The second Thursday of March every year, is celebrated as World Kidney Day (WKD). This campaign was started in 2006 and has been there every year with different themes. The theme of World Kidney Day in 2018 was Kidneys & Women’s Health. It was an important issue to highlight. Women play a very integral role in our lives. They are pillars of the community and be it our mothers, sisters, wives or daughters, they are the pillars of our family. As the saying goes ‘A house is made a Home by a lady’. Imagine a day without a lady at home.
Another unfortunate story of our society is that these ladies ignore their health to take care of the family. All she wishes is “mera husband theek rahe”, “mere bacche theek rahe” (let my Husband be healthy and kids be healthy). And very often I come across ladies saying, ‘I am okay, please take care of my family member’. This concept needs to change. All of us should understand that their ill health will be devastating for them, their families and our entire communities.
World Kidney Day (WKD) is celebrated across the globe and the mission of this campaign is to spread awareness about the amazing kidneys. With increasing incidence of Diabetes and Hypertension, the incidence of kidney disorders is increasing and it is estimated that 10% of the world’s population is affected by Chronic Kidney Disease (CKD), and millions die each year because they do not have access to affordable treatment.
The scenario in our country is not different. It has been recently estimated that the age-adjusted incidence rate of End State Renal Disease (ESRD) in India to be 229 per million population (pmp), and more than 100,000 new patients enter renal replacement programs annually in India. On the other hand, because of scarce resources, only 10% of the Indian ESRD patients receive any renal replacement therapy (RRT). Another unfortunate problem with kidney disease is that it remains symptom free for long and when symptoms occur, it is usually too late to intervene. Only early screening and detection of kidney disease help. Individuals who are at risk of developing kidney disease should be screened regularly.
Why Women Get CKD
CKD though more common in males, has a poor outcome in females. Currently it is estimated that CKD is the 8th leading cause of death in women, with close to 600,000 deaths each year. Along with the common causes of CKD like Diabetes, Hypertension, Chronic Painkiller use and certain genetic disorders, there are certain kidney diseases which occur exclusively or more commonly in females.
Kidneys are extremely important organs to keep us healthy. The kidneys not only purify blood, they also help in maintaining blood pressure, regulate our hemoglobin levels and are important for the health of our bones. They also regulate water and electrolytes in our body. Unfortunately, kidneys have remained a neglected organ, as heart and brain diseases take precedence in the global health scenario.
Kidney disease which occur exclusively in female are those related to pregnancy viz. Eclampsia, Preeclampsia, HELLP syndrome and Pregnancy induced hypertension. These disorders not only carry increased maternal mortality, they are also associated with increased infant mortality. Women with pre-existing Kidney disease will have menstrual irregularities and often are not able to conceive, and if at all they do, there is increased mortality and morbidity.
Then there are certain kidney disorders which occur more commonly in females viz. CKD secondary to recurrent UTI and Systemic Lupus Erythematosus (Lupus Nephritis). This is an autoimmune disorder which can virtually affect all the organs of the human body. The disease if diagnosed early, has good outcomes with immunosuppressive medications. However because of negligence and nonspecific symptoms the disease is diagnosed late and outcomes are poor.
Another problem which we encounter in our country is self-medication especially the pain killers. Homemakers and working women (busy double the time as they look after the home as well as their work) usually pop in painkillers without sharing the pain, as they feel the family will get disturbed. Long term ingestion of pain killers leads to kidney disease and this has been well established. The toxic effects of these common painkillers in long term need to be spread and one should be aware.
The sad part of our country is that the health is never on our priority list. We save money for many purposes e.g. marriage, studies, home etc. We never save for our health, and this holds true more so for women. If I look back 25 years ago, the health of women was a neglected chapter. It has improved, but still lacking much behind when compared to western world. The proportion of females getting long term dialysis is much lower when compared to males. Usually because of financial reasons, the females tend to skip dialysis to reduce the cost of treatment and is associated with poor outcomes. In Kidney transplants, the scenario is no different. Women as donors are much more common as compared to males as donors. A very usual case is wife donating to husband, vice versa is quite rare though improving now.
To keep our kidneys healthy, we need to take certain precautions, as prevention is better than cure. Drink at least 6 to 8 glasses of water every day, avoid routine use of painkillers, keep a check on blood sugar (if diabetic) and of blood pressure (if hypertensive). Symptoms come very late and hence early detection with screening is an important tool. So, if you are diabetic or hypertensive or have certain risk factors for kidney disease, get yourself screened annually.
What we need to understand is that kidney disorders though less common in females, have a more rapid downhill course. We need to be aware and spread awareness amongst our friends and colleagues. Women are the pillars of our families and we need to care of them, more than we care for ourselves.