Kidney problems on the rise

GO out and ask random people of what medical problem they fear most, and they would most likely answer “a stroke” or “a heart attack.” “Many don’t realize that developing kidney failure can be just as disabling and life-threatening,” says Dr. Rafael R. Castillo, a cardiologist at the Manila Doctors’ Hospital.

On March 10, Davao City joined the international community in commemorating the World Kidney Day. However, a few days before the celebration, two doctors from Southern Philippines Medical Center—Dr. Tes Bañes and Dr. Maria Therese Bad-ang—guested the Kapehan sa Dabaw at the Annex of SM City Davao telling the media that kidney problems are “alarmingly increasing” among children and young adults.

In terms of kidney dialysis patients, based on the records of the Renal Disease Controlled Program, Davao region ranked fifth nationwide. It comes after Pampanga, Bulacan, Batangas and Cebu.

Of the 1,200 new patients undergoing a maintenance dialysis in Davao region, some 600 cases are from Davao City.  

In an editorial, EDGE Davao pointed out: “The age of patients has also gone down to as young as 8 years old suffering from inherited diabetes and worsened by lifestyle choices. The majority of new cases recorded in the region are from the 60 to 65 age range. She also said there was also an increase in the number of patients on dialysis among young professionals. Young patients aged 12 to 18 years are also vulnerable to kidney diseases.”

The Department of Health reports that one person dies every hour from kidney failure. More than 7,000 cases of kidney failure in the country are recorded every year. This puts kidney failure as the ninth-leading cause of death among Filipinos today, according to the National Kidney and Transplant Institute. Dr. Aileen Riego-Javier, NKTI executive director, said that, for every 1 million Filipinos, 120 of them are most likely to develop kidney failure. Each year approximately 10,000 people need to replace their kidney function.

Healthy kidneys clean our blood by removing excess fluid, minerals, and wastes. They also make hormones that keep our bones strong and your blood healthy. But, if the kidneys are damaged, they don’t work properly.  

Medical science tells us that harmful wastes can build up in our body. Our blood pressure may rise.  Our body may retain excess fluid and not make enough red blood cells.  Doctors call this kidney failure.

“If your kidneys fail, you need treatment to replace the work they normally do,” says the National Institute of Health in the United States. “Before dialysis was available, total kidney failure meant death,” notes the US National Kidney Foundation (NKF). “Today, people with kidney failure can live because of treatments, such as dialysis and kidney transplant.”

According to medical experts, dialysis is a way of cleaning our blood when our kidneys can no longer do the job. It gets rid of our body’s wastes, extra salt and water, and helps to control our blood pressure.

Actually, there are two kinds of dialysis: hemodialysis and peritoneal dialysis. “In hemodialysis, blood is pumped out of your body to an artificial kidney machine, and returned to your body by tubes that connect you to the machine,” NKF explains. “In peritoneal dialysis, the inside lining of your own belly acts as a natural filter. Wastes are taken out by means of a cleansing fluid called dialysate, which is washed in and out of your belly in cycles.”

Among these patients with kidney failure in the Philippines, “only around 86 percent could undergo dialysis and only 14 percent could undergo transplantation because of the high cost of treatment,” wrote Francis James B. Gatdula in an article that appeared in Health and Lifestyle. 

Dialysis does help lengthen the life of the patient, but it is expensive. It costs around P60,000 to P70,000 a month—that’s P720,000 to P840,000 a year. This does not yet include the fees for required laboratory tests and medicines.

“In the long term, kidney transplantation is cheaper than dialysis,” said Dr. Enrique Ona, former NKTI director. “Moreover, survival rates and quality of life in transplants are much better.”

A transplant costs half a million pesos to P1-million for a one-time surgery, as long as the donated organ is not rejected by the recipient’s system.

“Kidney diseases are on the rise, and it can be considered part and parcel of the dreaded epidemic of noncommunicable diseases,” points out Dr. Castillo. “In fact, there can be hardly any argument that most chronic kidney disorders are also lifestyle-related problems, and share the same risk factors as cardiovascular and cerebrovascular diseases.”

An ounce of prevention, so goes a saying, is better than a pound of cure. The same is true with your kidneys.  In their book, Stay Younger, Live Healthier, Dr. Willie Ong and his wife, Dr. Liza Ong, shared ten ways to protect your kidneys (based from their interview with Dr. Elizabeth Montemayor, a nephrologist at the Philippine General Hospital):

Limit your salt intake.

Too much salt is not only bad for your blood pressure; it’s also bad for your kidneys. Many die of kidney disease, which can be partly attributed to a high salt intake and fondness for fish sauce, soy sauce, salt and salted fish. Even instant noodles, chips and nuts are teeming with salt.

Don’t load up on high-protein foods, such as meat and steaks. A high-protein diet makes the kidneys work twice as hard. Pretty soon, your kidneys could get tired, and some of the weaker kidney cells can die. Eat a balanced diet of rice, vegetables, fish and fruits, and you can’t go wrong.

Keep your blood pressure at 130/80 or lower. If your blood pressure is above 140 over 90, this can cause kidney damage within five years. The kidneys are said to be “happiest” with a blood pressure of 130/80 or lower. To help control your blood pressure, you should limit your salt intake, reduce weight and take medicines for high-blood pressure, if needed.

Keep your blood sugar below 120 mg/dl. Diabetes and high-blood pressure are the two leading causes of kidney failure. A person with uncontrolled diabetes for 5 to 10 years may develop significant kidney damage. Consult your doctor and keep your blood sugar under control with diet, exercise and maintenance medicines.

Drink 8 glasses of water a day. Doctors usually advise people to take in eight glasses of water a day, but this really depends on your age and condition. If you’re sweating a lot and work outdoors, you may need to drink more than 8 glasses a day. However, if you are above 65 years of age, you may do well with just 6 glasses a day. Drinking enough water also prevents the formation of kidney stones.

Watch your intake of pain relievers and other drugs. Taking pain relievers for a prolonged period of time may cause kidney damage. Because of this, we should limit taking these medicines to only a week, or just take them as needed. For those with chronic arthritis, try to look for other ways to relieve the pain, such as using a hot water bag, pain-reliever ointments or the safer paracetamol tablet.

Be careful with tests and procedures using contrast dyes. Some tests, like CT Scans and MRIs, and angiograms, use a contrast dye, which helps doctors delineate the organs better. The problem with such dyes is that they can cause kidney damage. To be safe, consult a kidney specialist before undergoing such procedures.

Don’t drink too much vitamin C. Excess vitamin C (ascorbic acid) can lead to the formation of kidney stones in predisposed individuals. If you need to take vitamin C, a dose of 500 mg or less is safer.

Don’t rely on food supplements to protect your kidneys. The aforementioned tips are, so far, the best tips to care for the kidneys.

10 Get a kidney check-up. Simple tests, such as a complete blood count and a urinalysis, are the first screening tests for the kidneys. Finding a trace of protein in the urine can alert the doctor of possible kidney disease.

“The health advice in this forum is only for general knowledge,” Dr. Ong reminds. “For your specific questions, kindly consult your personal physician.”

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