Women and Chronic Kidney Disease (CKD)

Chronic Kidney Disease (CKD) is a worldwide public health problem with adverse outcomes of kidney failure and premature death. CKD affects approximately 195 million women worldwide and it is currently the 8th leading cause of death in women, with close to 600,000 deaths each year.

The risk of developing CKD is at least as high in women as in men, and may even be higher. According to some studies, CKD is more likely to develop in women compared with men, with an average 14% prevalence in women and 12% in men. However, the number of women on dialysis is lower than the number of men. At least three major reasons are recognized so far: CKD progression is slower in women compared to men, psycho-socioeconomic barriers such as lower disease awareness lead to late or no start of dialysis among women and uneven access to care is a major issue in countries with no universal access to healthcare. Kidney transplantation is also unequally spread, mostly due to social, cultural and psychological aspects: even in some countries that provide kidney transplantation and equitable treatment for men and women, women tend more often to donate kidneys and are less likely to receive them.

There is indeed a clear need to address issues of equitable healthcare access for women where it is currently lacking and increase awareness and education to facilitate women’s access to treatment and better health outcomes. 

Lupus Nephropathy & Kidney Infection

Some kidney diseases, such as lupus nephropathy or kidney infection (acute or chronic pyelonephritis) typically affect women. Lupus nephritis is a kidney disease caused by an autoimmune disease, which is a disorder in which the body’s immune system attacks the own cells and organs. Pyelonephritis is a potentially severe infection that involves one or both kidneys. Kidney infections (as most urinary tract infections) are more common in women and the risk increases in pregnancy. To ensure good results, as most renal diseases, diagnosis and treatment should be timely.

Kidney Disease & Pregnancy

CKD is also considered a risk factor for adverse pregnancy outcome and reduced fertility. Women who have CKD are at increased risk for negative outcomes for the mother and the baby; pregnancies in women with advanced CKD are most challenging with high rates of hypertensive disorders and preterm births. They may have reduced fertility but conception is possible, even if infrequent, on dialysis. On dialysis, results improve with intensive (daily or nearly daily) dialysis treatment, thus calling for dedicated programs for women of childbearing age.

In successfully transplanted women, fertility can be restored and chances of successful birth increase. However, as complications are observed more often than in the general population, preconception medical counseling should always be sought. There is a clear need for higher awareness on CKD in pregnancy, to timely identify CKD in pregnancy, and to follow-up women with CKD during and after pregnancy. In this respect, pregnancy may be also a valuable occasion for early diagnosis of CKD, thus allowing planning of therapeutic interventions.

In turn, pregnancy-related complications increase the risk of kidney disease: pre-eclampsia, a syndrome in which a defect of the implantation of the placenta affects normal kidneys inducing hypertension and proteinuria, is one of the 3 leading causes of maternal mortality. Preeclampsia, septic abortion (infection of the placenta) and post-partum haemorrhage (major bleeding after giving birth) are leading causes of acute kidney injury (AKI) in young women, and may herald future CKD in survivors.

The burden of those maternal complications is particularly high for women in developing countries, due to insufficient access to universal and timely prenatal care, to improper management of women with preeclampsia, and to lack of availability of dialysis for severe AKI.

There is a clear need for higher awareness, timely diagnosis and proper follow up of CKD in women, especially during pregnancy. In fact, pregnancy may be a valuable occasion for early diagnosis of CKD, allowing planning of therapeutic interventions.

Listen to Consultant Nephrologist, Dr. Archan Sumsher Rana to learn about Kidney Disease in Context of Nepal https://www.youtube.com/edit?o=U&video_id=InNSHHN_mFU

WHAT YOU CAN DO TO SAVE YOUR BEANS?

Kidney diseases are silent killers, which will largely affect your quality of life. There are however several easy ways to reduce the risk of developing kidney disease.

Keep fit and active

Keeping fit helps to reduce your blood pressure and therefore reduces the risk of Chronic Kidney Disease.

Keep regular control of your blood sugar level

About half of people who have diabetes develop kidney damage, so it is important for people with diabetes to have regular tests to check their kidney functions. Kidney damage from diabetes can be reduced or prevented if detected early. It is important to keep control of blood sugar levels with the help of doctors or pharmacists, who are always happy to help.

Monitor your blood pressure

Although many people may be aware that high blood pressure can lead to a stroke or heart attack, few know that it is also the most common cause of kidney damage.

The normal blood pressure level is 120/80. Between this level and 139/89, you are considered pre-hypertensive and should adopt lifestyle and dietary changes. At 140/90 and above, you should discuss the risks with your doctor and monitor your blood pressure level regularly. High blood pressure is especially likely to cause kidney damage when associated with other factors like diabetes, high cholesterol and Cardio- Vascular Diseases.

Eat healthy and keep your weight in check

This can help prevent diabetes, heart disease and other conditions associated with Chronic Kidney Disease.

Reduce your salt intake. The recommended sodium intake is 5-6 grams of salt per day (around a teaspoon). In order to reduce your salt intake, try and limit the amount of processed and restaurant food and do not add salt to food. It will be easier to control your intake if you prepare the food yourself with fresh ingredients.

Maintain a healthy fluid intake

Although clinical studies have not reached an agreement on the ideal quantity of water and other fluids we should consume daily to maintain good health, traditional wisdom has long suggested drinking 1.5 to 2 liters (3 to 4 pints) of water per day.

Consuming plenty of fluid helps the kidneys clear sodium, urea and toxins from the body, which, in turn, results in a “significantly lower risk” of developing chronic kidney disease, according to researchers in Australia and Canada. The findings, the researchers said, do not advocate “aggressive fluid loading”, which can cause side effects, but they do provide evidence that moderately increased water intake, around two liters daily, may reduce the risk of decline in kidney function. It’s important to keep in mind that the right level of fluid intake for any individual depends on many factors including gender, exercises, climate, health conditions, pregnancy and breast-feeding. In addition, people who have already had a kidney stone are advised to drink 2 to 3 liters of water daily to lessen the risk of forming a new stone.

Do not smoke

Smoking slows the flow of blood to the kidneys. When less blood reaches the kidneys, it impairs their ability to function properly. Smoking also increases the risk of kidney cancer by about 50 percent.

Do not take over-the-counter pills on a regular basis

Common drugs such non-steroidal anti-inflammatory drugs like ibuprofen are known to cause kidney damage and disease if taken regularly.

Such medications probably do not pose significant danger if your kidneys are relatively healthy and you use them for emergencies only, but if you are dealing with chronic pain, such as arthritis or back pain, work with your doctor to find a way to control your pain without putting your kidneys at risk.

Get your kidney function checked if you have one or more of the ‘high risk’ factors.

Source: World Kidney Day (http://www.worldkidneyday.org/)