The month of March is known nationally and internationally as World Kidney Month, and in line with that, we spoke to one of the forerunners in the medical scene who led the field of nephrology in Malaysia to where it is today: Datin Dr Norella Kong. She spilled the beans (pun intended) on how to keep your kidneys in good shape.

Datin Dr Norella Kong isn't just any nephrologist. In fact, her list of accolades, experiences and qualifications can take up pages but she is notably known for her contribution to the development and expansion of medicinal education as well as nephrology in our country – which we will cover in our upcoming print issue. Now, she sits on the Board of Trustees at MAA Medicare Charitable Foundation, and is also the Professor Emeritus of Nephrology, Faculty of Medicine, UKM and ongoing Clinical Teacher of MMED (Int Med) at PPUKM. 

But first, a couple of facts sourced from the National Kidney Foundation, which we may not know: 

  • 10% of the population worldwide is affected by chronic kidney disease and millions die each year because they do not have access to affordable treatment. 
  • According the 2010 Global Burden of Disease study, chronic kidney disease was ranked 27th in the list of causes of total number of deaths worldwide in 1990, but rose to 18th in 2010. This degree of movement up the list was second only to that for HIV and AIDs. 
  • In middle-income countries, treatment with dialysis or kidney transplantation creates a huge financial burden for the majority of the people who need it. In another 112 countries, many people cannot afford treatment at all, resulting in the death of over 1 million people annually from untreated kidney failure.
  • Noncommunicable diseases (such as heart disease, diabetes, or kidney disease) have replaced communicable diseases (such as influence, malaria, or AIDs) as the most common causes of premature death worldwide. An estimated 80% of this burden occurs in low- or middle-income countries, and 25% is in people younger than 60 years.
  • Chronic kidney disease can be treated. With early diagnosis and treatment, it's possible to slow or stop the progression of kidney disease.

Following that last point, here are some of the steps, as provided by Datin Dr Norella, on how you could take care of your kidneys. 

1. Drink plenty of CLEAR fluids.

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This means no soft drinks and all the modern health drinks. Avoid traditional and herbal drinks too. In the meantime, check out this article on H20 Myths.

2. Do not take over-the-counter medications without a doctor's advice.

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Be sure to check with your doctor before purchasing any additional tablets from the pharmacy. Plus, do not go for health foods and medicines that have hearsay benefits only and without scientific proof.

3. Strive to achieve your ideal weight.

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Body mass index (BMI) is a common tool for deciding whether a person has an appropriate body weight. It measures a person's weight in relation to their height. According to the National Institutes of Health (NIH): 

  • A BMI of less than 18.5 means that a person is underweight.
  • A BMI of between 18.5 and 24.9 is ideal.
  • A BMI of between 25 and 29.9 is overweight.
  • A BMI over 30 indicates obesity.

Calculate your BMI here.

4. Start and stick to a healthy diet.

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Practice a healthy diet of low sodium/salt, low calories, no sugar, low saturated fats and go for a restricted protein diet if there is a known kidney disease afflicting you. Check out this easy recipe article to help kickstart your new diet, or if you're considering going vegan, check this article out.

5. Exercise.

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Walk for at least 30 minutes, three to four times a week. Otherwise, choose appropriate and enjoyable exercises. Check out these 11 Fitness Kickstart Videos for inspiration.

6. If you are diabetic, try to achieve euglycaemia.

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Checking your blood glucose levels throughout the day will help you to figure out how to keep your blood sugar in good control. Your numbers can help you pattern manage and learn how to identify how food, exercise, stress, and illness, to name a few, affects your blood sugar control. First thing in the morning (when you are fasting for at least 8 hours) before breakfast, two hours after a meal and before bed are good times to test. Other recommended times include before, during, and after an exercise session, especially if it is strenuous or if you are feeling like your blood sugar may be low or high.

7. If you are hypertensive, achieve normal blood pressure.

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There are some ways in which your blood pressure can be controlled, such as losing pounds and watching your waistline, exercising regularly, reducing sodium in your diet, limiting the alcohol and caffeine you drink, quitting smoking and reducing stress.

8. If dyslipidemic, lifestyle changes can help normalise levels of the various lipids.

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Lifestyle changes may be able to help you get your cholesterol and triglyceride levels under control. The first step is to change your diet. Changes should include consuming less saturated fat, refined sugar, and alcohol. Adding more fruits, vegetables, lean proteins, and whole grains to your diet may help.

9. If protein is found in the urine, special medications can be prescribed.

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If you are diabetic and find that your urine contains protein, special medications such called ACE-inhibitors or ARBs are prescribed to help control and regulate it.

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