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Kidneys play an important role in the human body, but Poles are not very aware of their needs. The vast majority of people 40+, i.e. those who may already develop serious diseases of these organs (such as Chronic Kidney Disease), have never done any tests to detect them. This is very bad news, because kidney diseases that are dangerous to life and health are often asymptomatic.
Poles do not examine their kidneys
The state of knowledge about kidney diseases, as well as about screening tests that would allow for their detection, is not satisfactory in Poland. The Ibris report prepared for the Polish Society of Family Medicine in 2022 shows that only 30 percent. of respondents know what Chronic Kidney Disease is, and even fewer, because only every fifth respondent, is aware of the health consequences of this disease. The percentage of Poles undergoing diagnostics for kidney diseases is also very worrying. As the report indicates, as much as 90 percent. respondents had never been tested for CKD. Only 3 percent. respondents were diagnosed in the last 12 months.
The data on access to knowledge about CKD among people at risk, i.e. suffering from chronic diseases such as diabetes, hypertension or cardiovascular diseases, are also surprising. It turns out that less than 1 in 10 patients has been informed about the risk of developing Chronic Kidney Disease.
Chronic Kidney Disease – How is it detected and why is it so important?
Public awareness of Chronic Kidney Disease is low. This also applies to people who have already suffered from it. It is estimated that 9 out of 10 patients have no idea that they are suffering from CKD. This is due to the fact that the disease develops for a long time and it happens quietly – in the early stages the kidneys do not show any strong symptoms that could cause anxiety in the patient.
We must realize that it is a complicated disease and has its degrees of severity – says Prof. Andrzej M. Fal, President of the Polish Society of Public Health and member of the coalition for Chronic Kidney Disease. – On the one hand, this is good, because we can react at its lowest levels, but this fact also raises diagnostic problems. Because even if a patient has diabetes, arteriosclerosis or hypertension, most often they do not know that they have sick kidneys. Symptoms of CKD do not appear until the changes in these organs are already irreversible and very extensive. Consequently, the patient finds out about the disease simply too late. Therefore, it is good to monitor kidney function in any chronic disease. Nay. I believe that kidney examination should be included in the canon of any periodic health check as one of the basic parameters. These are really simple things like creatinine levels, eGFR or urinalysis, she lists.
Patients are often unaware that such tests should be performed, and the absence of renal symptoms does not prompt them to visit a nephrologist or worry about these organs.
In the first and second stages, the patient usually does not feel any discomfort, while the disease develops into the third stage. Then the eGFR is below 60, problems begin and edema appears. Often the first symptom that something is happening can be chronic, but very slight, anemia. I would like to make all readers aware that CKD is a long and asymptomatic disease, which is why it is also potentially very dangerous – emphasizes prof. Halyard.
It is best to start a CKD diagnosis early. Waiting until your 50th birthday with screening is not worth it.
All risk factors for chronic kidney disease, such as smoking, being overweight, atherosclerosis and diabetes, are either behavioral or result-related factors. We see in the populations of wealthy countries that they are already developing in 40-year-olds. Therefore, waiting for the 50th birthday to be screened for CKD, diabetes or arteriosclerosis. It was good maybe 30 years ago, but not in today’s world – summarizes the expert.
Advanced Chronic Kidney Disease significantly increases the patient’s risk of death, incl. as a result of a heart attack or stroke. In addition, a patient who has already undergone serious changes will require dialysis – his kidneys will never regain full function. The only way to reverse the degeneration process is to diagnose CKD early.
Who is most at risk of Chronic Kidney Disease?
Risk factors for Chronic Kidney Disease are primarily atherosclerosis, hypertension and other cardiovascular diseases and diabetes. The disease usually occurs in patients with multiple diseases, developing in the shadow of other serious ailments.
The most common causes are civilization diseases. Diabetes comes first, and it goes hand in hand with the second culprit – hypertension. The third place is glomerulonephritis. In the fourth – chronic interstitial nephritis, which is most often caused by urolithiasis or recurrent urinary tract infections. The fifth most common cause is a genetically determined disease – polycystic kidney disease – enumerates prof. Beata Naumnik – Head of the Nephrology and Transplantology Clinic with the Dialysis Center, Medical University of Białystok and member of the coalition for Chronic Kidney Disease.
CKD is also a greater threat to people over 50, who are overweight or obese, and who smoke.
Chronic Kidney Disease – What Next?
If Chronic Kidney Disease is diagnosed at an early stage, the patient still has a chance to improve. For this, however, constant contact with a doctor is necessary, as well as following specific recommendations.
After making the diagnosis, the patient must be under the care of a specialist from whom he will receive recommendations. Remember that most often it will be a person who has not only CKD, but also other chronic diseases, so they will require constant contact with a doctor. Once a month, or less frequently if they are mild. With CKD, the issue of diet is very important, and here comes another problem. Because while patients treat taking medications or taking injections rather seriously, the slogan “please limit phosphorus” is often beyond their minds. Unfortunately, we are still skeptical about dietary treatment as a society. And here public health must strengthen education – this will allow us to understand the disease, but also to start treatment as it is. Including the diet – says prof. Halyard.
When the disease is already well advanced, the patient will require radical methods of action. Their goal, however, is only to slow down degradation, because kidneys damaged by a chronic condition will not regain full function. This is not a reversible process.
In the fourth stage (eGFR between 30 and 15), the patient is slowly getting ready for renal replacement therapy techniques. Below 15 we are already thinking about it firmly – we are starting to create an arteriovenous fistula needed as a vascular access for hemodialysis, we prepare the patient for pre-transplant, i.e. one that will take place before the patient enters dialysis therapy, or we set up a Tenckhoff catheter implantation procedure for access to peritoneal dialysis .
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