Let Her Kidney Speak Good Health

Though kidney diseases can affect people of different ages and races; women tend to be more susceptible to its impacts, and to the related (specific) challenges. The chances and risks of developing Chronic Kidney Disease (CKD) is at least as high in women as in men and may even be higher. CKD affects approximately 195 million women worldwide. Currently, CKD is known to be the 8th leading cause of death in women among other cause. And, in fact, CKD is responsible for 6, 00,000 deaths every year and poses risk of morbidity and may also progress towards the renal failure, which may lead to requiring renal replacement therapy – dialysis and/or even kidney transplantation.

Some eye openers:

One of the common kidney related problems related women that can often be heard is UTI.

Urinary tract infections (UTIs) lead to approximately 10 million healthcare visits each year. The dangerous truth of it is that if it is not treated in early phase then the germs can travel up to the kidneys and cause a worse type of infection, called pyelonephritis (pie-yeh-low-nef-right-us). UTIs and kidney infections are quite common in women, and the risk of it increases during pregnancy.

With the levels of life expectancy and prevalence of lifestyle related diseases, India has been witnessing a significant upsurge in the occurrence of CKD. It is currently one of the most commonly occurring non-communicable diseases in India. The most common cause of CKD in population-based studies is diabetes. Recent studies have also shown that even rising air pollution is a factor in increasing risk of Chronic Kidney Diseases (CKD).

Did you know this?

With increasing occurrences of CKD, the number of patients undergoing dialysis in India is also gradually increasing by 10 – 15 percent every year. This percentage includes many children as well. Unfortunately, despite its steadily increasing incidence, kidney disorders are still not a high priority condition in India. The condition is further worsened by a shortage of operational beds in hospitals and shortage of doctors and paramedics. The economic factor of treatment and management of CKDs is also a major concern for patients and their families.

Dr. Gaurav Thukral, Critical Care expert and Chief Operating Officer at HealthCare atHOME (HCAH) says, "Studies have pegged the burden of chronic kidney diseases (CKD) in India to 800 per million people - which is a significant number considering our population. Treatment and management of CKDs is a long process made painful by long admissions to the hospitals - which leads to mental, physical and economical discomfort to patients and their families. Quality home healthcare solutions are striving to reduce this discomfort by providing a comprehensive health education plan, developing and executing a special care plan for CKD patients and ensuring patient adherence to a healthy lifestyle - all at the comfort of the patient's home. Home healthcare solutions are a more convenient and cost-effective option for patients and their families as well. For instance, HCAH provides hospital quality peritoneal dialysis to patients at their homes at 30% lesser cost and also reduces stress of care givers by eliminating bi-weekly visits for patients to the hospital for dialysis. Home healthcare is indeed an immediate, cost effective, comfortable and high-quality solution to managing India's CKD burden." HealthCare atHOME pioneered specialty care solutions in India. Their home healthcare solutions for nephrology specialty are helping thousands of patients and their families across India.

On the occasion of World Kidney Day, Dr. Umesh Gupta, Senior Consultant and Director, Nephrology & Renal Transplantation at Aakash Healthcare highlights the need for awareness about (CKD) “Chronic Kidney Disease (CKD) is incurable and progressive disease which decreases the function of kidney over a period of time and patient requires lifelong care and medical treatment. The kidney is made up of millions of tiny structures called nephrons that filter blood. If these nephrons got damaged, then it may affect the functioning of kidney, which may also cause kidney disease”.

Dr. Gupta, also stated, “Kidney disease has no sign and symptoms, it mainly affect people having hypertension and diabetes which is very common. Some uncommon symptoms are inflammation (glomerulonephritis), infections (pyelonephritis), blockage in urinary system, and maximum intake of painkillers (NSAID). People, who are having busy schedule and do not take proper balanced diet, are likely to be at a higher risk for a kidney disease. Those who are more conscious about their fitness and take fitness supplements to get an attractive and muscular body, are also at risk and these can over a period of time may lead towards chronic kidney disease”.

Role of awareness in early detection and hence, right management of CKDs and the option of home healthcare solutions for high quality, cost effective, convenient and comfortable management of the disease are indeed immediate and easy to implement options for managing the burden of CKDs in India.

What is World Kidney Day (WKD) all about?

The main objective of WKD is to make people aware of how important their kidneys are, and how they also have an impact on their overall health. People also need to know how they can prevent or slow down the progression of kidney diseases by taking proper precautionary measures and treatments. Millions of people across the world undergo CKD, which can affect anyone, barring their age, gender, race, or ethnic background. The day assigns a yearly global theme, helping the larger kidney community to focus on a specific issue. Well, then every specific issue branches out to related fission-issues. In 2016, WKD focused on kidney diseases and children. While in 2017, the theme was obesity and its effects on kidney health. Next theme is Kidneys & Women’s Health: Include, Value, Empower. This is because women have certain risks for CKD that men do not. WKD aimed at bringing attention to these risks and inform women on how to lower their risk. Some research studies show that the risk for CKD is slightly greater in women than in men - 14% women versus 12% men. The theme of World Kidney Day 2019 was “Kidney Health for Everyone Everywhere”.

