Chronic Kidney Disease continues to challenge experts and caregivers

World Kidney Day underscores the importance of early detection

The importance of good Kidney Care and good Kidney Health, augmented by easy access and treatment, was the highlight of World Kidney Day observed with two recent events in Auckland. 

Organised by the Adult Renal Service to mark World Kidney Day at the Auckland Hospital on March 14 and at Pak N Save Mount Albert on April 17, 2024, the key message was to advance Kidney Health Education.

Rajeev Kumar led a Renal Multidisciplinary Team from the Chronic Kidney Disease Early Detection and Self-Management Centre to create greater awareness of issues related to good kidney care. The information that they provided targeted priority and vulnerable communities. Visitors were offered basic screening, blood pressure, blood sugar, urine protein eGFR and Creatinine.

This year’s annual event was held under the theme, ‘Kidney Health for All: Advancing Equitable Access to Care and Optimal Medication Practice.’

Hundreds of people of European, Indian, Chinese, Pacific Islander and Maori origin had the opportunity to be tested for their kidney health. Of these, 59% were female. About 29% of all people screened were identified as hypersensitive, 11% were diabetic and about 4% suffered from both illnesses. Almost 13% of the people screened were examined by Specialists who later referred the patients to their GPs for further consultation.

Fredric Doss is a Haemodialysis Educator and Professional Leader of Renal Physiology at the Auckland Hospital. The above article was edited at our Copy Desk.

Our Staff Reporter adds:

About the World Kidney Day

World Kidney Day is a global health awareness campaign focusing on the importance of the kidneys and reducing the frequency and impact of kidney disease and its associated health problems worldwide. It is observed annually on the second Thursday in March.

World Kidney Day aims to raise awareness of the importance of our kidneys to our overall health and to reduce the frequency and impact of kidney disease and its associated health problems worldwide.

Chronic Kidney Disease (CKD) is estimated to have affected more than 850 million people worldwide and resulted in over 3.1 million deaths in 2019. Today it ranks as the eighth leading cause of death and if left unaddressed, it is projected to be the 5th leading cause of years of life lost by 2040.

Over the last three decades, CKD treatment efforts have centred on preparing for and delivering kidney replacement therapies. However, recent therapeutic breakthroughs offer unprecedented opportunities to prevent or delay disease and mitigate complications such as cardiovascular disease and kidney failure, ultimately prolonging the quality and quantity of life for people living with CKD.

The high risk of diabetes

Diabetes is the biggest health risk for kidney failure and hence, regular medical checkups are essential for early detection and treatment.

According to the New Zealand Health Ministry, renal problems affect more than 400,000 people in the country.

“Chronic kidney disease (CKD) is a debilitating illness and expensive to treat. Many people die without treatment. Only about 10% of the world’s population can afford the cost of dialysis.  Taiwan is the world leader in dialysis for treating kidney failure,” officials said.

Hypertension is the second largest cause of kidney disease in India and New Zealand, and diabetes accounts for 50% of kidney ailments. Other causes are glomerulonephritis, hereditary (such as reflux nephropathy and polycystic kidney disease) and kidney stones.

Kidney stones as a cause of kidney failure are much more common in Pakistan and India than in New Zealand and people living in hot and equatorial countries face a higher risk of contracting kidney stones problems, compounded by limited access to quality water.

“Diabetes is more common in Asians and people from the Indian Subcontinent; the rate of kidney failure is probably similar in India and New Zealand. Apart from diabetes and hypertension, other issues such as smoking, obesity and heart problems contribute to renal failure, health officials said.

Obesity epidemic

New Zealand is stated to be the third ‘fattest’ country in the world, after the US and Mexico.

Experts warn that the obesity epidemic will hit us severely in the foreseeable future and developing countries are particularly at risk of this ‘wealthy’ disease, because of the availability of excess (ready-made meals, fast foods) high-energy foods.

“Most people do sedentary work, enjoy more leisure and do less physical exercise, all of which increase the risk of contracting the causes that lead to kidney failure. People in developing or under-developed countries try to emulate their counterparts in the First World countries. Emulating the latter’s habits could result in higher incidence of diabetes, heart disease, eyesight/blindness, vascular disease with limb amputation, stroke and kidney failure,” health officials said.

Diabetes and hypertension are two killer diseases that are found in increasing numbers among people of Indian origin in New Zealand.

Early Detection and Treatment

One of the main problems relating to kidney disease is early detection and treatment.

There are no symptoms specific to kidney diseases. However, people with a family history of diabetes mellitus, high blood pressure, heart disease or stroke and kidney stones are in the high-risk group. People with kidney stones, urinary infections or glomerulonephritis are also vulnerable. Apart from regular medical checkups, it is important to keep blood pressure under control and avoid kidney toxins such as anti-inflammatory drugs, some ‘Over-the-Counter’ medicines (purchased without a prescription) and herbal and cultural therapies.

The Role of Kidneys

One of the many functions of the kidneys is to filter, or clean, the blood of waste products. When the filters are inflamed, the body’s waste products accumulate in the body and cause symptoms.

Both kidneys make about 180 litres of urine daily; fortunately, most of it is reabsorbed by the kidney tubules before it reaches the bladder! There are about 50 kilometres of tubules in each kidney. Each kidney has about one million filters. Once the filter is damaged and scarred, it cannot regrow. It is lost forever.

Sometimes part of the immune system goes haywire, and instead of protecting us, the immune damage starts to destroy us. Sometimes the kidney is on the receiving end of this.

The symptoms suffered depend upon which type of glomerulonephritis, and how quickly the gn develops. The symptoms include blood in the urine; swelling of the legs, eyes and wrists; frothy urine. Generalised, non-specific symptoms such as tiredness, nausea, joint aches and rashes may also occur.

Other findings include protein and blood on urine testing; high blood pressure; and abnormal kidney function (high urea and creatinine).

Glomerulonephritis is the second to most common cause of kidney failure, leading to dialysis or kidney transplantation, in New Zealand. Approximately one-third of patients on dialysis in New Zealand have glomerulonephritis as the underlying cause.