Kidney disease in South Africa: Its link to ‘lifestyle diseases’ and how it’s treated

The World Health Organization ranks kidney disease as being among the top 10 causes of mortality worldwide. Locally, although the prevalence of Chronic Kidney Disease (CKD) remains understudied, the International Society of Nephrology estimates that roughly 11 out of every 100 South Africans suffer from CKD. Many cases of renal disease – particularly on the local front – are associated with ‘lifestyle diseases’ such as hypertension and diabetes. Thankfully, there is much that can be done proactively to prevent contracting renal disease or slow its progression.

Commenting on this is Michelle Dennis, Renal Operations Manager at Mediclinic Southern Africa, who says that: “The most important thing to understand about the kidneys is that their main job is to maintain homeostasis in the body. Here, ‘homeostasis’ simply means a balanced environment where substances like water and electrolytes are maintained at the perfect levels to support the body’s functions.

Kidneys also filter out waste generated by the metabolism in order to keep healthy blood pumping throughout the body. Suffering from any form of renal disease inhibits this process and in the long-term, can prove both debilitating and life-threatening.”

Causes of renal disease in South Africans

The causes of kidney disease may vary from one geographical region to another, but South Africa has seen a steep increase in renal disease sufferers who also suffer from hypertension (high blood pressure) and diabetes. Due to the fact that these comorbidities are linked to lifestyle and dietary choices, early medical intervention along with lifestyle modifications can go a long way in curbing the progression of renal disease.

Adding to this, Dennis explains that Mediclinic has also noted an increase in cases of renal failure due to patients using traditional medicines and ‘muti’ prescribed to them by traditional healers.

A study conducted by the National Kidney Foundation corroborated this finding and concluded that at least 35% of all cases of acute renal failure in Africa can be linked to the use of traditional remedies. Much of the concerns raised among the medical community around this issue, relate to the fact that these medicines are not regulated and/or properly tested, and patients are often unaware of the ingredients.

Apart from these causes, the overuse of nonsteroidal anti-inflammatory (NSID) drugs have also been linked to cases of irreversible kidney damage. Furthermore, certain autoimmune disorders can also affect renal health. For this reason, individuals who have family members who suffer from an autoimmune disorder are advised to undergo proactive testing and pre-screening as a preventative measure.

How renal disease is treated

Many people who have heard of renal failure or been affected by it, associate renal replacement therapy with dialysis, which is a medical procedure that filters and purifies the blood when the kidneys can no longer perform this function effectively.

However, as Dennis asserts: “Renal care is much broader than just dialysis. This is because renal disease affects a range of systems and functions within the body, including the body's ability to maintain normal blood pressure and create the red blood cells that are important for managing anaemia.

The kidneys also play a crucial role in managing the body’s parathyroid hormone (PTH) levels, which are vital for healthy bones, and the removal of excess phosphates which can lead to pruritis (itching skin). These are the aspects that a renal team will investigate and consider when providing guidance on the best course of treatment.

Spotlight on dialysis

Although treating renal failure necessitates a multi-disciplinary approach in order to manage the far-reaching symptoms, dialysis remains one of the primary methods of treatment, particularly in acute cases. The most recent South African Renal Registry Annual Report found that at least 8866 patients were treated with chronic dialysis or transplantation in 2021 – an increase of 132 from the previous year.

The growing number of South Africans in need of dialysis prompted Mediclinic to establish its Renal Services centres in a bid to broaden access to these essential services. Mediclinic Renal Services currently has 11 clinical sites across South Africa, many of which are situated in lower-income or outlying regions where patients would otherwise have not had access to this level of treatment.

For Dennis, one of the major benefits of having access to Mediclinic Renal Services is the fact that it has no shareholding affiliation with any one dialysis product provider. “We were therefore able to go into the market and find the best equipment available to our patients. Our units are equipped with high-end equipment and products capable of providing high-quality dialysis to patients,” she says.

Live better, live longer

Despite the high level of therapy on offer to Mediclinic’s patients and its ongoing mission to make quality healthcare more accessible, taking preventative measures is still the best policy.

As Dennis concludes: “It's essential to prioritise regular testing for blood pressure and glucose levels, as these can impact kidney health significantly. Annual blood tests that include measures of Urea, Creatinine, and Electrolytes are also crucial, as they can provide valuable insights into your renal function.

Additionally, maintaining a regimen of regular exercise and abstaining from smoking are vital steps in kidney disease prevention. For individuals with gout, it's important to manage this condition effectively without the excessive use of nonsteroidal anti-inflammatory drugs (NSAIDs), which can strain kidney function. Lastly, staying adequately hydrated is essential for supporting overall kidney health.”