Here's how to prevent the silent onset of chronic kidney disease

Kidney disease is an irreversible illness that affects 10% of people across the world, and up to 1 in 8 people in SA. Kidneys are vital organs and it is important to live in a way that promotes kidney health. 

The kidneys are a pair of bean-shaped organs found at the back of the body at the level of the waist. Each kidney holds thousands of filtering units. As our blood moves through them, kidneys filter out waste products and extra water and release them in our urine. 

Paediatric nephrologist, Professor Errol Gottlich, who also heads Discovery Health Medical Scheme’s Kidney Care programme for members on chronic dialysis, says: “Kidney disease is silent, meaning it often develops without any noticeable symptoms. By the time most people become aware their kidneys are failing, they will already have lost 50% of their kidney function.” 

Professor Gottlich says kidneys balance  fluid levels, ensuring we don’t become over-hydrated or dehydrated. 

“They normalise electrolytes and blood pressure, assist in calcium metabolism and prevent anaemia. Our kidneys are essential for a normal, healthy lifestyle. The kidneys fulfil many roles, the most important of which is excreting toxins out of the body in the urine,” he says. 

Paediatrician Dr Nokukhanya Ngubane-Mwandla says: “The kidneys have multiple important functions in the body, including controlling acid-base homeostasis, water and electrolyte balance and blood pressure. They also produce certain hormones important for the production of red blood cells and bone mineralisation.”

Ngubane-Mwandla is the recipient of a 2020 Discovery Foundation Sub-specialist Award and is using this support to work towards improving the lives of children with congenital and acquired renal pathology.

Here’s how you can look after your kidneys: 

Taking care of your kidneys is as simple as leading a healthy lifestyle. Gottlich recommends people do the following: 

• Ensure regular exercise. Exercise for 30 minutes, five days a week. Even a brisk walk is an excellent form of exercise. 
• Eat a balanced, healthy diet of unprocessed, fresh foods with no more than a teaspoon of added salt a day. 
• Regularly check and control your blood sugar. 
• Regularly check and control your blood pressure. 
• Drink an appropriate amount of fluids. Your doctor can explain how to adjust your fluid intake if you have kidney, heart or liver disease. 
• Don’t smoke as smoking slows the flow of blood to the kidneys. 
• Don’t take over-the-counter pain or anti-inflammatory pills regularly. Long term, frequent use of medicines such Ibuprofen, can harm your kidneys. 
• Get your kidney function checked regularly if you have any high risk factors such as diabetes, high blood pressure, a family history of kidney disease, and being overweight or obese. 

A silent disease: What damages kidneys and how?

Discovery Health’s data shows that about 75% of renal (kidney) failure is a result of diabetes or hypertension (high blood pressure).

Data from the National Kidney Foundation mirrors this with up to 65% of kidney failure in SA adults being attributed to hypertension and up to 25% due to type 2 diabetes.

“Uncontrolled diabetes can damage the blood vessels in your kidneys and can gradually decrease the functionality of this vital organ. Untreated high blood pressure causes damage to kidney tissue as a result of blood vessels being exposed to a higher than normal blood pressure,” says Gottlich. 

Other causes of kidney disease include living with HIV/Aids and other infectious and auto-immune diseases, and structural abnormalities. 

“There is also a relatively high incidence of kidney problems among SA children. Some of these problems are congenital, which means that children are born with them, but several conditions are caused by malnourishment and gastric issues," says Ngubane-Mwandla. 

“It would be great to implement screening programs at schools or at primary health care facilities,  in particular,  to ensure blood pressure and urine screening. Screenings will also help to detect the early onset of kidney disease, especially in babies born prematurely, at a low birth weight or who have a family history of kidney disease.”

The National Kidney Foundation says that up to 80% of chronic kidney failure may be preventable, making it vital to keep up regular screening checks that will identify signs of chronic diseases such as kidney disease, as early as possible, in adults and children.

Catch the onset of kidney disease early on – simply screen!

The good news is that, for most people, screening for kidney disease can be done as part of regular health check-ups. 

“It’s really as simple as going to your primary healthcare provider and doing a screening test for high blood pressure, blood glucose levels and kidney functionality,” says Professor Gottlich. 

“Essentially, your urine is an easily accessed window to your kidney health. A dipstick into the urine sample will show markers of possible kidney health issues.”

Treating chronic kidney disease 

Once a person has chronic kidney disease, they will need to undergo chronic dialysis for an average of three sessions a week, says Gottlich. Patients may either undergo: 

• Peritoneal dialysis, which uses the lining of their abdomen to filter the blood inside their body or;
• Haemodialysis, which uses a dialysis machine and a special filter, called an artificial kidney or dialyser, to clean the patient’s blood. 

“In addition to dialysis treatment, it is critical that patients live a healthier lifestyle and take prescribed medicine to control blood pressure, improve anaemia and bone health,” says Gottlich. 

Chronic kidney disease is a complex illness that is expensive to treat. 

• In 2021, Discovery Health paid out R1.5bn in kidney treatment related claims for about 3,000 members of which 0.6% was for members under the age of 18, reflecting that kidney disease affects children too.

• In 2020 Discovery Health paid out a slightly higher R1.6bn in claims from about 3,500 medical scheme members for kidney treatment. The 14% drop in members claiming between 2020 and 2021, shows the decrease in screening and treatment for kidney disease and other chronic treatment over the course of the Covid-19 pandemic. This is because people stayed away from healthcare facilities in fear of exposure to Covid-19, due to stay-at-home measures imposed to curb the spread of infection, and due to the redirection of resources in healthcare towards Covid-19 care - especially during peaks of infection.

^{Discovery Health Medical Scheme, registration number 1125, is regulated by the Council for Medical Schemes and administered by Discovery Health (Pty) Ltd, registration number 1997/013480/07, an authorised financial services provider.} 

This article was paid for by Discovery Health.