Kidney Failure & Prevention

The kidneys are a pair of bean-shaped organs located at the posterior wall of the abdomen. Each day, the two kidneys excrete about 1.5 to 2.5 litres of urine. In doing so, waste products and excess water are removed from our body.

Our kidneys maintain the body's balance of various salts such as sodium, potassium, calcium, phosphate as well as acid substances. They also release several hormones such as renin, erythropoietin and an activated form of Vitamin D. Renin regulates blood pressure while Erythropoietin stimulates the production of red blood cells in the bone marrow, and activated Vitamin D helps to maintain normal bone structure.

Kidney failure is a condition where the kidneys are incapable of performing its normal functions. This results in toxic substances such as urea and creatinine being accumulated in the body. Blood creatinine level is most often used by doctors as a measure of the degree of kidney failure. Generally, when creatinine level in the blood reaches a level of 900 µmol/L the patient should start on dialysis.

In kidney failure, the volume of water in the body increases, resulting in the swelling of tissues. Excess salt and water retention may cause high blood pressure, swelling of the legs, face and abdomen and breathlessness. As the kidneys fail to excrete phosphate, blood phosphate levels will increase and calcium levels will fall, resulting in bone disease and risk of bone fractures, worsened by the lack of active Vitamin D. Inadequate production of erythropoeitin leads to anaemia.

The most common cause of kidney failure in Singapore is diabetes. Other causes include glomerulonephritis, kidney stones, polycystic kidneys, systemic lupus erythematosus, uncontrolled hypertension and drugs.

In mild kidney failure, no symptoms are present although kidney tests will show some abnormalities. As kidney failure worsens, the patient may experience the following:

  • pale and sallow complexion
  • fatigue
  • shortness of breath
  • body itch
  • poor appetite, sometimes accompanied with nausea and vomiting
  • swelling of the face and legs
  • frequent urination at night or
  • passes little urine

If you are suffering from diabetes and high blood pressure, you belong to the group of people who are at risk of developing kidney failure. Measures can be taken to prevent or delay the progression to kidney failure.

  • Have your blood pressure checked regularly. Uncontrolled high blood pressure can speed up the progression of any underlying kidney disease.
  • If you suffer from diabetes, make sure your blood sugar level is well controlled.
  • Be cautious of taking medications especially painkillers. It is wise to discuss with a doctor or pharmacist before taking it.
  • Certain substances like toxins, pesticides and illegal drugs can also cause kidney damage. There are problems associated with long-term use or abuse of these substances.

If you want to stay healthy, you have to look after yourself and your important organs.

  • Avoid eating sweet and oily food
  • Avoid drinking alcohol
  • Drink more water
  • Prevent or treat diabetes and high blood pressure
  • Eat well-balanced diet
  • Control any infection
  • Go for routine medical check-ups