World Kidney Day (WKD) or the ‘Boukvat Doh’ is a pan world awareness campaign, of letting know people the importance of the kidneys and hence try to reduce the frequency and impact of kidney disease/s. It is observed on the 2nd Thursday of March every year. WKD which began as joint initiative of the International Society of Nephrology and the International Federation of Kidney Foundation has now expanded and presently is an effort by many renal societies, NGO’s, celebrities, governments and the common man. This year on 9th March we are celebrating the 12th WKD with the theme “Kidney Disease and Obesity – Healthy lifestyle for Healthy kidneys”, aimed to promote education about the harmful consequences of obesity and its association with kidney disease, advocating healthy lifestyle and health policy measures that make preventive aspects an affordable option.
Recently the news that gained lot of media attention was that of Eman Ahmed, the world’s heaviest living woman, who was specially airlifted from her home in Egypt to Mumbai for management, is an example of extreme effects of obesity. Lesser degrees of obesity are highly prevalent in all countries and it would be right to mention that there is an obesity iceberg out there, the tip of which we see whereas much is hidden beneath. Obesity is a nutritional disorder that spans all ethnicities, all ages and both sexes. It is an abnormal or excessive fat accumulation that has a negative effect on health and is defined by body mass index (BMI) or the waist: hip ratio. It has attained epidemic propositions and all countries rich or poor are facing the wrath of obesity. Presently worldwide nearly 700 million adults are obese. According to WHO by 2025, obesity will affect 18% of men and over 21% of women worldwide and severe obesity will affect 6% of all men and 9% of all women. In some rich nations, obesity is already present in more than one-third of their adult population and contributes significantly to overall poor health and high annual medical costs. In India malnutrition and obesity are scourges that lead to wide variety of disease and negatively affect the health care system. Kashmir also has the problem of obesity and in particular this issue is of concern in children who may have the consequences in particular taking into account the number of year these kids will have to live and hence the ill effects of obesity may manifest in them at a later stage of their life. A number of studies done on school children in Kashmir have shown a prevalence of obesity to be around 5%, more so in the adolescent group and slightly more in the urban than the rural areas. This is related to the dietary food habits and sedentary life style in this particular age. In young adult as well this issue has been studied and the overall prevalence of age-adjusted prevalence of obesity among young Kashmiri adults aged 20–40 years is 5.1%
In general obesity increases the risk of death and contributes to heart disease, hypertension, diabetes, lipid abnormalities, obstructive sleep apnea, fatty liver, gall bladder disease, osteoarthritis, mental disorders and poor quality of life. Kidney disease is more likely to develop in obese people particularly in those who have concurrent diabetes and hypertension. Obesity can have direct and indirect consequences on kidney. Indirectly it affects kidneys by predisposing to diabetes and hypertension both of which are most important risk factors for the development of kidney disease. Acute kidney injury also occurs more frequently in obese people. As the kidneys have to work harder, filtering more blood than normal (hyperfiltration) to meet the metabolic demands of the increased body weight obesity may directly affect the kidneys and increases the risk of developing Chronic Kidney Disease (CKD). Obese have manifold chances of developing ESRD compared to those of normal weight. Obesity also is one of the strongest risk factors for nephrolithiasis and for kidney cancer.
But it is without say that obesity as well as CKD is largely preventable. Education and awareness of the risks of obesity and a healthy lifestyle, including proper nutrition and exercise, can dramatically help in preventing obesity and kidney disease. Reducing obesity by diet, medicines and surgery may reverse or slow CKD progression.
We can prevent kidney disease and keep kidneys healthy to a large extent in obese as well as normal weight individuals by following few basic rules;
•By maintaining proper body weight through a healthy life style that includes daily walking, running, cycling and exercises.
•In diabetics it is imperative to maintain and control the blood sugar level, by having regular medications, tests and check of kidney functions.
•In all and especially hypertensive’s regular monitoring of blood pressure and its control by adopting a healthy lifestyle and diet as well as monitor blood pressure on regular basis.
•By encouraging good dietary habits like reducing the salt intake (5-6 grams or 1 teaspoon of salt a day), limit the intake of fatty, processed or junk food, increase green leafy vegetable content.
•By maintaining a good fluid intake on daily basis (at least 2 to 3 liters a day to have a urine output of 1-2 liters per day) as it helps the
kidneys to filters out sodium, urea and other body toxins from body.
•By avoiding smoking and encouraging addicts to refrain from it.
•By avoiding the intake of pain killers on regular basis as these may lead to the kidney damage. Also discourage having any medication unless prescribed.
With awareness through various campaigns done on the World Kidney Day, we can help ourselves and others to live long without any kidney problems. Whatever our socioeconomic status, let us strive at individual, domestic, community, institutional level to have ideal weight and hence a healthy life and healthy kidneys.