The global chronic kidney disease prevalence is between 11 to 13% and expected to increase disproportionately in future. Moreover, in 40-60% of the cases the cause of chronic kidney disease is pre-existing diabetes and hypertension. In this era where high blood pressure and diabetes have become an epidemic, it becomes even more important to spread awareness about risk factors of chronic kidney disease. Although, ‘Prevention is better than cure’, when it comes to kidney disease there are some risk factors that can be prevented and few impossible to avoid.
The unavoidable risk factors that increase the susceptibility to chronic kidney disease are:
- Age: Chronic kidney disease can occur at any age. However, the prevalence of kidney disease is markedly higher in elderly population that is age > 65 years. The changes seen in aging kidneys are: decrease in renal mass, scarring effect on nephron, overall impaired filtering ability and gradual decrease in glomerular filtration rate. In addition, presence of co-morbid conditions like, diabetes, high blood pressure and cardio vascular disorders in elderly patients contributes to deteriorating kidney function and renal disease.
- Family History: A positive family history of kidney disease is strongly associated with an increased risk of kidney disease. Two to three times higher incidence of end stage renal disease (ESRD) is noted in first or second degree relatives of ESRD patients.
- Ethnicity: Asian, South Asian, Pacific Island, African/Caribbean and Hispanic descent are at higher risk for chronic kidney disease.
The avoidable risk factors that can directly initiate kidney damage are:
- Diabetes: Uncontrolled diabetes is the leading cause of chronic kidney disease. Elevated blood sugar over a long period of time damages kidneys’ tiny blood vessels. This can gradually lead to serious kidney damage. Hence, it is essential to regularly monitor diabetes and kidney functioning.
- High blood pressure: High blood pressure is identified as both a cause and complication of chronic kidney disease. High blood pressure on a longer run damages blood vessels throughout body. If the kidneys are affected, it results in reduced blood supply leading to destruction of nephrons. As a result, the kidneys are unable to remove the wastes and toxins out of the body leading to build up of extra fluid in the body which in turn exacerbates blood pressure.
- Heart disease: Chronic kidney disease and heart diseases are closely inter-related and dysfunction of one can lead to failure of the other.
- Drug toxicity: Long term use of certain medicines like, antibiotics, NSAIDs, angiotensin converting enzyme inhibitors (ACEI) and contrast agents can cause drug-induced kidney disease. The ever growing list of newer medicines and their easy availability are two main causes for the increase in rate of drug-induced kidney disease.
Once the kidney damage has occurred, the following risk factors if left unchecked can lead to worsening of kidney disease/ faster decline in kidney function:
- Uncontrolled proteinuria
- Uncontrolled high blood pressure
- Poor glycemic control
Only Solution: ‘Get Screened and Monitor’
The kidney damage can be delayed and prevented if we keep a check on the risk factors and routinely monitor blood and urine.