About 200 million individuals in Pakistan suffer from kidney disease. Millions of people are susceptible to contracting this illness. The majority of us link kidney disease to dialysis and occasionally transplant, however there is a period of time between the diagnosis of kidney disease and dialysis during which we can take the most proactive steps to slow the progression of the disease. Go more slowly. Leading healthcare systems in the world seize this chance and focus their entire effort on halting the course of disease. Unfortunately, Pakistan has a very small window of opportunity because diagnosis is delayed, allowing little time for medical therapy of the disease, and the majority of patients require dialysis or a transplant within a few years of diagnosis, frequently within months.

It will take time to lessen the burden of kidney disease and enhance the health of CKD patients.

Let's say our goal is to lessen the impact of kidney disease. In such situation, we must take action at every stage of the disease's progression, from preventing kidney disease to ensuring early detection, from early medical intervention that follows established guidelines to late replacement therapy. By saving one kidney at a time, we can preserve hundreds of thousands of kidneys over many years.

But where do I begin?

Knowledge of kidney function

Understanding kidney function can be an excellent place to start. Every individual is born with two kidneys that are each home to around 2 million nephrons, or tiny filtration plants. These four million tiny filters cleanse poisons and undesirable minerals out of our blood. Although it is most well-known, filtration is not the only function of our kidneys. A whole different, less-discussed side-hormonal balance exists. A hormone released by the kidneys prompts bone marrow to start producing blood. Furthermore, the kidneys maintain the health and durability of the bones by controlling phosphorus, calcium, and vitamin D. Kidney health keeps the body in good shape.

Screening

The majority of kidney disease guidelines tacitly defer to regional practitioners the decision about whether to screen the general populace for renal illness. This avoidance may occur for a variety of reasons. As a practising nephrologist who works in both the United States and Pakistan, I can infer that there is one major reason for this silence: the guidelines' authors, who are typically from first-world nations, had it in mind that nearly everyone in society should have their blood checked beginning at the age of 14. They may not feel the need to weigh in on the question of when a patient should undergo a first-ever kidney function test as a result.

One needs advice on kidney screening in nations like Pakistan where routine medical exams and blood tests are as uncommon as good news.

I advise two tests: blood creatinine and comprehensive urinalysis because of the toxic environment we live in, which includes an unregulated food business, poisoned water, polluted air, dubious pharmaceutical practises, and, most importantly, unrestricted use of illegal cure-all drugs. The general population should get these tests once a year beginning at age 18. Each of them costs 500 rupees. It's not that expensive to have assurance that your kidneys are healthy once a year—just one thousand rupees. In no way.

Test for Kidney Function

Even if our patients with kidney illness currently receive the necessary care frequently, the desired results are only infrequently achieved. Why? I once wondered. but only briefly. After a few weeks of training in Pakistan, I understood that there is no movement of any muscles necessary to inform the patient about their condition and how to keep track of it. Most of the patients looked confused because they had never seen anything like it when I sat with them and, using kidney function charts, traced the evolution of their kidney illness through time.

We must inform our renal patients about their condition and how to monitor improvement or identify further worsening. These patients need to be well familiar with their renal function text for this purpose.

Regular management and follow-up

Chronic kidney disease, or CKD, is the most prevalent type of kidney disease, and a diseased kidney qualifies for this moniker once it has persisted for more than three months. The medical appointment is merely the beginning of the management of CKD; it does not end it. This illness, like all other chronic conditions (high blood pressure, diabetes, heart failure), can only be effectively controlled if you take your medication as prescribed, keep track of your improvement, and work closely with your healthcare team.

A commendable note

It will take time to lessen the burden of kidney disease and enhance the health of CKD patients. We would require a comprehensive plan, one that would include participants at all levels of a community web, each of whom would play a specific role in advancing the healthcare objectives of patients with renal disease. I see my share of patients, but I continue to put in effort towards this transition as well by writing blogs, making videos, and giving speeches and lectures. How may renal illness be treated in Pakistan?