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Over 2 million people worldwide are currently receiving treatment with dialysis or kidney transplant to stay alive. AFP

“Never say no till we fail.” If there is a slogan for our pair of kidneys, this would be a good one.

Our kidneys may be small, but they perform many vital functions that help maintain our overall health, including balancing our body fluid, salts and minerals while discarding the wastes from our blood. They also produce a hormone that tells our body to make red blood cells. They serve us 24/7 in spite of all the tortures and torments we hurled on them, day after day. We should be taking good care of them. Instead, we have almost always forgotten this pair of organs that are always doing their best for our well being and survival.

Our kidneys, as hardy as they are, may fail one day. There is a limit to everything. Thus, as we can see in the statistics of the world, hundreds of thousands, if not millions, are on the dialysis machine at any one moment. Many more have cleansing fluid pump in and out of their abdomen (peritoneal dialysis) every day, and so many are waiting for the compassionate donors to give them one of their precious kidneys. Some lucky ones received it from the donors who happened to die prematurely.

About 1 in 10 people of the world population are having chronic kidney disease and 5 to 10 million die each year from it. Over 2 million people worldwide are currently receiving treatment with dialysis or kidney transplant to stay alive.

It is important to note that there is a strong link between kidney disease and metabolic diseases such as diabetes and hypertension. And they are all strongly linked to heart disease. The number of people who die of heart disease secondary to chronic kidney disease is significantly high. There were 1.2 million such deaths documented in 2013.

Apart from the causes mentioned, it has been observed that our kidney function decreases by an average of one percent each year after the age of 40. Thus, about half of the people aged 75 or more have some degree of chronic kidney disease. Many of them do not have any definable disease of their kidneys. The organs are just ageing normally.

The first time I heard about the word ‘diabetes’ was when my mom told me that a particular aunty had diabetes, or “sweet-urine-disease” in my mother-tongue lingual. That was when I was a little boy of 5 and I remember asking her inquisitively, “What is diabetes?”

“A serious disease causing kidney failure and death. That aunty will soon die,” she whispered. In those days, kidney dialysis was non-existent in the small county that I lived in. If my mom who had never attended school could define diabetes as she did, it simply implies that diabetes was indeed a fearsome disease that usually led to kidney failure and premature death in those old days when treatment was grossly inadequate. Diabetes was a relatively rare disease then. It is so common nowadays, so much so that I tend to look at it as a complication of modernisation.

Diabetic kidney disease had increased 40 percent globally in the ten years between 2005 and 2015. In many countries, half of all the cases of kidney failure are attributable to diabetes. This had been conclusively documented in Mexico, China and India. It is obvious that diabetes is the champion cause of kidney failure.

It is a disease of blood sugar that is persistently too high, causing damage to many organs in our body, including the kidneys and heart, as well as blood vessels, nerves and eyes.

The number 2 cause of chronic kidney disease is high blood pressure. Together with diabetes, it is responsible for up to two-thirds of the cases. The remaining one third are caused by glomerulonephritis, infections, kidney stones, inherited diseases such as polycystic kidney disease, overused of some over-the-counter painkillers including paracetamol (Panadol), and consumption of illegal drugs such as heroin.

There is a serious lack of focus in kidney diseases. Many people know nothing about these diseases until they are too late. Kidney diseases often cause no early symptoms. Thus, those who have damaged kidney function don’t often feel it. And they are also not aware that their damaged kidneys contribute towards increased risk of serious life threatening conditions such as heart problems, infections and kidney failure.

Thus, in July 2018, the world renal experts called for a focus in renal diseases, highlighting that kidney diseases is a “hidden epidemic” affecting more than 850 million people worldwide. This figure is horrendous. It is twice the number of diabetics and more than 20 times the number of people currently suffering from cancer or HIV/AIDS.

“It is high time to put the global spread of kidney diseases into focus,” said Prof. David Harris and Prof. Adeera Levin in the news released for the American Society of Nephrology in June 27, 2018.

The good news about most kidney diseases is the fact that it can be treated very effectively if it is detected in the early stages. For people with diabetes, keeping the blood sugar under good control is of paramount importance. There are also medications to protect the kidneys if the kidneys are losing abnormal amount of protein which is an indicator of kidney damage.

If high blood pressure is present, they too must be kept under good control with low salt diet, physical exercise and medication if necessary. There are two groups of antihypertensive medications that are proven to confer protection to the kidney. These medications are especially helpful for people suffering from both diabetes and hypertension.

Kidney disease is usually a progressive disease. Whatever damage that occurs is irreversible. Thus, it is important to identify the disease early before the damage is done.

A yearly screening of blood pressure, blood sugar and urine test with additional blood tests to determine the kidney function for the older age group and people with features suggestive of higher risk of kidney diseases are recommended.

Dr. Victor Ti, MD, MFAM (Malaysia), FRACGP (Australia), Dip P Dermatology (UK), Dip STDs/AIDS (Thailand), Dip. AARAM (USA), LCP of Aesthetic Med.(Malaysia) is an experienced expat specialist generalist (Family Physician) of BH Clinic, Phnom Penh. As a specialist generalist, he is skillful at diagnosing all general diseases and excluding the sinister ones. Apart from the general diseases, Dr. Victor is also known for his skill in skin diseases, sexually transmitted diseases, minor surgery and aesthetic medicine. He can be contacted via email [email protected] Tel: 023900446 or Whatsapp: +60164122977.

Facebook name: Victor Ti.

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