“When people have early kidney problems, they often aren’t aware of it. The kidney is silent when mild damage is present, and by the time symptoms are noticeable, the condition could have already become severe. Unfortunately, treatment is often delayed,” says Ara Damansara Medical Centre consultant nephrologist Dr Tan Li Ping.
Tan advises all Malaysians to go for regular check-ups. This is important as Asians are known to be more genetically susceptible to kidney disease caused by diabetes.
“According to the US Renal Data System 2013 Annual Data Report, 64% of Malaysian patients on dialysis have kidney failure thought to be a complication from diabetes,” he says.
“This figure is much higher than the 44% rate in the United States. Given that Malaysia is considered a hotspot for high blood pressure, high cholesterol, diabetes and obesity, this percentage is only expected to increase.
“If you have diabetes, you should get a urine and blood test at least every three to six months. If you are physically healthy, once a year should suffice.”
Tan shares that losing weight, practising a healthy diet, exercising regularly, making sure your blood pressure and sugar levels are normal and avoiding or quitting smoking are important to mitigate the risk of kidney disease.
However, there is hope for those who experience kidney failure – renal replacement therapy.
“The most common form of renal replacement therapy for kidney failure is dialysis, where toxins and excess fluids are filtered out of the bloodstream. Another option for patients with kidney failure is a kidney transplant. Ask your nephrologist which option is the better one for you,” he advises.
One common misconception is that diabetes medications cause kidney damage. This belief often leads patients to avoid taking their medications regularly or at all, leading directly to health deterioration.
“Most medications pose only a small risk of causing kidney damage; a risk that is further reduced when the medication is prescribed under expert guidance. The likelihood of uncontrolled diabetes causing kidney problems far outweighs the small risk of medications harming your kidneys,” he says.
Better Late Than Never
It is crucial to attend regular check-ups and find out the condition of your kidneys. Seek treatment as soon as you encounter any of these symptoms:
♦ Foamy urine – This is a sign that the kidney is breaking down and protein from the kidneys are in the urine
♦ Itching – Kidneys filter toxins from the body. When they do not work properly, the toxins stay in the body, causing itching
♦ Back pain
♦ Weakness or tiredness
♦ Lack of appetite
♦ Breathing problems
Protection Of The Mind
ParkCity Medical Centre clinical psychologist Michelle Ho Sueh Yeng says: “Coping with an illness is never easy, even more so with chronic illnesses that are long-lasting and can potentially stay with the patient for life. On top of that, patients must adjust to physical weakness, lifestyle changes and probable financial burdens because of treatment.
“People with chronic diseases are at a higher risk of developing mental health disorders because of unexpected life changes. As a result, they can become less active, avoid social contact and be irritable, moody and anxious.”
Be The Helping Hand
During difficult times, it is especially important for a patient to receive adequate support to enhance their mental state and quality of life. Ho lists four types of social support, which are:
♦ Emotional – Expressions of empathy, love, trust and care
♦ Instrumental – Tangible aid and service
♦ Informational – Advice, suggestions and information
♦ Appraisal – Expressions of confidence or encouragement
She further shares that people who actively confront their diagnoses, seek social support and use active coping strategies could experience better adjustment, inner peace and life satisfaction compared to those who feel resigned to their fates and either deny or avoid their diagnoses.
Ho advises loved ones and guardians to accompany the patients in their journeys. “Empowering the patient with accurate knowledge of the disease and treatment while helping her develop coping strategies may also be beneficial,” she adds.
Besides that, Ho asserts on the importance of patients surrounding themselves with positive, supportive people. She says: “Try to find small things that you enjoy every day and set realistic goals for yourself. Small goals such as a visit to the park or phoning a close friend can help you make the most of each day.”
See Something, Do Something
Every hardship is more difficult when experienced alone and chronic illnesses can have a heavy psychological effect on patients. Family and friends of patients must check in with the patients on how they feel or cope when changes in behaviour are noticeable, such as:
♦ Avoiding social interactions
♦ Isolating themselves
♦ Changes in appetite
♦ Changes in sleeping pattern
♦ Changes in weight
♦ Heightened sensitivity to offhand comments
♦ Depressed mood
♦ Crying spells
Creating A Safe Place
Ho acknowledges that while there is now increased awareness of mental health in Malaysia, it is still not proportionate to the growing number of people facing such issues.
“Despite experiencing overwhelming emotions from being diagnosed with a chronic illness, patients may have an underlying fear that getting mental health treatment equals being ‘crazy’. This stigma causes them to avoid seeking help for fear that their family members will be shamed,” she explains.
Although many initiatives have been implemented by the Government, public and private healthcare providers and non-governmental organisations, Ho suggests that the stigma surrounding mental health and the optimism that “this will never happen to me or my loved ones” tend to dominate societal mindsets, thus deterring much-needed care.
Therefore, more impactful awareness programmes are needed to educate the public on the existence and debilitating effects of chronic diseases on patients, their families and communities.