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Kidney diseases: Dreaded burden to carry

BY: Doreen Andoh
Dr Winfred Baah
Dr Winfred Baah

It is a worrying sight to see people who are already in pain as a result of their medical condition, waiting patiently to take their turns on a dialysis machine, at the Renal Unit of the Korle Bu Teaching Hospital.

Doctors say people with the last stage or stage five of kidney diseases, often referred to as the end stage kidney disease, required dialysis three times a week and each session takes four hours for a life time until a kidney transplant is done, that is if one can afford and has a donor.

The dialysis machine serves as an artificial kidney which performs the functions of the kidney, when diseases render the organ ineffective.

Prevention is key

Speaking in an interview, a Consultant Physician and Kidney Specialist at the Department of Medicine at the Korle Bu Teaching Hospital, Dr Winfred Baah, said apart from the physical pain involved, treating kidney disease was time consuming and demanded a lot of money.

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He said cases of kidney diseases were increasing, particularly among the younger generation, due to drug and herbal medication abuse, and advised that everyone should go for regular checkups, keep healthy lifestyles and make conscious effort to maintain a healthy kidney.

He said while the prevalence rate was 13.9 per cent globally, it was between 13 to 17 per cent in Ghana.

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He said though chronic kidney diseases were seen more in people between 50 and 70 years globally, in Ghana, the disease was rather high among people between the ages of 30 and 50 years, on the average.

That, he said, meant that among every 100 Ghanaians sampled randomly, between 13 and 17 were at various stages of chronic renal diseases.

What is kidney disease?

Explaining the functions of the kidney, and what constituted kidney diseases, Dr Baah said the kidney regulates fluid and electrolyte balance in the blood.

He said it performed an excretory function, which includes taking out excess fluid, toxins and other waste products in the body, which comes out as urine through the bladder.

He mentioned the two main types of the manifestation of kidney disease as acute kidney injury and chronic kidney diseases.

He defined the acute type to be the shutting down of the kidney temporarily due to certain conditions such as heavy loss of fluid through bleeding, vomiting and diarrhoea and was reversible while the chronic kidney disease, also called chronic kidney failure, was the gradual loss of kidney function permanently.

He said chronic kidney disease occurred when a disease or condition impaired kidney function, causing kidney damage to worsen over several months or years.

“Your kidneys filter wastes and excess fluids from your blood, which are then excreted in your urine. When chronic kidney disease reaches an advanced stage, dangerous levels of fluid, electrolytes and wastes can build up in your body,” he said.

However, he said untreated acute kidney disease could progress to a chronic condition, after a while.

Causes

He mentioned the top three causes or risk factors of chronic kidney disease in Ghana to be diabetes, high blood pressure and an inflammation of the kidney's filtering units (glomeruli), known as Glomerulonephritis.

He said other conditions such as an inflammation of the kidney's tubules and surrounding structures (Interstitial nephritis), prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers (Polycystic kidney disease).

He said others included recurrent kidney infection, also called pyelonephritis, smoking, drinking alcohol and not drinking enough water daily. Smoking, Obesity, family history of kidney disease, abnormal kidney structure and older age.

Symptoms

Dr Baah said there were five progressive stages with regard to the chronic kidney diseases, explaining that stage one to three and in some cases four, do not present any symptoms.

He said signs and symptoms of chronic kidney disease developed over time if kidney damage progresses slowly.

He mentioned the signs as nausea, vomiting, loss of appetite, fatigue and weakness, sleep problems, changes in the quantity of urine passed, and decreased mental sharpness.

“Edema such as swelling of feet and ankles, arms , scrotum and in other parts of the body, including the lungs, which affects breathing leading to emergency situation, as well as feeling very sick and unwell, are symptoms as well,”

The others, he said, included muscle twitches and cramps, persistent itching, chest pain, fluid build-up around the lining of the heart, shortness of breath, fluid build-up in the lungs, high blood pressure (hypertension) that's difficult to control.

Complications

Dr Baah said a sudden rise in potassium levels in the blood (hyperkalemia), which could impair the heart's ability to function, weakness in the bones and an increased risk of bone fractures, anaemia, decreased sex drive, erectile dysfunction or reduced fertility, are also some of the symptoms.

He advised against using nonprescription pain relievers, such as aspirin and ibuprofen and taking such drugs for a long time and encouraged people to maintain a healthy weight and also avoid smoking, as cigarette smoking could damage the kidneys and worsen the condition of an already damaged kidney.

Treatment

He said treatment for stage one to stage four kidney disease was known as conservative management, “where we basically control blood pressure, control diabetes if any, treat all infections, asking patients to avoid taking anything that can affect the kidney, such as herbal medication and other hospital medications that could worsen the situation.”

Others, he said, include putting patients on diet to check the intake of things that could harm the body such as high intake of potassium that could lead to slow progression to the stage five known as the end stage renal diseases at which point dialysis or better still kidney transplant was required.

Dialysis is required optimally three times a week for life or until a patient gets a kidney transplant.

“A kidney transplant involves surgically giving a healthy kidney from a donor to a patient.

Transplanted kidneys can come from deceased or living donors.

You will need to take medications for the rest of your life to keep your body from rejecting the new organ,” he explained.

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