Manila to observe world kidney day on Thursday

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TOMORROW is World Kidney Day (WKD) and this year’s celebration focuses on chronic kidney disease and aging.

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The Transplantation Society of the Philippines and the Philippine Society of Transplant Surgeons Inc. will hold the 4th Joint Transplant Symposium from March 13 to 14 at the Dr. Enrique Ona Auditorium, Diagnostic Center of NKTI coinciding with the worldwide celebration of World Kidney Day.

Transplant experts from around the world have been invited, and the highlight of the symposium is the evaluation of the patient with cardiac disease and vasculopathy and the launching of the NKTI Transplant Manual.

The kidneys perform life-maintaining functions as monitors and regulators of body fluid.

They excrete fluids when the body has an excess of them and retain the substances necessary for the body’s continuing function. They produce and release a variety of chemicals to keep the body healthy and filter the entire blood supply every two minutes, excreting waste materials through the urine.

In the Philippines, chronic kidney disease—a silent killer—is the seventh leading cause of death brought about by a lethargic lifestyle, wrong food choices and inadequate sleep in addition to other trigger factors like hypertension and diabetes.

The Department of Health (DOH) said close to 23,000 Filipinos underwent dialysis due to kidney failure in 2013, nearly four times higher than the 4,000 cases recorded in 2004, or a 10 percent to 15 percent increase a year.

The website of the National Kidney and Transplant Institute (NKTI) said kidney diseases, especially End Stage Renal Disease (ESRD), are the seventh leading cause of death in the country.

One Filipino develops chronic renal failure every hour, or about 120 Filipinos per million people a year, it said.

Before 2010, the NKTI said over 5,000 Filipino patients were undergoing dialysis and approximately 1.1 million people worldwide were on renal replacement therapy. Those figures have doubled beginning in 2010.

The cost of treating a kidney disease is exorbitant and beyond the reach of ordinary patients. Renal transplantation is limited due to the expense and the shortage of donors.

The best that can be done is to focus on the prevention of progression of renal diseases.

Kidneys are important parts of the urinary system. They are found at each side of the spine, below the rib cage. Each kidney is as big as a fist, weighs one-fourth pound and shaped like a kidney bean.

In the past, chronic glomerulonephritis was the most common cause of chronic renal failure. Today, diabetes mellitus and hypertension have taken center stage as the main causes of ESRD, which together account for almost 60 percent of dialysis patients.

Majority of individuals with early stages of CKD goes undiagnosed, which is why WKD is calling on people to check if they are at risk for kidney disease and encourage the people with risk factors to take a simple kidney function test.

Most people have no symptoms until CKD is advanced. Signs of advancing CKD include swollen ankles, fatigue, difficulty concentrating, decreased appetite, blood in the urine and foamy urine.

If detected early, Chronic Kidney Diseases can be treated–thereby reducing other complications and dramatically reduce the growing burden of deaths and disability from chronic renal and cardiovascular disease worldwide.

Dr. Antonio Paraiso, manager of the Philippine Network for Organ Sharing, was quoted in online reports as saying that last year, at least 12,000 Filipinos developed kidney failure, requiring crucial transplants or expensive dialysis.

Paraiso also noted a steep rise in diabetes and hypertension cases, both contributors to kidney disease and a third called glomerulonephritis, or several renal diseases usually affecting both kidneys often characterized by inflammation of either the glomeruli or small blood vessels in the kidney.

Glomerulonephritis can come from bacterial, viral or parasitic pathogens, drugs, systemic disorders or diabetes.

Kidney disease usually progresses silently, often destroying most of the kidney function before causing any symptoms. The early detection of failing kidney function is crucial because it allows suitable treatment before kidney damage or deterioration manifests itself through other complications.

Simple laboratory tests are done on small samples of blood to measure serum creatinine (waste product in the blood) and to estimate the GFR (glomerular filtration rate) and blood sugar to be certain against diabetes.

Creatinine is removed from the body by the kidneys but when kidney function (GFR) slows down, creatinine levels rise. The normal creatinine level is 100ml/min so lower values indicate the percentage of normal kidney function. If the GFR falls below 60ml/min this means one has to see a kidney specialist (or nephrologist). The specialists would say if kidney failure has to be addressed by treatments like dialysis or transplants. A GFR below 15ml/min shows one has to start any of these treatments.

Another mark of CKD is the presence of excess protein in the urine, which is a better indicator of risk for progression and for premature heart attacks and strokes than GFR alone.

Excess protein in the urine can be screened for by placing a small plastic strip embedded with chemicals that change color when protein is present (urine dipstick) into a fresh urine specimen or can be measured more accurately with a laboratory test on the urine.

Here are eight golden rules to reduce the risk of developing kidney disease: reduce high blood pressure; take specific medications to reduce proteinuria and lower blood pressure; reduce intake of salt to lower blood pressure; control glucose, blood lipids and anemia; cease smoking; increase physical activity and control body weight.

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