During my work in the hospital I’m often struck by just how impressive our kidneys are. They do so many things to keep us healthy, from carefully balancing the amount of fluid in our bodies to chucking out all sorts of poisons and even controlling the production of red blood cells.
Kidneys are also remarkably resilient, and although many diseases can affect the kidneys they have a lot of reserve and usually bounce back once the illness is treated.
However, many diseases do eventually take their toll on your kidneys, affecting them long term in what is known as chronic kidney disease. But because your kidneys are very efficient, you will be able to live reasonably well even when they are only working at a fraction of their normal levels.
In the early stages of chronic kidney disease, many people are unaware that they even have a problem. But eventually symptoms appear and other problems develop.
The chance of developing CKD increases with age, mostly because the diseases such as high blood pressure and diabetes that cause it are more common as we age. One in four women and one in five men have some degree of kidney disease by the age of 65.
Chronic kidney disease usually progresses gradually, resulting in symptoms such as poor appetite, nausea, weight loss, swollen ankles, shortness of breath, itchy skin, frequent urination especially
at night, and blood in your urine.
Your blood tests may show a typical pattern, with high levels of chemicals called urea and creatinine, and anaemia, which will confirm your diagnosis. Once you’ve been diagnosed the next step is to try to work out why CKD has developed and whether there are any reversible or treatable factors involved.
There is no cure for chronic kidney disease but some treatments can slow or stop its progression. It’s also vital to follow a healthy lifestyle because this will keep your kidneys working as well as possible.
If CKD becomes very severe, which is known as end-stage renal failure, you may be offered a treatment known as dialysis (an artificial kidney). Dialysis is a major commitment, because it needs to be done several times a week. It doesn’t suit everyone, so many people choose simply to carry on and try to live their best with CKD.
Q. I want to go on a coach holiday but I get terrible motion sickness. What can I do?
Dr Trisha says: Motion sickness is caused when your brain gets conflicting messages – what your eyes see doesn’t match information coming from the balance centre in your inner ear. Add in the frequent jolting around, stuffy atmosphere, noise and traffic fumes and it’s quite astonishing that we manage to travel at all.
Avoid heavy meals, take anti-nausea medicines or try natural remedies such as ginger. Carry a bottle of water to sip and peppermints to suck. Acupressure bands worn around the wrists help some people. Find a seat in the middle of the coach, take a soft pillow to keep your head still and try to keep your eyes fixed on the horizon, or the road ahead. This helps your brain to make sense of movement.
- Dr Trisha writes a column every fortnight in Yours magazine. Ask Dr Trisha about your health problems by emailing firstname.lastname@example.org.