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Kidney disease is a ‘silent killer’

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Kidney failure disproportionately affects individuals of African descent and has been dubbed a “silent killer”.

Professor Feziwe Bisiwe is a nephrologist, a doctor with expertise in the care of kidneys. Picture: Supplied

KIDNEY failure disproportionately affects individuals of African descent, more so than other racial groups.

This disparity is primarily attributed to genetic predispositions that make them susceptible to uncontrolled high blood pressure, a condition that often leads to kidney disease.

Professor Feziwe Bisiwe, the head of the neurology clinical unit at Universitas Academic Hospital, has aptly classified kidney disease as a “silent killer”.

Bisiwe made the remarks at an event to mark World Kidney Day earlier this month.

The annual event, organised by Universitas Academic Hospital and Pelonomi Tertiary Hospital, was held at Pelonomi under the theme: “Kidney health for all”.

Bisiwe said the day is observed to improve awareness about kidney diseases and to educate the public, especially black people, about the signs and symptoms of kidney failure, and also how to prevent it.

She highlighted the importance of noticing the pre-disposing signs and symptoms of kidney disease, how to screen for kidney disease, and what to do once you are diagnosed.

Bisiwe highlighted that the common habit of “waiting for the symptoms” was the biggest problem.

According to Bisiwe, kidney disease usually results from other infections like HIV infection and non-communicable diseases like high blood pressure, sugar diabetes and hypertension.

She pointed out that these diseases often do not present with any major signs and symptoms early on.

Thus, according to her, specialists rely on general screening of populations in order to create awareness on how to look after oneself, how to live healthily and how to avoid acquiring the symptoms and lifestyle habits that increase the risks of kidney disease.

Bisiwe pointed out that in Africa and South Africa, health-care services are already facing a crisis, especially in rural areas, and this is where people struggle to access certain important services related to kidney health care.

She blamed this on infrastructural challenges.

Treating kidney conditions at the outset can slow the advancement of the illness more effectively than treating the issue once it has already taken a firm hold.

Bisiwe stressed the importance of health-care services making kidney screening services available to the public.

“That is so that we can detect kidney disease early and delay its progression, also to avoid the need to go for dialysis and transplants,” said Bisiwe.

She highlighted that kidney diseases do not have pronounced symptoms, which is what makes it crucial for people to go for routine screening.

“Any normal citizen over the age of 18 should consult or see their general practitioner annually in order to measure their blood pressure and have a urine dipstick to measure for evidence of kidney disease.”

She said there were non-specific symptoms like swelling of the body or the face around the eyes, itching of the skin, shortness of breath and tiredness. “Foam in the urine, which may suggest that you have a lot of protein in the body, and also blood in the urine are the signs to be careful of.

“These symptoms might occur quite late in the progression of the kidney disease, so you must not wait until you see the symptoms.

“Also, when your urine is burning, you should be checked for infection of the bladder.”

According to Bisiwe, people who take medication for HIV infection, hypertension and diabetes are at risk of suffering from kidney disease due to the medication they take.

“The HIV itself can harm the kidneys, as well as the medication that they take can harm the kidneys.

“People who have a family history of kidney disease are at risk because it can be carried down by genetic predisposition.

“Pain medication like Voltaren and Brufen and over-the-counter medication like Grand-Pa and Disprin are also risk factors.”

Bisiwe revealed that treating kidney failure is very expensive, and the opportunities for transplantation are very limited.

“Thus you need to shift your focus to the early detection and prevention measures because you would want to delay a disease that you cannot treat.

“The fact that we cannot treat kidney failure and are unable to provide everybody who needs a kidney with a kidney or putting them on dialysis, means we need to shift our focus.

“Ways of slowing the progression of kidney infection is through early detection and prevention – early screening. It is beneficial as well. Sometimes we are able to treat it and it can be reversed. But if you detect it in the advanced stage, it means you have missed the boat and will need dialysis or a new kidney.”

She elaborated that dialysis is usually needed when a patient’s kidney function drops below 15ml per minute, which is stage 5, and has abnormalities that indicate that the body can no longer function without the adequate function of the kidney.

“We need to encourage the public that a healthy lifestyle should start before you have kidney disease.”

She emphasised that steering clear of an unhealthy lifestyle, lack of fitness, and excess weight are crucial steps to prevent high blood pressure and diabetes.

Bisiwe further warned communities to avoid smoking and taking in too much salt and alcohol as it increases the risks.

She advised that it is always beneficial to change one’s lifestyle.

Kidney disease patients are urged to adhere to the lifestyle prescribed by the doctor, avoid herbal or over-the-counter medication, drink clean water accordingly, keep a positive attitude and honour and attend all doctor’s appointments, she said.

Families and workplaces are encouraged to give support to those patients with kidney disease and allow them to honour all their sessions and appointments.

Professional nurse Tseliso Kheleli taking the vital signs of Alice Majale. Picture: Supplied

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