Patients need to know their kidney function number and clinicians need to revolutionize practice and educate.
Dr. Rafael Burgos Calderón, renowned Puerto Rican nephrologist and noted worldwide for his contributions to kidney health. Photo: Provided by the specialist to the Journal of Medicine and Public Health.
Kidney disease is a serious health problem for Puerto Ricans, as well as the Latino community in the United States. According to data from the Renal Council of Puerto Rico, more than 6,000 patients on the island are receiving dialysis treatments, in the terminal stage, and in the United States Hispanics represent the second most prevalent ethnic group following the African-American community.
People of any age and gender can be at risk for kidney failure without knowing it. In the early stages of chronic kidney disease, a person may have few signs or symptoms. This disease may not manifest itself until kidney function is fully affected.
If kidney damage progresses slowly, the patient may experience symptoms such as loss of appetite, fatigue, sleep problems, muscle cramps, swollen feet and ankles, chest pain, and high blood pressure.
The treatment of chronic kidney disease focuses on delaying the progression of kidney damage, by controlling the undiagnosed cause.
Chronic renal failure can develop into end-stage renal failure, which is fatal if artificial filtration or a kidney transplant is not performed.
The doctor Rafael Burgos Calderon, renowned Puerto Rican nephrologist y recognized worldwide for its contributions to kidney health, indicates that the kidney is the organ, a vital organ, there is a link 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, excess salt, excess protein and not exercising.
With the arrival of the covid-19 pandemic, there was a lack of control in healthy lifestyles, such as good nutrition and exercise, since isolation prevailed.
“There is an increase in obesity in children, adolescents are marked by audiovisual media and a sedentary lifestyle”, which is remarkable, since it might be considered that the risk factors for kidney disease do not only concern adults.
However, rather than blaming only the person, the renowned doctor considers that “the structure of health systems is aimed only at disease, but not at prevention”, and adds: “that is why we, in 1995, coined the term kidney health, but that term still lacks prevention at the Latin American level, we need to find where the link is with other concepts.”
Regarding the diagnosis, Burgos considers that this is the most critical point in his practice, since people know their hemoglobin, cholesterol, urine and others, but they are unaware that the kidney is classified by stages: stage 1, stage 2, stage 3, stage 4 and stage 5, so people should know what your number is, that is, your kidney function, as this might save your life.
To this he adds: “if they give you Advil, iodine, antibiotics, without knowing the function of the kidney, they can speed you up on dialysis.”
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.