Monday, June 5, 2023

“In chronic kidney disease, early diagnosis is key, otherwise everything becomes very complicated”

Health workers agree on the main message about chronic kidney disease (CKD): it is necessary to detect it in its onset, to treat it in time and to avoid dialysis or kidney transplantation. However, despite the efforts of doctors to refer to the pathology as a cure, there is a great ignorance among the population about this condition, and as a result there are people who have it and do not know it. In Spain, 15% of the adult population suffers from some type of CKD. It is the tenth leading cause of mortality in Europe and is expected to become the fifth in the world by 2040. Because of excess blood sugar, people with type 2 diabetes are at high risk of developing it.

Dr. Maria Soler, nephrologist and group leader of Nephrology and Renal Transplantation at the Vall d’Hebron Hospital, spoke in this way to explain all the risks of the disease and to raise awareness of the magnitude of the problem.

When will CKD appear?

Chronic kidney disease occurs when the kidneys stop working properly. Its main purpose is to spread the blood and to clean, cut, through the urine all the body does not need. When the kidney’s glomerular filtration rate drops below 60 milliliters per minute and/or it eliminates more protein in the urine than it should, that’s when it’s CKD.

Like Dr. Soler explains, the people most likely to suffer from CKD are those with type 2 diabetes, specifically one in four. But not unless. Soler also mentions people over 60, people with high blood pressure, obesity, cardiovascular problems (those who have had a heart attack or stroke) or patients in the family with kidney failure.

“A person with type 2 diabetes has increased blood sugar (glucose), which causes the main structure of the kidney, the nephron, to hypertrophy and work more than it should and run faster. That’s when a certain type of CKD appears,” says the nephrologist.

For this reason, a doctor may assume that there are more chances that someone will develop some type of CKD compared to someone who does not have diabetes.

first detection

The doctor insists on the importance of regular tests for all those who are at risk, but especially with type 2 diabetes.” All you need is a blood test and a urine test, a very simple and cheap test”, insists Soler.

“If it’s diagnosed early, it’s easier to treat and reduce the risk of mortality,” he says.

In the event that the disease is detected quickly, the treatment will be through drugs that, since 2015, have demonstrated their effectiveness in slowing down the progression of the pathology. In this way, dialysis and kidney transplantation can be avoided, two very aggressive possibilities for the patient’s physical and emotional health.

the smallest signs

Soler warns that the symptoms of a patient with some type of CKD come when the disease is very advanced and very subtle and inaccurate.

“Whipping, desire in the middle of the night, nausea, anemia or occasional vomiting, can be symptoms. They are so inaccurate that it is very difficult to associate them with CKD, so it comes late for testing,” he laments.

The doctor also highlighted some actions that people at risk can take to prevent CKD. First of all, weight control, avoiding obesity at all times, since it is the cause of many diseases. Control blood pressure, of course sugar, exercise, eat healthy food and do not smoke.

According to Soler, if the population is more aware of the power of this disease and tries to prevent it and undergoes regular repressions, the chances of its occurrence will be greatly reduced.

There are more and more drugs available for CKD that help slow its progression, which is encouraging. But there is still ignorance on the part of society. A more aware society can prevent the growth of CKD.


She is a nephrologist. His professional career began 24 years ago at the Hospital del Mar. However, since 2018 he has worked in the Office of Nephrology of the University of Vall d’Hebron Hospital, where he is also the principal investigator of the Research Institute of the Vall d’Hebron Institute of Nephrology group. VHIR).). In addition, since 2012 he is the editor-in-chief of the Journal of Clinical Kidney, in nephrology.

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