KIDNEY TURNS KILLER

Pratik Rimal/TNP

Kathmandu, March 8



There are around 10,000 known kidney patients in Nepal. However, only 10 per cent of them are undergoing treatment because of the high costs.



It is believed that around 500 million people around the world have some form of renal diseases. One out of every 10 people suffers from some kidney ailments. “You might look fit from the outside, but you never know if you have renal diseases," Dr. Rishi Raj Kafle, Executive Director of National Kidney Center (NKC) said.



In order to mark the World Kidney Day, NKC organized a free kidney checkup at Chettrapati Hospital. Out of the 317 people who came to take a free test, 30 were found to have some sort of problems related to kidney. "Kidney diseases have no symptoms, and that's why it's even more threatening," Kafle said, adding, "By the time a patient encounters symptoms, they are critical."



A vast majority of the country's population still lag behind on regular medical checkups. As a result, they are unlikely to know what is going inside their bodies. “Moreover, with no symptoms to cast doubts about renal ailments, every individual must have regular screening of blood and urine,” Kafle asserted.



Prevention, way better than Cure



"You don't know when you suffer, and prevention here, is much better than cure." Kafle shared. However, very few people care to do so. They usually turn up for treatment at critical stages. "At such final stages, all we can do is prolong a patient's life; ease their sufferings through dialysis," Kafle added.



Bimal Baral, administrative officer at NKC said that, given the high costs involved, precautions should be taken earlier. "When you go into treatment for kidney failures, it means dialysis, and it's very expensive," Baral said, adding, that even the wealthiest cannot afford the treatment for long due to high costs involved. "A patient spends around Rs. 30,000 a week," Baral shared.



A woman from Dhading is undergoing treatment at NKC. She has been receiving dialysis treatment for the last three years. The costs have already pushed her family towards the depths of poverty. "In three years, I've spent around three million rupees," the woman, who seeks anonymity shares. Tears fill her eyes when she recalls what her husband, a government school teacher at Pokhara, faces every day. "It is so hard to manage money. Until now, I've been taking help from every relative, but how long will they support?" she laments. "This treatment will ruin a family," the woman shares in tears, adding, how she can neither die, nor afford the treatment any longer.



Dr. Sudha Khakurel of KIST Medical College said that renal failures could be prevented in three stages. "The first is primary prevention. Here, we ask people to live a healthy life, control their weight, and exercise," Khakurel said, adding, kidney failures can be easily cured at this stage.



"In secondary stage, kidney slowly starts to get damaged. Here, it is important that people control their sugar level, blood pressure and do regular screenings of urine."



The final prevention is only to prolong life. "It is called tertiary prevention. At this stage, we can only work to save further damage of the kidney," Khakurel said.



AWARENESS IS THE KEY



Another way of prevention is awareness, Khakurel said. "It is important that we aware people of all ages start from the younger ones," Khakurel said, adding, "It is important that schools, colleges, and other private or government institutions inform and educate everyone regarding renal diseases and their prevention," Khakurel said.



Khakurel sees awareness and healthy lifestyles as the key to stay away from renal diseases. However, Khakurel adds that, few myths have also barred timely identification of the disease. "When one sees a swollen ankle, people blame the cold weather, and facial puffiness with a snake's bite," Khakurel said about possible symptoms of renal diseases. "Other symptoms are frothy urine, red urine, backache, and poor urinary stream," Khakurel said.



What seems interesting is that anyone can suffer from diseases related to kidney. However, Khakurel sees some categories as high-risk people. "People suffering from diabetes, high blood pressure, obesity and those above 40 are at high risk," he said. Apart from that, family history of kidney ailments, diabetes or hypertension too could contribute to renal diseases in the long run, Khakurel explained.



The 2012 Campaign will focus on the positive outcome of kidney transplantation and the life-saving aspect of organ donation. The slogan for this year's campaign is Donate - Kidneys for Life - Receive.



Some striking figures:



- Recent reports from the United States estimate that nearly half a million patients in the United States were treated for end-stage renal disease (ESRD) in 2004 and by 2010 this figure is expected to increase by approximately 40%.



- The cumulative global cost for dialysis and transplantation over the next decade is predicted to exceed US$ 1 trillion. This economic burden could strain healthcare budgets in developed countries. For lower income countries it is impossible to meet such costs.



- The economic burden for developing countries is particularly severe, partly because Chronic Kidney Diseases (CKD) generally occurs at a younger age. For example, in Guatemala, 40% of patients receiving renal replacement therapy (RRT) are under 40. In China, the economy will lose US$558 billion over the next decade due to effects on death and disability attributable to chronic cardiovascular and renal disease. For more information please see the diagram



- The number of people with renal replacement therapy has increased from 26,000 in 1990 to 1.5 million in 2000 and is expected to rise to 2.5 million by 2010.



- In Europe, it is estimated that screening for urinary protein loss exceeding 50 mg/day costs 7,000 Euros per life year gained, according to the PREVEND study, which is largely cost-effective.



- More than 80% of individuals receiving RRT live in the developed world because in developing countries it is largely unaffordable. In countries such as India and Pakistan, less than 10% of all patients who need it receive any kind of renal replacement therapy. In many African countries there is little or no access to RRT, meaning many people simply die.

- Chronic Kidney diseases are not curable, the patient needs care for the rest of his life

- If CKD are not detected early enough, the patient will suffer from kidney failure which requires Renal Replacement Therapy (dialysis or transplantation), which is extremely costly and weighs heavily on healthcare budgets.



8 Golden Rules

Kidney diseases are silent killers, which will largely affect your quality of life. There are however several easy ways to reduce the risk of developing kidney disease.
1. Keeping fit and active
2. Keep regular control of your blood sugar level
3. Monitor your blood pressure
4. Eat healthy and keep your weight in check
5. Maintain a healthy fluid intake
6. Do not smoke
7. Do not take over-the-counter pills on a regular basis
8. Check your kidney function if you have one or more of the 'high risk' factors

( Credit: Worldkidneyday.com)