SAVE YOUR KIDNEYS BEFORE

TOO LATE !!!!

Issued in public interest by

Dr. Rajan Ravichandran,

MD, FACP(USA), FRCP(EDIN)

Director, MIOT Institute of Nephrology, Chennai 600 089

(Mg Trustee, Balaji Medical and Educational Trust)

What is Chronic Kidney Disease (CKD)?

The word Chronic refers to a disease which has been present for more than 6 months in the body.
Often it indicates, the disease is progressive and irreversible. But, if it is detected early, the
progression can be stopped or the disease can be reversed. So, a longstanding reduction in kidney
function is called Chronic Kidney Disease (CKD).

What are the causes of Chronic Kidney Disease(CKD)?

The two most important causes are Diabetes and High Blood Pressure. There are other causes
like allergic disorders, drugs, heavy metals, genetic disorders etc. Since Diabetes and Blood
Pressure are the most leading causes, every diabetic or hypertensive should check the urine for
Albumin atleast once a year.

Who is a Diabetic?

Anybody who has the following values present on 2 occasions is a diabetic:

⇒ Fasting Blood Sugar more than 126 mg% or
⇒ Random Blood Sugar more than 200 mg% or
⇒ Blood Sugar 2 hrs after 75 grams of glucose (PP) more than 200 mg%
The normal Blood Sugar fasting should be less than 110 mg% and Post Prandial (PP) should be less
than 140 mg%. If the Blood Sugar value falls in-between these values, then the person is called Pre-
Diabetic.

Diabetes is a Chronic Disease where there is insufficient insulin production or utilisation. This leads
to long term complications involving the Heart, Kidneys, Eyes, Nerves etc.
Who has High Blood Pressure?

An adult more than the age of 20 years, who has a Systolic Blood Pressure of equal or more than 140
mm of mercury and a Diastolic BP of equal or more than 90 mm of mercury on two occasions when
recorded in a relaxed sitting position is considered hypertensive.

A person with Systolic Blood Pressure between 120 and 139 or Diastolic Blood Pressure between 80
and 89 is considered pre-hypertensive and has to be periodically watched for hypertension in future.

Why is Chronic Kidney Disease (CKD) without symptoms?

It is possible to pass normal quantity of urine inspite of the kidneys chronically damaged, since about
180 litres of ultrafiltrate is formed in the kidneys. So, even when 90% of kidneys are damaged, there
can be a normal urine output. Disease of the kidneys often do not produce urinary symptoms when
chronic. The body also adapts when a disease is chronic.

How can you detect CKD early?

More than 80% of kidney diseases can be detected by estimating the urinary protein loss.

Other basic test to detect kidney disease:

Blood Urea and Serum Creatinine estimations

This is a blood test which can be done without a fasting state.

The normal blood urea level varies from 20 to 50 mg%. The
normal serum creatinine values range from 0.6 to 1 mg%.

Once you detect CKD, what can you do?

Once the disease is detected at an early stage, it is possible to arrest or reverse the disease. Good
control of diabetes and Blood Pressure, lifestyle and diet modifications are important. Now drugs
are available to arrest protein loss in the urine and prevent further progression of CKD.

For more information, please visit www.sugarbp.org