Are Your Kidneys, OK?

World Kidney Day, is observed on the second Thursday of March every year. This year on 13^th march 2025 world kidney day is celebrated and aims to raise awareness about the need for routine kidney health testing. The campaign focuses on early detection, urging more people to get tested before symptoms appear. The importance of the approach is that kidney disease often progresses silently, making widespread screening strategy pivotal in reducing preventable complications and mitigate the rapid progression of disease.

Who Should Get Their Kidneys Tested?

In a significant number of individuals kidney disease develops without noticeable symptoms, making regular testing essential for those at higher risk. Testing is particularly important for:

• People with diabetes or high blood pressure – being the causal risk factor in around 60% of kidney disease worldwide. High blood sugar and elevated blood pressure can gradually damage the kidneys, often without symptoms in the early stages. Routine screening helps detect changes before significant harm occurs.
• Individuals with a family history of kidney disease – Genetic factors can increase susceptibility to kidney problems. Those with close relatives affected by kidney disease should undergo regular check-ups.
• People with heart disease or a history of stroke – The heart and kidneys are closely linked. Poor heart function can reduce blood flow to the kidneys, increasing the risk of kidney disease.
• Those over 60 years old – Kidney function declines naturally with age, making older adults more vulnerable to kidney-related complications. Routine testing helps in early detection and management.
• Individuals who are overweight or obese – Excess weight increases the risk of high blood pressure, diabetes, and metabolic disorders, all of which can affect kidney function.
• People with recurrent kidney infections or kidney stones – Frequent infections or blockages can cause long-term damage, leading to a decline in kidney function over time.
• Individuals taking long-term medications that affect the kidneys – Certain painkillers, antibiotics, and other medications can strain the kidneys when used for prolonged periods. Regular testing helps monitor kidney health in such cases.
• Even those without these risk factors may benefit from occasional testing, as early detection remains the most effective way to prevent kidney-related complications.

How can we Assess our Kidney Health?

Kidney function tests help detect problems early, even before symptoms appear.

Blood Tests

The serum creatinine test measures the level of creatinine, a waste product that the kidneys should filter out. High creatinine levels may indicate reduced kidney function. The blood urea nitrogen (BUN) test measures urea levels, which can rise if the kidneys are not filtering waste efficiently.

Urine Tests

The albumin-to-creatinine ratio (ACR) detects small amounts of albumin in urine. Protein leakage may be an early sign of kidney disease, particularly in those with diabetes or high blood pressure. A general urinalysis can also identify abnormalities such as blood, excess protein, or white blood cells, which may indicate infection or kidney problems.

Imaging Tests

A kidney ultrasound provides a clear picture of kidney size, shape, and structural abnormalities, such as cysts, stones, or blockages. In some cases, a CT scan or MRI may be required for a more detailed view of the kidneys, especially if a tumour or severe damage is suspected.

Kidney Biopsy

In certain cases, a kidney biopsy is performed to diagnose specific kidney diseases. A small sample of kidney tissue is examined under a microscope to assess the extent of damage or disease.

Additional Tests

An electrolyte panel checks sodium and potassium levels, which the kidneys help regulate. The Cystatin C test is sometimes used as an alternative to creatinine-based kidney function tests, particularly for detecting mild declines in kidney function.

What Can Be Done to Maintain Kidney Health?

Keeping the kidneys healthy is essential for overall well-being. Several lifestyle changes and preventive measures can help protect kidney function and reduce the risk of kidney disease.

Stay Hydrated

Drinking enough water helps the kidneys flush out toxins and maintain proper function. Dehydration can strain the kidneys and increase the risk of kidney stones. Aim for an adequate daily intake of fluids, adjusting based on climate, activity level, and health conditions.

Follow a Balanced Diet

A diet rich in fruits, vegetables, whole grains, and lean proteins supports kidney health. Reducing salt intake helps prevent high blood pressure, a major risk factor for kidney disease. Processed foods, excessive sugar, and unhealthy fats should be limited to avoid unnecessary strain on the kidneys.

Monitor Blood Pressure and Blood Sugar Levels

High blood pressure and diabetes are leading causes of kidney disease. Keeping blood pressure within a healthy range and managing blood sugar levels through diet, exercise, and medication can help protect the kidneys from damage.

Exercise Regularly

Physical activity helps maintain a healthy weight, improve heart health, and regulate blood pressure, all of which benefit kidney function. Moderate exercise, such as walking, swimming, or cycling, can be incorporated into daily routines.

Avoid Smoking

Smoking reduces blood flow to the kidneys, increasing the risk of kidney disease. Quitting smoking can help maintain kidney function.

Limit Overuse of Painkillers and avoid self-medication

Frequent use of Analgesics like non-steroidal anti-inflammatory drugs (NSAIDs) and certain medications can harm the kidneys over time. Consulting a doctor before long-term use of painkillers or supplements is important, especially for those with existing kidney concerns.

Dr Hilal Ahmad Malla (Consultant nephrologist, Paras Health Srinagar)