World Kidney Day: ‘Living Well With Kidney Disease’

World Kidney Day brings together various stakeholders, including medical professionals, educationists, patient groups, kidney advocacy groups, health policymakers, students, and the general public to raise awareness and prioritize kidney health on the national and international health agenda.

The 2021 World Kidney Day Theme: "Living Well with Kidney Disease"

Each year, World Kidney Day has a unique theme. This year's theme is "Living Well with Kidney Disease". The major objective of this theme is to encourage people living with kidney disease to lead a life that is as normal as possible. To this end, it aims to increase education and awareness on how to look for early warning signs of kidney disease and ways to manage them. The theme also encompasses the area of patient empowerment and encouraging them to participate in normal daily activities.

Kidney Disease: Facts & Figures

• 850 million people suffer from kidney disease worldwide
• 5-10 million people worldwide die from kidney disease every year
• Kidney disease is the 6th fastest growing cause of death
• 1 in 10 adults suffer from chronic kidney disease (CKD) worldwide
• Prevalence of CKD is 14 percent in women and 12 percent in men
• CKD doesn't exhibit any symptoms initially and so, is regarded as a silent killer
• Acute kidney injury (AKI) affects 13 million people annually worldwide
• AKI kills 1.7 million people annually worldwide
• Kidney failure is the last stage and fatal without dialysis or a kidney transplant
• Blacks, Asians, and other minority ethnic groups are more prone to develop kidney failure
• Deprived people are more likely to develop kidney disease, requiring dialysis and die from the disease

What Happens When the Kidneys Fail?

The kidneys are vital organs that help to maintain the status quo by regulation of fluid balance and excretion of toxic waste products from the body. Kidneys have a bean-shaped structure, about the size of a clenched fist, and are located on both sides of the abdomen. When the kidneys fail, the normal bodily functions are perturbed, leading to the following complications:

• Accumulation of toxic waste products in the body
• Dysregulation of fluid-electrolyte balance
• Fluctuation of blood pressure
• Inability to maintain acid-base balance

Kidney Disease and the COVID-19 Pandemic

Kidney patients have been severely affected by the ongoing COVID-19 pandemic. This group of patients is especially vulnerable to getting infected by SARS-CoV-2, the virus that causes COVID-19. This can result in serious illness and even death in these patients.

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Avoiding the virus is very difficult for kidney patients. They have to undergo dialysis in the hospital several times a week and therefore, have to leave the safety of their homes. It is equally a nightmare for kidney transplant patients who are on regular immunosuppressants, and therefore, unable to fight-off the virus like normal people.

Besides the already existing kidney patients, the COVID-19 pandemic is giving rise to many more. It has been observed that serious COVID-19 patients on ventilation in an ICU, end-up with severe acute kidney injury (AKI), requiring emergency dialysis. AKI can result in temporary loss of kidney function or even complete kidney failure. In the latter case, chances of recovery are very slim indeed!

Challenges Faced by Kidney Patients and Ways to Overcome Them

Kidney disease can be life-changing, both for the patients themselves, and their families, who have to take care of them. This poses a huge challenge for them - physically and mentally, as well as financially.

Management of kidney patients, especially in advanced stages, can be extremely challenging due to the negative impact on their lives. The disease can dramatically hinder daily activities, work capacity, travel restriction, and participation in social activities. In a nutshell, it prevents them from leading a meaningful and fulfilling life.

The current strategy for managing patients with a failing kidney aims to prolong their lives by preserving or restoring kidney function, and whenever possible, performing kidney transplantation. Its primary aim is to enable patients live as well as possible, maintain social functioning, and develop a sense of control over their physical, mental, and emotional wellbeing. This can be achieved by actively involving the patients in their treatment to become more engaged and motivated and play a proactive role in the betterment of their overall health and wellbeing.

How Can "Living Well with Kidney Disease" be Achieved?

