‘Chronic kidney disease incidence much higher in Pakistan than Western countries’

Pakistan ranks eight in the list of countries with a high rate of kidney diseases, with 17 million people suffering from such diseases.

This was stated by Prof M. Zaman Shaikh, renowned consultant diabetologist and endocrinologist, and vice president of the Diabetic Association of Pakistan, at a public health awareness seminar held in connection with World Kidney Day.

Prof Zaman Shaikh, who is also the founder member of Pakistan Endocrine Society, said that across the world, about 850 million people suffer from kidney disease. Doctors believe that the rate of chronic kidney disease in Pakistan is much higher than the rate in the Western world, he added.

Prof Zaman said the major cause for this is of course the prevalence of diabetes and hypertension, which are themselves brought on by obesity and unhealthy lifestyle choices. About one in four adults in Pakistan are diabetic, and a third of them suffer from hypertension, he told the seminar, which was held recently in collaboration with Dr Essa Laboratory and Diagnostic Center recently to raise awareness about the importance of keeping kidneys healthy.

“There are several kinds of blood pressure drugs; however, not all are equally good for people with diabetes. Doctors usually prefer people with diabetes to take blood pressure drugs called renin angiotensin system inhibitors. Renin angiotensin system inhibitors are recommended for most people with diabetes, high blood pressure and kidney disease. Recent studies show that renin angiotensin system inhibitors slow kidney disease in addition to lowering blood pressure. In fact, these drugs are helpful even in people who do not have high blood pressure,” Prof Zaman explained.

There are also new classes of sugar medication that protect the kidneys as well that prevent the reabsorption of glucose from the urine — known as SGLT-2. These drugs have also been shown to confer kidney protection. Although medications are very well tolerated and suited for the majority of people with diabetes, they should only be prescribed by doctors.

Another treatment some doctors use when protein leaks from the kidneys into the urine is a low-protein diet. Protein seems to increase how hard the kidneys must work. A low-protein diet can decrease protein loss in the urine and increase protein levels in the blood, but this must only be followed under the supervision of a physician, he advised.

“Common drugs such as non-steroidal anti-inflammatory medicines and pain killers can harm the kidneys if taken regularly. For those with kidney function impairment, taking even a few doses can do much harm. Smoking slows the flow of blood to the kidneys. When less blood reaches the kidneys, it can decrease their ability to function normally. Smoking also increases the risk of kidney cancer by about 50 per cent,” Prof Zaman further said.

“Chronic kidney disease (CKD) is rapidly growing in Pakistan due to late diagnosis, increasing number of patients suffering from diabetes and high blood pressure, renal stone disease, consuming junk and low-quality food, self-medication or excessive use of medicine, low water intake, obesity or a family history of kidney disease” said Dr Aqeel Ahmed, consultant physician & chief medical officer (CMO) of the Pakistan National Shipping Corporation (PNSC).

“One in 10 people worldwide has chronic kidney disease, and nine out of 10 patients are unaware about their condition while chronic kidney diseases cause at least 2.4 million deaths per year and is now the sixth fastest growing cause of death. Recent research shows that chronic kidney disease is predicted to increase by 17 per cent over the next decade and is now recognized by WHO and other organizations as a global public health issue” Dr Aqeel Ahmed elaborated.

Kidney disease is often called a silent killer because its signs & symptoms like shortness of breath, swelling in the arms and legs, nausea, loss of appetite and confusion, fluid retention in lungs and anemia often only manifest when much damage has already occurred to your kidneys.

“Medical innovations have eased the treatment options available for patients with end stage kidney disease, allowing them to go to hospital just once a month if they are on home type of dialysis. It makes a patient’s life easier and comfortable as they can live their regular life, work and spend time with family,” added Dr Aqeel Ahmed.

He said that the treatment of kidney failure is either hemodialysis or kidney transplant, whereas dialysis offers an excellent short time cure. He added transplant is the option, which gives a best chance of a good long-term survival with good quality of life.

People with kidney impairment must be vigilant about maintaining their weight, blood sugar, blood pressure and cholesterol at acceptable levels; otherwise, they may develop diabetic or hypertensive nephropathy and should be checked for these complications regularly and seeing the physician regularly can significantly reduce the risk of complications over time,” he recommended.

Earlier, at the inaugural session, Dr Farhan Essa Abdullah, CEO of Dr Essa Laboratory & Diagnostic Center, presented few scientific fact-based recent studies that show every person needs a certain number of fasting hours to cleanse the body of toxins if that person does not suffer from any illnesses.

He highlighted the benefits of fasting with diabetes, explaining how it can help control blood sugar, as well as improve insulin sensitivity, considering that patients end their fast with a healthy meal. Dr Farhan also shows some of the benefits of fasting for heart patients that cardiac patients improve their vascular risk by fasting, and by the end of Ramazan, patients can also show improvements in their levels of TG, LDL and HDL cholesterol.

Ge further advised and gave tips for fasting in Ramazan: Consult your doctor before deciding to fast, especially in cases of type 1 diabetes, kidney or liver disease. If you are taking certain medications, adjust the time of taking them in preparation for fasting after consulting your doctor.

Make sure to follow a healthy diet as recommended by the doctor and nutritionist. Drink sufficient amounts of water between Iftar and Sehri, and reduce the intake of stimulants such as tea, coffee, and soft drinks. Postpone exercise until after Iftar to avoid episodes of low blood sugar.