Chronic Kidney Disease: Are You At Risk?

By Dr Rafidah Dato’ Abdullah

The kidneys are bean-shaped organs situated at the back, weighing only 0.5% of the total body weight. It is an important organ as it receives 25% of blood of every single heartbeat.

From the heart, blood travels to the kidneys through renal arteries. The ureter is responsible of channelling the passage of urine through to the bladder. The kidneys have millions of “nephrons” in its cortex, which is on its own a unique structure responsible for various important functions.

Main functions of the kidneys

The kidney participates in whole-body homeostasis, such as:

1.            Regulating acid-base balance, electrolyte concentrations

2.            Maintaining fluid balance and volume

3.            Regulation of blood pressure

4.            Release hormones into your blood to help your body make red blood cells and promote strong bones

Dr Rafidah Dato’ Abdullah

The kidney accomplishes these homeostatic functions both independently and in concert with other organs. Many of the kidney’s functions are accomplished by relatively simple mechanisms of filtration, reabsorption, and secretion, which take place in the nephron.

Filtration is the process by which cells and large proteins are filtered from the blood to make an ultra-filtrate that eventually becomes urine. The kidney generates 180 liters of filtrate a day, while reabsorbing a large percentage, allowing for the generation of only approximately 2 liters of urine.

Reabsorption is the transport of molecules from this ultra-filtrate and into the blood. Secretion is the reverse process, in which molecules are transported in the opposite direction, from the blood into the urine.

WHAT IS CHRONIC KIDNEY DISEASE (CKD)?

Chronic Kidney Disease includes conditions that damage your kidneys and decrease their ability to keep you healthy by functioning as it should. If kidney disease gets worse, wastes can build to high levels in your blood and make one feel sick.

You may develop complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage.

Kidney disease increases your risk of having heart and blood vessel diseases and  cardiovascular disease. These problems may happen slowly over a long period of time.

Early detection and treatment can often keep chronic kidney disease from worsening. When kidney disease develops, it will eventually lead to kidney failure; a condition which requires dialysis treatment or a kidney transplant to maintain a patient’s life.

WHAT CAUSES CKD?

The two main causes of chronic kidney disease are diabetes and high blood pressure, which are responsible for up to two-thirds of all cases.

Diabetes happens when your blood sugar is too high, causing damage to many organs in your body, including the kidneys and heart, as well as blood vessels, nerves and eyes.

High blood pressure, or hypertension, occurs when the pressure of your blood against the walls of your blood vessels increases. If uncontrolled, or poorly controlled, high blood pressure can be a leading cause of heart attacks, strokes and chronic kidney disease. Chronic kidney disease can also cause high blood pressure.

Other conditions that affect the kidneys are:

  • Glomerulonephritis, a group of diseases that cause inflammation and damage to the kidney’s filtering units. These disorders are the third most common type of kidney disease.
  • Inherited diseases, such as polycystic kidney disease, which causes large cysts to form in the kidneys and damage the surrounding tissue.
  • Malformations that occur as a baby develops in its mother’s womb. For example, a narrowing may occur that prevents normal outflow of urine and causes urine to flow back up to the kidney. This causes infections and may damage the kidneys.
  • Lupus and other diseases that affect the body’s immune system.
  • Obstructions caused by problems like kidney stones, tumors or an enlarged prostate gland in men.
  • Repeated urinary infections.

STAGES OF CKD

There are 5 stages of chronic kidney disease. Stage 1 is the earliest stage and it advances to other stages with increasing severity of kidney disease. Stage 5 will need to commence renal replacement therapy (transplant or dialysis) as kidney function is extremely poor and complications will occur if treatment is not instituted the soonest possible.

SYMPTOMS OF CKD

Most people may not have any severe symptoms until their kidney disease is advanced, until it has reached Stage 5. However, you may notice that you:

  • Feel more tired and have less energy
  • Have trouble concentrating
  • Have a poor appetite
  • Have trouble sleeping
  • Have muscle cramping at night
  • Have swollen feet and ankles
  • Have puffiness around your eyes, especially in the morning
  • Have dry, itchy skin
  • Have the need to urinate more often, especially at night

 

This article is Part 1 in a 3-part educational series in conjunction with celebration of the World Kidney Day. All are invited to join us in the launching ceremony and also the awareness run on 4 March 2012 at Dataran Merdeka. For more information, please visit www.msn.com.my or www.moh.gov.my.

The National Kidney Foundation (NKF) Malaysia is a non-profit charitable organisation dedicated to helping Malaysians suffering from end stage kidney failure who lack access to or cannot afford dialysis treatment. Currently there are over 1,400 dialysis patients receiving subsidised dialysis treatment in our 24 dialysis centres nationwide, and the numbers are growing annually.

NKF needs funds to continue providing subsidised dialysis treatment to patients and to run the operations of our dialysis centres and the foundation in general. Please call us at 03-7954 9048 ext 208 to contribute to our fundraising efforts or via email fundraising@nkf.org.my

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