Failure to Diagnose Kidney Disease Early Claims Many Lives; Treatment Is Available, but Not the Funds to Afford It, Writes Charles Swanepoel
Kidney disease is common, harmful and treatable - this was the message from the World Kidney Day initiative of the International Society of Nephrology and the International Federation of Kidney Foundations on March 8.
Nephrology communities throughout the world participated by advertising - and in so doing |increased awareness of - kidney disease.
"Are your kidneys normal?" was the question asked on that day.
Our kidneys remove waste products from our bodies and maintain the internal milieu which sustains life. The kidney also produces active vitamin D, which is essential for bone development and bone strength, and erythropoietin, which ensures adequate production of red blood cells.
While there are no accurate statistics on the prevalence of kidney disease in South Africa, the medical literature claims "about a 10%" prevalence in the adult population throughout the world.
"Diseases of the kidneys" are not spoken about much at home or in the community. Kidneys are seen as of nuisance value only - they fill bladders and cause you to find a loo! No one flinches at the idea of eating a steak-and-kidney pie.
Contrast the reaction when heart disease is mentioned. All pay immediate attention and eagerly wish to know more. No one eats "steak-and-heart" pie!
How many times has your loved one rushed to you to confess loving you with all his or her kidney? Few are aware that chronic kidney disease (CKD) is a risk factor for cardiovascular disease. If you ignore kidney disease, you ignore a potentially fatal process.
CKD can result from different"insults" that cause the kidneys to malfunction. Once malfunction begins, progression to total renal failure ensues in 75% of cases, and this can take place rapidly or over many years.
Early diagnosis can slow progression and, thereby, prolong the time to end-stage renal failure and reduce the risk of developing cardiovascular disease.
Kidney machines are widely available to sustain life in those with kidney failure. In addition, kidney transplantation is a routine form of treatment.
A little known fact is that late Professor Chris Barnard did a kidney transplant before his famous heart transplant in 1967. This single kidney transplant gave an additional 22 years of life to the patient before dying from heart disease.
Despite advances in kidney transplantation, it is preferable to try to retain your own kidney function for as long as possible. So it is crucial that people diagnosed be started early on a programme to slow the progressive nature of kidney failure.
The South African Renal Society (Sars) prides itself on maintaining standards and ensures that nephrology training in this country is of the highest standard. Registered nephrologists are in a good position to facilitate prolonging renal function and should be involved early in this important task.
It is a major concern that, despite all our knowledge, individuals with CKD continue to arrive late for treatment, necessitating emergency, invasive and often expensive procedures for kidney failure.
Sadly, late referrals are very common among patients with high blood pressure who were not investigated for kidney disease (the two diseases often go hand-in-hand). …