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Kidney Disease: Regular Screening Check Is Important

KIDNEY is one of the vital organs in the human body, which could become diseased, and fatal if not well treated. Kidney disease kills both the young and old in Nigeria and other parts of the world.

Dr. Adebowale Adewunmi is a consultant nephrologist at the Lagos University Teaching Hospital (LUTH), who specialises in the treatment of kidney disease. He explains that the kidney is one of the few paired organs in the abdomen, comprising the right and left kidneys. The kidney is bean shaped with various parts.

"The kidney performs several functions, but for the purpose of general consumption, I can easily say that they majorly do three things. The kidney helps to carry out and wash out waste products of metabolism. It is like a sieve that filters out through the blood. Secondly, the kidney helps in blood formation. There is a chemical supplied by the kidney called Erythropoietin. If a kidney cannot supply this at all or not enough, the blood suffers. That is why most kidney disease patients have low blood pressure.

"The third major function is in bone formation. The kidney helps to produce a hormone known as Vitamin D (calciferol). The active form of Vitamin D is vitamin D3. Before it is formed, the liver must contribute CH3 group 1 to the position 1 to make Vitamin D. The second organ is the kidney,which must produce another CH3 group and position 25. Kidney is very important because if the liver does its own work without the kidney, Vitamin D is never formed. The kidney job is to also control and equalise electrolytes," he explained.
Highlighting the causes of kidney failure or kidney disease, Akinwunmi sayed when the kidney is sick or there is kidney failure, vitamin D cannot be formed. Kidney disease could be inherited and any one can have the disease at any age.

"There are two types of kidney failure, which are Acute Kidney Failure (Acute Renal Failure), Chronic Kidney Failure also known as Chronic Kidney Disease (CKD).
When it is acute, it means the damage occurred less than three months, while the chronic one is a kidney damage of more than three months. The most common cause of kidney failure is kidney infections, which is called glomerulonephritis. This happens at any age because infection in the blood can get to the kidney and cause havoc. The second most common is hypertension, which can be inherited.

"Whenever hypertension is present and not well controlled, it can damage the kidney. One of the jobs of the kidney is to equalise pressure or control electrolytes. So, whenever the blood pressure is high, it gives a lot of pressure to the kidney, which can choke the glomerulus (tiny filters that make up the kidney) and not enable them do their function. That is why the blood pressure of anybody who is hypertensive must be controlled by taking medications. If this is controlled, there will be no kidney failure, but blood pressure that is high over a long time can cause kidney failure.

Another thing that causes kidney failure is diabetes. Too much pressure in the blood can choke the filters in the kidney (glomerulus).
"Drug abuse can also result in kidney failure. Using drugs indiscriminately is a major contributor to kidney disease. Some of the drugs are prescribed, but they are used in over dosages, especially drugs that are not kidney friendly. That is why drugs such as Gentamycin 280mg were recently banned because they are high dosage drugs that can knock off the kidney. But if you visit some Chemist shops or roadside drug hawkers, you will find them there and people are ignorant of this. There are several other drugs that people consume but don't know it is harmful to the kidney.


How to damage your kidneys?
Written by Biodun Ogungbo

Dr. Biodun Ogungbo
Early in the mornings, I see men drinking some concoctions near a local hotel. Many are taxi drivers and local menial workers with blood shot eyes, a cigarette in the mouth and a glass of some concoction in the hand. Usually, there is a woman sitting in front of bottles of the stuff. What are they drinking, I asked myself?

I also often ask my patients if they smoke, drink alcohol, sniff cocaine, smoke marijuana or drink herbal medications. The key drug and one major cause of kidney damage and chronic renal failure are the concoctions many Nigerians take. This is one of the unknown, unrecognised and frightening causes of kidney damage, hypertension and stroke in Nigeria.

A silent killer
A patient felt weak and tired for weeks. She was having problems breathing and her legs became swollen. She blamed stress and the divorce she was undergoing for this. One day, she simply collapsed and became unconscious. She was rushed to hospital where her blood pressure was found to be ridiculously high (200/120 mmHg). This required management in the intensive care unit. The doctors also found that she had kidney failure. Dialysis was recommended and she would be on dialysis for years. Now, that is not funny!

The kidneys
The kidneys filter urine, removing water and poisons from the body. They play a vital role in controlling the blood pressure. The kidneys also manufacture a hormone that helps us make blood. So, if the kidneys fail, dangerous poisons are left in the body to damage other organs, water is left in the body, making the sufferer bloated and less blood is made; so, anaemia (low blood level) results. Failure of the kidneys lead to difficulty with blood pressure control and the blood pressure becomes very high, with the risk of damaging other organs such as the heart and the brain.

How do you know?
One of the earliest signs that one notices with kidney damage is decreased urine flow and increase in the frequency of urination. The colour of the urine may also be darker, cloudy and red in some instances. Urine may be cloudy because there is protein in it since the kidneys have lost their ability to keep such vital material in the body. Red, because there may be blood in the urine: a really bad sign.

What should you do?
Many adults and young people have KIDNEY DISEASE. We do not have any statistics about the number of sufferers. Millions more are at increased risk for getting it, and most don't know it. Kidney disease can be found and treated early to prevent more serious disease and other complications. The National Kidney Foundation in America recommends two simple tests to check for kidney disease:

Get some urine to the laboratory or diagnostic centre. A urinalysis is a test that checks a sample of your urine for the amount of protein, blood (red blood cells and white blood cells) and other things. Protein and red and white blood cells are not normally found in the urine; so, having too much of any of these may mean kidney disease. Having protein in the urine is one of the earliest signs of kidney disease, especially in people with diabetes.

Glomerular filtration rate
Give some blood to the laboratory of diagnostic centre. Ask them to calculate your GFR. GFR is estimated from results of a serum (or blood) creatinine test. The GFR tells how well your kidneys are working to remove wastes from your blood. It is the best way to check kidney function. A serum (or blood) creatinine test alone should not be used to check kidney function. GFR is calculated using the serum creatinine and other factors such as age and gender.
In the early stages of kidney disease, GFR may be normal. A value of 60 or higher is normal (GFR decreases with age). A GFR number of less than 60 is low and may mean that you have kidney disease.
Ask your doctor about these two simple tests. They should be done at least once a year so that if you have early kidney disease, it can be treated right away.

In your hands
Prevention of damage to your kidneys by watching what you eat, drink and the drugs you put into your body is the real message here. Do not drink concoctions or use herbal medications that people swear will cure all your ailments, including poverty and joblessness! Also, watch other drugs such as the routine pain killers people take for headaches, back pain and malaria.
Be careful and do not risk your kidneys. I don't want to scare anyone, but long- term dialysis is not the answer, even if you can afford it!

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