What you need to know about your kidney

Last Thursday (March 12th) marked the World Kidney Day, an annual event aimed at raising awareness on the importance of kidneys to overall health. The day is celebrated every second Thursday in March, with a mission to reduce the frequency and impact of kidney disease and its associated health problems worldwide. What is Kidney disease? Kidneys are two bean-shaped organs, each about the size of a fist. They are located just below the rib cage, one on each side of the spine. Every day, the two kidneys filter about 120 to 150 litres of blood to produce about 1 to 2 litres of urine, composed of wastes and extra fluid. They are involved in regulating blood pressure, electrolyte balance, and red blood cell production in the body. Kidney disease is a condition where the kidneys do not work effectively, eventually leading to kidney failure and the need for dialysis or a kidney transplant to survive. Signs and symptoms According to Austin Kamari, a retired nephrologist in Kigali, high blood pressure, fatigue, shortness of breath, loss of appetite, nausea, thirst, are some of the signs and symptoms of a kidney ailment. “Most people experience no symptoms until chronic kidney disease is advanced. In fact, one can lose up to 90 per cent of their kidney function before experiencing any symptoms,” warns Dr. Kamari. “Between 8 to 10 per cent of the adult population have some form of kidney sickness, but fewer than 1 in 10 are aware of the importance of regular kidney checkups,” he says, “and of those affected, only 1 in 5 people with kidney failure are ever referred to a specialist.” The doctor remarks that the most common causes of chronic kidney disease are associated with the skyrocketing rates of non-communicable diseases such as obesity, Type 2 diabetes and high blood pressure. Precaution According to Dr Cory Couillard, who works in collaboration with the World Health Organisation’s Goals of Disease Prevention and Control, and a regular columnist with The New Times newspaper, Rwanda, it’s important to keep one’s weight in check through a healthy diet and regular exercise regimen, as both of these are known to prevent diabetes, heart disease and other conditions associated with chronic kidney disease. “Monitoring one’s blood sugar is also important in managing chronic kidney disease, since about 50 per cent of people who have diabetes develop progressive kidney damage over time,” he cautions. “Blood pressure-induced kidney disease is another silent condition that can develop for decades with very few noticeable symptoms. One should monitor blood pressure regularly and maintain a healthy diet that is low in salt and unhealthy saturated fats,” he advises. Dr. Couillard mentions that salt-induced high blood pressure is well known but salt intake is also directly linked to kidney disease and eventual failure. Salt intake is similar to other cumulative risk factors such as obesity, tobacco and alcohol use — the longer you abuse it, the greater your risk. Kidney disease in Rwanda Although the statistics are not up-to-date, data published by the WHO in April 2011, show that Kidney Disease Deaths in Rwanda reached 849. For most victims of kidney failure, Dialysis, a procedure that is a substitute for many of the normal duties of the kidneys is the only remedy. Unfortunately, it is so costly that very few can afford it. According to an expert physician, the procedure, which is performed once a month, costs between Rwf 900,000 to Rwf 1.2 million, depending on which procedure one uses. Dr Joseph Ntarindwa, Consultant Nephrologist at King Faisal Hospital, says deaths caused by kidney failure and the increase in number of patients requiring dialysis cannot be ignored. “The cost of dialysis is too high to be afforded by most of the patients and there are no kidney transplant services in the country to rely on. The total burden of kidney disease is currently bigger than government budget can handle,” Ntarindwa said. In addition, there is no surgeon in the country capable of doing kidney transplant and we have no pathologist leave alone one specialized in renal pathology and no tissue typing technologist.