In Puerto Rico, according to a census by the Puerto Rican Kidney Foundation, there are 6,519 patients with chronic kidney disease. Even 1,400 cases of this condition are diagnosed per year, according to Ana Laboy Rodríguez, executive director of the organization.
Chronic kidney disease arises when the kidneys – in charge of filtering the blood and removing toxins from the body – stop working. In turn, it is a condition that worsens over time and is divided into five stages or stages, explained Carla González, coordinator of education and community services at the Puerto Rican Kidney Foundation.
The fifth and final stage arises when the patient experiences kidney failure or failure, requiring dialysis treatment or a kidney transplant. People who are in the early stages can slow the progression of this disease through regular diagnostic tests, medications to control the condition, and changes in their diet.
According to the National Institute of Diabetes and Digestive and Kidney Diseases, to determine if a person has kidney disease, a doctor may order a blood test known as the glomerular filtration rate (eGR) to check how well the kidneys are working While a doctor may also order a urine test to detect albumin, which is a protein that can pass into the urine when the kidneys are damaged. If you have chronic kidney disease, your doctor will order these tests to monitor your condition periodically.
Causes of the disease
Chronic kidney disease has several causes. However, diabetes is one of the most common causes of this condition.
“Food is involved in this process of cleaning the blood. So the more uncontrolled the patient with diabetes is, the more risk the kidneys run, ”said Laboy Rodríguez.
González commented that hypertension, hereditary conditions –such as polycystic kidneys–, reflux and inappropriate taking of medications can also cause kidney damage. According to the coordinator, the population that suffers the most from this condition are people over 65 years of age. However, he assured that there has been an increase in cases in young people between 30 and 40 years old.
Warning signs
Laboy Rodríguez mentioned that some of the warning signs of chronic kidney disease are edema –which is a swelling in the hands or feet–, itchy skin, burning when urinating, blood in the urine, urine infections – which can be due to the reflux of this -, high blood pressure, fluid retention and having a stone in the kidneys.
Treatment alternatives
Although there is no cure for chronic kidney disease, early-stage patients can slow the progression of the condition and kidney failure through diet adjustments, lifestyle changes – such as quitting smoking and being active. physical – and incorporating oral medications.
After more than 20 years of research, significant advances have emerged in the treatment of chronic kidney disease. For example, today there are medications that function as inhibitors of the renal sodium-glucose cotransporter. These have been shown to improve kidney function. But when the patient has already had kidney failure (stage five), the available treatments are peritoneal dialysis, hemodialysis, or a kidney transplant.
In peritoneal dialysis, a fluid filters the blood through a catheter in the abdomen. In the case of hemodialysis, the patient must be connected to a machine that filters the blood. This process can take five hours and should be done about three times a week.
Urge to continue treatments amid the pandemic
Although the COVID-19 pandemic has caused an overload on health services, Laboy Rodríguez urged kidney patients to continue their medical treatments. He assured that, in the middle of the emergency, there were patients who were neglected and suffered kidney failure.
Chronic conditions usually have to be monitored every three months. The pandemic caused a lot of anxiety and fear in these patients. Some neglected their weight, did not monitor their blood chemistry, which is what allows them to monitor the prescription of drugs, dose adjustments or start new treatments, “said the executive director.
He added that, in case a person needs a modification in their care, they can go to their doctor virtually or in person.
They bet on prevention
Chronic kidney disease is found with laboratory tests that everyone should have at least once a year.
“The method to monitor kidney function is the laboratories that must be done every six months or annually. If it is discovered that there is a kidney failure, a sonogram or a biopsy can be done to find out the cause ”, pointed out González.
While Laboy Rodríguez stressed that with early detection the deterioration of the kidneys can be avoided.
“It is important that patients always ask how their kidneys are doing. The percentage of kidney function should be 60% or more. Once it is diagnosed, a renal diet must be established, which is very particular. In the renal diet it is very important to control sodium, potassium and protein levels. Patients cannot neglect diabetes. They should not think ‘I eat everything I want and then take insulin’. That should not happen ”, pointed out the executive director of the Foundation.
Due to an increase in diabetes cases among the child population, the coordinator recommended that parents take their children to the doctor so that the corresponding examinations are administered.
Not smoking and maintaining a healthy weight can also help prevent this condition. Likewise, according to the Medline Plus portal –ascribed to the United States National Library of Medicine– patients with chronic kidney disease should limit their fluid intake.
For people who need more information or patients seeking support during their dialysis treatment, they can contact the Puerto Rican Kidney Foundation at 787-282-6509.
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