Toiling the streets every day to make ends meet and to live a comfortable life is our utmost desire. Live being the best gift of God to man beats us down but we thrive, we fight, we push until things happen the way we aspire them and boom! The enemy knocks at our doors just when we thought the struggle was over; our life long machines begin to fail (kidneys). It makes us weak, wearied and sucks the life out of us. All we work for comes crumbling before us but giving up is the last thing we would do. Together we will tackle the enemy and learn to leave with him.
The kidneys are very important organs in the body. They are two bean-shaped organs, each about the size of a fist, located just below the rib cage, one on each side of the spine. The kidneys are composed of tiny functional units called the nephrons which consist of glomeruli (small blood vessels that filter waste and excess fluids) and tubules that collect waste products, drugs, and toxins which are excreted in the urine.
Functions of the kidneys
∑ Regulate electrolyte (salt) concentrations.
∑ Regulate the amount of fluid within the body.
∑ Helps regulate blood pressure
∑ Help maintain the body’s acid base balance.
∑ Produce hormones such as erythropoietin that is responsible for the formation of red blood cells by stimulating erythropoietic activity of the bone marrow
∑ They filter waste products of metabolism
∑ They activate a form of vitamin D that helps the body to absorb calcium
Is a condition that occurs when the kidneys are damaged and cannot perform their function. According to the latest WHO data published in 2018 kidney disease deaths in The Gambia reached 192 or 1.38% of total deaths. The age adjusted death rate is 23.99 per 100,000 of population ranks The Gambia number 50 in the world. The leading causes of kidney disease diabetes and hypertension. They are responsible for up to two-thirds of the cases
Types of kidney diseases and their causes
Chronic kidney disease: This is the most common form of kidney disease and it is a long-term condition that does not improve over time. It is commonly caused by high blood pressure. High blood pressure is dangerous for the kidneys because it can increase the pressure on the glomeruli. Glomeruli are tiny blood vessels in the kidneys where blood is filtered. Overtime, the increased pressure damages these vessels and kidney function begins to decline. Kidney function will eventually deteriorate to the point where the kidneys can no longer perform their job.
Diabetes which is a condition characterized by high blood glucose (sugar) is also a major cause of chronic kidney disease. The increased level of sugar in the blood damages the vessels in the kidneys overtime resulting to loss of kidney function due to toxin overload. The Gambia is a member of the International diabetes federation African region and out of 463 million diabetics worldwide ,13 million are in the AFR region and a great number of this people are at risk of developing kidney disease if there blood sugar is not put in check.
Kidney stones: They are also a common kidney problem. They occur when minerals and other substances in the blood crystalize in the kidneys, forming solid mass (stones). Kidney stones usually come out of the body during urination. Passing kidney stones can be extremely painful, and may result to traumatic lesions on organs like the urethra, ureters and bladder.
Glomerulonephritis: Is an inflammation of the glomeruli. Glomeruli are extremely small structures inside the kidneys that filter the blood. Glomerulonephritis can be caused by infections, drugs, or congenital abnormalities (disorders that occur during or shortly after birth). It often gets better on its own.
Polycystic kidney disease: Is a genetic disorder that causes numerous cysts (small sacs of fluid) to grow in the kidneys. These cysts interfere with kidney function and cause kidney failure.( it is important to note that individual kidney cysts are fairly common and almost always harmless. Polycystic kidney disease is a separate more serious condition.)
NOTE: Urinary tract infections(mainly bacterial) of any part of the urinary system such as the bladder, and urethra are most common and are easily treatable.Howerver, if left untreated, these infections can spread and cause kidney failure.
Symptoms of kidney disease
Kidney disease is a condition that can easily go unnoticed until symptoms become severe. The following are early signs that you might be developing kidney disease.
∑ Fatigue: A state of weariness or exhaustion.
∑ Difficulty concentrating
∑ Poor/decreased appetite
∑ Difficulty/trouble sleeping
∑ Muscle cramping: A painful contraction of the muscles which cannot be controlled
∑ Swollen feet or ankles
∑ Puffiness around the eyes in the morning
∑ Dry, dehydrated, scaly skin
∑ Frequent urination, especially late at night
Severe symptoms that could mean your kidney disease is progressing into kidney failure include:
∑ Loss of appetite
∑ Changes in urine output
∑ Fluid retention
∑ Anemia (decrease in red blood cells)
∑ Decreased sex drive
∑ Sudden rise in potassium levels (hyperkalemia)
∑ Inflammation of the pericardium(fluid filled sac that covers the heart)
Risk factors for developing kidney disease
People with diabetes have a higher risk of developing kidney disease Diabetes is the leading cause of kidney disease, accounting for about 44% of new cases. You may also get kidney disease if you:
∑ Have high blood pressure
∑ Have other family members with chronic kidney disease
∑ Are elderly
∑ Are of African, Hispanic, Asian, or American Indian descent
Diagnoses of kidney disease
Your doctor will first determine whether you belong in any of the high-risk groups. They will then turn some tests to see if your kidneys are functioning properly .These test may include:
Glomerular filtration rate: This test will measure how well your kidneys are working and determine the stage of kidney disease.
Ultrasound or computed tomography (CT) scan: Ultrasounds and CT scans produce clear images of your kidneys and urinary tract. The pictures allow your doctor to look for blockages or abnormalities in your kidneys.
Urinalysis: Your doctor may take a urine sample to test for any abnormalities, including abnormal protein or sugar that spills in the urine. The may also perform a urinary sedimentary examination. The test measures the amount of red and white blood cells, looks for levels of bacteria, and searches for high numbers of tube shaped particles called cellular cast.
Urine volume measurements: Measuring urine sample is one of the simplest tests to help diagnose kidney disease. For example low urine output may suggest that the kidney disease is due to a urinary blockage, which multiple illnesses or injuries can cause.
Blood samples: Your doctor may order blood tests to measure substances that are filtered by your kidneys, such as blood urea nitrogen (BUN) and creatinine. A rapid rise in these levels may indicate acute kidney failure.
Treatment of chronic kidney disease
There is no cure for chronic kidney disease but treatment can help relieve the symptoms and stop it from getting worst.
Your treatment however, will depend on the stage of your disease. The main treatments are:
∑ Lifestyle changes-to help stay as healthy as possible one must always practice good hygiene, eat healthy diets and avoid any bad habits that would worsen your condition.
∑ Medicine-to control associated problems such as diabetes, high blood pressure and high cholesterol.
∑ Dialysis-treatment to replicate some of the kidneys functions , which may be necessary in advance chronic kidney disease
∑ Kidney transplant may be necessary in advanced stages of the disease
Key lifestyle changes
The following lifestyle measures are recommended for people with kidney disease:
∑ Do not smoke
∑ Restrict your salt intake to less than 6g a day
∑ Do regular exercise for at least 150 minutes a week
∑ Manage your alcohol intake to not more than 14 units a week
∑ Avoid over the counter non- steroidal anti- inflammatory drugs such as ibuprofen
Living with kidney disease is very difficult and worrisome. Lot of people around the world battle with the fear of having to lose a kidney and consequently one’s life but the light at the end of the tunnel is that we can learn to leave with the disease through the various lifestyle changes that help boost our courage of thriving and making a difference amongst many. Living with a kidney disease is not a limitation to our self-realization and worth. Together we can fight the conditions and together we can kick the enemy.