The rise of kidney problems

TEN years ago the kidneys of Elisa started to deteriorate as a result of the disease she had since she was still a teenager. By 2005 she had a chronic kidney failure and was into a program of dialysis three times a week. Since dialysis treatment is a long process, she thought of getting a kidney transplant.

“My husband tried to donate his other kidney, but it was incompatible with mine,” Elisa recalled. Her brother offered his kidney, too, but she was crushed when the doctor told her that her brother’s kidney was also a mismatch.

Since she could not find any donor, she went to another province and eventually found one. On September 30, 2005, she had her kidney transplantation. “My body, has very strong resistance towards foreign organs,” Elisa lamented. “It went into acute rejection on the fifth day of the transplant while I was still in the hospital.” 

She was flown back to her hometown. Her surgeon administered high dosage of drugs and after two days, the new kidney was activated. “Thank God, I was discharged after one week,” she said.


Elisa was also grateful for that person who donated his kidney to her. “I had a new lease on life because someone did that for me before he died,” she said. “Whoever he was, I will always be thankful to him.”

The kidneys, two bean-shaped organs which measure about 4 to 5 inches each, produce urine from waste products removed from the blood. While most people have two kidneys, there are few who are born with only one. “All functions normally performed by two kidneys can be carried out adequately by one healthy kidney,” according to The Merck Manual of Medical Information.

Unknowingly, health problems affecting the kidneys are becoming common compared in the past. If you go out and ask people of what medical problem they fear most, they would either mention stroke or heart attack. “Many Filipinos don’t realize that developing kidney failure can be just as disabling and life-threatening,” said Dr. Rafael R. Castillo, cardiologist at the Manila Doctors’ Hospital.

The Department of Health (DOH) reported that one person dies every hour from kidney failure. Every year, more than 7,000 cases of kidney failure in the country are recorded. 

This puts kidney failure as the ninth-leading cause of death among Filipinos today, according to the National Kidney and Transplant Institute (NKTI).

Dr. Aileen Riego-Javier, NKTI executive director, said that for every 1 million Filipinos, 120 of them are most likely to develop kidney failure.  

As stated earlier, healthy kidneys clean the blood in the body by removing excess fluid, minerals and waste. Not only that, kidneys also make hormones that keep the bones strong and the blood healthy. But if the kidneys are damaged, they don’t work properly.   

Harmful waste, it has been found, can build up in the human body.  Blood pressure may rise, which may cause hypertension.  When the body retains excess fluid and does not make enough red blood cells, kidney failure may result.

“If your kidneys fail, you need treatment to replace the work they normally do,” the National Institutes of Health in the United States said.  “Before dialysis was available, total kidney failure meant death,” the US National Kidney Foundation (NKF) said. “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 the blood when the kidneys can no longer do the job required from them. Dialysis gets rid of the body’s waste, extra salt and water aside from helping control the 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 explained. “In peritoneal dialysis, the inside lining of your own belly acts as a natural filter. Waste is taken out by means of a cleansing fluid called dialysate, which is washed in and out of your belly in cycles.” 

Kidney disease, particularly end-stage renal disease (ESRD), is already the seventh-leading cause of death among Filipinos, recent statistics show. For patients with ESRD, a kidney transplant is often the only hope for survival. While the number of patients with ESRD is increasing, the number of living and deceased kidney donors remains dismally low.

Dr. Enrique Ona, who used to be the director of NKTI before he became health secretary, said that kidney transplantation is cheaper than dialysis “in the long term.”  “Moreover, survival rates and quality of life in transplants are much better,” he added”

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 they can be considered part and parcel of the dreaded epidemic of noncommunicable diseases,” Castillo pointed out.  “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 is better than a pound of cure, so goes a saying. The same is true with your kidneys. In their book, Stay Younger, Live Healthier, Dr. Willie Ong and his wife, Dr. Liza Ong, shared 10 ways to protect your kidneys (based on 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 eight glasses a day. However, if you are above 65 years of age, you may do well with just six 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 reminded. “For your specific questions, kindly consult your personal physician.”


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