Avoid the kidney busters

Dr Alka Bhasin

Chronic kidney disease (CKD) is a “silent killer” which could be as fatal as diabetes and hypertension, but carries a much lower profile, with less awareness about it in society. It is, however, important to recognise the growing epidemic of CKD in young adults in our country. In a study in Chennai, 6 per cent prevalence of urinary protein leakage was noted in a sample population of young adults.

Young people often ignore warning signs about their health such as odd readings of high blood pressure, headaches, frothy urine, leg swelling and fatigue, etc.

The genesis of kidney disease can usually start early in youth and largely with the onset of modifiable risk factors.

Risk factors for CKD in young adults:

1. Low birth weight (28 per cent of children are < 2.5 kg at birth ).

2. Hypo-vitaminosis (condition of abnormally high storage levels of vitamins like A or D, which can lead to toxic symptoms) and under-nutrition of the pregnant mother may lead to smaller kidney volume at birth, hence lower eGFR (filtration efficiency).

3. Co-sanguinity and genetic inbreeding can lead to greater risk of congenital anomalies of the renal tract at birth.

4. Kidney filter diseases may result from the impact of poverty, poor sanitation, pollutants, water contamination, overcrowding, exposure to unknown nephrotoxins (heavy metals, plant toxins, indigenous remedies) and lack of access to affordable health care.

5. Growing burden of hypertension and diabetes in India. 

6. Scarcity of nephrologists. 

7. Autoimmune diseases such as systemic lupus erythematosus (SLE).

8. Consumption of non-steroidal anti-inflammatory pain medicines, use of steroids and excesses of whey protein / muscle gain products in an attempt to build muscle bulk and enhance body image. It can cause severe kidney filter damage, proteinuria and increased risk of stone formation. 

Prevention of kidney disease in 

young age: Early screening to identify risk factors, combined with education on ways to keep the kidneys healthy, could provide great opportunity to prevent or abate kidney disease before it becomes a problem. The youth must be made aware of:

1. Avoidance of extreme physical exercise.

2. Avoidance of extremes of heat to prevent heat stroke and dehydration.

3. Drinking good volume of water and fluids to prevent renal stone disease, especially in hot climates.

4. Avoidance of whey protein. 

5. Avoidance of smoking & alcohol.

6. Avoidance of creatine tablets.

7. Reduction of weight in obese youth.

8. Monitoring BP and controlling it. 

9. Avoidance of nonsteroidal anti-inflammatory drugs.

Short education sessions/ videos ought to be shown to the millennial generation to create awareness about kidney disease and how to avoid it. With advancing technology and social networking, this could be spread “virally” not only among younger adults but also possibly later via secondary mechanisms (e.g., verbal) to older family members as well.

— The writer is director, nephrology, Max Smart Super Specialty Hospital, Saket, New Delhi.