Our kidneys work like a special filtering machine which is magical and essential for life. Each kidney has 1 million cellular units (nephrons) of blood filtration process filtering about 180 liters of blood everyday. The liquid is excreted in a form of urine and useful substances are absorbed back to the body as part of regulation process of fluid and electrolytes. In addition, kidneys are a source of hormone called erythropoietin which stimulated the bone marrow to produce mature red blood cells to keep us away from anemia.
Our kidneys also produce renin, a hormone that control blood pressure levels, and calcitriol, the vitamin D derivative, to control the balance of calcium and phosphorus at the kidneys and digestive tract. Chronic kidney diseases are caused by many reasons including severe urinary tract infections, diabetes, hypertension, gout, kidney stones, severe obesity, nephritis, SLE, kidney tumors, kidney cysts, nephritis and side effects from some medication, herbal medicines or some dietary supplements such as vitamin C consumed more than 500 mg/day.
Dr.Siriporn Leehacharoenkul, our nephrologist at Bangkok Hospital Hua Hin shares that kidney diseases are ones of the major medical problems and sometimes considered a silent threat that can occur to anyone of any age. In normal conditions, organs will deteriorate with increased age which is unavoidable. The reduced kidney function usually occurs after the age of 30 years at an average rate of 1 percent per year. However, people can live normally without knowing that their kidneys are deteriorating as kidney functions are gradually reducing which does not affect the overall physical conditions.
The kidney disease occurs when the kidney functions decrease at a higher rate than the natural changes in normal people. The condition in which kidney function decreases abruptly is called acute kidney injury which may return to normal function if receiving proper treatments and care. However, if the abnormality of kidney functions exist longer than 3 months, it will be considered as a chronic kidney disease. Patients with chronic kidney disease have significantly reduced kidney functions meaning that the rate of kidney filtration is less than 15 percent of their normal capacities are referred to as end-stage kidney failure.
Those patients have symptoms from the accumulation of wastes in the blood, water and electrolyte imbalance and some hormones deficiencies leading to lack of energy, loss of appetite, vomiting, swelling, anemia, high blood pressure, itching, pain, muscle cramps, dry and rough skin, darkening of the skin, fragile bones and etc. The treatment for this condition is kidney replacement therapy. The duration of disease progression to the end-stage kidney failure varies in each patient. There are many factors involved such as the cause of the disease and the age of diagnosis of kidney disease.
There are 4 methods for treating chronic kidney disease with end-stage kidney failure: 1) Kidney Replacement Therapy with Hemodialysis. 2) Peritoneal Dialysis 3) Kidney Transplantation and 4) Symptomatic Treatment At Bangkok Hospital Hua Hin, we provide services of Kidney Replacement Therapy with Hemodialysis. In hemodialysis, a dialysis machine and a special filter called an artificial kidney are used to clean the blood which is carried out under close supervision of a team of specialists at hemodialysis unit. The hemodialysis machine imitates the functions of the regular kidneys to balance the electrolyte and fluid, also eliminates wastes in the blood.
At the end of the process of hemodialysis, the good blood is restored back to patient’s body without contamination. Normally, the hemodialysis process takes 4 – 5 hours and 2 – 3 times per week, depending on the patient’s conditions and levels of waste in blood. From the explanation given above, the kidney disease is a disease that may be hidden in a person that has no symptoms at all and it can be caused by various reasons. Some chronic kidney diseases may not have any severe symptoms that affect your lifestyle until the kidney function is greatly reduced. Those patients will come to see the doctor only when at the end-stage kidney failure has occurred and they are losing the opportunity to receive treatments to slow the deterioration of kidney functions which may help them to have a better quality of life and delay the kidney replacement therapy as long as they could.
Therefore, the regular health check-up every year or as required is important to screen whether you are at risk for the kidney disease. The three basic examinations including blood pressure measurements, kidney function test (Serum BUN, Creatinine) and urine examination are made during the examination. In case of abnormal findings, you may need additional investigations and a consultation with our nephrologist. Dr. Siriporn Leehacharoenkul also suggests that to prevent having kidney failure is an important step which can be made by annual health check-up as mentioned above.
Furthermore, changing personal behaviors by eating good food and avoiding salty, sweet, high saturated fat diets especially, high cholesterol food, processed food, some unknown herbal medicines and dietary supplements. In addition, you should quit smoking and limiting drinking alcohol, control body weight and have a regular exercise, drink enough water, keep blood sugar, lipid and blood pressure levels under control to keep your kidneys healthy.