About Kidney Diseases

About our kidneys Figures and Statistics Early Detection 8 Golden Rules Medical Professional Patients Fact sheet downloads Scientific editorial

What can you do for your kidneys?

Kidney diseases are silent killers, which will largely affect your quality of life. There are however several easy ways to reduce the risk of developing kidney disease. 8 GOLDEN RULES TO 1. Keeping fit and active Keeping fit helps to reduce your blood pressure and therefore reduces the risk of Chronic Kidney Disease. 2. Keep regular control of your blood sugar level About half of people who have diabetes develop kidney damage, so it is important for people with diabetes to have regular tests to check their kidney functions. Kidney damage from diabetes can be reduced or prevented if detected early. It is important to keep control of blood sugar levels with the help of doctors or pharmacists, who are always happy to help. 3. Monitor your blood pressure Although many people may be aware that high blood pressure can lead to a stroke or heart attack, few know that it is also the most common cause of kidney damage. The normal blood pressure level is 120/80. Between this level and 129/89, you are considered prehypertensive and should adopt lifestyle and dietary changes. At 140/90 and above, you should discuss the risks with your doctor and montior your blood pressure level regularly. High blood pressure is especially likely to cause kidney damage when associated with other factors like diabetes, high cholesterol and Cardio- Vascular Diseases. 4. Eat healthy and keep your weight in check This can help prevent diabetes, heart disease and other conditions associated with Chronic Kidney Disease. Reduce your salt intake. The recommended sodium intake is 5-

6 grams of salt per day (around a teaspoon). In order to reduce your salt intake, try and limit the amount of processed and restaurant food and do not add salt to food. It will be easier to control your intake if you prepare the food yourself with fresh ingredients. For more information on nutrition and kidney friendly cooking, visit our nutrition page. 5. Maintain a healthy fluid intake Although clinical studies have not reached an agreement on the ideal quantity of water and other fluids we should consume daily to maintain good health, traditional wisdom has long suggested drinking 1.5 to 2 litres (3 to 4 pints) of water per day. Consuming plenty of fluid helps the kidneys clear sodium, urea and toxins from the body which, in turn, results in a significantly lower risk of developing chronic kidney disease, according to researchers in Australia and Canada. The findings, the researchers said, do not advocate aggressive fluid loading, which can cause side effects, but they do provide evidence that moderately increased water intake, around two liters daily, may reduce the risk of decline in kidney function. It's important to keep in mind that the right level of fluid intake for any individual depends on many factors including gender, exercise, climate, health conditions, pregnancy and breast feeding. In addition, people who have already had a kidney stone are advised to drink 2 to 3 litres of water daily to lessen the risk of forming a new stone. 6. Do not smoke Smoking slows the flow of blood to the kidneys. When less blood reaches the kidneys, it impairs their ability to function properly. Smoking also increases the risk of kidney cancer by about 50 percent. 7. Do not take over-the-counter pills on a regular basis Common drugs such non-steroidal anti-inflammatory drugs like ibuprofen are known to cause kidney damage and disease if taken regularly. Such medications probably do not pose significant danger if your kidneys are relatively healthy and you use them for emergencies only, but if you are dealing with chronic pain, such as arthritis or back pain, work with your doctor to find a way to control your pain without putting your kidneys at risk.
8. Check your kidney function if you have one or more of the 'high risk' factors
o o o o o

you have diabetes you have hypertension you are obese you or one of your family members suffers from kidney disease you are of African, Asian, Aboriginals origin

About Kidney Diseases

About our kidneys Figures and Statistics

Early Detection 8 Golden Rules Medical Professional Patients Fact sheet downloads Scientific editorial

We have amazing kidneys

The main job of our kidneys is to remove toxins and excess water from our blood. Kidneys also help to control our blood pressure, to produce red blood cells and to keep our bones healthy.

Roughly the size of fists, kidneys are located deep in the abdomen, beneath the rib cage.

