One in ten affected

Kidney diseases are often detected late

Kidney diseases hardly cause any symptoms at first.

(Bild: stock.adobe.com null)

 While sudden kidney failure is detected quickly, chronic kidney disease sometimes only becomes noticeable when most of the function has already been lost. To mark World Kidney Day on March 13, an expert explains the risk factors and early detection.

Although the number of unreported cases is high, it is assumed that one in ten adults worldwide is affected. "Internationally, both kidney disease and the mortality caused by it are on the rise. According to estimates, chronic kidney disease could be the fifth most common cause of death by 2040," reports Prof. Dr. Erich Pohanka, specialist in internal medicine, nephrology, endocrinology and metabolism at the Health Center Vienna Airport Medical Center.

According to estimates, chronic kidney disease is expected to be the fifth most common cause of death by 2040.

Univ.-Prof. Dr. Erich Pohanka, Health Center Vienna Airport Ärztezentrum

Bild: Erich Pohanka

Chronic kidney disease often goes unnoticed by those affected and then develops slowly and insidiously. Early detection of kidney disease can only be achieved through blood tests and urine tests.

"Symptoms can only appear when 80 to 90 percent of kidney function has already been lost. The tasks of the kidneys are not limited to urine production and excretory functions. They control blood pressure, regulate the mineral balance as well as the acid and alkaline balance in the blood and tissue and stimulate the formation of red blood cells," says Prof. Pohanka. 

Could I be affected?
High blood pressure and diabetes mellitus are the most important risk factors for kidney disease. "After years of progression and poor control, both diseases can cause severe damage and even complete loss of kidney function, and a combination of both conditions is not uncommon. Other causes include genetic and immunological diseases as well as chronic inflammation," says the expert.

As kidney disease occurs in different stages and the early phase cannot be detected without symptoms, Austrian specialists recommend regular screening by measuring albumin in the urine if the risk is high.  

Signs of a disease

Because the kidneys have an influence on numerous bodily functions, the symptoms of damage also vary greatly:

• High blood pressure occurring for the first time or becoming more difficult to adjust can be an early sign of the disease.
• Likewise, water retention, shortness of breath, rapid weight gain, urinary abnormalities such as reddish-brownish discoloration and foaming.
• As the disease progresses and metabolic poisoning and anemia increase, symptoms such as rapid fatigue, pallor, itching, malaise, loss of appetite, vomiting and confusion often appear.

Heart and kidneys damage each other
Many people are not aware of how closely kidney health is linked to heart health. This is because high blood pressure and other factors can lead to mechanisms that damage the heart at an early stage. And this can happen even if the kidneys' detoxification function is still intact and does not cause any symptoms. Conversely, a pre-damaged heart can damage the kidneys, creating a vicious circle with long-term consequences.

Prof. Pohanka: "Around four out of ten patients with heart disease also suffer from kidney failure. Conversely, one in four patients with chronic kidney failure also develops a heart problem. A common risk factor is often diabetes mellitus. Around every second diabetic suffers from heart failure."

Disturbance of the salt and acid balance
The human body has sensitive sensors that constantly monitor the electrolytes (minerals, salts), which can change as a result of food intake, physical exertion or environmental influences. Healthy kidneys react promptly and compensate for possible fluctuations caused by a high-salt diet or loss due to heavy sweating at work or sport in the heat.

Prof. Pohanka: "In advanced renal insufficiency, however, certain salts cannot be eliminated efficiently, which can lead to serious cardiac arrhythmia. Disruptions to mineral metabolism, in turn, can lead to hormonal imbalance and jeopardize normal bone remodelling, while at the same time the blood vessels calcify prematurely."

8 golden rules for healthy kidneys

• Stay physically fit and active: This reduces blood pressure and therefore the risk of chronic kidney disease.
• Check your blood sugar regularly: One in two diabetics will develop chronic kidney disease. Early detection is particularly important because kidney damage in diabetes can be prevented or slowed down.
• Measure blood pressure: High blood pressure can not only lead to strokes and heart attacks, but is also the most common cause of chronic kidney disease. If your blood pressure is 140 systolic and 90 diastolic or higher, you should consult a doctor. Kidney damage is particularly common if other risk factors such as diabetes, high blood lipids or cardiovascular disease are also present.
• Eat healthily and keep your weight under control: This can help prevent diabetes, heart disease and other risk factors for kidney disease. Reduce salt intake to 5-6 g per day (about 1 teaspoon). Prepare fresh meals yourself and do not add salt to food.
• Healthy amount to drink: An average amount of 1.5 - 2 liters of water per day is recommended, depending on e.g. climate, level of physical activity, general state of health, gender, pregnancy or breastfeeding. A higher amount is recommended for people with a history of kidney stones.
• Do not smoke: Smoking reduces blood flow to the kidneys, which can hinder their function. The risk of kidney cancer is 50 percent higher in smokers.
• Becareful when taking medication: Anti-inflammatory painkillers in particular can damage the kidneys if taken regularly and in an uncontrolled manner. Patients with chronic pain, e.g. arthritis or back pain, should work with their doctor to find alternative ways of treating pain that do not pose a risk to the kidneys.
• Regular screening for risk factors: If one or more risk factors are present - these include diabetes, high blood pressure, obesity, advanced age, family history of kidney disease - experts recommend regular screening.

The acid and alkaline balance is particularly sensitive. Regulation takes place via respiration and urinary excretion. Disorders of kidney function lead to acidification of the body, which then has to be compensated for by medication or, in the final stage, by dialysis, the expert continues.

"Doping" for kidney patients
The hormone erythropoietin (EPO) is known as a doping agent in sport to increase the number of red blood cells that transport oxygen from the lungs to the tissue. However, EPO is also produced naturally in the kidneys. If they are unable to perform this important function due to damage, anemia (lack of red blood cells) can occur. "The preparations available today were developed to replace this hormone in kidney patients so that their anemia can be treated effectively," explains Prof. Pohanka.