ESRD or End Stage Renal Failure is a major medical problem and particularly so in our country. First of all, the treatment options for ESRD are limited, secondly, the options are available at only a few major centers in the country, finally, the most important fact is that the cost of treatment is prohibitive for most of the people. Therefore every possible effort should be made to prevent Chronic Renal Failure (CRF); if CRF develops, aggressive efforts should be made at an early stage to prevent or delay its progression to ESRD.
How To Prevent Kidney Disease ?
1) All unnecessary drugs should be avoided. It would be incorrect to think that there are no side-effects of non-allopathic drugs. Every drug will have some side effects whether it is allopathic or non-allopathic.
2) If one has diabetes or high blood pressure, these should be well controlled. There may not be symptoms, but in long run both these diseases when poorly controlled, can damage the kidneys.
3) If one has kidney stones or any condition causing obstruction to the flow of urine and back pressure damage to the kidneys, it should be immediately corrected. An early correction ot obstruction can prevent irreversible damage to kidneys.
4) For those with hereditary kidney disease, a proper genetic counselling should be sought in order to avoid the disease in subsequent generations.
How to detect Kidney Disease at an early stage ?
In order to detect kidney disease at an early stage it is important to know disease and not ignore any symptom when it is present. Many people think that swelling of legs is common after prolonged sitting and quite often ignore it. Normally, swelling of legs should not occur on prolonged sitting or standing. if anyone does develop swelling of legs, it should be invetigated.The swelling may not necessarily be due kidney disease; it could be due to other causes like Liver disease or Heart problem. In any case swelling of legs is not normal and requires proper evaluation. Similarly, swelling around the eyes is quite often mistaken for allergy when reality it is often due to kidney disease. Some people, when they develop weakness, attribute it to hard work which they may have be doing. There is no reason why one should feel weak with work he/she was doing all long. In such situation, some people take leave and go to their native place for rest to realise that their weakness persists. When invetigated, they are found to have severe aneamia which is the cause of weakness. Aneamia and increasing weakness could be the first manifestation of kidney disease and one must keep that possibility in mind. Bone pain may also be first manifestation of kidney disease. Weak bones and rickets in children warrant investigations for kidney disease. High blood pressure at young age (below 35 years) is uncommon. Further, amongst known causes of high BP, kidney disease is the commonest cause. Therefore every case of high BP requires investigations for kidney disease.
[1]When Kidney Failure is Detected:(a) Patients are generally advised to take a specific quantity of common salt (1gm, 2gm, 3gm, etc) and liquids depending upon how much salt and water they are accumulating. Excessive intake of salt and water can lead to swelling, breathlessness and high blood pressure.
(b) Patients should take limited quantities of fruits and other high potassium containing items. (Chocolates, Coconut water, green leafy vegetables), or as advised by the doctor. Avoid use if low-salt and rock-salt which are high in potassium content.
(c) Patients with renal failure are generally advised to restrict the intake of protein in the diet. High biological value protein( milk, egg and animal protein) are better digested. Patients have to avoid excessive use of pulses and dals. (Poor biological value protein). Rice is preferred to wheat.
(d) Adequate intake of calories should be maintained.
