Hitting the Nation as well as globally, the COVID pandemic continues to be a growing health crisis day-by-day. With over six months of the crisis, the geriatric population has been recorded to be affected the most and the age factor poses an extreme threat to mortality and rate of infection. Even though the recovery rate shows a positive outlook with India having a rate of around 75% recovery, yet the mortality rate further needs to be curbed down.

Even though the Governments are taking very precautious steps during their unlock phase, the public also need to take additional precautionary measures. The rate of infection is fifteen folds higher in people aged 80 or above and is observed to be around six folds in people above the age of 60 years. Data suggest that, of the total cases of mortality due to COVID, around 15% of them have had a history of some type of cardiac ailment leading to renal failure.

People with kidney disease are much more prone to develop heart and blood vessel disease. This increased risk is related to kidney disease and other health problems such as diabetes, high blood pressure and certain lifestyle factors including being overweight and smoking.

It is very important for patients suffering from kidney to take steps for the prevention of heart and blood vessel problems. Once the initiation is triggered towards a healthy heart, the kidneys are automatically taken care of simultaneously.  These are the following steps to following order to keep your kidney as well as heart to be healthy: –

1. Timely and regular test – It turns out that heart disease is a risk factor for kidney disease and kidney disease is a known risk factor for heart disease. Hence, if you know you have one, you should have yourself tested for the other.

2. Eat a balanced, kidney and heart healthy diet – Reduce sodium in your diet. Reduce foods that are high in saturated fats and cholesterol like eggs, whole milk, cheese and fried foods. Eat more foods that are rich in omega-3 fatty acids like cold water fish flaxseed oil, canola oil and walnuts.

3. Increase physical activity – Physical activity like walking offers many health benefits, including decreasing blood pressure, lowering blood fat levels, increasing muscle strength, and helping control body weight which will make you feel good.

4. Maintain the Cholesterol levels – High blood levels of fats like cholesterol increases the chance of developing heart and blood vessel problems. Simple blood tests can check for total cholesterol and other fats in your blood. If your levels are too high, you may need to follow a low-fat diet and exercise more. Some patients may also need to take pills to help lower cholesterol.

5. Control high blood pressure – Follow your treatment plan carefully to control high blood pressure. This will help to protect your heart. Be sure to follow your fluid and sodium limits to keep fluid from building up in your body and increasing your blood pressure.

6. Regular monitoring of Blood Glucose levels – Over time, having high blood sugar can cause damage to your eyes, nerves, heart, blood vessels, and kidneys. Good control of blood sugar and other self-management actions can help slow or stop this damage from happening.

7. Smoking cessation -The strongest risk factor for both kidney and heart disease is smoking. Smoking causes harden of the arteries which causes both coronary artery disease and nephrosclerosis. Smoking is also a risk factor for high blood pressure which can cause both heart and kidney disease.

Get started protecting your heart today! Fix personal goals and start making changes one at a time. Your healthcare provider can help you prioritize your areas of change. If a person is suffering from any degree of kidney dysfunction, then they may have to change some of the above recommendations as per unique condition. Your kidney doctor and your dietician can assist with these changes.

Dr Sudeep Singh Sachdev
Nephrologist
Narayana super speciality hospital
Gurugram

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Each of us has two kidneys. The kidneys are bean Shaped and about the size of a fist. They are located on either sides of the spine just below the ribcage. The main function of the kidneys is to filter the extra water and waste products from the blood and make urine. They also help in keeping blood pressure under control and keeping bones healthy. They make certain hormones that our body needs to stay healthy.

Kidney diseases:

There are two major types of kidney disease, namely acute and chronic kidney disease. The acute variety is due to various causes like drugs, infections, dehydration, radio contrast injections etc. The acute kidney injury or failure is curable. Some may need dialysis support for a short period before recovery. Chronic kidney Disease (CKD) is one in which the kidneys are damaged slowly and irreversibly. As a result the kidneys are not able to do their job. Waste and water builds up in the blood. This is very harmful to the body and makes the person unwell.

It is estimated that 20 million people are suffering from CKD worldwide. Above one million patients are being treated for End State Kidney Disease (ESRD) with dialysis or transplantation. The incidence of CKD is increasing raidly. In India only about 5% of the patients get some form of treatment for ESRD for the rest it is either not available or prohibitively costly.

Chronic Kidney Disease (CKD) is a silent disease!

There are no symptoms in the early stages of the disease. Symptoms occur only in the late stages of the disease. Early detection of CKD is possible only by testing the blood and urine. The following are some of the symptoms of kidney disease:

1. Getting tired easily.

2. Poor appetite.

3. Sleep disturbances.

4. Swelling of feet and ankles.

5. Early Morning puffiness around the eyes.

6. Frequent urination, especially at night.

There is no cure for chronic kidney disease. It slowly gets worse over time. Kidney disease can turn into kidney failure (End Stage Kidney Disease). At this stage the only treatment options available are DIALYSIS AND KIDNEY TRANSPLANTATION.

Diabetes is the most common cause of CKD:

Diabetes is a very common ailment now. An estimated 177 million people have diabetes worldwide. It is predicted that by the year 2030, 360 million people would be suffering from diabetes worldwide. About 40% of the diabetics are likely to develop kidney disease. This makes diabetes the most common cause of CKD.  High blood pressure, hereditary diseases like polycystic kidney diseases, kidney stones and urinary infections are some of the other cases of chronic kidney diseases.

Early detection of kidney disease helps:

If detected early, right treatment can prevent further damage and slow down the progression of kidney disease. Prompt treatment with medications like ANGIOTENSIN CONVERTING ENZYME inhibitors or ANGIOTENSIN RECEPTOR BLOCKERS and other measures including diet and lifestyle modifications can keep the kidneys healthy for a longer period of time. If you have one of the risk factors it is worthwhile to get screened for kidney disease with blood and urine tests. The risk factors for chronic kidney disease are:

1. Diabetes

2. High blood pressure

3. A close family member suffering from kidney failure

4. Age over 50 years

5. Having heart disease

Tips to keep kidneys healthy:

1. Get blood and urine checked for kidney disease if at risk.

2. Diabetic patients   need   to   get   their kidney tests done at least once a year.

3. Keep blood pressure below 130/80.

4. Keep diabetes under control.

5. Keep cholesterol  levels  in  the  target range.

6. Take medicines as prescribed.

7. Eat healthy and cut back on salt.

8. Quit Smoking.

9. Be physically active.

10. Maintain healthy body weight.

The kidney tests:

1. Serum creatinine   level   and   eGFR estimation.

2. Urine for albumin.

Know your kidney Number – GLOMERULAR FILTRATION RATE(GFR):

GFR stands for Glomerular Filtration Rate. GFR measures how much blood your kidneys filter each minute. It is reported as a number. It is calculated from the blood creatinine levels.

1. GFR of 60 of higher is in normal range.

2. GFR below 60 may mean you have kidney disease

3. GFR of 15 or lower may mean kidney failure.

Urine albumin test:

Urine test detects protein or albumin. Albumin does not pass through a healthy kidney into the urine. If kidneys are damaged, albumin can pass into the urine, One cannot see or feel albumin in urine. So urine test is very important to detect kidney disease.

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