They mobilize waste products produced by the body that are filtered from the blood and eliminated in the urine, regulate blood pressure, eliminate excess fluids, and generate essential hormones. These are some of the main functions that the kidneys perform in the body and that are impaired in almost 5 million people in Argentina, although only one in 10 knows.

Contributing to this lack of knowledge is the fact that damage occurs for years in complete silence. Kidneys suffer at the expense of very prevalent diseases such as diabetes and hypertension and when they finally start to show warning signs it is already too late.

So don’t world kidney dayspecialists highlight the importance of making this often “forgotten” organ visible and of detecting and treating chronic kidney disease (CKD) early.

chronic kidney disease

Diabetes, hypertension and kidney disease

The kidneys age with us, explains nephrologist Carlos Castellaro, a professor at the CEMIC Medical Institute. It’s programmatic aging.

Although chronic kidney disease can occur at any age, its frequency increases with age: 4 in 10 over 65 They live with some degree of IRC.

From 45 years old my kidney function normally declines, to the point where I can last my whole life without problems, as long as I behave reasonably well,” says Castellaro.

“When things like diabetes, hypertension, obesity happen to me, that rate of decline accelerates dramatically. And this acceleration causes my real function to decrease in the short term and reach the situation of needing a machine to survive (dialysis) and/or a transplant, with all the costs that this implies (health, emotional, economic, environmental )”, alert.

These “things” Castellaro talks about happen to them more and more people: nearly 7 out of 10 are overweight, more than one out of 3 have high blood pressure, one out of eight has diabetes. And they usually appear in “combo” (they are comorbidities), with negative consequences for the kidneys in particular and for cardiovascular and metabolic health in general.

This is what the statistics show: the joint analysis of data from the last National Survey of Nutrition and Health and the 4th National Survey of Risk Factors showed that 23.4% of people with hypertension, 22.6% of those living with diabetes and almost 15% of people with obesity also have chronic kidney disease, which affects the 12.7% of the adult population.

Castellaro speaks of an involution. “We are hunters. We have hands and feet to get the food we are going to eat and, in the end, today we choose to stay on the couch, call delivery, Let the pizza come, the ice cream“.

“We are worse, we are fatter, more diabetic, more hypertensive. We are paying a price. The kidney clearly pays that price.“, emphasizes.

“They are all silent diseases, they don’t hurt and, as they don’t hurt, we don’t consult the doctor”, adds nutritionist Silvia Lapertosa, former president of the Argentine Society of Diabetes (SAD).

A study that the doctor co-directed several years ago showed that, in the case of diabetes, newly diagnosed people already had complications.

“Chronic kidney disease was already present in almost 20% of patients. Also cardiovascular disease and even retinopathy.”

That’s why it says “We only see the tip of the iceberg” of a much bigger problem. Even because they are diseases that manifest themselves earlier and earlier. “Before we only saw type 2 diabetes in adults, now we are seeing it in children”, he exemplifies.

One in four people with hypertension also have CKD.  Shutterstock photo.


One in four people with hypertension also have CKD. Shutterstock photo.

What is chronic kidney disease: symptoms and risk factors

Chronic kidney disease is characterized by progressive damage and loss of function of the kidneys and is diagnosed when such damage is observed over a period of time. period longer than three months.

“A person can lose between 80% and 90% of your kidney function before feeling any symptoms”, warns nephrologist Cristina Vallvé, member of the Renal Health Committee of the Argentine Society of Nephrology (SAN).

“It is a disease that occurs asymptomatically. For 15 or 20 years I’m breaking down internally, until an event occurs, at which point it is too late. Among patients undergoing dialysis, who already have symptoms, in stage 5, half do not know they have the disease,” adds Castellaro. “And the less kidney I have, the more risk I have of dying”.

CKD symptoms usually appear when the disease is already very advanced. Some of them are: nausea, vomiting, loss of appetite, fatigue, weakness and sleep problems, changes in urine production, swelling of the legs and ankles, high blood pressure, confusion.

When the diagnosis is made at this stage, it is considered late. “Only 11% of people assessed at ENNYS knew they had chronic kidney disease. The remaining 89% did not know they had it. doomed to disease where there was something to do”, emphasizes Castellaro.

