Overhydration Could Harm Kidneys: Nephrologist

World Kidney Day is celebrated to raise awareness about kidney diseases and their impact on global health. It's observed on the second Thursday of March every year, and its main goal is to highlight the importance of kidney health and the prevention of kidney disease. As the saying goes, "prevention is better than cure," but it’s a concept that’s often difficult to follow. That’s why this day is so important – it brings attention to the need for early detection and prevention of kidney diseases, encouraging people to take their health seriously before it's too late.

Every year, there is a new theme to focus the awareness efforts. This global event is so crucial because kidney disease can be silent for a long time, so by the time symptoms appear, the disease might already be advanced. Awareness and regular testing can make a huge difference in early diagnosis and treatment.

Kidney diseases are quite varied. As nephrologists, we deal with all types of kidney diseases, including acute and chronic conditions. Acute kidney problems can happen suddenly and, with proper treatment, they may be reversible. On the other hand, chronic kidney diseases, often caused by conditions like diabetes and hypertension, develop over time and are typically irreversible.

Other common kidney issues include kidney stones, infections, and diseases related to the kidney's many functions such as fluid management, blood pressure regulation, and electrolyte balance. Kidney dysfunction can result in symptoms like swelling, fatigue, nausea, and even difficulty breathing in advanced stages.

Unfortunately, kidney diseases are often "silent" in the early stages. By the time people notice symptoms like swelling, fatigue, or nausea, kidney damage has usually progressed significantly, often beyond 70%. That's why early detection is so important. If there is swelling, especially in the legs, and symptoms like feeling tired, loss of appetite, or nausea, it might be an indication that kidney function is compromised. However, these are usually late-stage signs, so regular screening is essential for those at risk.

Chronic kidney disease is most often caused by diabetes and high blood pressure. In fact, diabetes alone accounts for about 50-60% of patients on dialysis. Other causes include genetic conditions, kidney stones, recurrent infections, and autoimmune diseases where the immune system damages the kidneys. Kidney disease can also be congenital, meaning people are born with kidney problems. It's important to manage these underlying conditions to prevent kidney damage.

Diabetes and high blood pressure can damage the kidneys over time. If these conditions are poorly controlled, they can lead to the gradual breakdown of kidney function. Not everyone with diabetes or hypertension will develop kidney disease, but if these conditions are left unmanaged, the risk of kidney damage increases significantly. Regular monitoring and maintaining a healthy lifestyle can help prevent kidney damage in individuals with these conditions.

Yes, absolutely. Both genetics and lifestyle play major roles. Lifestyle diseases like obesity, hypertension, and diabetes are heavily influenced by our daily habits, including diet, exercise, and stress management. Genetics also play a role in how these conditions manifest, especially in populations like Indians, who are genetically predisposed to certain lifestyle diseases. The combination of poor lifestyle habits and genetic susceptibility can significantly increase the risk of kidney disease.

The most important thing people can do is maintain a healthy lifestyle. This includes regular exercise, a balanced diet, and managing conditions like diabetes and hypertension. Avoiding over-the-counter painkillers or weight loss supplements without a doctor's advice is also crucial, as these can harm the kidneys. People should also stay hydrated, but not overdo it, as excessive water intake can strain the kidneys. Regular health check-ups, especially for those at risk, are essential for early detection.

Diet plays a critical role in kidney health. A healthy diet, especially one that limits excessive salt and animal protein, is important for kidney function. While people with advanced kidney disease may need more restrictive diets, most people should focus on eating a balanced diet with plenty of fruits, vegetables, and plant-based proteins. For those with kidney disease, vegetarian proteins are usually safe, while high levels of animal protein can place additional strain on the kidneys.

Hydration is important but needs to be balanced. A healthy intake of water is typically between 1.5 to 2.5 liters a day for most people. Too little or too much water can both be harmful, especially for people with existing kidney or heart problems. In cases of kidney stones or recurrent infections, higher fluid intake is often recommended, but it should always be tailored to the individual’s needs and health status.

Excess salt and protein intake can put stress on the kidneys. The kidneys work hard to filter and excrete these substances, and over time, this can lead to kidney damage. A diet high in salt and animal protein increases the workload on the kidneys, potentially causing them to become fatigued. This kind of damage accumulates over the long term, which is why it's important to avoid excessive salt and animal fats in your diet.

Treatment for kidney disease depends on the stage and type of disease. Acute kidney problems can be reversed with proper care, but chronic kidney disease is usually progressive. While we cannot reverse chronic kidney damage, we can slow down its progression with medications and lifestyle changes. In advanced stages, dialysis or kidney transplantation may be required. The goal is to control the disease and prevent it from progressing too quickly.

One common myth is that drinking excessive amounts of water is always beneficial for kidney health. This isn't true; overhydration can actually be harmful. Another myth is that strict diets can cure kidney disease – while diet plays a role in managing kidney health, it won’t reverse kidney damage. Also, some people believe that Ayurvedic or alternative medicines can cure kidney disease, but unfortunately, there’s no cure for chronic kidney disease once it's advanced. It's important to stick to proven treatments and consult a doctor regularly.

People at risk, such as those over 40, diabetics, those with hypertension, or those with a family history of kidney disease, should get tested at least once a year. Early detection through simple tests like checking protein in urine, creatinine levels in blood, and monitoring blood pressure can catch kidney disease early, preventing progression.

On World Kidney Day, I want to stress the importance of early testing. Simple tests like checking for protein in urine and measuring creatinine levels in blood can help identify kidney issues early, even before symptoms appear. If you're at risk, getting tested annually can make all the difference in maintaining good kidney health. Remember, prevention is better than cure. Stay healthy, stay aware, and take action early.