A very happy world kidney day to all…It’s march time of the year…world kidney day on march 12th ..As a nephrologist we deal with in and out cases of Chronic kidney Disease..The word chronic is like a big doom for them.. not reversible makes them wonder how to live…why not talk about prevention? What could I have done doctor to prevent this? this question is hardly asked by many of the patients who see physicians…CKD – as its called.. It is preventable in the majority of the cases…
The common causes of kidney diseases are Diabetes mellitus, Hypertension, CKDu – Chronic Kidney disease of unknown origin, Autoimmune diseases, Congenital anomalies of the kidney and urinary tract and drug induced kidney disease. Diabetes mellitus being the leading cause itself its a preventable disease. Many hospitals do talk about diabetes reversal program, then why diabetic kidney disease is not preventable..
Well the natural history of diabetes means that you will get end organ damage namely diabetic nephropathy many years after diagnosis.. The starting stages are visible within the kidneys and not seen outside by symptoms or signs…It is recommended to check urine ACR(albumin creatinine ratio) and eGFR atleast once a year after the diagnosis of type 2 diabetes mellitus and once in 5 years after the onset of type 1 diabetes….Sugar control is the main prevention strategy…others like BP control, uric acid and bicarbonate control all become a part of it….Drugs like ACE inhibitors/Angiotensin receptor Blockers are the corner stone of the therapy while new drugs like finerenone further help in kidney protection in Diabetic nephropathy at the microalbuminuria stage itself…Once the macroalbumin stage has reached (urine alb – 3+) or so, the above therapies do not help and CKD progression becomes inevitable…
In the next one year I plan to write on common myths and facts about kidney disease ..Stay tuned