{By: Dr. Suresh D.R., Chief of Laboratory – Centralab Metropolis, Karnataka, and Regional COL – Andhra Pradesh and Telangana, Metropolis Healthcare Ltd.}
Kidneys are the most vital organs involved in excretion of wastes from the human body. Although globally many deaths are attributed to kidney disease, lack of awareness or unpreparedness for the devastating diagnosis has created asymptomatic silence among the disease population. Fulcrum revolves around the etiology related to nature of kidney disease being either reversible or irreversible.
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The Impact Of Undiagnosed Kidney Disease
Impact of undiagnosed kidney disease depends on age, stage, lineage and environmental damage. Chronic Kidney Disease (CKD) refers to decreased kidney function shown by estimated glomerular filtration (eGFR) less than 60 mL/min per 1.73 m2 and/or evidence of kidney damage markers, at least for 3 months, regardless of the underlying cause. CKD is expected to be a major cause of global deaths by 2040 apart from diabetes, mental diseases or accidents according to recent surveys. CKD is silent & poses a diagnostic challenge in early stages as serum creatinine increases only after considerable renal damage. Delaying medical care can exacerbate chronic kidney disease, resulting in heightened multi-systemic complications such as cardiovascular issues, anemia, bone complications, malnutrition, and a diminished quality of life.
Risk Factors Contributing To CKD
Obesity, diabetes and hypertension are key risk factors for chronic kidney disease. Additional risks include family history of kidney disease, prior acute kidney injury, pregnancy-related kidney disease, kidney stones, cancer, autoimmune disorders, low birth weight or preterm babies, and congenital anomalies of the kidney and urinary tract. Environmental threats like heat stress for agricultural workers, environmental toxins, traditional medicines, and viral infections like hepatitis or HIV, climate change, air pollution also indirectly influences kidney health.
Early identification of kidney disease can protect kidney health, prevent disease progression and related complications, reduce cardiovascular disease risk or death. Even in early-stage CKD, multisystem morbidity decreases quality of life. CKD progresses to kidney failure which makes inevitable for kidney transplantation or kidney replacement therapy as ultimate options for survival. This will disharmonise the social life due to substantial economic burden and heavy social pressure on individuals, families, and the country.
Diagnostic Approaches To Kidney Disease
Blood pressure measurement, simple laboratory tests like fasting blood sugar, glycosylated haemoglobin, serum creatinine, estimated glomerular filtration rate (eGFR) & tests for visceral adiposity are recommended to detect kidney disease and predict the impact of disease burden. In adults and children, a first morning urine sample is preferred for assessing either protein or albumin in urine referred as urinary albumin-creatinine ratio (uACR) or urinary protein-creatinine ratio or haematuria i.e. blood in urine. Radiological evaluation plays a significant role to confirm structural or disease patterns like kidney masses, cysts, stones, hydronephrosis, or urinary retention. Challenges of diagnosis include cost, reliability of testing, and lack of trackable uniform health information systems.
Preventive Strategies And Measures For Kidney Health
Primary prevention treats the risk factors and improves kidney health. High-risk individuals with conditions like diabetes mellitus, hypertension, and polycystic kidney disease should undergo regular screenings and medical consultations. Secondary prevention reduces disease progression and renal complications in CKD patients. Recommended prevention strategies are healthy diet, adequate hydration, physical activity, blood pressure monitoring, sugar monitoring, avoiding nicotine or misuse of nonsteroidal anti-inflammatory drugs etc. Tertiary prevention improves outcomes in kidney failure patients by improving healthcare deliveries like vaccination or optimal dialysis delivery. Genetic testing may be advised for known genetic risk of kidney disease.
Evaluating occupational risk of developing kidney disease will be a remarkable preventive health program. Similarly, for kidney donors, post donation surveillance program to assess kidney health over the long term will be beneficial. Eco-friendly advantages to save water and plastic waste, especially associated with dialysis can be a real boon. This will benefit the individual, healthcare system and boost the collective economy in terms of improved productivity, developmental or educational improvements in children and young adults.
The author, Dr. Suresh D.R., is the Chief of Laboratory – Centralab Metropolis, Karnataka, and Regional COL – Andhra Pradesh and Telangana, Metropolis Healthcare Ltd.
[Disclaimer: The information provided in the article, including treatment suggestions shared by doctors, is intended for general informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified healthcare provider with any questions you may have regarding a medical condition.]
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