What you should know to take care of your kidneys

In March, World Kidney Day was commemorated, a date that aims to raise awareness in society about the incidence of kidney disease as a global public health problem through the promotion of healthy habits.

According to Dr. Cristian Espinosa, a nephrologist at the Serena del Mar Hospital in Cartagena de Indias, the prevalence of kidney disease in developed countries is 7.2%. In Colombia, according to figures from the High Cost Account, an entity endorsed by the Ministry of Health, approximately 5,346,278 cases of people with hypertension, diabetes, and chronic kidney disease were reported in 2022.

Regarding chronic kidney disease, it is important to clarify that it encompasses a wide range of pathologies whose main characteristic is the deterioration of markers of kidney function. These markers are influenced by both non-modifiable factors such as age, ethnicity, and sex, and modifiable factors such as diabetes management, blood pressure control, uric acid levels, and habits like smoking.

Dr. Espinosa points out that in the last ten years, new medications have been developed that can slow the progression of kidney disease and its most severe stages. Kidney disease has five stages, with the fifth being the most advanced, where patients require renal replacement therapy.

Early Detection

Today, it is recommended that all patients with a risk factor, such as a family history of hypertension or diabetes, undergo active screening with paraclinical tests such as albuminuria and creatinine levels. These tests allow for risk characterization and the development of a strategy for managing the condition and controlling the disease.

Recommendations for Healthy Kidneys

Low salt intake: Scientific evidence shows that reducing salt consumption to a maximum of 3 grams per day improves blood pressure control.

A healthy diet rich in fruits and vegetables.

Quit smoking: Cigarette smoking is considered an independent risk factor for cardiovascular disease and kidney disease.

Drink plenty of fluids

Exercise regularly

Don't self-medicate

Monitor your blood pressure

Check your blood sugar levels

Clearing up doubts and myths

Diet depends a lot on the stage of the disease; not all patients are the same. The basic rule is to avoid high salt intake and drink plenty of fluids.

The leading cause of kidney disease worldwide is diabetes, and the second is hypertension. These conditions must be controlled, and self-medication or discontinuing treatment should be avoided.

Many patients ask if metformin is toxic to the kidneys. It is not. In fact, clinical results from metformin use in populations with type 2 diabetes and moderate chronic kidney disease were associated with fewer cardiovascular complications. These results were published in the journal Annals of Internal Medicine in 2017. However, as the disease progresses to more advanced stages, metformin should be discontinued.

It is false that medications like losartan are harmful to the kidneys. Losartan demonstrated in a clinical trial published more than 20 years ago that it slows kidney disease progression, reduces protein excretion in urine, and decreases cardiovascular complications in patients with type 2 diabetes mellitus. However, in advanced stages of kidney disease, levels of certain substances, such as potassium, should be monitored to determine whether to discontinue or continue treatment. There are some very specific conditions where its use is contraindicated.