Have you ever heard of chronic kidney disease? Perhaps not. But statistics suggest rates are increasing.
The condition is where the kidneys stop working as well as they should. It progresses over time and, in some cases, the kidneys can fail completely – but many people are still able to live long lives.
The issue is generally associated with ageing – roughly 50% of all people over 75 have the disease – and it’s more common in people who are black or of south Asian origin, states the NHS.
There were an estimated 1.23 million deaths globally due to chronic kidney disease (CKD) in 2017. And rates of people needing dialysis – a procedure to remove waste products and excess fluid from the blood when the kidneys stop working – have increased 40% since 1990, a new study published in The Lancet suggests.
“Chronic kidney disease is a global killer hidden in plain sight,” said Dr Theo Vos, professor of health metrics sciences at the University of Washington’s School of Medicine. “The evidence is clear: many nations’ health systems cannot keep pace with the dialysis demand. Cases far exceed and are well beyond the ability of those systems to handle.
“The consequences, literally, are deadly.”
Globally, CKD was the 12th leading cause of death in 2017, up from 17th in 1990. There were 697.5 million global cases of chronic kidney disease in 2017. Nearly one-third of those patients lived in China and India; while Andorra, Finland, Iceland, and Slovenia have the lowest burden.
Despite the prevalence of CKD being “lower than expected” in western Europe, the issue will develop in one in eight people, according to Kidney Care UK.
The causes of CKD
Causes vary, however high blood pressure (hypertension) and diabetes tend to be the most common. Around one in three adults in the UK has high blood pressure, while diabetes is estimated to impact more than four million people.
Other possible causes include high cholesterol; kidney infections; polycystic kidney disease; long-term use of non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, naproxen, mefenamic acid and high-dose aspirin; and blockages in the flow of urine, caused by recurring kidney stones or an enlarged prostate.
The symptoms
CKD can range from a mild condition with no symptoms, to a serious one where the kidneys stop working – sometimes called kidney failure, which happens in around one in 50 people with the condition.
It’s largely an invisible illness until it has progressed to an advanced stage. At this point, you might start to experience issues like: swelling of the ankles, feet or hands; tiredness; shortness of breath; blood in your urine and nauseousness.
The likelihood of CKD being diagnosed in the early stages is quite slim. The NHS states it might only be diagnosed if you have a blood or urine test for another reason and the results show a red flag with your kidneys.
The general advice is that you should see a GP if you have persistent or worrying symptoms that you think could be caused by kidney disease.
The prognosis
Many cases of CKD are mild and risks can be managed by patients and GPs without ever visiting a hospital, says Kidney Care UK. But in some cases, the condition can worsen to the point of needing specialist medical help.
In addition to deaths resulting from organ failure in chronic kidney disease, impaired kidney function puts people at higher risk of developing cardiovascular disease. Globally, chronic kidney disease resulted in an estimated 1.23 million deaths in 2017, The Lancet study said, with an additional 1.36 million deaths attributable to cardiovascular disease resulting from impaired kidney function.
“CKD is largely preventable and treatable and deserves greater attention in global health policy decision making,” the study’s authors said.
The treatments
There’s no cure for CKD, but treatments can help relieve the symptoms and stop it getting worse. The treatment, usually discussed with a GP, will depend on how severe the condition is. These can include: lifestyle changes (see below); medicines to control associated problems such as high blood pressure; dialysis; and kidney transplants.
How to look after your kidneys
:: Drink lots of water (6-8 glasses a day).
:: Eat a balanced diet including plenty of fruit, vegetables, grains, bread and rice, and steering clear of too much salty or fatty food.
:: Keep your blood pressure down. Ideally, it should be between 90/60mmHg and 120/80mmHg.
:: Drink less booze and quit smoking, if you can.
:: Try to stay at a healthy weight by keeping active and not overeating. We should all be aiming at least 150 minutes of exercise each week.
:: Make sure you manage conditions like diabetes, heart disease and high blood pressure, with the help of a GP.