The problem? “Nobody goes looking for them, nobody finds them, nobody does anything at all,” she says.

Chronic Kidney Disease: How It’s Detected and Why It’s Important to Get It Early

Identify and treat. This is the formula that, according to experts, will help you get started bending the curve for chronic kidney disease.

CKD is one of the easiest to diagnose. For detection, a blood test, in which creatinine is measured, and a urinalysis that looks for protein loss. Creatininemia and albuminuria have a cost that, until now, do not exceed 500 pesossays Castellaro.

And he questions that, despite being a cost-effective measure, it is currently indicated for “less than 5% of the population”.

Therefore, experts agree that each time a person is indicated for a routine laboratory examination, these two markers of kidney health. Failure to do so is a missed opportunity to screen the population for CKD and find it at an early stage.

These tests, however, are especially important in people who are at higher risk of developing kidney disease.

So who yes or yes should have at least one annual check-up to assess kidney function are those who have one or more risk factors: hypertension, diabetes, obesity or age over 50 years. In childhood, anyone who has congenital kidney disease, had hemolytic uremic syndrome or suffers from frequent urinary tract infections should be monitored.

Lapertosa cites other risk factors for chronic kidney disease: high uric acid and frequent use of anti-inflammatories and analgesics.

To contribute to better identification, registration and subsequent management of people with CKD, the RAS and INCUCAI signed an agreement in which they proposed a series of guidelines to achieve this objective. “The motto that guides us in the execution of these ideas is ‘Make the invisible visible’a situation that characterizes CKD,” said Carlos Bonanno, president of the Argentine Society of Nephrology.

“And for that, what we nephrologists will do is record -in a computer system- the state of our kidney patients from the first stages of the disease, so that those responsible for public health and also specialists can have a very good idea better. information about its evolution and which patients should be followed in detail“He added in a statement distributed by SAN.

“This agreement will also give us concrete tools to be able to implement a better preventive kidney health public policyincluding the creation, in the medium term, of interdisciplinary clinics (called ERCA), throughout the country, units that will be dedicated to the treatment of these complex pathologies”, he explained.

Healthy habits are essential to prevent the early decline in kidney function.  Shutterstock photo.


Healthy habits are essential to prevent the early decline in kidney function. Shutterstock photo.

Treatment of chronic kidney disease

Early diagnosis is followed by another key measure: timely treatment.

Is that people who are detected in early stages -when the disease has not yet shown symptoms- can receive specific treatments that prevent progression to chronic kidney failure and the need for dialysis (renal replacement therapy) and/or transplantation.

The CKD Approach also reduces cardiovascular riskwhich is the most serious and frequent complication associated with kidney malfunction.

“Once the disease is detected at this stage, the patient begins to be cared for in a certain way so that it does not progress and does not end up connected to a machine. Specific medications are indicated so that the decline curve is as close to normal as possible“, says Castellaro.

For Lapertosa, reversing what is considered the “chronicle of an announced death” requires a “paradigm change” that involves the health system, health professionals and individuals and that requires a combination of measures: changes in lifestyle, early detection, treatment of complications and better management of hypertension, diabetes, obesity and heart failure with cardioprotective drugs.

How to take care of the kidneys: 8 golden rules

In prevention, healthy habits are essential to take care of the health of the kidneys. From SAN, they list eight “rules of thumb”

1. Control your blood pressure. It is one of the most frequent causes that alter the functioning of the kidneys.

2. Control blood sugar level. It is the first cause of development of renal deterioration. It is important for people with diabetes to have frequent tests to monitor their kidney function.

3. Follow a healthy diet, rich in vegetables and control weight, trying to keep it within the proper parameters. It is also important to reduce salt intake.

4. Stay hydrated. Water consumption should be around 1.5 or 2 liters per day.

5. Practice physical activity regularly to stay active and at a healthy weight. Exercise helps to lower blood pressure and improve blood glucose, thereby reducing the risk of CKD.

6. No smoking. Smoking impairs circulation and therefore can affect kidney function.

7. Do not use drugs that can damage the kidneys (do not self-medicate).

8. Take routine exams periodically and ask your doctor to check the health of your kidneys.

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