Chronic kidney disease (CKD) is rapidly becoming a concern, with one in ten people worldwide suffering from the condition. The alarming fact is that figures suggest that nine in ten of those with CKD are unaware they have the disease. Indeed, CKD affects populations all over the world, with some countries faring worse than others.
According to The Global Kidney Health Atlas report, compiled by the International Society of Nephrology, Saudi Arabia and Belgium have the highest CKD prevalence, with 24 per cent of the population having the condition. Meanwhile, the Emirates Nephrology Society estimates that more than 720 Emiratis per million and more than 320 expatriates per million suffer from chronic kidney disease in the UAE.
“Our prevalence is most likely high like other GCC countries,” says Dr Ahmed A. M. Ewaida, Consultant, Nephrology & Internal Medicine at Al Zahra Hospital, Dubai. “We don’t have the exact data regarding the prevalence of chronic kidney disease in the UAE. Still, we can assume that we exceed the worldwide average due to the increasing number of diabetes and hypertension patients in our region. Of course, we can lower these numbers with a healthy lifestyle.”
Following a healthy lifestyle is essential to avoid CKD, mainly since risk factors include smoking and obesity. People with diabetes and high blood pressure are also at risk of CKD.
“The common cause of CKD in our region is the same across the world, which is diabetes mellitus, hypertension, glomerular diseases, and others,” explains Dr Ewaida.
With so many patients not aware that they have CKD, paying attention to the remotest sign that something could be wrong is essential.
“Chronic kidney disease develops over time and is often not specified; this is why it is called a silent disease,” adds Dr Ewaida. “Most patients come in with nausea, vomiting, loss of appetite, fatigue and weakness, sleep problems, decreased mental sharpness, swelling of feet and ankles, and dry and itchy skin. They may also have high blood pressure (hypertension) that is difficult to control and shortness of breath if fluid builds up in the lungs.”
If CKD is left untreated, this would eventually lead to end-stage kidney disease (ESKD) and the need for dialysis.
To avoid getting to this stage, Dr Ewaida says, “First, we must discover or diagnose the kidney disease early to work together to prevent the disease's progression. Second, we need to treat the most common causes of CKD such as diabetes mellitus and hypertension, properly and at an early stage to have these diseases well controlled.”
At Al Zahra Hospital, the specialists offer individual care and treatment options so that the team can tackle CKD from every aspect.
“We provide integrated care for patients with CKD where specialists from different specialties including nephrology, endocrinology, dietetics, cardiology and vascular surgery come together to offer complex care, as they suffer from many diseases,” explains Dr Ewaida. “If the patient reaches end-stage renal disease, we prepare them physically and mentally to start dialysis without complications. Our dialysis unit has private rooms, so the patient has complete privacy.”
Although Al Zahra Hospital offers dialysis in private rooms to ensure utmost privacy and convenience, having dialysis in the comfort of a patient's own home is also becoming favourable.
“The trend is now moving to home dialysis either by portable dialysis machine or conventional one,” he says.
However, in the future, patients' treatment could become particularly high-tech.
“The future plan for patients' treatment with ESKD will be an implantable bioartificial kidney.”
Such a device would be implanted into the abdomen and act similarly to a kidney transplant. While not quite yet developed, this is certainly something that could drastically improve the lives of ESKD patients.
In the meantime, to ensure that those kidneys are fully functioning, it is crucial to take good care of them. It is also important for anyone already suffering from CKD to take care when fasting during Ramadan.
“Before fasting, patients must consult their physician and make the decision together,” explains Dr Ewaida. “We can maintain good kidney health during Ramadan by drinking enough fluid between the iftar and suhour, avoiding excessive food intake, and taking their chronic medications as per agreement with the physician.”
By being mindful of diet and exercise and ensuring that other chronic diseases are kept in check, you can help avoid end-stage kidney disease and the need for dialysis. And remember to carry out regular kidney checks, which can be done quickly via routine blood and urine tests, to ensure that those kidneys are in tip-top condition before it is too late.