Screen kidney, be safe

Screen kidney, be safe
13 Mar 2008, 1015 hrs IST,Risha Chitlangia,TNN

NEW DELHI: On World Kidney Day on Thursday, nephrologists want to raise awareness about Chronic Kidney Disease (CKD), incidents of which are increasing at an alarming rate.

If you have diabetes or high blood pressure, then you are at a risk of developing CKD. Unfortunately, by the time a person is diagnosed with CKD, nearly 50% of his kidneys are damaged. This happens because the blood creatinine levels, which are the indicators for kidney disease, don't rise till 50% of the kidney functioning is affected.

During routine check-up, most doctors don't study the creatinine levels of the patient if it is in the normal range. "But normal creatinine level doesn't mean that the patient's kidneys, especially those who have diabetes or high BP, are functioning properly. There is a need to study the creatinine levels seriously with respect to the patient's weight, age, sex and history of diseases," said Dr Vijay Kher, director, nephrology and kidney transplant unit, Fortis Healthcare.

Routine check-up doesn't involve creatinine level assessment. "It is only in cases which have history of high BP or diabetes or any other ailment or they present with CKD symptoms, then we screen for CKD," said Dr Mukesh Mehra, HoD, internal medicines, Max Healthcare.

Creatinine is freely filtered by the glomerular capillaries, inside the nephrons, and a small amount is also secreted in our body. But when these nephrons get damaged either due to high BP or diabetes, then the Glomerular Filtration Rate (GFR) also decreases. As a result of this, the creatinine level increases in a patient’s body.

"Unfortunately, the creatinine levels increase only after the GFR is affected nearly 50%. This means when the kidneys are nearly 50% damaged, it is then a patient is diagnosed with CKD. But by then it is too late," said Dr Sanjeev Bagai, director and paediatric nephrologist, Rockland Hospital.

The prevalence of CKD is "one in 10 people in different stages of the disease. This varies from mild to severe form called, the End Stage Kidney Disease (ESKD)," said Dr S K Agarwal, additional professor, department of nephrology, AIIMS.

He added, "The reason for this in most cases is lifestyle related. High BP and diabetes are very common today. Most of the CKD patients have either of the two, especially in the urban population.

"If CKD is diagnosed in the early stages, it can be managed well and need for dialysis and a transplant in a patient can be delayed. A creatinine clearance test along with patient's medical history can help a physician diagnose whether he/she is a case of CKD or not," said Dr Kher.

CKD can happen in children too and can affect newborns as well. "A woman's nutrition during pregnancy can affect the baby. It has been seen that newborns with low birth weight stand a chance of developing kidney diseases and also high BP when they grow up," said Dr Agarwal. The common symptoms of CKD are: high HP, diabetes, low haamoglobin, difficulty in passing urine or blood in urine and swelling in body parts.

"If anybody has all these symptoms, then a routine ultrasound of the kidneys is a must. With this we can pick up kidney problems in the early stages," said Dr Bagai.

Though there are no screening programme for CKD by the government, doctors say a screening test would not cost more than Rs 100 when compared with the cost of treatment of renal failure cases. So next time you go for a routine check-up, do ask the doctor for a CKD screening test, especially those who have above-mentioned symptoms and are BP or diabetes patients.