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Everything you need to know about kidney failure
Dr Frank Asiimwe, a urologist, says kidney disease is more prevalent among people who are 40 years and above due to lifestyle diseases.
What you need to know:
- If your kidneys are not able to function properly, your body becomes overloaded with toxins. This can lead to kidney failure, which can be life threatening if left untreated.
World Kidney Day is commemorated every second Thursday of March and this year, it will be celebrated under the theme; ‘Bridge the knowledge gap to better kidney health’. According to worldkidneyday.org, an online portal, one out of every 10 adults have chronic kidney disease and by 2040, it will be the fifth leading cause of death in the world.
Kidney disease occurs when the kidneys are unable to perform their functions. Dr Joseph Gyagenda Ogavu, a nephrologist, says these functions include removing waste and extra fluid from the body as well as removing acid that is produced by the cells. Kidneys also aid in maintaining a healthy balance of water, salts, and minerals such as sodium, calcium, phosphorus, and potassium, in the blood.
“That is why one will pass less urine when it is hot and a lot when it is cold. With kidney disease, this balance is lost,” he explains.
Hormones
Kidneys also produce a vital hormone called Erythropoietin that supports the formation of blood in the body, and they contribute to the management of glucose levels in the body. Therefore, when ones kidneys are failing, they will be unable to perform any or all of the above functions.
Dr Frank Asiimwe, a urologist, says kidney disease is more prevalent among people who are 40 years and above due to lifestyle diseases. Additionally, he says, there has recently been a spike in patient numbers since previously, people suffered and died in silence. However, today, specialists (nephrologists) and treatment centres have increased.
“Sadly though, lifestyle diseases have increased owing to changes in lifestyle,” he adds.
Causes
Dr Ogavu says diseases affecting the body can result in kidney failure or injury since the kidney is served with about 25 percent of the blood from the heart at any one time.
“Therefore, if you have disease in the lungs, skin, throat, or an allergic condition, they will deposit complexes (products of the disease) and toxins in the kidneys,” he says, adding that these could be infections, or malaria. This is compounded by complications such as low blood pressure, blood loss, dehydration as well as some medications that usually accompany severe illness.
Connective tissue disease also causes a fight in the body that should not happen in the normal process. Ultimately, Dr Ogavu says, the fight leads to deposits in the kidneys which impair their vital functions.
Prescription drugs are ordinarily good for managing pain and these include non-steroid non-inflammatory drugs. However, when misused or given to someone who is already at risk, over a period of time, they can cause kidney malfunction.
Diabetes
Other causes of chronic kidney disease are diabetes (high blood sugar) and hypertension (high blood pressure).
“Most patients being managed for chronic kidney disease have diabetes, hypertension or both. When ill-managed, these chronic illnesses lead to kidney damage,” says Dr Ogavu.
Among men, the urethra, which is the tube that takes urine from the bladder thus enabling one to pass it out, gets obstructed by the enlargement of the prostate gland. While it can be treated with drugs or surgery, when not treated early and properly, the ensuing blockage of flow results in kidney damage.
Among women, cervical cancer is common among those suffering from HIV, especially if they are not receiving treatment (ARVs).
“Cervical cancer is preventable through vaccination of girls aged nine and 13 and can be extended to 26 years of age as long as one tests negative for the Human papillomavirus (HPV), which is present in most women that are diagnosed with cancer of the cervix. The same is treatable when caught early although most women present late when the disease is in its advanced stages, causing blockage of the urethra (small tubes that drain urine from the kidneys to the urinary bladder),” Dr Ogavu says.
Congenital conditions
Sometimes, children are born with blocked or malformed kidneys or with problems in the tubes that connect to the bladder. Dr Ogavu adds that during pregnancy, if one develops high blood pressure (preeclampsia) and is not well managed, their risk of getting kidney disease is high.
Lifestyle habits
These include excessive alcohol intake, smoking, and illicit drugs such as cocaine and marijuana as they damage the blood vessels.
Others include taking lots of salt, not drinking enough water, not getting enough sleep, and eating foods that are high in sugars. Most of these can result in someone having high blood pressure, which leads to kidney damage.
Prevention
Water is important in guarding against kidney disease because every condition that causes dehydration, when not dealt with will result in kidney failure.
“These include diarrhoeal conditions, especially in children. Therefore, when children are sick and have diarrhoea, they must be rehydrated through taking enough fluids, oral rehydration salts, and breastfeeding,” Dr Ogavu says.
Signs and symptoms
If the disease discovery is late, then the kidneys must be supported because they are not making enough blood. The person at this point is:
● Having severe swelling of the body, especially the face (most pronounced in the morning) and the feet (less in the morning and getting worse by the day).
● Not sleeping well.
● Weak and can hardly work.
● Retaining a lot of water in the body that must be taken out.
● May make little or no urine.
● Have poor appetite.
● May vomit blood or pass it in stool.
Treatment
Dr Asiimwe says apart from ensuring that the patient remains hydrated, treatment is through drugs. However, if that fails, the patient will be put on dialysis to get their blood cleansed of excess product, remove water, salt and balance the acid.
‘‘Currently, dialysis machines are available at (Nsambya Hospital, Panorama Medical Centre, Nakasero Hospital, International Hospital Kampala, UMC Victoria Hospital, Norvik, Case Medical Centre, Mengo Hospital, BHL, Kiruddu National Referral hospital and Mulago Super Specialised Referral Hospital) and Mbarara (Mbarara Regional Referral Hospital), among others,” says Dr Asiimwe.
He adds that in case a drug is the cause of one’s kidney disease, then that drug will be taken off their treatment plan.
Cost
Dr Asiimwe says in instances where the cause of kidney failure is reversible, the cost is pegged on treating the offending condition to reverse it and this varies.
“It should also be noted that the treatment period is dependent on the condition being treated,” he says.
On the other hand, dialysis goes for between Shs200,000 and Shs450,000.
“However, at government facilities such as Kiruddu National Referral Hospital, this cost is subsidised to Shs60,000 per session and the patient will have to visit the dialysis centre at least three times every week. Dialysis is given for life or until one receives a kidney transplant,” he says.
