The prevalence of kidney failure and its major risk factors including chronic kidney disease (CKD) are increasing worldwide and most rapid growth is observed in low and middle income countries. The corresponding increase in the burden of kidney failure in Kashmir is a major challenge for health systems due to growing demand for expensive kidney replacement therapies such as dialysis. Dr Masood Rashid, Critical Care Expert with J&K Health department, in an interview with Rising Kashmir’s Health Correspondent M Peerzada talks about the scenario of kidney issues in valley and the way forward.
What are the primary causes of kidney and liver failures in Kashmir?
Diabetes, Hypertension, Hyperuricemia, chronic use of non-steroidal anti-inflammatory drugs (NSAIDs) can cause kidney diseases similarly fatty liver, infective pathologies like hepatitis B and C can lead to chronic liver disease.
What is the role of uncontrolled diabetes and hypertension in contributing to kidney failures among elders?
Uncontrolled diabetes and uncontrolled hypertension can deteriorate kidney functions more quickly and severely in elderly populations. CKD is more commonly seen in patients with uncontrolled blood sugar levels and uncontrolled blood pressures due to tissue damage.
How is misuse of painkillers and self-medication affecting kidney health?
Self-medication is always harmful. Chronic use of NSAIDS and other nephrotoxic drugs can lead to nephrotoxicity.
How prevalent are autoimmune and congenital factors in kidney failures compared to lifestyle-related causes?
Autoimmune diseases are more prevalent in the female population as compared to male population. 3 percent of people suffer from autoimmune diseases where the body develops antibodies against its own tissues. People suffering from autoimmune diseases are also prone to develop kidney diseases which also depend upon the autoimmune disease type and other comorbid factors.
What is causing the increasing number of liver failure cases, and how is fatty liver disease contributing to this trend?
Chronic liver disease (CLD) is again the end result of various infective and non-infective conditions including fatty liver, untreated chronic hepatitis B and C, autoimmune pathology and other diseases. Non alcoholic fatty liver disease (NAFLD) and Non-alcoholic steatohepatitis (NASH) if not treated can lead to chronic liver disease and ultimately liver failure.
Could you explain the growing concern around Hepatitis B and C, and their link to liver failure if left untreated?
Rising trend of hepatitis C and B infection in our population is worrisome especially if left untreated. Infection rate is high among IV drug abusers due to use of infected syringes for IV drug injection. Unhygienic dental and surgical practices can also lead to hepatitis B and C infections.
What are warning signs of kidney problems that people in Kashmir should be aware of?
Regular check-up and kidney/liver panels/investigations can detect liver and kidney diseases in high risk populations. Swelling in feets, puffy eyes, skin changes, gum bleeding after brushing, urinary symptoms, loss of appetite, itching, dizziness, distaste for smoke can be the symptoms of such diseases.
How can the health system in Kashmir better address the rising trend of diseases affecting kidneys and liver?
Health care authorities have to play a major role in such diseases. Preventive measures are always better for good outcomes. Public awareness regarding hygienic practices, harmful effects of self-medication, healthy and balanced diet, lifestyle modification practices, early diagnosis and treatment of disease, promotion of clinical research. There should be free medication for hepatitis B and C and the fatty liver should not be ignored.
What steps can people take to prevent kidney and liver damage, especially in high-risk groups like diabetics or those with hypertension?
Patients with diabetes and hypertension should not ignore such diseases. Uncontrolled diseases can lead to quick deterioration of organ functions and target organ damage. At times multimodal therapy is needed to control disease.
Is there enough public awareness of proper treatments, such as physiotherapy or safer pain management alternatives, in Kashmir?
Public awareness is needed for alternative pain management modalities. Chronic use of NSAIDs is not safe for kidneys and other body organs. Alternate treatment modalities like never blocks and physiotherapy are better options.
Are kidney failures potentially preventable?
Kidney failure is potentially preventable not just through primary prevention of risk factors for kidney disease such as hypertension and diabetes, but also by timely management of established CKD.
Among people with established or incipient kidney failure, there are three key treatment strategies: conservative care, kidney transplantation, and dialysis, each of which has its own benefits. Joining up effective preventive care for people with or at risk for milder forms of CKD with all 3 therapies for kidney failure (and developing synergistic links between the different treatment options) is termed “integrated kidney care” and has potential benefits for patients, families, and providers.
In addition, because integrated kidney care implicitly considers resource use, it should facilitate a more sustainable approach to improving the health of people with kidney failure than providing one or more of its components separately.
Why is preserving kidney function essential for maintaining overall health, and what factors contribute to poor kidney health?
The kidneys are vital organs responsible for filtering waste products from the blood, regulating blood pressure, producing hormones, and maintaining electrolyte balance. When kidneys malfunction or fail, waste products and fluids can build up in the body, leading to serious health complications such as CKD, kidney stones, infections, and eventually, kidney failure.
Poor kidney health is often linked to lifestyle factors such as high blood pressure, diabetes, obesity, and smoking. Additionally, certain genetic and environmental factors can increase the risk of developing kidney diseases. Given the crucial role kidneys play in overall health, preserving their function is essential for leading a long and healthy life.
