CHRONIC KIDNEY DISORDERS

Chronic kidney disorders threaten India's diabetics

    For the diabetes capital of the world, this might sound alarming. Experts in India say nearly 40 per cent of diabetics can be affected by chronic kidney disorders (CKDs). What’s more, around 1.5 lakh (150,000) new cases of kidney failure are diagnosed annually in India, they say.“Chronic kidney disorder, where the kidney suffers irreversible damage, has become closely linked with lifestyle related disorders. Some of the common causes behind CKDs are diabetes, blood pressure and high cholesterol level,” Sandeep Mahajan, associate professor, department of nephrology at the All India Institute of Medical Sciences (AIIMS), told IANS.“Nearly 40 per cent of diabetics can be affected by CKDs,” he said.Kidneys, essentially the filters for toxic material produced in the body, are also affected by urinary tract infections, stone diseases and medicine-related disorders, according to nephrology experts. What bothers experts is the high prevalence of diabetes among the young Indian population.

     “Diabetes has several lifestyle related causes to it, including a sedentary lifestyle, blood pressure, junk food, and erratic work schedules among others. And when the disease strikes the young population, they are at an eventual risk of suffering from CKD,” cautions Mahajan. The International Diabetes Foundation has reported approximately 54 million diabetic patients in India in 2010, and the number is likely to touch 70 million by the year 2025.“Uncontrolled blood sugar levels triggered by diabetes affect the kidney’s membrane that is pivotal as a filter of protein in the body. There is excess protein loss leading to CKD,” Vijay Kher, chairman of the department of nephrology and transplant medicine at the Medanta Kidney and Urology Institute, told IANS.“Once the CKD patient reaches stage 5, also the last stage of the disease, the disorder progresses to fatal end-stage-renal disease (ESRD) where the kidney fails because of less than 15 per cent functioning,” said Kher.

         Nearly 150,000 new cases of ESRD or kidney failure come up annually in the country, the majority of whom die due to shortage of dialysis units, according to doctors.“The average age for CKD affecting a diabetic is 40 years, almost 10 to 15 years after diabetes,” explained Mahajan.He believes the disease is no more an urban phenomena, as there are patients from rural areas reporting CKD. “Smoking, obesity, high blood pressure are not present just among urban population. We have been seeing patients from rural areas at AIIMS,” he said.Warning signs for CKDs range from a simple urine test to ultrasound, said experts. Kher says simple awareness tips can help diabetics or even the general population keep the disease at bay: “Keep a tap on the blood sugar level, cholesterol, eating habits, and water intake.”Echoed Mahajan, “Early symptoms like lethargy, swelling over the feet or face, or frequent urination can be attributed to something else and they are very difficult to pinpoint. So the best is to get a regular kidney function test done once in six months for the high risk group.”

      After ESRD, the patient is left with two options - dialysis or kidney transplantation.“Transplantation can be ideal only when you are a donor who is a blood relative,a spouse or their child who is willing to donate a kidney, or it has to be an authorised donor, and they need to be tested for blood type and other matching factors that determine whether your body will accept the available kidney,” Mahajan added.The other method doctors vouch for is dialysis.“One can either go for peritoneal dialysis or hemodialysis. While the former offers dialysis treatment at home, the latter takes place at the hospital. It is better to consult a doctor before going for one particular method,” advises Mahajan.

                                                                           Prof.John Kurakar