Early diagnosis vital in kidney disease

Dozens of people got their blood
pressure and blood sugar levels checked in free health screenings at the Cayman
Islands Hospital last week as part of World Kidney Day.

The event on Thursday at the
hospital foyer was organised to help screen individuals at risk of kidney
disease and to heighten awareness about it.

This year, the World Kidney Day
theme was diabetes and kidney disease.

Christina Rowlandson, president of
the Diabetes Support Group, explained: “We need to urge all diabetics to
monitor their kidney function by asking their doctor to check for microalbuminuria
(small protein). This test should be repeated at least once per year. The
target is less than 30 micrograms of microalbumin.”

Kidney disease specialist Frits
Hendriks, from the Grand Harbour Medical Centre, who is chairman of the Cayman
Islands Kidney Foundation, gave a presentation on World Kidney Day to medical practitioners.

Dr. Hendriks said more people
worldwide have diabetes now than ever before in human history. “There has been
an explosion in diabetes worldwide,” said Dr. Hendriks. “It starts with the
babies. If the babies are becoming obese, they will have Type 2 diabetes later
in life.”

According to studies, the
prevalence of type 2 diabetes in the United States has almost doubled, and has
increased three to five times in India, Indonesia, China, Korea and Thailand.
By 2025, it is estimated that the number of people with the disease will be 380

Diabetes is the major cause of
kidney failure, but studies show that many diabetics, especially those with
milder impairment, are unaware that their condition can lead to kidney disease,
and only 8.7 per cent of the general population identified diabetes as a risk
factor for kidney disease.

Dr. Hendriks stressed the
importance of early diagnosis of diabetic kidney disease.

“Kidney disease due to diabetes
takes decades to develop. If it is identified early, you can take medication to
slow it down and even stop it so that people do not require dialysis,” he said.

In his presentation, he pointed out
that there were 2.5 million people worldwide on dialysis.

“There’s a very simple and easy
test that checks for protein in the urine. It has to be done three times in a
row, over about three months,” he said, adding that people in the early stages
of kidney disease often feel perfectly well and display no symptoms of kidney
disease, so blood and urine tests for at-risk individuals was vital.

But just because a person has Type
2 diabetes – one of the major risk factors in kidney disease – a bleak
future is not inevitable for diabetics.

Dr. Hendriks cited the case of his
step-mother, who turned 90 on World Kidney Day and who has had diabetes for
decades. She holds gym classes for other elderly people, regularly exercises,
eats well and, when he last heard from her this week, she was embarking on a
two-week hiking and camping trip across Europe.

“She has type 2 diabetes, but she’s
a perfect example of how you can control this with exercise and diet,” he said.

He advises that anyone at risk of
kidney disease should get themselves checked regularly.

“People at risk of diabetic nephrology
[diabetic kidney disease] are people with a family history of diabetes; people
who are obese; people who smoke are absolutely at high risk; people with high
blood pressure; certain people aged above 50-60 – all those people should have
early screening for protein in their urine and a simple blood test,” Dr. Hendriks

 The Cayman Islands Hospital has 10 dialysis
stations, and in recent years, it has been seeing about 40 patients on a
regular basis.

“Dialysis is a lousy life. You have
to go three times a week for four hours each time,” Dr. Hendriks said, adding
that it was important that people in Cayman watched their diet, exercised and
also took note of the warning signs of diabetes.

“People come and get checked and
get diagnosed, and then they don’t come back for years until they are in
advanced stages of diabetes,” he said.

Cayman has an estimated 3,220
diabetics. The Health Services Authority has 2,255 registered diabetics,
accounting for 70 per cent of diagnosed diabetics. The remaining 30 per cent
are treated by private doctors, but health experts say many others have not
been diagnosed and are not being treated for the disease.

Last week’s screenings were offered
by the Health Services Authority in conjunction with the Cayman Islands Kidney
Foundation, St. Matthew’s University, the Cayman Diabetes Association and the
Diabetic Support Group, Cayman.


Maggie Powery from Cayman Islands Hospital dialysis unit takes Paul Hydes’ blood pressure at a free screening last week.
Photo: Photo: Norma Connolly