To keep your kidney healthy, a low carb, low fat and low salt diet is a must along with regular exercises, says Dr Sanjay K Agarwal, Professor and Head, Department of Nephrology, All India Institute of Nephrology, New Delhi. In a conversation with Happiest Health, he detailed the measures required to ensure renal health and prevent chronic kidney disease ahead of World Kidney Day. Excerpts from the interview:
Q 1: What are the early signs of renal failure or renal disease that people do not notice?
A: Kidney diseases are broadly classified into two as acute kidney disease (AKD) and chronic kidney disease (CKD). AKD happens within a few days (one or two weeks) and is potentially reversible, despite the affected person requiring dialysis briefly. CKD is a state where the kidney disease persists beyond three months in absence of a reversible factor. CKD can range from mild to severe and is based on the kidney function which is measured through glomerular filtration rate (GFR), which must be close to 90 ml per minute for every 1.73 sq m of body surface area.
Those in stage 5 of CKD require either dialysis or kidney transplant and can’t manage with only medicines. In the majority of those affected with stage 1-3 of CKD, there will be no symptoms. This forms 90% of those with CKD in whom the disease gets diagnosed only if kidney function test is done. However, one must be aware of the typical symptoms of CKD like swelling in the leg, hand and face, anemia, blood in the urine and frequent urination especially in the night. The earlier we diagnose the person with CKD, the longer it takes to reach stage five.
Q2: What are the risk control measures one can adapt to keep away the fifth stage of chronic kidney disease?
A: As most affected with CKD are asymptomatic till stage 3, only regular screening can help in picking up the infection early and prevent the person from going to stage 5. In a country like India, screening everyone is logistically impossible. There is a high-risk group of people with diabetes, hypertension and high blood pressure who are the most vulnerable people to develop CKD and they must get screened for kidney function.
This is also applicable to everyone above the age of 60 years and those who have a person with CKD in the family. Besides, though AKD is potentially reversible, about 15-20 % of them end up suffering from CKD. Hence those with past history of AKD are also considered high risk groups and they must undergo kidney function tests annually.
Q3: Tell us about the link between diabetes, hypertension and kidney health.
A: Those with diabetes and high blood pressure constitute 60% of CKD affected people. Diabetes and hypertension affect blood vessels. The kidney has a very high blood supply. Any disease in the body which affects the vessels is likely to affect the kidneys too.
Filtering unit in the kidneys is actually a bunch of blood vessels. The filtering function of the kidneys is done through the blood vessel. The blood vessel has an outer membrane through which the filtration happens. When the membrane gets hardened or damaged due to high blood sugar or high blood pressure, it decreases the filtering mechanism of the kidney. So, the longer these two diseases persist, the poorer the control is. It hampers the functioning of the kidney. That is how these two diseases commonly affect the kidney.
Besides, high blood pressure and diabetes do not show symptoms in early stages. So once diagnosed with these two diseases, one must ensure they take medication to keep the condition in control. They must also undergo a kidney function test.
 Q4: What are the five healthy lifestyle options one can follow to keep kidneys healthy?
A: There are some basic concepts to prevent CKD:
- Ensure regular exercises and do not become obese.
- Take adequate quantity of water, which is for a healthy adult 1.5 to 2 litre of fluid a day
- Do not take excess salt. This can help in preventing developing high blood pressure
- Ensure your food has less junk items and choose a low fat, low carbohydrate diet.
- Avoid excess non-vegetarian protein
- If you have diabetes and hypertension, take medication to control the condition
Takeaways
Though Acute kidney disorder is a reversible condition, it leads to chronic kidney disease in 15-20 % of the affected. Initial stages of the chronic kidney diseases don’t show alarming symptoms and hence diagnosis is delayed in most cases. Controlling diabetes, hypertension is essential to prevent kidney diseases. Low salt, low fat, low carbohydrate diet, avoiding excess non-vegetarian fat, along with exercises can help keep the kidney healthy.
