‘How fasting makes you vulnerable to kidney failure’

Dr. Laz Eze is an Abuja-based public health physician, Chief Executive Officer (CEO) of TalkHealth9ja and also Founder of the MakeOurHospitalWork Campaign. He spoke to PAUL ADUNWOKE on the appropriate ways to practice fasting so as not to damage the kidney and other related issues.

Recently, the Director General, National Agency for Food and Drug Administration and Control (NAFDAC), Prof. Moji Adeyeye, was reported as saying that fasting for long hours without drinking water could lead to kidney damage. Medically and/or scientifically, how possible is this claim?
Prof. Moji Adeyeye is right. Fasting involves no intake of food and water for a long period of time. This may cause dehydration. The kidneys help in maintaining fluid balance in the body, control of blood pressure and filtering of waste products from the blood. Dehydration stresses the kidneys and alters its functions. It may cause acute kidney failure, which can be reversible. However, prolonged fasting may lead to a permanent kidney damage and failure. 

Could you explain the metabolic activities that go on in the body during a fast?
During fasting, the lack of food consumption causes hunger, low blood sugar level, hypoglycaemia, and low level of other nutrients. This may weaken the body’s immune system and make the body vulnerable to infectious diseases to come. 
The resultant dehydration starves the body cells of water and will lead to a false rise in the various metabolites in the blood stream. There will also be a retention of some electrolytes and waste products like urea, creatinine, among others in the blood stream. 

What conditions predisposes humans to suffering from kidney failure in the event of a long-term fast? 
Severe dehydration arising from a long-term fast may cause kidney damage. Therefore, people should find out the potential impact of fasting on their health from their doctor because dehydration poses a risk to the kidney and the risk level may vary from one person to another.

Can every human practice fasting and what are the appropriate ways to practice fasting so as not to damage the kidney?
Everyone cannot withstand fasting. People should find out the potential impact of fasting on their health from their doctor. Dehydration poses a risk to the kidney and the risk level may vary from one person to another. 

What other risk factors exist for kidney damage. And what are the signs and symptoms of an impending damage/failure of the organ?
The kidneys are a pair of organs located in the region of your lower back. One kidney is on each side of your spine. Kidney failure occurs when your kidneys lose their ability to sufficiently filter waste from your blood.

Your kidneys filter your blood and remove toxins from your body. These toxins go to your bladder and are eliminated when you urinate. When these do not work properly, you can get kidney failure.
If your kidneys are not able to function properly, your body becomes overloaded with toxins. This can lead to kidney failure, which can be life threatening if left untreated. However, infections may also cause kidney damage, as well as autoimmune diseases.
Early sign of kidney disease may be low production of urine, passage of reddish urine, and face swelling. Urine test may show presence of glucose in the urine, proteins and other substances.
Diabetes is the most common cause of kidney damage – both type 1 and type 2 diabetes. But heart disease and obesity can also contribute to the damage that causes kidneys to fail. Urinary tract issues and inflammation in different parts of the kidney can also lead to long-term functional decline.
Therefore people should visit their doctors on time for screening and treatment of diabetes as soon as possible and not when the person is at the point of death.

What are the statistics for kidney failure in the country?
Data on kidney failure is not centrally tracked in Nigeria. However, various studies may attempt to provide national estimates.