Chronic kidney disease has been called the “new silent killer” and is an example of a chronic condition that is more common than is generally realized¹. In Ghana, the prevalence of chronic kidney disease is estimated to be around 17% of the population ^2.  World Kidney Day, a global campaign aimed at raising awareness of the importance of our kidneys to our overall health, falls on the 9^th March this year. The 2017 campaign focuses on promoting a healthy lifestyle for healthy kidneys. In light of this, let us educate ourselves on reducing our risk of this silent killer.

What is Chronic Kidney Disease?

Chronic kidney disease is a progressive loss of kidney function over a period of months or years. The kidneys are two bean-shaped organs, located on each side of the spine, below the lowest ribs and against the back muscles. The main function of the kidneys is to filter out excess water, waste products and toxins from the blood to form urine. Additionally, the kidneys control the body’s chemical balance, produce red blood cells and keeps bones healthy. Chronic kidney disease occurs when the kidneys are damaged and cannot perform its normal functions. Early chronic kidney disease has no signs or symptoms and does not usually go away but can be managed. If not managed, eventually the kidneys may stop working altogether resulting in kidney failure which will require costly and major long-term treatments such as dialysis or kidney transplant.

The risk factors for developing chronic kidney disease are numerous and include diabetes, high blood pressure, high cholesterol, kidney infections and inflammation, kidney stones, long term use of some medicines known as non-steroidal anti-inflammatory drugs (NSAIDS) and some herbal drugs.

Reduce your risk of Chronic Kidney disease

There are several ways to reduce the risk of developing chronic kidney disease. These include a healthy diet, healthy weight, avoiding smoking, cutting down on alcohol if you drink and exercising regularly. Following medical advice in managing health conditions such as diabetes and high blood pressure is extremely important in reducing your risk of developing chronic kidney disease. Following are some recommendations from World Kidney Day^3.

Eat Well: Eating well will help keep your blood pressure and blood cholesterol at a healthy level. Eating well involves a balance and wide variety of foods.

• Plenty  of  a wide variety of fruits such as oranges, pineapple, watermelon, mangoes etc.
• Plenty of  a wide variety of non-starchy vegetables such as okro, garden eggs, kontomire, tomatoes, onions, salad vegetables, beans etc.
• Moderate portions of starchy foods such as bread, yam, plantain, rice, kenkey, fufu etc. Include wholegrains such as whole wheat, brown rice, maize, millet and sorghum.
• Moderate portions of proteins such as fish, eggs and meat. Includes beans and lentils.
• Minimise your intake of fats, especially animal fats and sugary foods.  

Cut back on salt: High salt intake leads to water retention and high blood pressure, a major risk factor for chronic kidney disease. Limit your salt intake and where possible avoid adding salt to your meals before eating. If you are struggling with adopting a low salt diet, gradually reduce salt added to your cooking and meals. Limit your intake of salty foods such as salty seasonings, stock cubes such as Maggi, salted fish(koobi & kako), salted pig feet, salted beef (beefy) and salty snack foods. Season your cooking instead with dried shrimps, peppers, onions, ginger, garlic and herbs.

Drink “plenty” of fluids:  Drinking of fluids helps the kidneys filter out waste products from the blood. Increasingly, research evidence suggests that recurrent dehydration might be a  cause of chronic kidney disease. Furthermore, there is some evidence that increasing hydration, particularly with water, may actually prevent CKD ⁴.

Scientific research differs in recommendations on how much fluid we should drink for good health.  Individual fluid needs vary widely depending on many factors including body size, climate and levels of physical activity.  The general consensus from many international bodies is aiming for a range of 1.5 litres – 2 litres of fluid daily. Suitable fluids include almost all drinks containing water except sugary drinks. A good way of telling if you are getting enough fluid is that your urine should be straw (pale yellow) coloured.

Control your body weight: Obesity can directly cause kidney damage by increasing the workload of the kidneys. Obesity also increases the risk of diabetes and high blood pressure which are the two main risk factors for chronic kidney disease. The best way to lose weight is by watching your food portions, decreasing your intake of sugary and fatty foods and exercising regularly.

Exercise regularly: Regular exercise helps decrease blood pressure and maintain a healthy weight, all of which will reduce your risk of developing  chronic kidney disease.  Daily moderate-intensity exercise such as brisk walking  lasting at least 30 minutes is recommended for good health.

Finally... Talk to your medical doctor if you have high blood pressure, diabetes, high blood cholesterol and/or a family history of kidney disease. You may need testing for kidney disease which if detected early and managed can delay or prevent kidney failure. Ensure you are taking your medications as recommended by your medical doctor to control high blood pressure, diabetes and high blood cholesterol.

You may also benefit from seeing a registered dietitian, who will provide you with individualised advice and support for managing your weight, hypertension, diabetes and high blood cholesterol.

Take care of your kidneys and reduce your risk of chronic kidney disease!

Laurene Boateng (MPhil, RD)

Olivera Kegey (MSc, RD)

References

1. Kopyt NP. Chronic kidney disease: the new silent killer. The Journal of the American Osteopathic Association. 2006 Mar 1;106(3):133-6.
2. Stanifer JW, Jing B, Tolan S, Helmke N, Mukerjee R, Naicker S, Patel U. The epidemiology of chronic kidney disease in sub-Saharan Africa: a systematic review and meta-analysis. The Lancet Global Health. 2014 Mar 31;2(3):e174-81.
3. http://www.worldkidneyday.org/
4. Roncal-Jimenez C, Lanaspa MA, Jensen T, Sanchez-Lozada LG, Johnson RJ. Mechanisms by which dehydration may lead to chronic kidney disease. Annals of Nutrition and Metabolism. 2015 Jun 18;66(Suppl. 3):10-3.