“But doctor, my kidneys have never given me trouble, I’ve never had pain and I’ve no problem urinating …” This is unfortunately due to the fact that very often, when patients seek the Nephrologist it is in a late stage of the disease where very little can be done; very little, but there is still an alternative: haemodialysis.
Contrary to popular belief, most kidney diseases do not present symptoms or complaints. In most kidney diseases, there is no back pain associated with the disease and the patient urinates normally. In most kidney diseases, the patient leads a completely normal life, with no indication of an impending kidney disease, until an unusual symptom appears that make him/her seek a doctor’s opinion.
Such symptoms may be drowsiness, lack of appetite, tiredness, itching, dry or cracked skin. It may also be an alteration in the urine, such as foamy, pink, red or darker than usual. It may also be a back pain that in fact is a renal colic. Other symptoms of kidney disease may also be a difficult-to-control hypertension or uncontrollable levels of diabetes.
In summary, the most frequent complaint is that there is no common pattern in the patient’s complaints.
It is for this reason that prevention and periodic screening by a Nephrologist plays a key role in a patient’s continued good health.
It is therefore no wonder that chronic renal disease is largely under-diagnosed and is present in many of the people who we come across daily and who are unaware of this disease. A neighbour, a friend or a close relative could be experiencing a chronic kidney disease and not be aware of it.
An ageing population, in association with increased hypertension (high blood pressure) or diabetes, means that chronic kidney disease is one of the fastest growing diseases in developed countries.
It is, therefore, justified that in less than 10 years the number of patients requiring haemodialysis in Portugal has risen from approximately 8,000 patients in 2003 to over 10,000 patients in 2013. An estimated increase of 20%-25% in a decade!
For all the above reasons, it is essential that we consult a doctor and that we all understand the need for prevention and screening. In the event that a kidney disease is suspected, referral to a Nephrologist (if you are not already seeing one) is of fundamental importance. It could mean the difference between stabilisation and control of a kidney disease or its progression that will inevitably lead to dialysis.
When the kidneys cease to function, dialysis is a technique which replaces all kidney function (know as terminal chronic kidney disease).
In general terms, there are two types of dialysis. Perhaps the type which is less known is peritoneal dialysis. It consists in the use of a membrane that exists inside our belly, to remove the toxic substances that are produced by the human body. It can be used at home on a daily basis, but for technical reasons is limited to younger patients.
The other form, often called dialysis is, in fact, haemodialysis and is carried out in Portugal almost 100% in haemodialysis clinics, where the patient has to go three times a week, with the treatment lasting for a minimum of four hours each day. The patient needs to undergo a small surgical procedure for the placement of a vascular access.
Hospital Particular do Algarve has various units throughout the region where screening can be done for kidney disease, but only the hospital in Gambelas (Faro) has a dialysis unit. It is possible for a patient to come on holiday to the Algarve with the rest of the family, and continue with his haemodialysis programme without concern and, at the same time, enjoy the sun in the company of his/her family.
By Dr. Alexandre Baptista
Dr Alexandre Baptista is specialist in Nephrology, now also working at the Hospital Particular do Algarve.