Did you know? Every day your kidneys carefully control the salt and water in your body so that your blood pressure remains the same.

Amazing organs

The kidneys are complicated and amazing organs that have numerous biological roles. Their primary role is to maintain the balance of bodily fluids by filtering and secreting metabolites and minerals from the blood and excreting them, along with water, as urine.

The kidneys control blood stream levels of many minerals and molecules including sodium and potassium, and help to control blood acidity.

Read more about The kidneys and how they work The kidneys are important regulators of blood pressure and the production of red blood cells.

Importance of Early Detection

About Kidney Diseases

About our kidneys Figures and Statistics Early Detection 8 Golden Rules Medical Professional Patients Fact sheet downloads Scientific editorial

Early Detection Screenings search

On WKD we are calling on everyone to check if they are at risk for kidney disease and encouraging more people to take a simple kidney function test. Screening is essential for people considered to be at-risk of kidney disease. The early detection of kidney impairment is essential and allows suitable treatment before kidney damage or deterioration manifests itself through other complications.

Did you know?

The majority of individuals with early stages of CKD go undiagnosed. Testing for Kidney Disease

Kidney diseases develop slowly and the symptoms only appear at a late stage when the patient already has kidney failure and may even need dialysis. Renal Replacement Therapy (RTT) requires major burdensome lifestyle changes for the patient and is extremely costly for any countrys healthcare system. A routine test of urine, blood and blood pressure can reassure or detect if there are any early signs of kidney problems. The needed laboratory tests are done on small samples of blood and urine. When your kidneys are damaged, proteins leaks into your urine.

A simple test can be done to detect protein in your urine. Persistent protein in the urine is an early sign of chronic kidney disease. Your doctor uses the results of your Serum Creatinine measured in the blood to calculate your overall kidney function, or Glomerular Filtration Rate (GFR) and your blood sugar to be sure you do not have diabetes.

Early detection and treatment of CKD not only slows or halts the progression of patients to endstate renal disease, but can also significantly reduce the increased incidence of cardiovascular diseases, the most common cause of premature deaths worldwide.

Serum Creatinine: Creatinine is a waste product in your blood that comes from muscle activity. It is normally removed from your blood by your kidneys, but when kidney function slows down, the creatinine level rises. Your doctor can use the results of your serum creatinine test to calculate your kidney function, or GFR.

Glomerular Filtration Rate (GFR): Your GFR tells how much total kidney function you have. It may be estimated from your blood level of creatinine. Normal is about 100 ml/min, so lower values indicate the percentage of normal kidney function which you have. If your GFR falls below 60 ml/min you will usually need to see a kidney disease specialist (called a nephrologist), If the treatment you receive from the nephrologist does not prevent a further reduction in GFR, your kidney doctor will speak to you about treatments for kidney failure like dialysis or kidney transplant. A GFR below 15 indicates that you may need to start one of these treatments soon.

Medical Professional
About Kidney Diseases

About our kidneys Figures and Statistics Early Detection 8 Golden Rules Medical Professional Patients Fact sheet downloads Scientific editorial

Medical Professionals Who is at risk How to detect

Physicians Nurses

In developing countries, simply put there is little or no chance at all to offer renal replacement therapy to those in need, now or in the future.

Prevention of kidney diseases and progression toward the end-stage phase is therefore key. The International Society of Nephrology (ISN) is committed to developing global efforts to prevent CKD in underprivileged countries. The International Federation of Kidney Foundations (IFKF) is also represented in a number of these countries.

As a medical or allied health professional you are at the forefront of combating kidney diseases around the world through early detection and prevention approaches. Your active engagement in the kidney cause is essential, and we are asking for your involvement in increasing awareness about the important role our kidneys play, prevent the onset of the disease where possible and detect and treat people with CKD.

Many of your patients may be at risk and we call on your proactive involvement.

