A Silent Danger: How Kidney Failure Can Be Prevented Through Regular Tests And Screening
The very resilience that makes kidneys able to function despite significant changes also makes kidney disease a silent danger for many patients.
The kidneys are a marvellous filtration system that help the body get rid of several kinds of waste products and toxins, and maintain proper fluid levels necessary for keeping all other organs in the body healthy. They are also a remarkably resilient organ, coping with many changes to the body and their own functioning. But when the kidneys are severely impacted, there are few treatments available, save frequent expensive dialysis or a kidney transplant, both of which come with their own complications.
Unfortunately, doctors point out, the very resilience that makes kidneys able to function despite significant changes also makes kidney disease a silent danger for many patients. “Most patients do not experience any significant symptoms until very late stages. This makes it very unlikely that patients will approach us on their own before it’s too late,” says Dr Muthu Kumar P, Senior Consultant of Nephrology at Gleneagles Global Health City, Chennai.
Kidney disease and kidney failure
The kidneys are made up of small units called nephrons, which are responsible for the production of urine. Within nephrons, networks of small blood vessels called glomeruli help purify the blood of toxins and chemicals. Kidney disease involves damage to these filtration units, leading to impaired function, explains Dr Muthu Kumar.
End-stage kidney disease, also called kidney failure, occurs when such damage reaches an advanced stage, preventing the kidneys from carrying out their vital functions. This can lead to a variety of complications in various organs and systems including the heart and the circulatory system, the lungs, the skeletal system, the nervous system and so on, eventually leading to death. In the late stages, regular dialysis or a kidney transplant become necessary for survival.
Risk factors for kidney failure
While the causal factors for kidney failure may not always be known, says the doctor, there are certain factors that contribute to the development of end-stage kidney disease. “All over the world, the most common cause of chronic kidney disease is diabetes, while the second is hypertension,” he says. According to research, 40-60% of cases of chronic kidney disease occur in patients with diabetes or hypertension.
Other risk factors include family history of end-stage kidney disease, blockage of the urinary tract by kidney stones, repeated urinary tract infections, overuse of particular kinds of medications such as painkillers, and anatomical abnormalities in the kidneys resulting from congenital or other conditions.
How kidney disease and kidney failure are detected
One of the main substances filtered by the kidneys is a chemical compound called creatinine, which is created as a by-product of protein metabolism. Doctors measure the level of creatinine in the blood in order to identify and classify kidney disease into five stages of severity, the doctor explains. Besides this, doctors also check for protein levels in the urine, as many (but not all) cases of kidney dysfunction lead to leakage of protein into the urine. Both of these are simple, routine tests that can be done on a regular basis to test for kidney disease, he adds.
Why screening for kidney disease is important
In the early stages of kidney disease most patients are unlikely to experience any symptoms. Even as the condition progresses, patients often ignore some symptoms that do arise.
“Some patients experience swelling in the feet or ankles, but they dismiss it as the result of travelling or prolonged sitting. Undue tiredness and weakness may also appear, but patients find a host of explanations for that too. And the reduced urine output they tend to experience is usually dismissed as a failure to drink enough water,” the doctor says.
Due to such progression, kidney disease is more often identified in the early stages due to screening tests rather than from patients observing symptoms. Hence, the doctor advises taking a serum creatinine and urine protein test on an annual basis, particularly for people who are aged 40 or over, diabetic, hypertensive, have a history of kidney disease in the family, have had kidney stones in the past or have chronic ailments such as cardiac disease, rheumatoid ailments and other auto-immune diseases.
Given the kidneys’ resilience, kidney disease can be managed with lifestyle changes and medication, provided it is caught early, says Dr Muthu Kumar. But if patients wait till they develop symptoms, they may already be too late.
Dr Muthu Kumar P
M.B.B.S, M.D (General Medicine), D.M (Nephrology)
Senior Consultant Nephrologist and Transplant Physician
Department of Nephrology