Chronic kidney disease becoming inexorable health threat: How to manage it

We are witnessing a rapid transition with increasing prevalence of non-communicable diseases (NCDs) especially in the urban areas. While cardiovascular diseases (heart attacks, heart failure, et cetera), diabetes, stroke and cancer are some of the better known among NCDs, what is now becoming an inexorable health threat is chronic kidney disease (CKD). According to the 2015 Global Burden of Disease Study, kidney disease accounted for 1.1 million (11 lakh) deaths worldwide.

Chronic kidney disease occurs when the normal functioning of the kidneys is impaired and they are unable to filter wastes and remove excess fluid from the body. Depending on the cause, it can progressively get worse and cause irreversible damage. Diabetes mellitus is one of the leading causes of CKD across the world and is often brought on by obesity. Hypertension (high blood pressure), kidney stones, chronic glomerulonephritis, autoimmune conditions like systemic lupuserythematosus (especially in women), certain hereditary disorders like polycystic kidney disease and heavy use of pain killers are some of the other causes. It is worthwhile to note that CKD may not become apparent in its early stages as most patients do not develop any symptoms. 

Dinesh Khullar, Chairman Nephrology & Renal Transplant Medicine, Max Super Speciality Hospital, Saket (New Delhi)

The disease can be controlled to slow down its progression through certain medications, diet and other lifestyle changes. If the kidney function continues to deteriorate and worsens beyond a certain point, the patient needs renal replacement therapy (RRT) in the form of dialysis or kidney transplantation. 

Dialysis: It is a way of cleaning the blood and removing wastes and toxins that build up in the body due to kidney failure.

Hemodialysis (HD): In HD, blood is pumped out of the patient's body into a machine where it is run through a filter to clean out the impurities and remove excess fluid and the clean blood is then returned to the patient's body.

Peritoneal Dialysis (PD): PD involves placing a synthetic tube called PD catheter in the abdominal cavity. A special type of fluid called dialysate is instilled into the abdomen through this tube and allowed to stand for a few hours. It draws out various wastes and impurities from the blood. The dirty or used dialysate is then drained out and clean dialysate filled once again. Peritoneal Dialysis is a simpler form of dialysis as it can be done at home or office and therefore involves limited lifestyle interruptions. 

Kidney transplantation: It’s the renal replacement therapy of choice. Compared to dialysis, it prolongs survival, decreases cardiovascular incidents and prevents complications of CKD on various parts of the body. It is more cost effective in the long run and can potentially ensure for the patient a normal quality of life. 

Considering the growing number CKD cases each year, it’s time to create more awareness regarding the risk factors causing CKD, and advise periodic blood tests and urine tests for early diagnosis and take preventive measures. 

Measures like dialysis and kidney transplantation play a pivotal role to let these patients successfully fight the dreaded disease.