Winnipeg Free Press - PRINT EDITION

Kidney problems price we pay for progress

Junk food, surgeries, misuse of medication extracting heavy toll

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Many North Americans will unknowingly fall into a trap during 2013. It results in the law of "unintended consequences." Moreover, as medical treatment progresses every year, more of such consequences are waiting to happen. This week, what you should know about is acute kidney injury (AKI).

The kidneys, not the bowel, comprise the body's main disposal system. Like a chemist, each day they control water balance, keeping blood neither too acidy nor too alkaline, help in the production of red blood cells, and every 30 minutes filter all of our blood.

A report from Johns Hopkins Hospital says 20 million Americans suffer from chronic kidney disease. Kidney dysfunction can develop silently for many years. But AKI can appear suddenly and be life-threatening, primarily affecting people over 60 years of age.

Unintended consequences that trigger AKI come from a variety of sources. The big one is infection and today it's a major problem for hospital patients. The few times I've been confined to hospital I've counted my blessings that I left without an infection.

Many are not so lucky. Following hip replacement or bypass heart surgery, infection may require the prolonged use of antibiotics. But life-saving drugs can also injure the kidneys' filtering system, the one-million nephrons of which stretch out 112 kilometres long.

I found one part of the Hopkins study hard to believe. According to Karl L. Womer, director of the Transplant Nephrology Clinic, five per cent of all hospital patients develop acute kidney injury. This figure can escalate to 23 per cent for those in intensive care and jumps to 30 per cent if you're scheduled for cardiac surgery.

That's enough to make anyone run for the woods. But the irony is, it's the price we pay for progress. Today, more invasive diagnostic procedures are being done, requiring the insertion of catheters and the injection of dyes. These procedures are performed with great care but hovering overhead is the risk of infection. And often the roll of the dice determines whether or not one of these infections strikes.

So how can you decrease the risk of developing AKI? The tragedy is repeated over and over when people rush into surgical procedures when their quality of life is minimally affected. It's often better to live with the devil you know than the one you don't know.

But it's not just hospital infections that result in badly injured kidneys. A huge number of North Americans of all ages commit even greater folly -- the chronic misuse of so-called minor painkillers that can slowly damage kidneys. Every time I visit a pharmacy and see the row after row of painkillers and other medication, it's easy to see how it happens. People have been brainwashed by pharmaceutical companies into believing there's no need to put up with any minor ache or pain.

A report in the British Medical Journal shows that people who take nonsteroidal anti-inflammatory drugs such as ibuprofen (Advil, Motrin), naproxen (Aleve) and Aspirin along with blood pressure medication face a 31 per cent increased risk of AKI.

The most tragic unintended consequence of drug misuse is when AKI progresses to being life-threatening and requires kidney dialysis. The number of people falling into this trap is shocking. Researchers at the University of California report the number of patients on this procedure is increasing 10 per cent every year. In 2000 there were 63,000 dialysis patients and now it's over 164,000. Moreover, one in four patients on kidney dialysis dies by heart attack.

The message is you can put garbage into your body in various ways. Too much junk food results in obesity and diabetes, with all its complications.

So as sure as night follows day, chronic misuse of medication can also have a devastating effect on the kidneys' filtering system. Nature did not design kidneys to handle the host and volume of synthetic drugs routinely available for people in today's pharmacies. It's asking too much from the Creator. Besides, the unintended consequence of being attached to a kidney machine each week, often for the rest of your life, is horrific.

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Republished from the Winnipeg Free Press print edition May 10, 2013 A23

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