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Reducing burden of chronic kidney diseases

By Stanley Akpunonu
20 March 2020   |   2:20 am
To mark the World Kidney Day (WKD), medical experts have harped on the need to intensify awareness to reduce the burden of the disease.They said WKD continues to raise awareness of the increasing burden of kidney diseases worldwide and to strive for kidney health for everyone, everywhere. However, the 2020 campaign highlights the importance of…

To mark the World Kidney Day (WKD), medical experts have harped on the need to intensify awareness to reduce the burden of the disease.They said WKD continues to raise awareness of the increasing burden of kidney diseases worldwide and to strive for kidney health for everyone, everywhere.

However, the 2020 campaign highlights the importance of preventive interventions to avert the onset and progression of kidney disease.Speaking at an event organised by Kidney Foundation for Africa to mark the day, First Lady, Lagos State, Ibijoke Sanwo-Olu, said kidney disease has been identified as a major killer of human beings, stating that the government would intensify awareness on the devastating effect of kidney disease.

According to her, hospital-based findings revealed that about 13 per cent of Nigeria’s population suffered from Chronic Kidney Disease (CKD), which could lead to kidney failure and result in death.

According to her, this percentage does not include patients who lack access to hospital care.Sanwo-Olu said that the World Health Organisation (WHO) projects that about two million people in Lagos State are suffering from CKD.

The medical expert noted that concerted efforts are being made to create awareness on the causes and prevention of the scourge.The First lady disclosed that the state government was doing all within its power to facilitate the reopening of the Cardiac and Renal Centre (CRC) in Gbagada to enhance screening and treatment of kidney-related diseases.

She continued: “The state government has also been conducting the State Wellness Week designed to create awareness and screen residents free of charge for Hypertension, Diabetics, Breast Cancer and Cervical Cancer, among others. The awareness aspect is critical because people must be made to come to terms with the fact that they are, first of all, responsible for their health and wellbeing.”

“We need to educate the people to embrace healthy lifestyle choices such as eating a balanced diet, engaging in regular physical activities, and maintaining normal body weight, among others. Emphasis must also be emphatically placed on reducing the risk factors which include Diabetes, High Blood Pressure, smoking and obesity.”

Similarly, Consultant Nephrologist, Dr. Ebun Bamgboye, highlighted the need to recognise, identify and screen sicknesses like hypertension, diabetics, sickle cell to because they are the risk factors that predispose one to kidney disease.He also said it is important to detect the ailment early enough for proper management and reducing the speed of progression of renal failure.

Bamgboye said we do not have the capacity to deal with kidney diseases in the country hence the best way is to prevent it and that is the focus.
He continued: “Our National Health Insurance Scheme covers only a few sessions of dialysis. So we must ensure that policymakers and stakeholders are informed about the significance and magnitude of the kidney failure.”

Meanwhile, Consultant, Internal Medicine and Nephrology, Cairo University, Egypt, Prof. Mohamed NasrAllah, said that the government of Egypt provides full sponsorship for dialysis thrice weekly to reduce deaths from renal failure across the country.He added: “We have a lot of contributions from the private sector. We have also started a national fellowship training programme to improve the standard of the doctors taking care of kidney disease patient.”

Also, scientists have raised fresh concerns that the global rate of people dying with renal disease has seen a sharp increase in the past 27 years and that many of these deaths were preventable.

The theme of 2020 WDD is “Kidney Health for Everyone Everywhere – from Prevention to Detection and Equitable Access to Care.”When a person develops chronic kidney disease (CKD), their kidneys slowly stop functioning over months or years. Usually, the kidneys filter excess fluid and waste from the blood, as the kidneys fail, these fluids accumulate.

There are no symptoms of CKD in the early stages, but if a person does not receive treatment, CKD will progress to end stage kidney disease; this requires dialysis treatment or a kidney transplant.

Scientists have estimated that 14 per cent of the United States population has CKD.People with kidney disease are also at a much higher risk of developing cardiovascular disease, which is the most common cause of death in people with CKD. Cardiovascular disease death rates in people undergoing dialysis are 10–20 times greater than in the general population.

High blood pressure or diabetes commonly causes CKD, but it can also develop because of Human Immuno-deficiency Virus (HIV) infection or exposure to toxins or heavy metals. Sometimes, the primary cause of a person’s CKD remains unknown.

There is no cure for CKD, although lifestyle changes can help prevent the condition from getting worse. People in later stages of the disease need expensive renal replacement therapy, for example, kidney dialysis or a kidney transplant to survive.

Meanwhile, a diet including daily avocado consumption improves the ability to focus attention in adults whose measurements of height and weight are categorized as overweight or obese, a new randomized control trial found.

Researchers at the University of Illinois at Urbana-Champaign conducted the 12-week study, published in the International Journal of Psychophysiology.

“Previous work has shown that individuals with overweight and obesity are at higher risk for cognitive decline and dementia in older age,” said kinesiology and community health professor Naiman Khan, who led the study. “We are interested in whether dietary approaches may have benefits for cognitive health, especially in midlife.”

The Hass Avocado Board and the U.S. Department of Agriculture’s National Institute of Food and Agriculture supported this work.Avocados are high in lutein, a dietary component associated with cognitive benefits. Though avocado consumption’s benefits have been studied in older adults and children, no randomized controlled trials had studied its cognitive effects on adults with overweight or obesity, despite 70 per cent of the American adult population falling into that category, said graduate student Caitlyn Edwards, the first author of the study.

In the new study, the researchers provided 12 weeks of daily meals to 84 adults with overweight or obesity. The meals were identical in calories and macronutrients, but one group’s meals included a fresh avocado every day, while the control group had no avocado in their meals.

At the beginning and end of the study, the participants completed three cognitive tests to measure attention and inhibition. In addition, the researchers measured lutein levels in the participants’ serum and in their retinas, which is associated with the lutein concentration in the brain.

They found that the participants whose diets included avocados improved their performance on one of the cognitive tests, called the Flanker task, which measures attentional inhibition — the ability to maintain focus on the task at hand even in the face of distraction. However, there was no difference in the other two cognitive tests.

“It could be that nutrients in avocados have a specific action in the brain that supports the ability to do this task in particular, or they could be more beneficial for certain cognitive abilities over others,” Khan said. “It’s also possible that with a longer study or different tests, we could see other effects. Other studies have found broader effects in other populations, so it is interesting to see a more specific benefit for this population.”

Another unexpected finding was that, while the participants who ate avocados had higher levels of lutein at the end of the study, the changes in lutein levels were not correlated with their cognitive changes.

“Avocados also are high in fiber and monounsaturated fats. It is possible that these other nutrients may have played a role in the cognitive effects we saw, but we focused on the lutein in our analyses,” Edwards said. “Future analyses may focus on other nutrients found in avocados, or avocado consumption’s impact on other measures such as weight status, inflammation and potential changes in the microbiome.”

Although this study focused on avocados, other dietary sources of lutein, fiber and unsaturated fats — such as green leafy vegetables or eggs — also have potential cognitive and health benefits. The researchers say their study shows that small dietary changes, such as eating avocados, can have measurable impacts on cognitive performance, even when other health behaviors remain the same.

“Our mission is to give people options. There are multiple ways people can eat to optimize brain health,” Khan said. “What we’re learning is that avocados may be one of those fruits that may be neuroprotective in certain ways. This work provides some evidence behind one option people have from a plethora of healthful foods that we can consume.”

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