The human body is an amazing machine that keeps us going. When we look after it, it continues its work silently.

However, when we fail to do our part, the body suffers. This is especially true for an organ like the kidney that does its work silently.

Up to 90 per cent of kidney function can be lost without experiencing any symptoms and hence it is a silent killer.

Astounded by this fact, I certainly was. We also know that about 500-600 Fijians are diagnosed with kidney failure every year.

The kidneys are two bean-shaped organs, each about the size of a fist weighting about 150 grams.

They are located just below the rib cage at the back, one on each side of the spine. Every day, the two kidneys filter about 120-150 litres of blood to produce about one – two litres of urine, composed of wastes and extra fluid.

The waste and water become urine which flows to the bladder through tubes called ureters.

The bladder stores the urine till you go to the bathroom.

So in essence, kidneys are sophisticated trash collectors.

Chronic Kidney Disease

Chronic kidney disease, also called chronic kidney failure, describes the gradual loss of kidney function.

Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine.

When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body.

In the early stages of chronic kidney disease, you may have few signs or symptoms. Chronic kidney disease may not become apparent until your kidney function is significantly impaired.

Treatment for chronic kidney disease focuses on slowing the progression of the kidney damage, usually by controlling the underlying cause.

Chronic kidney disease can progress to end-stage kidney failure, which is fatal without artificial filtering (dialysis) or a kidney transplant.

Symptoms of Chronic Kidney Disease

Signs and symptoms of Chronic Kidney Disease include are often nonspecific and can be caused by many other illnesses as well. These include:

Nausea

Vomiting

Fatigue and weakness

Loss of appetite

Persistent itch

Swelling of feet and ankles

Muscles twitches and cramps

High Blood Pressure (that’s difficult to control)

Shortness of breath if fluid builds up in the lungs

Change in the appearance of your urine- frothy, foamy or blood in the urine

Metallic taste in your mouth

Lack of concentration

Tiredness

Global Facts about Kidney Disease (From the National Kidney Foundation)

10 per cent of the population worldwide is affected by chronic kidney disease (CKD), and millions die each year because they do not have access to affordable treatment.

According the 2010 Global Burden of Disease study, chronic kidney disease was ranked 27th in the list of causes of total number of deaths worldwide in 1990, but rose to 18th in 2010. This degree of movement up the list was second only to that for HIV and AIDs.

Over two million people worldwide currently receive treatment with dialysis or a kidney transplant to stay alive, yet this number may only represent 10 per cent of people who actually need treatment to live.

Of the two million people who receive treatment for kidney failure, the majority are treated in only five countries – the United States, Japan, Germany, Brazil, and Italy. These five countries represent only 12 per cent of the world population. Only 20 per cent are treated in about 100 developing countries that make up over 50 per cent of the world population.

More than 80 per cent of all patients who receive treatment for kidney failure are in affluent countries with universal access to health care and large elderly populations.

It is estimated that number of cases of kidney failure will increase disproportionately in developing countries, such as China and India, where the number of elderly people are increasing.

In middle-income countries (Including Fiji), treatment with dialysis or kidney transplantation creates a huge financial burden for the majority of the people who need it. In another 112 countries, many people cannot afford treatment at all, resulting in the death of over one million people annually from untreated kidney failure.

In the US, treatment of chronic kidney disease is likely to exceed $48 billion per year. Treatment for kidney failure consumes 6.7 per cent of the total Medicare budget to care for less than one per cent of the covered population.

In China, the economy will lose US$558 billion (FJ$1140bn) over the next decade due to effects on death and disability attributable to heart disease and kidney disease.

In England, according to a recent report published by NHS Kidney Care, chronic kidney disease costs more than breast, lung, colon and skin cancer combined.

In Australia, treatment for all current and new cases of kidney failure through 2020 will cost an estimated $12 billion.

In people aged 65 through 74 worldwide, it is estimated that one in five men, and one in four women, have CKD.

As you can see, Chronic Kidney Disease is a huge financial burden globally and the best solution we have is early diagnosis and treatment, to slow or stop the progression. So many developing countries cannot afford expensive treatments like haemodialysis and kidney transplantation. We need solutions such as increasing the uptake of peritoneal dialysis which is an equally effective however a less expensive treatment. We also need to work on encouraging renal supportive care whereby

Symptoms are managed with the aim to improve quality of life. On many occasions patients are being dialysed, however it may not always improve their quality of life. We need to understand what we are trying to achieve.

Keeping your Kidneys Healthy

There are several things that you can do to keep your kidneys healthy.

Keeping fit and active helps to reduce blood pressure and therefore reduces the risk of chronic kidney disease.

For those of you who have diabetes, it is absolutely important to keep your blood sugar levels under control and to get regular checks for your kidney function.

Almost 50 per cent of people who have diabetes will develop kidney damage, hence the importance of regular medical checkups.

Monitoring your blood pressure is very important. Most people are aware that high blood pressure can lead to heart attacks and stroke, however most people are not aware that it can lead to chronic kidney disease. Eating a healthy well balance diet is also important.

The recommended sodium intake is 5-6 grams of salt per day, which is about one teaspoonful.

By reducing the intake of processed and restaurant foods, this can be achieved. Maintaining a healthy fluid intake is essential to good kidney health.

About two litres of water intake daily is recommended. It’s important to steer away from carbonated drinks, sugary, sweet beverages.

Smoking reduces the blood flow to kidneys and impairs the ability of the kidneys to function well. So if you are a smoker, please quit smoking so that you can give your kidneys a healthier blood flow.

Medications such as anti-inflammatory medications like ibuprofen are used commonly for pain. It is important not to use them on a daily basis as they can also impair kidney function.

Kidney function can be monitored through a blood test called eGFR and also through a urine test called urine albumin creatinine ratio.

So my fellow Fijians, I urge you to take this challenge. If we are to achieve good kidney health we need to get back to basics.

We need to eat a healthy diet. We need to exercise. We need to make lifestyle changes if we are to tackle this issue.

A beautiful quote by Sean Elliot, American former basketball player “I was a healthy young man, and I thought I was invincible before I was diagnosed with kidney disease.” So please visit your doctor and ask for a kidney health check.

Feedback: maraia.vula@fijisun.com.fj