The growing burden of chronic kidney diseases (CKD) is known to renal professionals and increasingly acknowledged by health authorities. The concern is enhanced by the emerging evidence that CKDs are not only a problem on their own: they are also a major risk factor for cardiovascular morbidity and mortality and are a deadly complication of diabetes mellitus.

The predicted increase in the number of patients with endstage renal diseases in developed countries where regular renal replacement therapy programs are available poses the risk that health care resources are inadequate to guarantee full coverage of dialysis expenses. In developing countries, simply put there is little or no chance at all to offer renal replacement therapy to those in need, now or in the future.

Many of the links on these web pages refer to information on renal diseases in general, but you will also find information related to the most important goal of World Kidney Day; the early detection and prevention of CKD.

You can find a complete overview of all relevant links on the website of the International Federation of Kidney Foundations

What can you do?

Particularly around World Kidney Day but also throughout the year inform patients about the important role of the kidneys. Monitor and educate your patients who are at particular risk for kidney diseases Get in contact with your local or national nephrology society or your local or national kidney foundation to find out how you can participate in initiatives, help disseminate information and become otherwise involved Review and refer to these brochures focused on kidney and related diseases. Review the guidelines on how to detect kidney diseases and how to implement a screening program. More about guidelines in the section for physicians on this website.

Patients
About Kidney Diseases

About our kidneys Figures and Statistics Early Detection

8 Golden Rules Medical Professional Patients Fact sheet downloads Scientific editorial

Patients Q&A's Nutrition

Many people are currently not aware that their kidneys are damaged and they might find out too late. Dialysis and transplantation can be prevented if kidney diseases are detected early. As a patientthere is something you can doshare your story and raise awareness of the risk factors for kidney disease with friends family and people you meet and you might just save a life!

Contribute to the World Kidney Day campaign now!

There are ways to act to improve the healthcare situation in your country. Get in contact with your national kidney foundation to see how you can participate in the government outreach efforts in your country. We also recommend that you read the government outreach toolkit where you will tips on how to reach out to your national healthcare authorities.

Q&A's

Kidney Diseases

About our kidneys Figures and Statistics Early Detection

8 Golden Rules Medical Professional Patients Fact sheet downloads

Patients Q&A's Nutrition

Diabetes
Diabetes mellitus is a disease in which the body does not make enough insulin or cannot use normal amounts of insulin properly. Insulin is a hormone that regulates the amount of sugar in the blood. A high blood sugar level can cause problems in many parts of the body.

Most common forms of diabetes are Type 1 and Type 2. Type 1 diabetes usually occurs in children. It is also called juvenile onset diabetes mellitus or insulin-dependent diabetes mellitus. In this type, the pancreas does not make enough insulin and the patient has to take insulin injections for the rest of his/her life. Type 2 diabetes, which is more common, usually occurs in people over 40 and is called adult onset diabetes mellitus. It is also called non insulin-dependent diabetes mellitus. With diabetes, small blood vessels in the body are injured. The kidneys are particularly vulnerable and when damaged cannot clean the blood properly. The body will retain more water and salt than it should, which can result in weight gain and ankle swelling. Diabetes also may cause damage to nerves in the body. This can cause difficulty in emptying the bladder. Pressure resulting from the full bladder can back up and injure kidneys. About 30 percent of patients with Type 1 (juvenile onset) diabetes and 10 to 40 percent of those with Type 2 (adult onset) diabetes eventually will suffer from kidney failure which is the most serious complication of the disease. The earliest sign of diabetic kidney disease is an increased excretion of albumin in the urine. This is present long before the usual tests done in the doctor's office show a loss of kidney function, so it is important to have this test on a yearly basis. Maintaining control of the diabetes can lower the risk of developing severe kidney disease. 2009 National Kidney Foundation www.kidney.org For more information: International Diabetes Federation www.idf.org;

Hypertension
High Blood Pressure is another important risk factor in CKD patients and needs to be carefully monitored. When people suffer from high blood pressure it puts more stress on blood vessels throughout the body, including the kidneys. When this happens kidneys cannot filter wastes from the blood properly. Achieving the recommended blood pressure goals can reduce the risk of needing dialysis or experiencing a heart attack or stroke.

