Protein In Urine - A Sign Of Kidney Damage

By Zulkiple Ibrahim Based on statistics by the health authorities, the number of Malaysians suffering from end-stage renal failure has increased to more than 12,000, from only about 40 in 1980. This is the first of three articles on Kidney Failure in conjunction with World Kidney Day on March 8. KUALA LUMPUR, March 2 (Bernama) -- According to human physiology, kidneys function to remove toxins and excess water from the blood, apart from helping to maintain blood pressure, produce red blood cells and keep the bones healthy. However, kidneys can be damaged by diabetes, high blood pressure (hypertension), infection and inflammation, as well as stones and cysts in the organs. Other causes of damage have been attributed to prolonged use of pain killers and consumption of alcohol. If kidney damage becomes too severe, the organ will lose its ability to function normally. This is known as end-stage kidney (renal) disease (ESRD), or simply kidney failure. Nephrologists have identified diabetes and hypertension as the leading causes of ESRD, accounting for more than 60 per cent of new cases of dialysis patients in Malaysia. KIDNEY FAILURE According to the National Kidney Foundation (NKF), there are three types of kidney failure -- acute, chronic and end-stage. Acute kidney failure is usually temporary and is reversible. "However, sometimes this type of kidney failure may not respond to treatment and may progress to chronic kidney failure or end-stage kidney failure," says a nephrologist. The nephrologist says when the loss of kidney functions is gradual and progressive, it is known as chronic kidney failure. "Eventually, the kidneys are unable to remove wastes or maintain the body’s salt and fluid balance, resulting in the need to receive dialysis treatment". He says a build-up of creatinine (a waste product normally removed by the kidneys) in the blood will indicate kidney functions and the level of kidney impairment, adding that the risk of chronic kidney failure increases with age. ESRF Health authorities reveal that the number of Malaysians suffering from end-stage renal failure has increased between 1980 and now — from more than 40 in 1980 to more than 12,000 now. Nephrologists believe that the number of registered patients may not reflect the actual situation in the country, as there could be many suffering in silence due to a lack of facilities. Some also could have resorted to traditional or alternative treatment, they say. Nephrology medical officer Dr B.H. Lim says medical authorities believe at least nine out of every 100 Malaysians have diabetes, and at least 40 out of every 100 diabetic patients have kidney disease. "The incidence of kidney failure is rising," he says, adding that there are about 92 new end-stage renal cases per million population, or between 2,000 to 3,000 new cases every year". He says early detection can help prevent kidney failure and this can be achieved only if people check regularly to see if they suffer from kidney disease, particularly those in the high-risk group. "Those with a history of family members having diabetes and kidney failure are also advised to go for medical checks," Dr Lim says. KIDNEY FUNCTION TEST "Everyone should check whether they are at risk for kidney disease. Screening is essential for people considered to be at risk of kidney disease. "The majority of individuals with early stages of CKD go undiagnosed, therefore early detection of kidney impairment is essential and allows suitable treatment before kidney damage or deterioration manifests itself through other complications," he explains. He says kidney diseases develop slowly and the symptoms only appear at a late stage, when the patient already has kidney failure and may even need dialysis. "Of course there is renal replacement therapy (RTT), but this treatment requires burdensome lifestyle changes for the patient and is extremely costly. "A routine test of urine, blood and blood pressure can detect if there are any early signs of kidney problems. The needed laboratory tests are done on samples of blood and urine. When your kidneys are damaged, proteins leaks into your urine. The medical officer says a simple test can be done to detect protein in a person's urine. "Persistent protein in the urine is an early sign of chronic kidney disease. The doctor uses the levels of serum creatinine measured in the blood to calculate the overall kidney function, or Glomerular Filtration Rate (GFR), and monitors your blood sugar to be sure you do not have diabetes. Creatinine is a waste product in the blood that comes from muscle activity. It is normally removed by the kidneys but when kidney function slows down, the creatinine level rises. Dr Lim says the kidney doctor can use the results of the serum creatinine test to calculate the kidney function, or GFR. Glomerular Filtration Rate (GFR) tells total kidney function. The normal level is about 100 ml/min. Dr Lim says if the GFR falls below 60 ml/min, the person will usually need to see a nephrologist. If the treatment from the nephrologist does not prevent a further reduction in GFR, the kidney doctor will explain to the patient about the treatments for kidney failure, such as dialysis or kidney transplant. The 7th World Kidney Day on 8th March 2012 has the theme: "Kidneys for Life", promoting organ donation and transplantation. -- BERNAMA