It is a sobering statistic —at least one in 10 of 26 million Malaysians suffers from chronic kidney disease and many more are at increased risk. Nephrologist Dr RAFIDAH ABDULLAH says early detection can help in the
battle against the disease

BETWEEN 2,500 and 3,000 new patients are diagnosed to have end stage renal failure (kidney failure) every year in Malaysia.

At the end of 2006, there were 14,647 patients undergoing dialysis, according to the National Renal Registry.

Early detection can prevent the progression of kidney disease to kidney failure, hence the importance to raise awareness of the disease.

Three simple tests can detect CKD -- blood pressure, urine albumin and serum creatinine.
The two main causes of kidney failure in Malaysia are diabetes and high blood pressure, which are responsible for up to two-thirds of the cases.

Other causes are inflammation of the kidneys, renal stone disease, toxins and those who "inherited" the disease.



In addition to removing bodily waste and fluid from the body, kidneys perform these other important jobs, such as:

- Regulate body water and other chemicals in your blood, such as sodium, potassium, phosphorus and calcium;

- Remove drugs and toxins introduced into the body; and

- Release hormones into the bloodstream to help the body regulate blood pressure and make red blood cells and promote strong bones.

Chronic kidney disease includes conditions that damage your kidneys and decrease their ability to perform their function.

If the kidney disease gets worse, waste can build to high levels in the blood and make you sick.

You may develop complications like high blood pressure, anaemia (low blood count), weak bones, poor nutritional health and nerve damage.

Kidney disease increases your risk of having heart and blood vessel disease. These problems may happen slowly over a long period of time.

Chronic kidney disease may be caused by diabetes, high blood pressure and other disorders. Early detection and treatment can often keep chronic kidney disease from getting worse.

When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a kidney transplant to maintain life.



The two main causes of chronic kidney disease are diabetes and high blood pressure.

Diabetes happens when your blood sugar is too high, causing damage to many organs in your body, including the kidneys, heart, blood vessels, nerves and eyes.

High blood pressure, or hypertension, occurs when the pressure of your blood against the walls of your blood vessels increases.

If uncontrolled, or poorly controlled, high blood pressure can be a leading cause of heart attacks, strokes and chronic kidney disease.

Chronic kidney disease can also cause high blood pressure.

Other conditions that affect the kidneys are:

- Glomerulonephritis: A group of diseases that causes inflammation and damage to the kidney's filtering units. These disorders are the third most common type of kidney disease;

- Inherited diseases: Example includes polycystic kidney disease, which causes large cysts to form in the kidneys and damage the surrounding tissue;

- Malformations: These occur as a baby develops in its mother's womb. For example, a narrowing may occur that prevents normal outflow of urine and causes urine to flow back up to the kidney. This causes infections and may damage the kidneys;

- Lupus and other diseases: These affect the body's immune system;

- Obstructions: These are caused by problems like kidney stones, tumours or an enlarged prostate gland in men;

- Repeated urinary infections.

Most people may not have any severe symptoms until their kidney disease is advanced. However, you may notice that you:

- tire easily and have less energy;

- have trouble concentrating;

- have a poor appetite;

- have trouble sleeping;

- have muscle cramps at night;

- have swollen feet and ankles;

- have puffiness around your eyes, especially in the morning;

- have dry, itchy skin;

- need to urinate more often, especially at night.

Dr Rafidah Abdullah is a consultant nephrologist at Hospital Selayang