Silent killer: Chronic kidney disease is hurting young adults, and they don’t even know it

If you use steroids or painkillers, have hypertension or high blood pressure, you could be at risk.

For months, Akriti Khanna, 27, ignored the splitting headaches that struck at least once a week. When she finally spoke to a doctor about it in January, she was told her blood pressure was through the roof – 240 / 140 mmHG against the normal 120 / 80.

“I was admitted to hospital immediately and tests revealed that my high BP had affected kidney function. I am overweight, I don’t exercise regularly and eat whatever is available because of my erratic timings at work,” says Khanna, who works at a radio station in New Delhi.

An estimated 17.2% of India’s population has chronic kidney disease (CKD), with the disease progressing to Stage 3 and beyond in nearly 6% of people, according to data from SEEK (Screening and Early Evaluation of Kidney Disease), a US-India initiative to track CKD in India.

Chronic kidney disease is hard to detect in its early stages because of its veiled symptoms.

“It is largely asymptomatic,” says Dr RP Mathur, head of the department of nephrology at the Institute of Liver and Biliary Sciences in Delhi. “People continue living normally until there has been a significant deterioration in kidney function. Almost 60% of CKD cases is diagnosed only at the end stage, when the only option left for the patient is organ transplant or maintenance dialysis.”

What you can look for, is uncontrolled blood pressure and diabetes, the most common causes of CKD.

“Nearly 40% of all chronic kidney disease cases are caused by uncontrolled diabetes; another 10 to 15% are caused by uncontrolled hypertension,” says Dr Vijay Kher, chairman of the Fortis Escorts Kidney and Urology Institute. “And these conditions are preventable with simple lifestyle changes such as cutting down salt and sugar intake, exercising regularly, not smoking, and maintaining a healthy body mass index.”

As lifestyles become more fast-paced, stressful and sedentary, cases of hypertension and high blood pressure are growing and this is not good news for the kidneys, doctors warn.

“One in three people in India have hypertension or high blood pressure and more than 60% don’t know they have it. Of the people who know, only 50% end up taking their medicines,” says Dr Sanjiv Jasuja, a senior nephrologist at the Indraprastha Apollo hospital.

According to Mumbai-based diabetologist Dr Pradeep Gadge, almost one in every three patients approaching him is displaying signs of chronic kidney disease (CKD) or borderline renal insufficiency (impaired kidney function). “The trick is to control diabetes and strictly monitor creatinine levels in the blood,” said says Dr Gadge.

SWEAT THE SMALL STUFF

“Most people do not realise how being complacent about small diseases can later add up to something as major as CKD and eventually necessitate transplantation or dialysis,” says Dr Rushi Deshpande, director nephrology academic, at Jaslok Hospital and Research Centre in Mumbai.

Even a urinary tract infection (UTI) or kidney stones, left untreated, can contribute to early-onset CKD. “Once the kidney stone is removed, the patient also needs to adopt a healthier lifestyle and ensure she has follow-up sessions with her doctor,” Deshpande says.

It’s also a good idea to look for the small indicators that your kidneys are in distress.

If you are prone to low haemoglobin or severe anaemia, for instance, it could be because your kidneys are not producing enough of the hormone erythropoietin, which hints at the possibility of CKD, says Dr Deepa Usulumarty, a nephrologist with Mumbai’s Zen Multispecialty Hospital. “Another typical symptom is puffiness of the eyes and face and frothy, acidic urine.”

PREVENTION

The daily salt intake recommendation is 5 gm or 1 level teaspoon. Indians consume more than double that amount.

Want to keep your kidneys healthy? Drink two litres of water a day, cut down on red meat, fast food and processed food, keep salt in your diet low.

Get diabetes, hypertension and kidney function tests annually. In fact, people at risk – those with known diabetes and hypertension, a family history of those diseases, a family history of kidney disease or an age of over 60 – must get tested twice a year.

And avoid steroids, extreme physical exercise, and the overuse of painkillers.

One patient, a 31-year-old accountant, learnt the importance of this last piece of advice the hard way. “I am passionate about working out and this January I wanted to participate in a bodybuilding competition, so I took steroids for immediate effect,” he says. Two months in, he was suffering from regular bouts of fever and body ache, and was diagnosed with CKD.

He won’t be using steroids again in a hurry, but when it comes to adopting a healthy lifestyle, starting young is important. “It is important to cut out junk food and snacks high on salt and sugars right from childhood,” says Dr Kher of Fortis. “Schools need to provide healthier food options, and parents should ideally set time aside every morning for exercise with the children, so they set an example of healthy living for the child.”