A person can lose up to 90% of their Kidney Function before experiencing any symptoms

Today is World Kidney Day, and it's important to take care of our kidneys. Kidneys remove waste and extra fluid from our blood, control blood pressure, help make red blood cells, and keep our bones healthy. Many people with kidney disease don't have symptoms until it's advanced, so it's important to get tested if you have risk factors like high blood pressure, diabetes, family history of kidney disease, or if you're overweight, smoke, or over 50. Kidney function tests measure creatinine and GFR in the blood and urine. Early detection is crucial to prevent kidney failure. There are 8 golden rules to prevent chronic kidney disease: stay active, eat a healthy diet, reduce salt intake, check blood sugar and pressure regularly, and drink appropriate fluids. Namaskar, hello and welcome to this special podcast from Arugyam Institute of Integrated Medical Sciences. Today is 9th of March and world over it is commemorated as the World Kidney Day. A person can lose up to 90% of their kidney function before experiencing any symptoms. So this is quite alarming part that we have to keep our kidneys well in place and keep doing the kidney function tests to just avoid this chronic damage. So we all know that our kidneys make urine, they remove waste and extra fluid from our blood, controls our body's chemical balance, help control our blood pressure, help keep our bones healthy and help make the red blood cells, the RBCs. The kidneys are complicated and amazing organs that do many essential tasks to keep us healthy. The main job of our kidneys is to remove toxins and excess water from our blood. Kidneys also helps to control our blood pressure to produce the RBCs, the red blood cells and to keep our bones healthy and each of our kidneys is roughly the size of our fist. They are located deep into the abdomen beneath the ribcage. Our kidneys they control blood stream levels of many minerals and molecules including sodium and potassium and help to control the blood acidity. Daily our kidneys carefully control the salt and water in our body so that our blood pressure remains the same. How do we know that we are at a kidney disease risk? Do you have a high blood pressure? Do you suffer from diabetes? Do you have a family history of kidney disease? Are you overweight? Do you smoke? Are you over 50 years of age? Are you African, Hispanic, Aboriginal or Asian origin? So if you have answered yes to one or more of these questions, you should discuss with your doctor. You may need the testing for a kidney disease. So early chronic kidney disease has no sign or symptoms. This is the most tricky part of kidney diseases but you can help delay or prevent kidney failure by treating kidney diseases early. So in order to treat the kidney disease early, we should understand that we can lose 90% of our kidney function before experiencing any symptoms. So what kind of symptoms people get until the CKD chronic kidney disease is advanced? Some of the signs of CKD are swollen ankles, fatigue, difficulty in concentrating, decreased appetite, decreased, there is blood in the urine and there is a foamy urine which comes over there. So kidney diseases can be detected. The majority of individuals with early stages of CKD, they unfortunately they go undiagnosed. On WKD, we are calling on everyone to check today, World Kidney Day, if you are at risk for kidney disease and we would like to encourage people with any risk factors to take a simple kidney function test. It is a very standard, simple kidney function test. Kidney diseases usually progress silently, often destroying most of the kidney function before causing any symptoms. The early detection of failing kidney function is crucial because it allows sustainable treatment before irreversible kidney damage or deterioration manifests itself through other complications. So what is kidney function test? They are simple laboratory tests which are done on small samples of blood to measure the creatinine content and estimate something called GFR and they are also conducted on urine to measure creatinine and albumin excretion. So your doctor uses the results of your serum creatinine measured in the blood to estimate your overall kidney function or glomerular filtration rate, the GFR and your blood sugar to be sure that you do not have diabetes. A simple dipstick test may be used to detect excess protein in the urine. So serum creatinine, it is a waste product in your blood that comes from muscle activity. It is normally removed from your blood by your kidneys. But when kidney function is reduced, the creatinine level rises and your doctor can use the results of your serum creatinine test to calculate your GFR, which reflects how well your kidney is functioning. The glomerular filtration rate GFR, it tells how much total kidney function you have. It may be estimated from a blood level of creatinine. Normal is about 100 millimeter per minute. So lower values indicate the percentage of normal kidney function which you have. If you have GFR falling below 60 ml per minute, you will usually need to see a kidney disease specialist who is known as a nephrologist. The treatment you receive from the nephrologist does not prevent a further reduction