08 issue: kidney
The HEALTH | AUGUST, 2018
08 issue: kidney
Anti-inflammatory drugs
A silent culprit causing kidney failure
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VER 58 per cent of kidney failure requiring dialysis is caused by diabetics, while an average of six to eight per cent are hypertensive patients. Stones only contribute one to two per cent of the statistics.
Sunway Medical Centre Consultant Physician and Nephrologist Dr Ng Eng Khim( pic) pointed out that kidney failure is actually a spectrum with the end of the spectrum being end stage kidney failure.
“ A majority of our work focuses on patients requiring dialysis treatment which is not a cure to the underlying kidney problems, but rather to replace the loss of kidney function so that they can continue to live on an acceptable health level.”
The other spectrum would be
detecting those with chronic kidney disease caused by a multitude of reasons such as a majority of diabetes and to stay away from offending medications that can burden the kidneys.
“ In western medication context it is the abuse of pain killers. Not all painkillers are bad for the kidneys, but specifically would be those in the family of nonsteroidal anti-inflammatory drugs( NSAID) which are very bad for the kidney,” he said.
NSAIDs are a large group of drugs that exhibit pain-relieving, fever-reducing and anti-inflammatory properties. Aspirin( Dusil), one of the first NSAIDs introduced in the market is available over-the-counter, whilst others like mefenamic acid( Ponstan), diclofenac sodium( Voltaren) and piroxicam( Feldene) are available only as dispensed medicines at licensed outlets such as clinics and pharmacies.
Statistics
Dialysis in Malaysia, G B Leong et all, 23rd Report of the Malaysian Dialysis and Transplant Registry 2015:
6479 new haemodialysis( HD) cases
1118 new peritoneal dialysis cases
The total number of HD and PD patients in 2015 increased to
33,456 and 3727 respectively
Over the last 10 years, both the acceptance and prevalence rate had increased by almost two-fold
Dialysis treatment rate by gender, per million male and female population from 2006 to 2015:
Male: 295 Female: 247
Dialysis treatment rate by state, per million population from 2006-2015
Pulau Pinang: 313 Melaka: 341 Johor: 296 Perak: 350 Selangor & Putrajaya: 289 Federal Territory: 385 Negeri Sembilan: 381 Kedah: 280 Perlis: 175 Terengganu: 284 Pahang: 274 Kelantan: 207 Sarawak: 198 Sabah & Labuan: 121
Detecting early signs of kidney cancer
THE kidney is a bean-shaped organ located on the either side of the body beneath the rib cage. The most common function associated with kidney is the production of urine. The other important function which is done by the kidney include retaining salt and water, regulation of blood pressure, stimulates the bone marrow to produce red blood cells and also in the calcium and phosphorus metabolism.
Pantai Hospital Kuala Lumpur Consultant Urologist Dr S A Balan( pic) explained that the main functional unit of the kidney is a nephron.
“ Kidney has about more than onemillion nephron each. Kidney cancers also are most commonly seen in older individuals.”
“ There are many types of cancer that can affect the kidney. The most common variant of kidney cancer is the clear type renal cell carcinoma( RCC) which is seen in more than 80 per cent of individuals. Other tumours which can involve the kidney include transitional cell carcinoma, Wilms tumour( kidney cancer that affects children), metastasis from other tumours and lymphoma.”
Common complains
Most times the tumour is found incidentally then being screened for other condition. Some individuals come with complains of having painless haematuria( blood in the urine).
“ There might also be a swelling or a lump on the side of the kidney and sometimes persistent dull aching pain in case the tumour is very large.”
Other symptoms include a general sense of feeling unwell, left testicular swelling in men( this is due to the
Dehydration common cause of stones in kidney
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“ Salt intake has always been associated to high blood pressure. An unhealthy eating habit leads to acquiring kidney failure and not stones.” |
KIDNEY stones is an important health factor one should be aware of, although it is uncommon these days.
Sunway Medical Centre Consultant Physician and Nephrologist Dr Ng Eng Khim reasoned that this is mainly for certain reasons; as having moved from agricultural base to industrial life.
“ Those days’ people worked for hours and hours under the sun and lacked water, leaving them dehydrated which then causes stones to form. However, increased awareness on healthy living, early health screening, drinking more water and adequately as well as diet modification helps to keep the formation of stones at bay.”
Compared to yesteryears, treating a kidney stone today no longer requires a major surgery but is only a minimally invasive procedure.
Salt intake and kidney stones
The myth of consuming too much salt in one’ s diet has also been attributed as a factor to developing kidney stones over the years.
Ng disagreed to this.
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“ Salt intake has always been associated to high blood pressure. An unhealthy eating habit leads to acquiring kidney failure and not stones.”
“ Common causes are high levels of calcium, uric acids and oxalate that form in the kidney causing them to develop as stones.”
“ The lack of water intake also poses a person to be of high risk.”
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“ These tendency, among my patience occur among those working off-shore— wearing the protective garments and working long hours— inadequate replenishment of water intake which predisposes them to develop stones.”
While both genders are exposed equally, it is however more prone towards men with a prevalence ratio of 3:1 compared to women.
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