On May 31, 1993, former President Fidel Ramos signed Proclamation 184 declaring June of every year as National Kidney Month. This year, the theme is, “Batong malakas sa panibagong bukas”.
Several activities are done by kidney specialists and other health workers to increase awareness on kidney disease – its prevention, early detection, and treatment options.
Here are some frequently asked questions about kidney disease:
1) What symptoms can warn me that I have early stage kidney disease? Unfortunately kidney disease is a silent ailment during its early stages.
It has been observed that nine out of 10 persons with kidney disease may not even be aware they have the illness. Signs and symptoms usually start to appear when the disease is in its moderate to severe stage.
When kidney function is greatly diminished, a person develops anemia so that the person may have symptoms like easy fatigue, chest pains, shortness of breath. Retained toxins cause decreased appetite. Retained water causes swelling of the feet or cough. Retained water and salt cause elevated blood pressure.
2) What is the best laboratory test that will detect kidney disease? No single test can detect kidney disease. Detection starts with a medical consult. You will be interviewed about the presence of risk factors like childhood diseases, family history of kidney disease, stone formation, recurrent urinary tract infection, use of medications that damage the kidneys, exposure to toxic chemicals, or use of medications that damage the kidneys (so called “nephrotoxic agents”).
Comorbid conditions and diseases that are risk factors for kidney damage are listed in the medical history.
Physical examination is also done to look for signs like elevated blood pressure, heart murmur or irregular rhythm (heart disease or heart failure can decrease blood flow to the kidneys), rashes (some allergies that cause skin inflammation can also cause kidney inflammation), pallor, or water in the lungs.
Without medical examination early identification can be missed. Some patients who do not feel anything at all seek consult because of “incidental” findings seen during routine checkups. These include abnormal urine and blood test results.
- How helpful is a urine examination? Urinalysis may show findings like protein, glucose, red blood cells, white blood cells, crystals that suggest kidney damage. A normal “routine” urine examination may appear normal, but if a person has a history of blood sugar elevation, elevated blood pressure, and kidney inflammation, one additional test to be done is another urine test to check if the person is spilling albumin or smaller proteins. This is because spillage of albumin or protein (microalbuminuria or proteinuria ) in the urine is considered a hallmark of ongoing kidney damage – a physician has to monitor the patient for progression of the renal disease and start management plans to reduce the rate of decline of kidney function.
- My serum creatinine is normal. Is my kidney function normal too? This blood test that is commonly done to check kidney function may be normal but the kidney function, referred to as glomerular filtration rate (GFR) may be low. Serum creatinine starts to increase when the GFR is less than 50 percent of normal.
A calculator is used to estimate GFR using serum creatinine (or cystatin which is more expensive and not readily available), age, and gender. Scanning of the kidneys (nuclear GFR scan) is done in special situations to asses kidney function.
- Are there drugs that reverse kidney disease? None but there are drugs that can be used by doctors to decrease the amount of protein being spilled in the urine or goal specific treatments to manage a patient’s comorbid conditions or risk factors like diabetes mellitus and hypertension, thereby decreasing risk for kidney damage.
- Is there a substitute for dialysis? Only a new kidney attained through kidney transplantation can replace dialysis.
In the Cordillera, there are three Department of Health-accredited transplant facilities – The Cordillera Hospital of the Divine Grace in La Trinidad, Benguet, Notre Dame de Chartres Hospital, and Baguio General Hospital and Medical Center in Baguio City.