Q & A

A: Dear Jonathan,

Kidney stones occur when mineral salts crystallise in the kidneys. Tiny crystals pass out of the body in urine but the larger stones cause a back-up of urine in the kidneys, ureter and the bladder, causing pain.

Untreated kidney stones might indeed increase the risk of kidney failure, causing blockage in blood urine flow. This can eventually result in a dilated kidney with minimal function.

However, the percentage of kidney failure related to kidney stone is small compared to diabetes and hypertension. In addition, kidney stones usually cause pain, hence are very seldom left untreated till its deterioration to kidney failure. Kidney stones usually cause damage to one kidney and kidney failure, also known as End-Stage Renal Disease (ESRD) happens only when both kidneys do not function properly.

There is also the likely occurrence of “silent” stones, which cause no pain and symptoms. They are often left untreated for long months to years, occasionally leading to kidney damage. One in 10 people will develop kidney stones at some stage of their lives. It is best to prevent them by drinking 2 to 3 liters of water, reduce the consumption of oxalate-rich foods like spinach, chocolate, nuts, tea, soya products, berries and salt and increase calcium intake. Specific measures to treat kidney stones, depend on the type of kidney stones. It is important to do a chemical analysis of the stone. Prevention is always better than cure as the saying goes.

A: Dear Pravin,

Back pain is not usually a symptom of most types of kidney disease. When kidneys become distended due to blockage of the flow of urine or become infected, it may produce pain. Severe pain may also occur with the presence of kidney stones, especially when the stones move down the ureter. Other causes of back pain also include muscle pain or diseases of the spine.

The term kidney disease does not equate to kidney failure. We say kidney failure only when the functions of the kidneys are compromised and are unable to maintain normal composition of the body fluids which will most likely result in the accumulation of toxins in the body.

Symptoms of kidney failure can vary between different people. Do look for other symptoms:

  • Decreased urination
  • Nausea and vomiting
  • Swollen hands and ankles
  • Puffiness around the eyes
  • Itching
  • Sleep disturbances
  • High blood pressure
  • Loss of appetite

A: Dear James,

Taking statins (medication that blocks the action of an enzyme in the liver that helps produce cholesterol) does not mean you can ignore advice about a cholesterol-lowering diet. There are people who have the misconception that their medication will undo any cholesterol overload, regardless of what they eat. Even while you are on medication, it is important that you watch your diet, especially saturated fat.

A: Dear Indra,

Not everyone with kidney disease needs dialysis. Kidney disease is a general term to describe a wide range of kidney abnormalities. Kidney disease can occur without kidney failure. Chronic kidney disease is a progressive disease. In its early stages, it is usually managed with diet and medication. With this approach, most people can slow or stop the progression of kidney disease and enjoy a normal lifestyle. That is why, it is important to find and treat kidney disease early. Dialysis or a kidney transplant is only needed if your kidney disease gets worse and progresses to kidney failure.

Dear Keith,

Yes, there are tests and procedures for kidney disease diagnosis. The tests include Serum Creatinine which is a key indicator to determine how well the kidneys are functioning and Urine Analysis to find out how much albumin (a type of protein) is in the urine as having too much protein is an early sign of kidney damage. Kidney disease is a progressive disease and there are five Chronic Kidney Disease (CKD) stages. The glomerular filtration rate (GFR) will determine what stage of kidney disease the person is at (see diagram at NKF’s website). You may require additional blood tests and screening depending on your condition.

In its early stages, it is usually managed with diet and medication. With this approach, most people can slow or stop the progression of kidney disease and enjoy a normal lifestyle. Those with medical or family history of diabetes, cardio-vascular disease including hypertension, stroke, obesity or kidney disease are at higher risk of kidney failure. Hence, it is important for one to go for regular health screenings and to consult one’s general practitioner or healthcare provider who will be able to advise on the necessary course of action where needed.

Find out more here

Dear Fatimah,

A kidney transplant offers best long term survival and quality of life. It is the most optimal solution to kidney failure. The transplanted kidney can substitute almost fully the lost functions of the failed kidneys and it usually begins to function right away, thus allowing the patient to lead a normal life. With a new lease of life, the patient no longer faces day-to-day restrictions due to having to undergo dialysis for the rest of his or her life.

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