High blood pressure is a global problem and the situation is projected to get worse. The world population is getting older and aging is the most common risk factor for the development of high blood pressure and diabetes as well as CKD. Nearly one billion people worldwide have high blood pressure, and that number is expected to increase to 1.56 billion by 2025. The prevalence of high blood pressure is predicted to increase by 24 percent in developed countries and by 80 percent in developing regions such as Africa and Latin America. High blood pressure is present in approximately 80 percent of patients with CKD. High Blood Pressure is related to CKD in a number of ways. High blood pressure can independently cause CKD, and CKD can cause high blood pressure. The treatment of high blood pressure has become the most important intervention in the management of all forms of CKD. Lowering blood pressure will reduce the risk of heart disease, which for most patients with CKD, is a more immediate threat than end-stage renal disease (ESRD). It will also reduce the chance of developing ESRD and requiring dialysis or kidney transplantation What can be done to control high blood pressure? Lifestyle changes, regular exercise and diet can have a profound impact on blood pressure and overall health. Weight loss of as little as eight to 10 pounds can have a dramatic impact on blood pressure. Blood pressure can also be lowered by reducing consumption of alcohol. Medications are also essential in many patients and include the use of high blood pressure medicine, controlling cholesterol and the treatment of symptoms like anemia. The kidney was designed to balance the salt intake naturally occurring in foods with body needs. Increased salt intake can lead to water retention. Eating as we do, many people accumulate more salt and water than their kidneys can handle. Excessive salt and water increases blood pressure and damages our heart and blood vessel walls. The higher the blood pressure, the more damage is done to kidney blood vessels and the more blood flow to the kidney is reduced, impairing the function of the kidney and ultimately leading to CKD. A healthy diet with salt reduction to roughly less than five grams (100 mmols sodium) substantially lowers blood pressure. In addition, measuring blood pressure regularly and using medications when necessary are vital to reducing the incidence and risk of CKD. For more information:

WHO Guidelines for assessment and management of cardiovascular risk http://www.ish-world.com/Documents/71665_71665_OMS_INT-RETIRATION.PDF World Hypertension League www.worldhypertensionleague.org Download: Salt and High Bloodpressure, World Hypertension League World Action on Salt and Hypertension WASH www.worldactiononsalt.com;

Nutrition
In most cases the prevention of CKD is, in the first place, a matter of a healthy lifestyle: physical exercise and/or sports, healthy food with limited calories and reduced salt, and not smoking.

An important role of medical professionals in the prevention of CKD is therefore to serve first as educators. On the website there is a special page written for people at risk to develop CKD. We encourage you to visit this page (link) The information starts with a number of important tips. You may use them in talking to your patients. We summarize the tips here:

Have your blood pressure checked regularly. Take steps to control your blood pressure. The easiest way to maintain a normal blood pressure is by lowering the amount of salt (sometimes called sodium) by not eating high-salt foods or adding salt to foods and by not becoming overweight. Check with a dietitian to create a diet that lets you eat foods you love without hurting your health. Keep your weight within the desirable range. Your doctor or dietitian can tell you what your weight should be. Tell your doctor if your family has a history of high blood pressure, diabetes or kidney disease. Stay alert for changes in your urine. If you have cloudy, smelly, foamy, cola colored or bloody urine or if it hurts when you urinate, see a doctor. Watch for symptoms of anemia. If you are constantly tired, too pale, become short of breath easily or suffer from dizziness you might be anemic. Have a yearly urine and blood test along with a physical examination. Stay active. Regular exercise will help keep your body functioning normally. Drink enough water.

