LPC Chairman’s Blog: Think Kidneys – Keep in Good Shape

How many people actually understand what their kidneys do and how vital they are? Pharmacists can play an important role in raising awareness and educating patients in how to keep their kidneys in good shape. Reducing the risk of chronic kidney disease (CKD) is a focus for World Kidney Day on Thursday 10th March.

Kidneys rid our body of dangerous toxins by processing them and producing urine. This is why CKD is so serious. It can lead to the need for dialysis or a kidney transplant, and is ultimately life-threatening.

The disease involves a gradual loss of kidney function over time, with increasing complications and ill health. However, its progress can be slowed by changes in lifestyle and the right diet – so people can directly influence their health prospects if they know how.

General advice for keeping kidneys healthy includes: avoiding a high salt diet (don’t add salt at the table); stick to a healthy balanced diet; maintain a healthy weight; keep active and exercise regularly; don’t smoke; and avoid regular or long-term pain medication (unless prescribed).

It’s also important to stay hydrated. A good rule of thumb is to drink eight good-sized glasses of fluid a day – that’s almost 2 litres (all fluids count toward the daily total).

Problems can arise rapidly through Acute Kidney Injury (AKI), often in someone who is already at risk (pre-existing kidney disease; aged 65+; congestive heart failure; diabetes; liver disease). All healthcare professionals need to be alert and aware of the triggers for AKI, including:

  • Sepsis or infections
  • Hypovolaemia (dehydration, bleeding)
  • Hypotension
  • Certain medicines (which can either damage the kidneys or impair renal function in some circumstances)

AKI may have no early symptoms, so it can be difficult to spot. A possible sign is a low volume of urine being produced, although this is not always the case. However, someone with AKI can suddenly experience nausea and vomiting, confusion, low or high blood pressure, abdominal pain, slight backache or oedema. There are up to 100,000 deaths annually, a third of which could be avoided! One in five people admitted to hospital as an emergency has AKI.

Community pharmacists are in a strong position to help those most at risk. We can develop understanding of the dangers and educate patients about what to do if they become acutely unwell. Pharmacists can also advise on the “Sick Day Rules”, which could involve a temporary cessation of medicines where the risk of AKI is deemed to be high – to stop things going ‘pear-shaped’…

John Sargeant

Chairman, Derbyshire LPC,

March 2016