Padmavati Prabhu
Panaji: This year on World Kidney Day, doctors have advised that at-risk individuals undergo regular screenings for early detection of kidney diseases, enabling patients to lead longer lives even with the condition.
“Kidney diseases in the risk populations can be detected through urine tests and blood examinations. The urine examination is conducted to check the urine albumin excretion which is done by measuring the Urine Albumin Creatinine Ratio (UACR) and blood test for recording the serum creatinine level. These two tests have to be performed at least once a year for all categories of patients who have risk factors,” said nephrologist Dr Shital Lengade, adding that many a time, the UACR turns out abnormal initially before the creatinine starts rising.
He pointed out that as per available data, approximately one out of eight adults in Goa may be having some form of kidney disease.
“The most common cause of kidney disease in Goa seen is diabetes mellitus in 30-35% patients, high blood pressure in 20-25% patients, recurrent kidney stone disease in another 10-15% of the patients, chronic glomerulonephritis in 15-20% patients, especially in 15-40 year age group. There is also Chronic Kidney Disease of unknown etiology (CKDu) in 15-20% of the patients where the reason for the disease is unknown,” he said.
Since screening for kidney disease in the general population is not feasible, targeting high-risk groups for screening is essential, as they are the most vulnerable and prone to developing kidney diseases.
“Consider a person with diabetes. In the type 1 diabetes, the risk of kidney disease usually starts 5-10 years after its onset and hence patients are advised to start screening for kidney disease after the initial few years. For type 2 diabetes which is also seen among young adults now, we advise for screening of kidney disease right from the day of diagnosis as its onset is uncertain and we do not know when it has actually started. There are risk factors that patients with type 2 diabetes have, which puts them at a higher risk of kidney disease. Hence, we advise each and every patient who has type 2 diabetes to carry out regular screening at least once in a year,” Dr Lengade said.
Senior nephrologist at SMRC’s V M Salgaocar Hospital Dr Sindhu Arjun said that anyone with one or more of the risk factors should undergo screening for kidney disease.
“Kidney disease can be prevented and the progression can be delayed with early detection and treatment. Get tested annually by your primary care physician, especially if you have the risk factors,” she advised.
Dr Lengade pointed out that most patients who have CKD do not have any particular or peculiar symptoms related to kidney disease in the initial phase as CKD in the majority of its time span is asymptomatic. As a result, the disease is diagnosed late.
“The symptoms usually appear very late when almost 80 per cent of your kidneys are damaged. That is the time when patients will start noticing something different in their health conditions,” he said, adding that symptoms commonly seen at that time include swelling around the ankles and eyelids or puffiness of the face, feeling fatigue or tired, cold intolerance, having difficulty in concentration, poor sleep, dry and itchy skin, changes in urine pattern, noticing excessive frothing of urine or decrease in the amount of urination.
Pointing out that it is only by regular screening that one would know about the kidney disease at an early stage, Dr Lengade said, “If it is diagnosed at an early stage, there are medications, lifestyle changes and dietary measures which can help to slow down the progression of the kidney disease. Because once it becomes progressive and goes beyond a certain stage then there is no going back.”
“When kidney disease is detected early, we can prevent the progression to later stages by tightly controlling risk factors as well as using certain medications which have been proven to slow progression of kidney disease. This provides a huge advantage as we can prevent further damage to the kidneys,” said Dr Arjun.
Dr Lengade, however, suggested that it should be made mandatory for patients with risk factors who visit the medicine OPDs and diabetes clinics to undergo screening for UACR and serum creatinine at least once a year.
“Secondly, many a time the diagnosis of the kidney disease comes after the eye check up is done. Diabetics who have diabetic retinopathy, nearly 70 per cent of them will have kidney disease along with eye disease. So if an eye check up is done periodically in all diabetics, then along with finding an eye disease we can also diagnose kidney disease indirectly through an eye examination,” he said.
