Kidney disease : Tips for early diagnosis

Dr Sanjeev Gulati *

The posterior surfaces of the kidneys, showing areas of relation to the parietes :: Pix - Wikipedia

There is an an increasing prevalence of kidney disease all around the world and also in our country. Most people know that a major function of the kidneys is to remove waste products and excess fluid from the body. These waste products and excess fluid are removed through the urine. This process is necessary to maintain a stable balance of body chemicals.

The critical regulation of the body's salt, potassium and acid content is performed by the kidneys. The kidneys also produce hormones that affect the function of other organs. For example, a hormone produced by the kidneys stimulates red blood cell production. Other hormones produced by the kidneys help regulate blood pressure and control calcium metabolism.

Hence it is important for people who have diabetes, high blood pressure or those who have may of the above symptoms to get themselves screened for kidney disease and get their kidney function (GFR) checked. An early diagnosis and prompt treatment can help avoid dialysis and transplantation or prolong the life of the kidneys and delay the need for the same.

The kidneys are powerful chemical factories that perform the following functions:
– Remove waste products from the body
– Remove drugs form the body
– Balance the body's fluids
– Release hormones that regulate blood pressure
– Produce an active form of vitamin D that promotes strong, healthy bones
– Control the production of red blood cells

What is Chronic Kidney Disease (CKD)?

Chronic kidney disease includes conditions that damage your kidneys and decrease their ability to keep you healthy by doing the jobs listed. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick. You may develop complications like high blood pressure, anemia (low blood count), weak bones, poor nutritional health and nerve damage.

Also, kidney disease increases your risk of having heart and blood vessel disease. Early detection and treatment can often keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.

How common is it ?

There is very little Indian data but initial studies suggest that the prevalence in India may be in range from 15- 20 out of 100 individauls in general population.

Early detection can help prevent the progression of kidney disease to kidney failure.
Heart disease is the major cause of death for all people with CKD.
Glomerular filtration rate (GFR) is the best estimate of kidney function.
Hypertension causes CKD and CKD causes hypertension.
Persistent proteinuria means CKD.
High risk groups include those with diabetes, hypertension and family history of kidney disease.

Three simple tests can detect CKD: blood pressure, urine and serum creatinine. Many people with Kidney Disease are still in the dark. Nearly half of people with an advanced form of kidney disease do not know they have weak or failing kidneys, according to recent research published in the American Journal of Kidney Diseases.

When it comes to diagnosing and determining the best diagnostic test measuring glomerular filtration rate, or GFR, is the most accurate way to diagnose kidney disease. GFR is also the best tool to gage a patient's stage of disease, enabling doctors to plot out the most appropriate course of treatment. In other words, knowing your GFR can save your life. Everyone who is at risk of kidney disease must get their GFR checked on a regular basis.

Who are the people at high risk of Chronic Kidney Disease?

Anyone can get chronic kidney disease at any age. However, some people are more likely than others to develop kidney disease. You may have an increased risk for kidney disease if you:
– have diabetes
– have high blood pressure
– have a family history of chronic kidney disease are older
– belong to a population group that has a high rate of diabetes or high blood pressure, such as Indians.

What Are the warning signs of kidney disease?

– High blood pressure
– Protein and/or blood in the urine
– Creatinine and BUN blood tests outside the normal range*
– Glomerular filtration rate (GFR) of less than 90**
– More frequent urination, particularly at night; difficult or painful urination
– Puffiness around eyes, swelling of hands and feet