Chronic kidney disease: What to do?

Chronic kidney disease (CKD) is a long-term condition characterised by gradual loss of kidney function. When CKD progresses into advanced stage, kidney cannot filter blood and excrete waste products from body. Thus dangerous level of fluid, wastes, electrolyte accumulates in body and lead to several serious complications.
The two main causes of chronic kidney disease are diabetes and high blood pressure, which are responsible for up to two-thirds of the cases. Like diabetes and hypertension, CKD can be silent.
In the early stages of chronic kidney disease, people may have few or vague signs or symptoms. Because our kidneys are highly adaptable and able to compensate for lost function, signs and symptoms may not appear until irreversible damage has occurred.
At advanced stage, patient may experience the following signs/symptoms: nausea, vomiting, fatigue and weakness, changes in urine output, muscle twitches and cramps, swelling of feet and ankles, chest pain, if fluid builds up around the lining of the heart, shortness of breath, if fluid builds up in the lungs, high blood pressure that is difficult to control.
Depending on the underlying cause, some types of kidney disease can be treated. Often, though, chronic kidney disease has no cure. In general, treatment consists of measures to help control signs and symptoms, reduce complications and slow progression of the disease. Good control of blood pressure and diabetes play a crucial role in halting progress.
Certain medicine especially some painkillers can affect the kidneys as a side-effect which can make CKD worse. People with CKD should avoid those medications.
The main way to reduce the chances of CKD developing is to ensure any existing conditions, such as diabetes and high blood pressure, are carefully managed. People with CKD are twenty times more likely to die from cardiovascular-related problems than from kidney failure. This is why reducing any other cardiovascular risk factors is so important.
Some lifestyle changes can also reduce the risk of CKD developing and its cardiac complications, including: exercising regularly, stop smoking if you smoke and cut back if you drink a lot of alcohol, eat a healthy diet which includes a low salt intake, keep your weight and waist in check.

The write up is compiled by Dr. Md. Arifuzzaman, Indoor Medical Officer, Mitford Hospital, Dhaka.
E-mail: nomanssmc@gmail.com