ISSN: 1391 - 0531
Sunday, March 04, 2007
Vol. 41 - No 40

Kidney disease: Prevention IS the best cure

A simple urine and blood test can prevent a life of agony and ultimate death

By Kumudini Hettiarachchi

An old woman patiently sews a brightly-coloured cockerel onto a cloth fitted to a frame, while a youth walks up and down the corridor.

It is Tuesday morning and both are keeping vigil from about 7 a.m. to 1 p.m. for two loved ones who are inside the dialysis unit of the Sri Jayewardenepura General Hospital.

Dr. Chula Herath

They do this not just for a day but two days a week, every week until a kidney transplant can be carried out or ………the thought is too unbearable for them to contemplate.

The woman’s 58-year-old daughter and the youth’s elder brother are in the dialysis unit getting machines to do the job of their kidneys. When asked how they got kidney disease, the stock answer of both was: Seeni control karapu nethi hinda. (They didn’t control their sugar)

“Although kidney disease is very common, it is still a hidden problem. What we are attempting to impress on people is that kidney disease is preventable,” stresses Dr. Chula Herath, Consultant Nephrologist of the hospital.

Underlining the importance of early screening, he emphasizes that a simple urine and blood test can prevent a life of agony and ultimate death.

The kidneys are organs which have a lot of reserves and will keep functioning though overloaded. As such people feel nothing until their kidney function is down by about 80-85%, The Sunday Times learns.

Attempting to tackle the awareness problem with regard to kidney problems, the Sri Lanka Association of Nephrology and Transplantation (SLANT) which is affiliated to the International Society of Nephrology, will launch a major campaign to increase awareness on kidney disease on March 8, which has been declared World Kidney Day. Starting with a poster campaign not only in hospitals but also public places such as supermarkets SLANT hopes to spread the message that prevention would be the best.

Kidney diseases are common worldwide but statistics don’t reflect the true numbers, says Dr. Herath who is also President of SLANT, explaining that people with diminished kidney functioning are also prone to cardiac diseases. “Sometimes a person may die of a heart attack for which the primary cause is kidney disease, but it won’t be reflected in the statistics because the cause of death will be listed as heart disease.”

Statistics are mostly of end-stage renal failure (where the kidneys have packed up and regular dialysis is required to carry out kidney functions with the ultimate need being a transplantation) patients and by that time it is too late, he says.

A simple urine test for albumin, a more sensitive test for micro-albumin or a blood test for serum creatinine can catch kidney disease early so that measures could be taken to deal with it as soon as possible.

Whereas the tests will enable the diagnosis of 95% of patients with kidney dysfunction, the blood test results checked out against a certain formula can calculate the percentage of kidney function accurately, The Sunday Times understands.

Dealing with the huge economic cost of treating end-stage kidney failure not only to the authorities but also to patients and their families, Dr. Herath says to keep one person alive on dialysis costs around Rs. 350,000 per year and taking into account the new end-stage renal patient numbers of 2,500 each year, he calculates that the cost for dialysis alone would amount to billions. This is in the light of Sri Lanka’s whole health budget being around Rs. 2.5 billion.

“This is just for dialysis. What of medication? What about the loss of working hours, not only for the patient but also for his/her family. Children’s education is disrupted. Family life disintegrates,” he says, reiterating the importance of prevention.


What is chronic kidney disease?

An increase in the excretion of albumin in the urine or a major disease in kidney function results in chronic kidney disease.

What are the causes?

Diabetes and hypertension are seen as the major causes of kidney disease while other contributory factors are nephrotic or inflammatory diseases of the kidney, infections, obstruction in the urinary tract or inherited disorders such as polycystic kidney disease.

The measures recommended to combat kidney disease in the early stages are:

  • Lifestyle changes with weight reduction, more exercise and saying a definite ‘no’ to smoking. According to Dr. Herath the decline in kidney functioning increases with smoking.
  • Controlling hypertension and diabetes (in Sri Lanka a disturbing 14% of adults have diabetes.) The World Health Organization has estimated that hypertension, diabetes and heart and kidney diseases will increase in leaps and bounds by 2025.
  • If medication is required two groups of drugs - ACEs or ARBs are prescribed to slow down the decline of kidney functioning.
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Copyright 2007 Wijeya Newspapers Ltd.Colombo. Sri Lanka.