Dr. H. SUDARSHAN BALLAL, MD Professor of Clinical Medicine,

St. Louis University School of Medicine & Manipal University.
Director. Manipal Institute of Nephrology &
Urology Manipal Hospital. Bangalore.

Introduction:

Severe chronic kidney disease (End stage renal disease/Kidney failure) afflicts about 150 - 200.000 people in our country and is a devastating problem and often means death for the patient and a major emotional and financial drain for the family. Hence it is very important that we detect kidney disease early to prevent progression to End Stage Renal Disease where dialysis or transplantation becomes inevitable.

The Causes of kidney failure

Kidney failure is caused by Diabetes, Hypertension, Glomerulonephritis, Interstitial Nephritis, infections, kidney stones, hereditary diseases and frequent use of drugs without proper medical advice & monitoring.

Signs and symptoms of Kidney failure

The signs and symptoms of Kidney Failure may be silent! They include weakness and fatigue, puffiness of face, swelling of feet, decreased urine output, shortness of breath, drowsiness, loss of appetite, nausea and vomiting, unexplained anemia, excessive, frequent urination at night.

Simple tests to detect Kidney Disease

Kidney Number:

Our endeavor is to familiarize the general public about the 'kidney number' which is the function of the kidney assessed using a simple formula by knowing the serum Creatinine, weight, age and sex of the person.

Urine Analysis for Albumin:

The vital numbers that are important for the normal health of a person are blood sugar blood pressure, cholesterol and the kidney number. These four numbers account for most of the non-infectious diseases of mankind. Who needs screening?Everyone needs screening for kidney disease, especially those who are above the age of 40 years. And also those who have the following:

  • Diabetes
  • High blood pressure
  • History of Kidney disease

Treatment of kidney failure:

In the early stages of kidney failure, the treatment is conservative and consists of dietary modifications, medication to control blood pressure, tight control of diabetes, avoidance of drugs that are toxic to the kidneys, measures to reduce the risk of heart disease and lifestyle modification.Renal Replacement Therapy (late Stage/End Stage Kidney disease)

  • Dialysis
  • Transplantation

It is important to remember that kidney disease is not only a problem in itself, but it also increases the risk of heart disease.

The Burden of Chronic Kidney Disease:

The cost of treatment:

  • Dialysis - 2 to 3 lakhs per year
  • Transplantation - 2 to3 lakhs initially followed by Rs. 10000 to Rs.20000 per month
  • This obviously is way beyond the means of most people in our country.
  • The solution to this is prevention, early detection and slowing of progression of chronic kidney disease.

Kidney disease has reached epidemic proportions. The burden of severe kidney disease is something that the common man and the society cannot afford. Hence our focus should be on prevention, early recognition and slowing the progression of chronic kidney disease. An ounce of prevention is truly worth a ton of cure in Kidney disease.