People do not always show symptoms early in the disease.
Ángela Díaz, executive director of the renal council of Puerto Rico. Photo: Archive of the Journal of Medicine and Public Health. Provided by the director.
The director executive of the kidney advice from Puerto Rico, Angela Diazhighlighted that “regarding 350,000 people might have kidney failure and not know it”, since the Isla is in the top ten countries with the highest incidence and prevalence of patients on dialysis, so: “it is something that worries us because being an island we are comparing ourselves to large countries,” he said Díaz.
Díaz adds: “There are some social determinants that affect whether the patient arrives on time, such as levels of poverty and educational levels of the population – how much do they know regarding health issues-”. He also points out that: “Almost 50% of patients arrive at dialysis without ever having received an orientation on time.”
Regarding the symptoms, the renowned Puerto Rican nephrologist, Rafael Burgos Calderonclarifies that these manifest themselves when it is very late, for example, when the persona is in stage 4 of the disease, who begin to experience nausea, a smell like nitrogen, for this reason, the specialist emphasizes that “one cannot let go of the symptoms, because, from stage 1 to 4, the People don’t feel anything.”
The expert Díaz highlights that in Puerto Rico there is a very diverse geography, as well as a shortage of health professionals, especially nephrologists; not all centers have a dialysis unit, in addition, there are few clinics where patients are treated at an early age and patients do not have a transportation system designed for health. The health system is fractured, points out the executive director.
Failure from the clinical perspective
Dr. Rafael Burgos Calderón, renowned Puerto Rican nephrologist and noted worldwide for his contributions to kidney health, indicates that the kidney is the organ, a vital organ, there is a connection between all the organs of the body and the kidney. This maintains the water balance, the basic acid balance of the body, controls hypertension in a certain way. When the kidney is damaged, it begins to excrete acids from the body, which can damage the region and the bones of the body.
Burgos states that “The kidney is also an endocrine organ, it produces important hormones for the body, one is erythropoietin -which increases hemoglobin- and others that increase calcium and reduce kidney bone disease in children”.
The specialist clarifies, regarding the risk factors for chronic kidney disease, that “in the biomedical model, smoking, obesity, uncontrolled diabetes, uncontrolled hypertension, cardiovascular disease, harmful lifestyles, too much salt, too much protein and not exercising.
The stages of kidney disease are classified as stage 1, when the glomerular filtration rate is 90 or higher, which means that kidney function is healthy; 60 to 89 is mild, 45 to 59 is mild to moderate; between 30 and 44 it is moderate to severe; between 15 and 29 is serious and less than 15 is considered dialysis.
The important thing is to know what that number is and the leak, which is part of educating people. The practice of medicine should be revolutionized towards education, points out Dr. Burgos.
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