When is it observed?

It is observed every year on 14^th March.

When it comes to women, they are more susceptible towards the kidney related issues. Let us see what types of kidney disease are more common in women.

Lupus Nephritis (LN): It is a kind of kidney damage that is caused by an autoimmune disease (systemic lupus erythematosus, also known as SLE), which is a disorder that makes the body’s immune system act like a traitor and attack the body’s own cells and tissues. Gradually, it may also get worse leading to kidney failure. It is much more common in women than in men. And often, it strikes women during their child-bearing years. Nine out of 10 people who have SLE are (unfortunately) women.

Pyelonephritis (kidney infection) is a type of urinary tract infection (UTI) that is most commonly caused by bacteria and starts in the lower urinary tract. If not treated, it moves upstream to one of both kidneys. Kidney infections may lead to sepsis, which can be life threatening. UTI is more common in women and girls due to their anatomy.

What are the challenges unique to women?

Conception: CKD is considered to be a risk factor for reduced fertility, especially in its advanced stage, when dialysis is required. While conception on dialysis may be tough, it is still possible that the results show improvements with intensive treatment (daily or nearly daily) sessions.

Access to healthcare: It is another such issue as the socio-economic and cultural issues may affect women’s wellbeing as well. Septic abortion after an illegal procedure or as a result of careless operation is the leading cause of AKI in the countries with no access to legal abortion. The burden and risks of those maternal complications is particularly high for women in developing countries, due to inadequate access to universal and timely prenatal care (adding to it) improper management of women with preeclampsia, and lack of availability of dialysis for severe AKI.

Access to Renal Replacement Therapies (RRT): Access to RRT, including dialysis and transplantation, may be of some concern for many women and girls in different societies. While women are more likely to donate a kidney for transplantation, they are less likely to receive one when in need.

Did you know that kidney problems can affect the course of pregnancy as well?

Yes, it is true – sadly though. A woman's health is dependent on the treatment and funcationalities of her unique biology/ anatomy. One thing we know for certain is that women of child-bearing age face different problems than men when it comes to kidney disease. Women with CKD are strictlydiscouraged to use the contracptive pills as birth control method as there is a greater chance for an increase in blood pressure and blood clots that can furtherworsen her kidney problems. Women with CKD may also face with more problems with pregnancy, causing increased risk to the mother and the child. Even women without CKD may be at risk during both pregnancy as well as birth because of pre-eclampsia and other problems, which collectively increase the blood pressure and put a strain on the kidneys. Hence, the prenatal care is crucial for all pregnant women for this reason. Pre-eclampsia and high blood pressure when pregnant can lead to kidney failure and the risk for CKD later in life.

Pregnancy-related kidney complications: both Acute Kidney Injury (AKI) and preeclampsia

(PE) may lead to the advancement of CKD. Preeclampsia is a complication of pregnancy, which is caused due to placental insufficiency or maternal factors/diseases, and leading to high blood pressure and kidney damage in the mother. Not only it poses threats on the maternal health, but is also associated with the intra-uterine and peri-natal death, pre-term delivery and restricted intra-uterine growth.

Any kind of pre-existing kidney disease in the mother has a negative effect on the pregnancy and may pose a threat to the health of mother and the fetus. There is an increase chance of adverse pregnancy outcomes in women with CKD, including preeclampsia, AKI, CKD progression, spontaneous abortion, stillbirth, malformations, and other long-term issues.

Jean Shinoda Bolen had aptly said, “When you recover or discover something that nourishes your soul and brings joy, cares enough about yourself to make room for it in your life.” Ladies, you need to make a room for the wellbeing of your kidney.

A WHO study reveals that a thousand women die every day because of the consequences of pregnancy and childbirth. Dr. Ranjana Sharma, Senior Consultant, Obstetrician & Gynecologist, Indraprastha Apollo Hospitals, New Delhi, shared that stress can lead to the problems with delivery. “When a mother goes into labour, if she is stressed then it is not good for a normal delivery. The labour lasts for hours, if the mother is stressed out, it may interfere with a normal delivery. But there is no evidence to suggest that if the mother is stressed then the baby will be abnormal.”Stress can lead to the development and dependence on the habits of smoking and drinking.

Dr. Gayatri Despande, Consultant Genealogist, Nanavati Super Speciality Hospital describes, “...As soon as you have a confirmatory test of the pregnancy you must consult a gynaecologist to know what is right and wrong for your baby’s health and you.”

Here are 5 take aways of keeping the kidney healthy.

Next time when you see a woman placing her hands on the sides of the waist, it might not necessarily be for her periods or backpain, but crucially it can be for some problems with her kidney even. Take care of your kidney, before time runs out.