in GFR. Your nephrologist will speak to you about treatments for kidney failure. You might need later like dialysis or kidney transplant. A GFR below 15 indicates that you may need to start one of these treatments soon. The urine albumin, its presence of excess protein in the urine is also a mark of CKD and is better indicator of the risk for progression and for premature heart attacks and strokes than GFR alone. Excess protein in the urine can be screened for by placing a small plastic strip imbedded with chemicals that change color when protein is present, it is called a urine dipstick into a fresh urine specimen and can be measured more accurately with a laboratory test on the urine. Urine albumin to creatinine ratio is another chemical part. A urine albumin to creatinine ratio which is called a UACR on a spot urine specimen is a laboratory test to measure and monitor urine albumin. UACR is the ratio between two measured substances albumin and creatinine in the urine. UACR is usually expressed as milligram albumin per gram of creatinine and estimates 24 hour urine albumin excretion. UACR is unaffected by variations in urine concentration and is therefore more accurate than a dipstick. Protein area is diagnosed when UACR is greater than 30 milligram per gram and is a sign of CKD. So this was a bit of a chemistry or biochemistry as we can all say just to tell you that kidney function test is a very simple one and we can get it timely, regularly, we can understand that our kidneys are well under check. So what are the 8 golden rules of prevention of CKD, the chronic kidney diseases? Kidney diseases as we have known again that they are silent killers which will largely affect our quality of life. There are however several ways to reduce the risk of developing a kidney disease. Now what can we do about it? The 8 golden rules, the first and the foremost which remains across all chronic diseases is keep fit, be active, which can help you maintain an ideal body weight, reduce your blood pressure and the risk of chronic kidney disease. The concept that on the move for kidney health is a worldwide collective march involving the public, celebrities and professionals moving across a public area by walking, running and cycling. Why not join them? By whatever means you prefer, check out the event sections across for more information. So eat a healthy diet, again this can help you maintain an ideal body weight, reduce your blood pressure, prevent diabetes, heart disease and other conditions which are associated with chronic kidney disease. Reduce your salt intake, the recommended sodium intake is 5-6 grams of salt per a day, not more. Now this includes the salt already in your foods which is around a tablespoon. So to reduce your salt intake, try and limit the amount of processed and restaurant food and do not add salt to your food, it will be easier to control your salt intake if you prepare the food yourself with fresh ingredients. Try to check and control your blood sugar, about half of the people who have diabetes do not know that they have diabetes, therefore you need to check your blood sugar levels as part of your general body checkup and this is especially important for those who are approaching middle age or older, about half of the people who have diabetes, they develop kidney damage but this can be prevented or limited if the diabetes is well controlled. Check your kidney function regularly with blood and urine tests. The fourth golden rule is to check and control your blood pressure, about half of the people who have high blood pressure do not know that they have high blood pressure, therefore you need to check your blood pressure as a part of your general body checkup, this is especially important for those who are approaching middle age or older age, high blood pressure can also damage the kidneys, this is especially likely when associated with other factors like diabetes, high cholesterol and cardiovascular diseases, the risk can be reduced with a good control of blood pressure, normal adult blood pressure is about 120 by 80, hypertension is diagnosed when measured on two different days, the systolic blood pressure readings on both days is greater than or equal to 140 mmHg and or the diastolic blood pressure readings on both days is greater than 90 mmHg as per the WHO protocol, so if your blood pressure is persistently elevated above the normal range, especially if you are a young person you should consult your doctor to discuss the risk, the need for lifestyle modification and also medication treatment, the American Heart Association and the American College of Cardiology revised the guideline for high blood pressure in 2017 and they suggested that the high blood pressure should be treated earlier with lifestyle changes and medication at 130 by 80 mmHg rather than 140 by 90 mmHg, however not all health organizations around the world have adopted this recommendation, it is best to consult your own doctor. The fifth golden rule to avoid chronic kidney diseases is to take appropriate fluid intake, the right level of fluid intake for any individual it depends on many factors including exercise, climate, health conditions, pregnancy and breastfeeding, normally this means 8 cups approximately 2 liters per day for a