Chronic kidney disease prevalent among Pinoys

MANILA, Philippines - In 2003, the Department of Health reported that the prevalence of CKD (chronic kidney disease) among adult Filipinos was 2.6 percent (or 2.6 out of 100 adult Filipinos). Recent research suggests that the incidence of CKD has worsened, affecting one in 10 adult Filipinos. In 2012, the National Kidney and Transplant Institute cited kidney failure as the ninth leading cause of death among Filipinos. Consistent with worldwide statistics, the Philippine Renal Registry reports that diabetes is the leading cause of CKD at 44.6 percent, with hypertension as the runner-up at 23 percent. Early detection and treatment can often keep chronic kidney disease from getting worse.

According to Dr. Benjamin Balmores of St. Luke’s Hospital, patients with CKD should know when their kidney function might be deteriorating, as urgent evaluation and treatment are warranted.  “Most people may not have symptoms until their kidney disease is advance. However, you may notice that you feel more tired and have less energy, have trouble sleeping, swollen ankles and feet, puffiness around the eyes, and dry itchy skin, and need to urinate more often. You may also suffer fatigue and weakness from the buildup of waste products, shortness of breath due to the accumulation of excess fluid, and high blood pressure. When you see these signs, the next best thing to do is see your doctor and undergo medical exams to understand your condition.”

“Anyone can get CKD, young or old. However, some people are more likely than others to develop kidney disease. Those who are more at risk are the elderly, those who have diabetes, high blood pressure, and a family history of CKD. It is preventable and the first step to take is really to have yourself checked by an expert,” he adds.

 CKD may be caused by common medical conditions like diabetes, high blood pressure or a combination of these factors. Early detection and treatment can prevent or slow down the onset of complications. According to Dr. Balmores, one of the most important contributors to the complications is the associated mineral and bone disorder. Phosphate retention and later hyperphosphatemia are central to the development of mineral and bone disorder in CKD.

Phosphorus is found in the body as phosphate, an important element for the proper functioning of the body. It is abundant in our diet, so that the average person ingests up to about 1,500 mg of it daily. When the kidneys are diseased and their function drops to half of the original capacity, as in the case of CKD, they are no longer able to clear the blood of phosphate and excrete it in the urine. The mineral starts to accumulate in the blood, way above the average normal 4.5 mg/dL phosphate levels.

“Currently, there is a good drug available to CKD patients which addresses hyperphosphatemia. Sevelamer, known as Renvela, is a product of Sanofi and  is a non-calcium, non-metal binder of phosphate in the blood. Metal-containing binders, while effective, accumulate in the body. Aluminum-containing binders, in particular, are associated with toxicity, dementia, brittle bones, and anemia. Because risks outweigh the benefit, this first class of binders is no longer used. The calcium-containing binders, on the other hand, have the added benefit of replenishing calcium levels but may lead to a dangerous excess of calcium in the blood. This causes calcification, or calcium being deposited in the blood vessels that eventually harden, which may lead to death.”

“Renvela is the first and only non-metal, non-calcium-based binder that effectively lowers phosphorus without the risks of calcium and metal accumulation. However, you should always consult your doctor first before taking any medication. And be sure to get your medicines from your trusted drugstores to ensure the quality of the medicines you are buying,” Dr. Balmores  points out.

“We know that there are people who buy medicines from sources other than the drugstores because they are looking for cheaper prices. However, this raises concerns  because medicines need proper handling for the safety of those who will use them. Medicines have specific storage conditions  and if we buy from unauthorized dealers, there is no guarantee as to their quality and  safety, ” Dr. Balmores stresses.