Consider this: 45-year-old Sanath Kumar, a banker by profession, has a history of diabetes and a blood pressure of 180/120. Now, he has been diagnosed with chronic kidney disease (CKD) and has to be put on dialysis.
Nephrologists warn that if Sanath Kumar had done his regular screenings for diabetes, hypertension, and serum creatinine every year, he could have avoided the CKD diagnosis.
But Sanath is not alone. The number of chronic kidney disease patients are increasing, say doctors, and a majority of them have diabetes and hypertension as underlying factors.
Speaking to South First, Dr Arvind Conjeevaram, Consultant Nephrologist and Transplant Physician at Trustwell Hospitals in Bengaluru, said, “In a recent Indian chronic kidney disease study, it was found that of the 4,700 patients screened, 87 percent had high blood pressure, 37% had diabetes, and 22% had cardiovascular disease. Diabetic kidney disease was the most common cause of kidney failure in this group,” he warned.
What is chronic kidney disease?
Kidney disease, also known as renal disease, is a medical condition that affects the proper functioning of the kidneys. This vital organ is responsible for filtering the blood and removing waste products from the body, as well as regulating electrolyte levels and blood pressure.
In diabetic patients, the high blood sugar can damage the blood vessels in the kidneys as well as nephrons. In hypertensive patients, the blood vessels can become narrow and constricted, eventually leading to damage and weakness of the vessels.
When the kidneys become damaged, they can no longer perform their functions effectively, leading to a variety of health issues.
There are many different types of kidney disease, each with their own causes and symptoms. One of the common types is CKD.
“This is a long-term condition in which the kidneys gradually lose their ability to function properly. It can be caused by a variety of factors, including diabetes, high blood pressure, and certain infections,” say nephrologists.
This silent disease can lead to a range of debilitating complications, however, it can be prevented and reversed if diagnosed in its early stages.
Why should diabetics screen for kidney disease?
An interesting panel discussion was recently held by NephroPlus — India’s largest dialysis network — and Kidney Warriors Foundation — India’s largest patient advocacy body — under the guidance of the Indian Society of Nephrology and Indian Medical Association, where it brought together medical experts from cardiology, diabetology, nephrology, and ophthalmology to address the growing risk of comorbid conditions, such as cardiac illness and diabetes, on kidney health.
Speaking at the discussion, D Randeep, Commissioner of Health, Department of Health and Family Welfare, called the current situation a wake-up call for all to act. He said, “Awareness and early screening is the key. It helps in keeping people away from ending up with CKD. The dialysis demand and waiting list for a kidney transplant are alarming.”
Speaking to South First, KN Manohar, a leading diabetologist who was also on the panel, focussed on the fact that diabetes is the leading cause of kidney failure worldwide and its management should not focus only on controlling blood sugar, but also on monitoring issues like hypertension, high cholesterol, kidney and heart functions, along with eye check-ups.
“There is a need for a shift towards holistic management of diabetes. The need for education on healthy living and regular monitoring of health parameters like weight, blood pressure, blood sugar, and cholesterol values is important and should even be included in school curriculums,” said Manohar.
Growing need for preventive nephrology
Stressing on the fact that there needs to be serious efforts in preventive nephrology with early intervention in all those who are at risk for hypertension and diabetes, Dr Rajan Shetty, Interventional Cardiologist at Manipal Hospital in Bengaluru, noted that, several times, even doctors tend not to link the risk of hypertension or diabetes to kidney disease.
Citing an example, he said, “Patients, whose blood pressure measures 180/120, often convince themselves that that their pressure is such because they walked up the stairs. But, instead, it is better for the doctor to direct them to do a few basic tests to rule out kidney issues and the presence of diabetes.”
Adding to this, another renowned nephrologist on the panel, Dr Sundar Sankaran, Program Director at Aster Institute of Renal Transplantation, said, “Any diabetic, hypertension patient should be asked for that kidney number (creatinine number). CKD is a silent killer and you won’t know until it gets diagnosed. Early diagnosis of diabetes and hypertension is the key. Even school children need to be screened for hypertension.”
Four magic tests to prevent kidney disease
Speaking to South First, nephrologists said that, each year, more than 1 lakh new cases of renal failure are enrolled in India. Diabetes and hypertension was the leading cause of end-stage renal failure.
Dr Gurudev KC, President of Nephrology at Ramaiah Memorial Hospital, at the panel discussion, highlighted that the clinical management of CKD is practiced widely, however, efforts in preventive nephrology with early intervention in at-risk people is the need of the hour.
“Unfortunately, most clinicians spend their time in curative nephrology rather than taking preventive measures. India has a massive gap between those who have and have not,” he said.
Here are the four magic tests — as listed by Dr Conjeevaram — to be done by every individual above 30 years and especially those who have family history of diabetes or hypertension. These tests detect if there is any kidney-related issues.
- HbA1C for three months
- Basic blood pressure check
- A urine dip test to know protein levels
- Blood and urine tests to check creatinine levels