Myths and Facts about Kidney Diseases

Myth 1 - All kidney diseases are incurable

Fact: No, all kidney diseases are not incurable. With early diagnosis and treatment many kidney diseases can be cured. In the majority of cases, early diagnosis and treatment can slow or halt progression.

Myth 2 : Kidney failure can occur if one kidney fails.

Fact: No, kidney failure occurs only when both kidneys fail. In most cases, affected individuals may not manifest any problem if one kidney fails completely, and in such cases, the values of blood urea nitrogen and creatinine in the blood tests may remain within the normal range. However, when both kidneys fail, waste products accumulate in the body and the raised level of blood urea nitrogen and creatinine in the blood tests may be indicative of kidney failure.

Myth 3 : In kidney disease, the presence of edema suggests kidney failure.

Fact: No. In certain kidney diseases, edema is present, but kidney function may remain normal (e.g. nephrotic syndrome). One has to understand that edema is simply a manifestation of altered fluid mechanics in the body, and one of the common causes of such a manifestation, is kidney disease.

Myth 4 : Edema is present in all patients with kidney failure.

Fact: No. Edema is present in the majority of patients with kidney failure, but not in all. A few patients do not have edema even in advanced stages of kidney failure. So the absence of edema does not necessarily rule out kidney failure.

Myth 5 : All patients with kidney disease should drink a large amount of water.

Fact: No. Reduced urine output leading is an important feature of many kidney diseases. So water restriction is necessary to maintain water balance in such patients. However, patients suffering from kidney stone disease and urinary tract infection with normal renal function are advised to drink a large amount of water.

Myth 6 : I am all right, so I don’t think I have a kidney problem.

Fact: Most of the patients are asymptomatic (showing no symptoms) in early stages of CKD. Abnormal values in laboratory tests are the may be the only clue (e.g., microalbuminuria) of its presence at this stage.

Myth 7 : I feel fine, so I don’t need to continue treatment for my kidney problem

Fact: Many patients with CKD feel very well with proper therapy, and so they may discontinue prescribed medications and dietary restrictions. Discontinuation of therapy in CKD can be dangerous., as it can lead to rapid worsening of kidney function leading to earlier requirement for initiation of dialysis / kidney transplantation.

Myth 8 : My serum creatinine level is slightly above normal. But I am perfectly well so there is nothing to worry about.

Fact: Even mild increases in serum creatinine can be a sign of kidney dysfunction and needs further attention. A variety of kidney diseases can damage the kidneys, so the nephrologist should be consulted without delay.

In the next paragraph, let us try to understand the importance of an increased serum creatinine (even a little) as it related to the different stages of CKD.

Early stage of chronic kidney disease is usually asymptomatic, and increased serum creatinine may be the only clue of underlying kidney disease. Serum creatinine level of 1.6 mg/dl means that, over 50% of kidney function is already lost, which is significant. Early detection of CKD and initiation of appropriate therapy at this stage is most rewarding. Treatment under the care of a nephrologist at this stage of chronic kidney disease helps to preserve the remaining kidney function for a longer time.

By the time the serum creatinine level goes up to 5.0 mg/dl, 80% of kidney function has already been lost. This value suggests seriously impaired kidney function. Proper therapy at this stage is beneficial to preserve the remaining kidney function. But it is important to remember that this is a late stage of CKD and an opportunity to get the best treatment outcome has unfortunately been lost.

When serum creatinine level is 10.0 mg/dl, it means that 90% of kidney function has already been lost and this points to end stage kidney disease (ESKD). At this stage of CKD, the opportunity to treat a patient with drug therapy is almost lost. Most of the patients need some form of kidney replacement therapy, such as dialysis (or kidney transplantation) at this stage.

Myth 9 : Dialysis performed once in patients with kidney failure, will subsequently become a permanent need.

Fact: No. There are many factors that dictate whether or not dialysis requirement is permanent or temporary.

Acute kidney failure or acute kidney injury (AKI) is temporary and a reversible type of kidney failure. A few patients with AKI may only require dialysis support for a short period of time. With proper treatment and few dialysis treatment sessions, the kidneys usually recover completely in AKI. Delay in dialysis because of fear of permanent dialysis can be life threatening.

CKD is a progressive and irreversible type of kidney failure. Advanced stage of chronic kidney disease (End Stage Kidney Disease) requires regular and lifelong dialysis support or kidney transplantation.

Myth 10 : Dialysis cures kidney failure.

Fact: No, dialysis does not cure kidney failure. Dialysis is otherwise known as kidney ‘replacement’ therapy. It is an effectiveand life saving treatment in kidney failure, which removes waste products, excess fluids and corrects electrolytes as well as acid base disturbances. If such substances accumulated in an individual, it can lead to death. Dialysis carries out the function that kidney is no longer capable of doing. Dialysis helps in prolonging survival in patients with severe kidney failure.

Myth 11 : In kidney transplantation males and females cannot donate their kidney to the opposite sex.

Fact: Males and females can donate their kidney to the opposite gender as the structure as well as the functions of the kidneys are similar in both genders.

Myth 12 : Now that my blood pressure is normal, I don’t need to take my antihypertensive pills anymore. I feel better if I don’t take antihypertensive pills, so why should I take them?

Fact: Many patients with high blood pressure discontinue their medications after the blood pressure is under controlled levels, as they don’t have any symptoms and/ or they feel that they are better without antihypertensive medicines. However, uncontrolled hypertension is a silent killer which in the long run can lead to serious problems like heart attacks, kidney failure and strokes. In order, to protect the vital organs of the body, it is essential to continue taking regularly prescribed medications and control blood pressure even in the absence of symptoms.

Myth 13 : Only males have kidneys which are located in a sac between the legs.

Fact: In males as well as in females, kidneys are located in upper and posterior part of abdomen with same size, shape and functions. In males the important reproductive organ, testes is located in a sac between the legs.

Source: Kidney Education Foundation