Approximately three million people across the UK have chronic kidney disease, however what is a real concern to me as a renal physician is that up to 1 million of these people are undiagnosed and overall awareness and understanding about the condition is still very low amongst the general public.
Today is World Kidney Day. This annual event provides a great opportunity to raise awareness of kidney disease amongst the general public. It also gives organisations such as Kidney Research UK a chance to educate people about conditions and lifestyle choices that put them at risk of developing chronic kidney disease and some of the warning signs to look out for.
What's really important for people to understand is that chronic kidney disease is known as a 'silent disease'. This is because symptoms often don't materialise until the disease has progressed to an advanced stage. The human body is usually able to cope with a significant reduction in kidney function so problems aren't always spotted early on. However, there are some important warning signs to be aware of that can suggest developing kidney disease. These include swollen ankles and feet, shortness of breath, blood and/ or protein in your urine (usually detected by a dip stick test), fatigue, an increased need to pass urine (which may suggest a urine infection) or simply a general feeling of un-wellness. Although many of these symptoms are not specific to kidney disease, if you are concerned about them it is important to seek medical advice.
There are several conditions that can lead to chronic kidney disease, some of which may come as a surprise to the general public. Although it is quite well recognised that poorly controlled diabetes can lead to kidney problems, it is less well known that uncontrolled high blood pressure is also a strong risk factor. Frequent urine infections in young children (under the age of 5) can cause kidney scarring if untreated and certain medicines such as non-steroidal anti-inflammatory painkillers can make kidney disease worse in people who are susceptible. There are also a number of other conditions that can directly cause kidney disease, some of which are inherited, so it is important to know if anyone in your family has had kidney disease.
Another key fact about chronic kidney disease, which can cause confusion, is that there are five different stages. These stages are determined by the glomerular filtration rate (GFR) of the kidneys - which essentially is a measure of how quickly the kidneys filter waste products out of the blood.
In stages 1 and 2, (early kidney disease) patients have relatively normal kidney function but may have another sign of kidney disease such as blood or protein in the urine. In stages 3 and 4 the function of the kidney is moderately reduced and in stage 5 there is less than 15% of normal kidney function remaining. At this stage patients are considered for renal replacement therapy in the form of dialysis or transplantation. Patients with mild or moderate kidney function, if diagnosed early, can often be treated, which allows their kidney function to stabilise. Due to this, it's really important to screen 'at-risk' people to offer treatment and advice on how to change their lifestyle to help look after their kidneys. People who have high blood pressure can often improve this by reducing the amount of salt in their diet and we know that smoking and obesity can both worsen kidney disease so there is quite a lot people can do to help keep their kidneys as healthy as possible.
The idea that everyone who is diagnosed with chronic Kidney Disease will need dialysis is a myth. Thankfully only a small percentage of people with the disease will reach the stage of needing renal replacement therapy, as early diagnosis can often prevent the disease from getting worse.
Chronic kidney disease is commonly diagnosed in older people, however, it's important to note that anyone at any age can get kidney disease. Therefore, everyone should be aware of the signs and symptoms, eat a healthy diet and exercise regularly.
Unfortunately it is not yet possible to cure chronic kidney disease, as the condition is associated with scarring in the kidneys that cannot be removed or replaced. The aim of treatment is to help manage the disease by preventing further kidney scarring and slowing progression, controlling symptoms and reducing complications.
I really hope that the increased publicity associated with World Kidney Day helps to raise awareness of some of the key risk factors that can lead to chronic kidney disease. As an organisation, Kidney Research UK is committed to working with medical professionals across the UK to help them identify "at risk" patients and ensure they have the support and guidance they need to work towards early diagnosis in as many cases as possible. This, accompanied by their support and funding of a constant stream of pioneering and ground breaking research projects, means that we are edging ever closer to the ultimate goal - to find a cure for kidney disease which could save thousands of lives across the UK every single year.