Living well with kidney disease may be made possible by addressing the following aspects, which are individually elaborated below:

• Symptoms
• Life impacts
• Education, engagement, and empowerment
• Life participation

Symptoms:

• Pain
• Fatigue and cramps
• Mobility problems
• Stress, anxiety, and depression
• Cognitive impairment
• Sleep disturbances
• Restless legs
• Gastrointestinal problems

Life Impacts:

• Ability to work
• Ability to study
• Ability to travel
• Impact on family and friends
• Financial impact
• Dietary restrictions
• Lifestyle changes
• Social activities
• Dialysis-free time

Education, Engagement, and Empowerment:

• Communication and education
• Building resilience
• Strengthening social connections
• Increasing awareness and knowledge
• Increasing access to support
• Building confidence and control with self-management

Life Participation:

• Patient-friendly lifestyle and diet
• Preservation of kidney function
• Pharmacological management
• Delaying dialysis as far as possible
• Incremental transition to dialysis
• Patient-centered dialysis

Tips to Keep Your Kidneys Healthy

Some simple tips to keep your kidneys healthy are briefly highlighted below:

• Keep Fit and be Active: Keep fit and lead an active lifestyle. Practice any of these activities - freehand exercises, walking, running, or cycling. These types of activities will help to maintain ideal body weight, check hypertension and reduce the risk of kidney disease
• Monitor Your Blood Pressure: Half of all people with hypertension don't know they have it. Hence, it is very important to monitor your blood pressure regularly. Since high blood pressure can accelerate the onset of kidney disease, monitor your blood pressure regularly to detect hypertension at an early stage so that treatment can be started immediately, which will prevent kidney disease in the long run
• Control Your Blood Sugar: Like hypertension, half of all people having diabetes don't know they have it. Since half of all diabetics develop kidney damage (diabetic nephropathy), it is of the utmost importance to regularly check and control your blood sugar levels to prevent the onset of kidney disease
• Eat a Healthy Diet: A balanced, healthy, and nutritious diet is recommended. Also, limit your salt intake. Remember that your daily sodium intake should not exceed 2 g, which is equivalent to 5 g of salt. A healthy diet coupled with reduced salt intake will help to keep your body weight in check, reduce blood pressure, decrease the risk of diabetes and cardiovascular diseases, as well as other conditions associated with kidney disease
• Don't Smoke: Smoking reduces the blood flow to the kidneys. Reduced blood flow hampers the optimal functioning of these vital organs. Moreover, the risk of kidney cancer increases by 50 percent in smokers
• Get a Kidney Function Test Done: A kidney function test (KFT) indicates whether your kidneys are functioning correctly. If you have diabetes, hypertension, or if you are obese or have a family history of kidney disease, get a KFT done at regular intervals
• Drink Lots of Fluids: Always keep your body well hydrated. Drink at least 2 liters of water daily in normal climatic conditions. This will help to flush out toxins and other harmful substances from the body, which will significantly lower the risk of kidney disease
• Don't Take Over-the-Counter Drugs Regularly: Avoid taking over-the-counter (OTC) anti-inflammatory drugs and painkillers. These include non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen, indomethacin, naproxen, and others. Taking these medicines regularly can damage your kidneys

Conclusion

Kidney disease is such a big topic that it's impossible to ignore. The disease can affect anyone, anytime, and it's a killer! World Kidney Day provides an ideal platform that allows us to discuss, debate, and look for solutions that benefit kidney patients.

Although face-to-face events are not likely to happen due to the raging COVID-19 pandemic, it shouldn't stop us from spreading the word by virtual means. So, on Thursday 11th March 2021, let's join hands to show our solidarity for those living with this killer disease, and find ways to alleviate their suffering and gift them a better future to look forward to.

References:

1. World Kidney Day 2021: Living Well with Kidney Disease by Patient and Care Partner Empowerment - Kidney Health for Everyone Everywhere. American Journal of Kidney Diseases - (https://www.ajkd.org/article/S0272-6386(21)00023-8/fulltext)
2. 2021 WKD Theme - (https://www.worldkidneyday.org/2021-campaign/2021-wkd-theme/)
3. World Kidney Day - (https://www.worldkidneyday.co.uk/)
4. 8 Golden Rules - (https://www.worldkidneyday.org/facts/take-care-of-your-kidneys/8-golden-rules/)
5. How Your Kidneys Work - National Kidney Foundation - (https://www.kidney.org/kidneydisease/howkidneyswrk)

Source: Medindia