control Blood Glucose Levels–High blood glucose (blood sugar) levels make chronic kidney disease worse. Simple tests at home can tell you the status of blood glucose levels. Self-monitoring of blood glucose is an important and integral component of modern therapy for diabetes management. If you have diabetes do, take the medications as your doctor prescribes. “Monitor diabetes control by getting a blood test called Glycosylated Hemoglobin (HbA1c) which gives last three months average blood sugars. This test should be done 3 monthly and targeted to be kept below < 7%.,” says Dr. Kher.

5. Quit Smoking–Smoking makes chronic kidney disease worse.

6. Shift to a healthy diet–Cutting down on salt, protein (if high), high-phosphorus foods (dairy products, peas, cola, nuts), and high-fat foods is important. Indian diets are usually low in proteins and one should not cut down proteins to the extent to cause malnutrition which is worse than chronic kidney disease.

Certain lifestyle changes can slow the progression of chronic kidney disease. These changes can also prevent complications of the disease.

The urine Microalbumin Spot Test is an early indicator of kidney disease. It measures the miniscule amounts of albumin the body releases into the urine several years before significant kidney damage becomes apparent. People at risk must be screened for possible kidney disorder or for early damage to the kidneys every six months to a year

Inputs provided by Dr Vijay Kher, Director—Nephrology and Renal Transplant Medicine with Fortis

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Category: Diabetes
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