healthy person in a comfortable climate condition but this needs to be adjusted when in severe climate condition, your fluid intake may need to be adjusted if you have kidney or heart or liver disease, do consult your doctor on the appropriate fluid intake for your condition, don't smoke, smoking slows the flow of blood to the kidneys, when less blood reaches the kidneys it can decrease their ability to function normally, smoking also increases the risk of kidney cancer by at least 50%, the seventh golden rule is don't take over-the-counter anti-inflammatory and painkiller pills regularly, common drugs such as non-steroidal anti-inflammatory, painkiller, drugs like ibuprofen, they can harm the kidney if they are taken regularly, if you have kidney disease or a decreased kidney function taking just a few doses can do harm to your kidney, so if you are in doubt check with your doctor or pharmacist to be sure and get your kidney function test done, if you have any one of the above high risk factors, if you have diabetes, if you have hypertension, if you are obese and if you have a family history of kidney disease, so commemorating the word kidney day, we highly recommend that you get a kidney function test ordered maybe in this week going forward, so how can the secondary prevention work, once this is the eight golden rules of prevention but how secondary, how we can slow the disease progression, this is again a strategy which is adopted by doctors and so key preventive measures have been defined and proven successful in those with early stages of CKD, as secondary prevention measures which help slow disease progression and they protect against both kidney and cardiovascular diseases, the body is very very intertwined, so any incidence of a disease on kidney has a manifestation on the cardiovascular front as well, so reduction of high blood pressure, the lower the blood pressure within the normal range and slower the GPI, the lower the blood pressure, the slower the GFR decline, specific medications they reduce protein, protein, protein urea as well as low blood pressure, angiotensin converting enzyme inhibitors which are called as ACE inhibitors or angiotensin receptor blockers, so these are the some of the strategies these doctors adopt in your treatment, yes you have to approach a doctor, an expert one, a nephrologist for fine tuning for calibrating this all but this is just for general awareness part, this is not something for self-medication at all, reduce salt intake to lower blood pressure, control of glucose, blood lipids and anemia, smoking cessation, increase of physical activity and control of body weight, so the treatment for CKD clinical research over the last two decades have shown that the potential benefit of blockade of the renin angiostim system by medicines known as ACE inhibitors and ARBs, this can significantly delay the progression of CKD especially in people with diabetes and hypertension at relatively low cost and what can you ask your doctor, the busy doctor, these days this becomes again quite a difficult proposition, so you can ask what's my GFR, what is my urine albumin test, what is my blood pressure, what is my blood glucose, so these are some of the parameters which affect or define your kidney functions and the other questions which you can ask the doctor is what happens if I have a kidney disease, what should I do to keep my kidneys healthy, do I need to be taking different medicines, should I be more physically active, what kind of physical activity can I do, what can I eat, do I need to talk with the dietician to get help with the meal planning, should I be taking ACE inhibitors or ARBs for my kidneys and how often should I get my kidneys checked, so with this we conclude this podcast, the core function is if you are in the high-risk zone as we said BP, hypertension, diabetes, overweight, smoking and all, do get your kidney test, kidney function test done positively and follow the eight golden rules for the prevention part of it all and do consult your doctor because 90% of the times we won't find the symptoms of a chronic kidney disease flourishing if we have not done a laboratory test of the kidney disease, so on this word kidney day let's take a resolve to keep ourselves free from the disease by being sensitive to our health, it just takes a small blood or a urine sample to get a kidney function test done, it's not very costly as well, so we from Arogyam Institute of Integrated Medical Sciences do hope and do wish you a very healthy kidneys and in any case if you feel like having a quick tele consult, you can surely book an appointment with Dr. Surbhi Vaishmitpal who is an excellent medical from All India Institute of Medical Sciences, New Delhi, you can ping her, ping for an appointment at 8700603112, 8700603112 that number is also on the emailers, so that is something and quick expert guidance on tele consultation basis, so with this we end this podcast and we hope that you take up some of the messages from here, do some further study and especially just ensure that your CKD or kidney function test is well in the tolerant levels and you have to follow the 8 golden rules of healthy kidney over there, thank you so much, we'll be back again with yet another Arugeda podcast till then Namaskar.