Did you know? 40–60% cases of chronic kidney diseases result from diabetes and hypertension [Rajapurkar et al 2012]. Usually, kidney disease is a seconday complication of long- standing hypertension or uncontrolled diabetes.
As per recent Indian Council of Medical Research data, prevalence of diabetes in Indian adult population has risen to 7.1%, (varying from 5.8% in Jharkhand to 13.5% in Chandigarh) and in urban population (over the age of 40 years) the prevalence is as high as 28%. [Raman et al 2014, Anjana et al 2011]
Likewise the reported prevalence of hypertension in the adult population today is nearly 17% (14.8% from rural and 21.4% from urban belt).
With rising prevalence of diabetes and hypertension in India, prevalence of Chronic Kidney diseases is expected to rise
SCREENING FOR PRESENCE OF KIDNEY DISEASES
It is a known fact that over 50% of diabetics and hypertensives are not aware that they are harboring the disease, and hence is recommended that every individual who is suffering from diabetes and / or hypertension for more than 5 years should be screened for normal kidney functioning.
The screening tests should include a urine test for proteinuria or albuminuria and a blood test for serum creatinine to estimate glomerular filtration rate (GFR). Initially testing with urine tests for proteinuria or albuminuria is more cost-effective. Initial screening test should be followed by serum creatinine estimation in patients with positive urine albumin.
The symptom of CKD develops slow and remains largely asymptomatic. Urine microalbuminuria, especially in patients with DM, detects patients at risk of kidney disease years before they manifest with gross proteinuria or elevated serum creatinine. Estimating GFR from serum creatinine is likely to avoid missing kidney disease at an early stage.
Diet and nutrition are an important part of living well with kidney disease. Depending upon the extent of damage to the kidney structure and function which relates to the stage of kidney disease, the dietary management changes.
Here are some basic guidelines to be followed:
DIET INSTRUCTIONS IN KIDNEY DISEASES
- All legumes and pulses are permitted. For ex. Turdal, moongdal, udad dal, whole moong, matki / moth, chavli, masoor, vatanas, etc. but the quantity of these may depend upon the protein restriction. If creatinine levels are very high, then only upto 1 katori of dal may be consumed daily
- You can consume idli, dosa, khichdi, dhokla, etc made from rice and dal combined
- Vegetable such as Lima beans-ghevda, kohlrabi-navalkhol, french beans-farasbi, ladies finger, snake gourd-parval, ridge gourd-dodka, tinda, raw mango, cucumber, pointed gourd-parwar, pumpkin, raw and ripe tomatoes can be consumed freely without any leaching
- Please record daily food and water intake. Also carefully record urine output for 2-3 days in order to determine allowance for water intake.
- Remove cream from the milk to lower fat content
- Oil quantity should be restricted to 3-4 small teaspoons everyday
- Oil, ghee and butter should be consumed in restricted amounts
- Potassium, phosphorous and fluid restriction in kidney diseases
- Tips to manage salt restriction during kidney disease
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