GUWAHATI, March 11 - Kidney disease is now one of the fastest growing non-communicable diseases globally. If the trend continues then it is expected to be the fifth most common cause of non-communicable disease by 2040. Despite this, only people in affluent countries have universal access to treatment. In low income countries there is no uniform availability of services, meaning, although health facilities may be good in urban areas, it is not so in semi urban or rural areas. Also, financial issues are a limitation to this. There is no universal health insurance in these resource-limited countries.
In India although some government schemes are coming up, these are yet to be uniformly implemented in various parts of the country. Different states give different amounts of financial coverage. While some give justifiable amounts of finance, others do not do so. There are lots of hidden costs, like loss of wage, expenditure on travel and stay during treatment. So, prevention of kidney disease still remains the best policy.
In children the causes of kidney disease are quite different from those in adults. Most kidney diseases in children are completely curable and they don�t carry any ill effects when they grow into adults. So the final outcome is very rewarding if treatment is prompt and adequate. Here comes the scope of prevention of kidney disease in adults. Paediatricians play an important role in detecting, treating and preventing kidney diseases. So we need to increase awareness about preventive measures for kidney ailments among general population, health professionals and also policy makers.
For this purpose World Kidney Day is celebrated on the second Thursday of the month of March every year. Various campaign materials are available free online to motivate health professionals and organisations to participate in activities to increase awareness about kidney disease.
Prevention of any disease can be done at three levels. First is primary prevention which is the most important and ideal way of prevention. It is about preventing kidney disease to occur by adopting a healthy lifestyle from early life and avoiding things bad for kidney health.
Secondary prevention means early and proper treatment of a person suffering from kidney disease so as to prevent its progression to a severe stage. Tertiary prevention means halting the progression of the disease so that complications out of it can be minimised. But the best option is prevention.
Ten commandments to prevent kidney disease:
1. Eat healthy and exercise regularly. When we talk about prevention there are certain �dos� and �do nots�. We should take a healthy and balanced diet with enough fresh fruits and vegetables. Water intake should be adequate, especially in summer days and also when one is having diarrhoea, vomiting, etc., and is losing fluids.
2. Avoid over the counter or off label drugs. All those herbal medicines which are claimed to be without side effects may not be so. Always use drugs as advised by the doctor only, because while prescribing a drug a lot of other general conditions need to be considered.
3. Blood pressure should be checked in any child over three at least once a year.
4. Avoiding constipation in a child may be one of the most important ways to prevent recurrent urine infection and hence repeated injury to the kidneys.
5. Kidney anomalies can be detected even before birth, when the baby is in its mother�s womb. Scans are done to screen major anomalies of the organs of the baby. If any anomaly is detected, it can be treated as early as possible after birth and the outcome is expected to be better than late intervention.
6. Most kidney diseases in children are completely curable if they are properly treated � like urine infections, nephrotic syndrome, post-infectious glomerular disease, etc. After proper treatment they don�t carry any brunt to adult life.
7. Nowadays with advanced treatment facilities, chances of survival after treatment of critical as well as chronic diseases are high. But they are not without risk of having chronic kidney diseases later, especially if they have kidney failure during these illness episodes.
8. Children who are born prematurely, are underweight at birth, obese, on long-term drugs like pain killers, need regular renal check up. Equally important is assessment of growth and development.
9. When kidney function in a child is chronically compromised for over a period of three months, the child is said to have chronic kidney disease. There are various measures by which we can halt further progression of the disease to advanced stages. This is secondary prevention of kidney failure.
10. The final stage of kidney failure that is, end stage renal failure, is when they don�t have enough kidney function for survival. This is the stage when tertiary prevention comes in to play. These children need kidney transplant as ultimate treatment, dialysis being the bridging gap. However, in resource-constrained countries like ours it is not only cost of treatment but also limited availability of skilled persons to deliver this care that proves to be a big problem. So it�s time to make policies to give financial insurance both in private and public sectors.
