World Kidney Day is an awareness day that brings global attention to the importance of kidney health and held on the second Thursday of March every year. The kidneys are two fist-sized bean-shaped organs located beneath the lowermost ribs at the back, one on each side.
Kidneys are responsible for filtering the blood and removing waste products and excess fluid in urine; regulating blood pressure and producing critical life-sustaining hormones that make red blood cells and maintain bone strength.
Chronic kidney disease (CKD) describes the breakdown in the function of the kidneys when it occurs over a period of months or years. CKD is common, affecting 10 per cent of the adult world population, and half the people aged over 75.
At best CKD results in poor health and at worst it can be fatal.
Once CKD has developed it cannot be reversed, but treatments are given to try and slow down the rate the disease progresses. In some people, CKD can lead to end-stage renal failure which is when the kidneys have no more function whatsoever.
To survive you need either regular dialy-sis treatment or a kidney transplant.
The illness is almost always silent, with no signs or symptoms, until the very late stages of the disease. In many people no cause can be found, but in most high blood pressure and diabetes are responsible. In some cases, a biopsy can help clarify the cause.
Besides end-stage renal disease, millions of CKD patients die prematurely every year due to the strong association between CKD and cardiovascular disease – heart attacks and strokes. CKD is also costly; costing more than breast, lung, colon and skin cancer combined in the UK.
World Kidney Day was established in 2006 as a joint initiative of the International Society of Nephrology and the International Federation of Kidney Foundations. The aims are to increase awareness of this under-recognised illness; to highlight the risk factors that can lead to CKD; to advocate best practices in detecting and effectively managing kidney diseases; to educate the public about the management of CKD; and to encourage people to consider kidney donation as transplants can give those with kidney failure the best outcome.
The illness is almost always silent, with no signs or symptoms, until the very late stages of the disease
This year World Kidney Day coincided with International Women’s Day and therefore the theme is kidneys and women’s health. Epidemiological studies suggest that CKD is slightly more prevalent in women than in men, but when it comes to dialysis and kidney transplantation, men outnumber women.
The factors that contribute to these disparities are complex. CKD can progress (worsen) more slowly in women, but on the other hand transplantation can be difficult as there is a higher chance of finding pre-formed antibodies that will cause rejection.
On a global level, sociocultural influences undoubtedly also affect access to care.
Reproductive health and pregnancy are important issues for women with CKD. Kidney disease is associated with reduced fertility and an increased risk of adverse pregnancy outcomes for both mother and baby, including pre-eclampsia; pre-term delivery; and foetal growth retardation.
In turn, pregnancy-related complications, such as pre-eclampsia, increase the risk of end-stage CKD by up to five times. Although rare, pregnancies in women with advanced CKD are the most challenging, with patients on dialysis benefiting from a daily treatment regime. In women with well-functioning kidney transplants, the chances of successful births are notably increased, although complications are observed more often than in the general population.
Certain kidney diseases are more common in women.
For example, urinary tract infections affecting the bladder are extremely common in women but if they are not treated promptly, bacteria can travel up the ureters and cause a more serious type of infection called pyelonephritis in the kidneys themselves. Lupus nephritis is another kidney disease that typically affects women and in which the body’s immune system attacks the body’s own organs.
Medical professionals suggest that healthy eating, keeping one’s weight in check, stopping smoking and keeping active are simple ways for people to ward off kidney disease. In addition, it is recommended that kidney function is checked routinely with a simple blood and urine test.
Additionally, people at risk of kidney disease should try to avoid using over-the-counter and prescription drugs, as well as regularly screening their blood sugar levels and blood pressure.
If detected early enough, kidney disease can be treated with medication and diet, slowing down or arresting progression to kidney failure, and reducing the risk of associated cardiovascular complications.
During World Kidney Day, Maltese kidney health groups, educators, medical professionals, and policy-makers organise outreach drives, talks and activities to bring attention to the importance of kidney health in maintaining a happy and fulfilling lifestyle.
Emanuel Farrugia is consultant physician and lead nephrologist, Mater Dei Hospital.