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Stopping the Silent Epidemic of Chronic Kidney Disease

"Most people may not have any significant symptoms until their kidney disease is advanced. "
By: Kristine San Miguel, MDStopping the Silent Epidemic of Chronic Kidney Disease

Borromeo Bagwis has managed his fishing boat business for 30 years. He spent his free time with his wife and children, and on weekends he would walk three kilometers daily to stay in shape. But everything changed when Bagwis lost consciousness one Sunday morning.

“The last time I remember was feeding the fishes in the nearby pond. I am fortunate that I did not fell in the water and drowned” says Bagwis. “It was heartbreaking to hear the doctor saying my kidneys were functioning at only 40 per cent capacity due to uncontrolled diabetes.”

Bagwis began taking medication to control diabetes and maintain kidney function. “I have managed to avoid dialysis for 15 years since I have strictly followed my exercise and low-salt, low carbohydrate diet plan. I have learned to prioritize my health after I was diagnosed with chronic kidney disease.”

There is No Exclusivity with Chronic Kidney Disease (CKD)

Kidney disease does not discriminate. Regardless of race, age and gender, one in 10 people have some degree of CKD. African Americans, Hispanics, American Indians and people of South Asian origin (those from India, Bangladesh, Sri Lanka or Pakistan) have increased risk of developing CKD due to higher rates of diabetes and hypertension in these communities. Recent reports show predilection of CKD with increasing age (partly due to normal aging of their kidneys) and in women with chronic diabetes (driven by kidney filtration rate).

Silent Epidemic: Damaged Kidneys Develop Overtime

The condition strikes silently, giving its victims the impression that they are healthy while their kidneys become irreparably damaged. Like Bagwis, most people do not know that they are affected until they have lost considerable kidney function. Some people are diagnosed by chance. When Anna Sy took a blood exam as prerequisite to karate class enrollment fifteen years ago, tests showed that she had hypertension, and further evaluation uncovered silent CKD.

“I was not aware that kidney problems can result from high blood pressure,” Sy says. “I was fit enough to run and play sports with my kids all day long.”

The two most common causes of the disease—hypertension and diabetes, which are associated with obesity—have become more widespread. In ten years, twice as many people could have CKD, according to some estimates.

Several conditions, including infections and genetic conditions, can also cause kidney disease, which damages both kidneys. When the kidneys do not function properly, waste and protein build up in the bloodstream, leading to hypertension and other problems that further damage the kidneys.

Research shows that 90 per cent do not die directly from CKD, but from cardiovascular events associated with it, such as heart attack or stroke. For the majority of these patients, when their kidney function goes down, their cardiovascular events go up exponentially. “End stage kidney disease is just tip of the iceberg,” says Dr. Clariz Gonzales, a practicing nephrologist in Marinduque. “We are trying to educate the public, since most patients do not consider their kidneys important.”

CKD Progression Can be Slowed Down with the Right Treatment

Lifestyle changes and medication may slow kidney disease in early­stage patients, while end­stage patients may receive dialysis or transplantation.

Sy has maintained kidney function by taking Angiotensin-converting enzyme (ACE) inhibitors, a class of blood pressure lowering medication that slow down or prevent further kidney damage. “I see ladies my age and they are fat, sitting in front of the TV eating treats,” says Sy, now 55. “I was fighting for fifteen years to get my health back. I think I am healthier than people in my age group because I learned to value health at a very young age.”

Soon, new treatments may ease kidney patients’ lives. Drugs that inhibit sodium absorption may help patients keep from further damaging their kidneys. Wearable artificial kidney, which could replace the need to connect to stationary dialysis machines, will increase the dialysis time from 150 hours per week continuously instead of there to four hours a day, making toxin removal process more efficient.

There is Still Life after Kidney Transplant

Patients with end stage disease can thrive after a transplant. Faye Daliva learned that she had kidney disease at 20, and needed dialysis four years later. Her sister donated a kidney and the surgery changed her life.

“The main difference is the energy,” Daliva says. “When I was on dialysis, I could not keep up with my younger sister when she started joining fun run events. That is not a problem anymore. I might join her soon.” “Transplant recipients take immunosuppressant drugs to prevent organ rejection, and their kidney function is lower than a healthy person’s. But they can live active lives again,” Gonzales adds.

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