Despite its relative obscurity, GFR, a measure of how well your kidneys are filtering out toxins from blood, is a critical yardstick of your health. With the incidence of kidney disease skyrocketing in the Philippines and with early diagnosis the key to avoiding the need for dialysis and transplants experts like Dr. Libertad P. Nazareno-Rosales, president of the Philippine Society of Nephrology, believes its time kidney disease is recognized as a major public health issue. After all, it is now the 10th leading cause of death in the Philippines.
Although its unlikely GFR will ever become a household health statistics soon, Filipinos should learn to recognize the early warning signs of kidney disease. These include high blood pressure; swelling of the face and ankles; puffiness around the eyes; frequent urination (especially at night); brown-colored urine; and back pain just below the rib cage. And those in high-risk groups should make sure they regularly receive blood and urine tests that show how well their kidneys are functioning. This week, we will discuss what causes kidney disease and what you can do to keep your kidneys healthy.
Those at elevated risk for kidney disease include people with diabetes or high blood pressure, people older than 50, people with family histories of kidney disease, and members of certain ethnic groups (including African Americans, Native Americans, Hispanics, Asians, and Pacific Islanders).
A high percentage of people with chronic kidney disease will develop kidney failure, also known as end-stage renal disease. The number of Filipinos with kidney failure has been increasing each year. High blood pressure and diabetes are the two most common causes of kidney failure; together they account for about 60 percent of cases. Other common causes include chronic kidney infections and inflammation, cysts, kidney stones, prolonged use of pain relievers, and abuse of alcohol, heroin, or other drugs.
Two types of drugs used to control high blood pressure angiotensin-receptor blockers and angiotensin-converting-enzyme (ACE) inhibitors have been shown to slow the progression of kidney disease independent of their effect on high blood pressure.
If chronic kidney disease progresses to kidney failure, a patients life is in danger without dialysis or a kidney transplant. Two types of dialysis exist: With hemodialysis, a tube connects the patient to a machine that removes blood from the body, filters it, and returns it to the body. Hemodialysis usually takes place at a dialysis center three times a week and takes three to four hours per treatment.
With peritoneal dialysis, the patient injects a blood-cleansing solution called dialysate into the abdomen through a permanently implanted catheter. Once inside the body, the dialysate extracts toxins and excess fluid from the blood, and the waste products drain out through the catheter. Peritoneal dialysis must be done four times a day, but it can be done at home.
Kidney transplants have a high success rate and eliminate the need for dialysis. Unfortunately, the demand far outstrips the supply of donated organs, so patients with kidney failure often wait years to receive a transplant.
Dialysis and transplants are final, drastic countermeasures for kidney failure. Lets step back and look at how your doctor can make an early diagnosis of kidney disease, allowing treatment that in most cases can prevent the disease from progressing to the point where these extreme measures are needed.
Next, a urine test checks for protein in urine. The presence of more than a small amount (a condition called proteinuria) suggests kidney damage. Previously, physicians thought that a 24-hour supply of an individuals urine was needed to run this test which discouraged many doctors from making it part of routine medical checkups but a standard sample given at the doctors office provides a sufficient, accurate protein assessment, according to the new guidelines issued last year by the US National Kidney Foundation.
Along with these two tests, a blood pressure reading can help your doctor assess whether youre at risk for kidney disease. A systolic blood pressure over 140 or a diastolic blood pressure over 90 is cause for concern.
While doctors always check blood pressure during routine exams, they dont always test blood for creatinine and urine for protein. Make it a point to ask your physician to do these simple tests if youre in a high-risk group. And if you want to put yourself on the cutting edge of the movement to make kidney health a front-burner public health issue, find out what your GFR is.
Remember, early diagnosis is key, so if youre at risk, make sure your doctor regularly tests your blood pressure and urine for signs of kidney problems. And to maintain the health of your kidneys: Drink plenty of fluids; exercise regularly; dont smoke; maintain appropriate weight; and get checked regularly for diabetes and high blood pressure.