For more information see for instance the website of the Journal of Renal Nutrition www.jrnjournal.org

More information for dieticians is available on many websites. See for example: Canadian Association of Nephrology Dietitians www.renalrd.ca; Dietitians Association of Australia www.daa.asn.au; National Kidney Foundation www.nkf.org; American Dietetic Association (Practice Group Renal Dietitians) www.eatright.org; Kidney Research UK www.kidneyresearchuk.org. Download: Nutrition and CKD, National Kidney Foundation, USA

Keep Your Kidneys Healthy

Nutrition and the Prevention of Chronic Kidney Disease In most cases the prevention of chronic kidney disease is, in the first place, a matter of a healthy lifestyle: physical exercise and/or sports, healthy food with limited calories and reduced salt, and not smoking. Why is diet so important? When food is broken down in the stomach and intestine and processed in the body, waste is made. The kidneys remove the waste from the blood. If the kidneys are not working properly, the waste builds up in the bloodstream and you may feel weak, tired, and sick. The other balancing act the kidneys perform is the regulation of the bodys fluid and mineral balance. Some people with kidney disease may retain fluid, which leads to puffiness, swollen ankles, hands and feet and breathlessness.

Ano ang maaari mong gawin para sa iyong mga bato? Bato karamdaman ay tahimik na killers, na sa kalakhan makaapekto sa iyong kalidad ng buhay. May gayunpaman ilang mga madaling paraan upang mabawasan ang panganib ng pagbuo ng sakit ng bato. 1. Pagpapanatiling akma at aktibong -Pagpapanatiling angkop ay tumutulong upang mabawasan ang iyong presyon ng dugo at samakatuwid ay binabawasan ang panganib ng talamak Sakit sa bato. Ang konsepto "sa paglipat para sa kalusugan ng bato" ay isang buong mundo sa sama-martsa na kinasasangkutan ng publiko, mga kilalang tao at propesyonal paglipat sa isang pampublikong lugar sa pamamagitan ng paglalakad, tumatakbo at pagbibisikleta. Bakit hindi sumali ang mga ito - sa pamamagitan ng anumang nangangahulugan na gusto mo! Tingnan ang mga kaganapan sa seksyon ng ang WKD website para sa karagdagang impormasyon. 2. Panatilihin ang mga regular na kontrol ng iyong asukal sa dugo sa antas ng Tungkol sa kalahati ng mga tao na diyabetis bumuo ng bato pinsala, kaya ito ay mahalaga para sa mga taong may diyabetis upang magkaroon ng regular na mga pagsubok upang suriin ang kanilang mga function sa bato. Bato pinsala mula sa diyabetis ay maaaring mabawasan o pumigil kung nakita maaga. Ito ay mahalaga upang mapanatili ang kontrol ng mga antas ng asukal sa

