Recently in an article published by Indian Medical Association stated that in our country 17 person per 100 populations suffer from kidney disease. In USA this number is 10% and in UK it is between 6 to 7 %. Definitely Chronic Kidney Disease (CKD) is a matter of great concern to all of us. Diabetes Mellitus and Hypertension are two main contributory factors for developing CKD.
Know the Urinary Tract:
Human Urinary Tract comprises of Kidneys, Ureters, Urinary Bladder and Urethra. There are two kidneys situated on upper abdomen below the diaphragm. Right kidney is situated below the liver and it is slightly smaller than the left kidney. Weight of a kidney in an adult is about 160 gram. Kidneys look like a bean and each kidney measures 10 to12cm (length) x 5 to 7 cm (breath). Each kidney contains one million filtering unit known as Nephron. Each Nephron has two parts viz. Glomerulus and Bowman’s capsule. Function of Nephron is to filter our blood. By doing so it preserves essential elements and helps excretion of waste products like creatinine, urea, uric acid in our urine. About 2 litres of urine is formed in 24 hours. Ureters connect kidneys to the urinary bladder and urine is excreted from it through urethra.
Function of the kidneys is to maintain blood volume, blood pressure and pH of blood (7.4). Kidneys maintain the inner balance of essential elements like Sodium, Potassium, Calcium, Magnesium, Manganese, Phosphorus and bicarbonates. Kidneys also produce vitamin and hormones namely Erythropoetin, Calcitrol and Renin.
Some common causes that may influence kidney health adversely:-
- Diabetes Mellitus
- Genetic factor
- Life-style related – Obesity and idle life leads to CKD
- Physical inactivity- normal person should do 30 to 40 minutes exercises per 6 days a week. Person with high creatinine should avoid vigorous exercises.
- Junk food
- Excessive caffeine- normally one should not exceed 2 cups of coffee or 3 cups of tea in 24 hours.
- Artificial sweetener- all increases chances of malignancy,Diabetes, heart and kidney diseases.
- Excessive meat intake
- Inadequate water intake- Normal male adult should consume 3.7 litres and adult female should consume 2.7 litres water in24 hours.
- Deficiency of vitamin complex & vitamin-D
- Negligence to health- Taking no care on getting a kidney stone or urinary tract infection may lead to CKD
- Environmental pollution – May be caused by soil, water and air due to contamination by mercury,arsenic,lead,cadmium, various pesticides. Such pollution may lead to CKD, heart & lung diseases, cancer etc.
- Haphazard use of drugs : Analgesics, antibiotics, hormones, Proton-pump inhibitor drugs used for gastritis, sex-stimulants and many other drugs may result in CKD.
How to know about getting the disease?
- Changes in urine
- Anaemia, fatigability
- Frequent urticarial rashes
- Bad smell on breath (halitosis)
- Nausea & vomiting
- Elevation of Blood Pressure
- Body pain, joint pain
- Feeling of excessive cold
- Breathing difficulty
- Chest pain
- Disturbed sleep
- Muscle pain
- Decreased sharpness of brain
How to identify kidney disease?
The following investigations help to know about the disease viz.
- Urine routine test and for micro albumin
- Measuring 24 hours urine output
- Blood test for creatinine, urea,uric acid,haemoglobin,sugar status, electrolytes etc
- X ray of abdomen & Chest
- Ultrasound abdomen
- CT scan/ MRI abdomen
- Kidney biopsy
How to know the level of Kidney activity?
By knowing the age, sex, height and creatinine level of a person Glomerular Filteration Rate (GRR) can be calculated. GFR indicates kidney activity. For example GFR of normal-functioning kidney will be 90 to 100%. 50% GFR means fifty percent of kidneys are functioning.
Stages of kidney diseases as per GFR:
- 1st stage : GFR 90% or above means health kidney.
- 2nd stage :GFR 60 to 89%
- 3rd stage A & B : GFR 30 to 59%
- 4th stage : 10 to 29%
- 5th stage : GFR 5% , means kidney failure
* Normal creatinine level for males is between 0.6 to 1.2 mg%
* Normal creatinine level for females is between 0.6 to 1.1 mg%
Kidney activity depending on creatinine level:
– Creatinine level up to 1.5 mg% means 75% active kidney
– Creatinine level up to 2 mg% means 50% active kidney
– Creatinine level up to 3.5 mg% means 25% active kidney
– Creatinine level up to 5 mg% means 10% active kidney
– Creatinine level 6 to 8 mg% means 5% active kidney
Protective measures to be taken when CKD is suspected:
- Balanced diet can keep on more than 50 percent of disease condition. Care should be taken so that there is no rise of sugar,cholesterol or blood pressure.
- Avoid Alcohol and smoking.
- Avoid self medication. Do not trust on advertisement products related to health.
- Dietary tips are
- Consume plenty of fresh vegetables and fruits. Okra,Parwal,Gourd,Capsicum, Brinjal,Papaya,Drumstick, Bitter gourd, Sweet gourd are healthy vegetables for kidneys. Onion, ginger, garlic, reddish,carrot, beet root are some beneficial underground vegetables. Bean,cabbage, cauliflower,brucoli,coriander,cucumber, avocado, canberry,cherri , pineapple are helpful for kidney. But persons having high uric acid should avoid bean. Better to avoid sour fruits. But lemon juice with honey may be taken. Dry fruits should be consumed less. Apple, red grapes,strawberry, blueberry,ripe papaya contains low potassium, so safe for kidney patients. Select low fat milk preparations. Curd is useful. But avoid dairy products. Oats, sabu,sattu, dalia, chira, pasta, noodles, brown bread may be taken. Avoid Maida and select Atta.
Avoid preservatives and all colouring agents. Avoid Dalda and transfat products. Olive oil or sunflower oil to be used for cooking. Spices may be consumed. Avoid meat,egg and fish. Consume pulses and soya bin as protein source. Avoid sugar. Sugar-can juice,jaggery,honey,dates are better substitute than sugar. Stavia leaves are best substitute for sugar. Use of common salt should be minimal only. No soup, sauce, gravy, diet- Cola or diet-Pepsi to be taken by kidney patients. Rice should be soaked under water for at least 6 hours before cooking.
Dialysis and kidney transplant may be avoided by health awareness and taking timely care as described on my above article.