dugo sa tulong ng doktor o pharmacists, na palaging masaya upang makatulong. 3. Subaybayan ang iyong presyon ng dugo Bagaman maraming mga tao ay maaaring magkaroon ng kamalayan na ang mataas na presyon ng dugo ay maaaring humantong sa isang atake serebral o atake sa puso, ang ilang mga malaman na ito ay din ang pinaka-karaniwang sanhi ng pinsala sa bato. Ang normal na antas ng presyon ng dugo ay 120/80. Sa pagitan ng mga antas na ito at 129/89, ikaw ay itinuturing na prehypertensive at dapat magpatibay ng mga pagbabago ng pamumuhay at pandiyeta. Sa 140/90 at itaas, dapat mong talakayin ang mga panganib sa iyong doktor at montior ang iyong presyon ng dugo antas ng regular. Mataas na presyon ng dugo ay lalo na malamang na maging sanhi ng bato pinsala kapag nauugnay sa iba pang mga kadahilanan tulad ng diyabetis, mataas na kolesterol at Cardio-Vascular Karamdaman. 4. Kumain ng malusog at panatilihin ang iyong timbang sa check Ito ay maaaring makatulong maiwasan ang diabetes, sakit sa puso at iba pang mga kondisyon na kaugnay sa talamak Sakit sa bato. Bawasan ang iyong paggamit ng asin. Ang inirerekomenda na paggamit ng sosa ay 5-6 gramo ng asin sa bawat araw (sa paligid ng isang kutsarita). Upang bawasan ang iyong paggamit ng asin, subukan at limitahan ang halaga ng proseso at restaurant na pagkain at hindi magdagdag ng asin sa pagkain. Ito ay magiging mas madali upang makontrol ang iyong paggamit kung maghanda ka ng pagkain ang iyong sarili sa mga sariwang ingredients. Para sa karagdagang impormasyon sa nutrisyon at pagluluto bato friendly na, bisitahin ang aming pahina sa nutrisyon. 5. Mapanatili ang isang malusog na likido ng paggamit Bagaman ang mga clinical pag-aaral ay hindi naabot ng isang kasunduan sa ideal na dami ng tubig at iba pang mga fluids dapat namin magsayang pang-araw-araw upang mapanatili ang mabuting kalusugan, ang tradisyunal na karunungan ay mahaba iminungkahing pag-inom ng 1.5 sa 2 liters (3 sa 4 pints) ng tubig sa bawat araw. Gugulin ng maraming likido tumutulong ang mga bato malinaw sosa, yurya at toxins mula sa katawan na kung saan, sa pagliko, ang mga resulta sa isang "makabuluhang mas mababang panganib" ng pagbuo ng talamak bato sakit, ayon sa mga mananaliksik sa Australia at Canada. Ang mga natuklasan, ang mga mananaliksik sinabi, hindi tagataguyod ang "agresibo fluid loading", na maaaring magdulot ng mga side effect, ngunit sila ay magbigay ng katibayan na ang Katamtamang nadagdagan na paggamit ng tubig, sa paligid ng dalawang liters araw-araw, ay maaaring mabawasan ang panganib ng tanggihan sa bato function na. Mahalaga na tandaan na ang karapatan na antas ng tuluy-tuloy na paggamit para sa anumang indibidwal ay nakasalalay sa maraming mga kadahilanan kabilang ang kasarian, ehersisyo, klima, mga kondisyon ng kalusugan, pagbubuntis at pagpapakain sa suso. Sa karagdagan, ang mga tao na pa nagkaroon ng bato bato ay pinapayuhan na uminom ng 2 sa 3 liters ng tubig sa pang araw-araw upang bawasan ang panganib ng bumubuo ng bagong bato. 6. Huwag magsigarilyo Paninigarilyo slows ang daloy ng dugo sa bato. Kapag mas mababa dugo umabot sa bato, impairs ang kanilang kakayahan upang gumana ng maayos. Ang paninigarilyo din nagpapataas sa panganib ng kanser sa bato sa pamamagitan ng tungkol sa 50 porsyento. 7. Huwag kumuha ng over-the-counter mga tabletas sa isang regular na batayan Karaniwang mga gamot tulad ng non-steroidal anti-namumula gamot tulad ng ibuprofen ay kilala upang maging sanhi ng pinsala at sakit ng bato kung kinuha regular. Tulad gamot marahil hindi magpose makabuluhang panganib kung ang iyong mga bato ay relatibong malusog at gamitin mo ang mga ito para sa emergency lamang, ngunit kung ikaw ay pagharap sa talamak na sakit, tulad ng sakit sa buto o likod sakit, trabaho sa iyong doktor upang mahanap ang isang paraan upang

makontrol ang iyong sakit walang paglalagay ng iyong mga bato sa panganib. 8. Suriin ang iyong bato function na kung mayroon kang isa o higit pang mga kadahilanan ng 'mataas na panganib' o mayroon ka diyabetis o mayroon ka hypertension o mo napakataba O ikaw o isa sa iyong mga miyembro ng pamilya suffers mula sa bato sakit o ng African, Asian, Aboriginals pinagmulan