University of São Paulo: Growth in the number of dialysis and transplant cases in the country demands attention

The increase in dialysis cases and the need for treatment for chronic kidney disease are worrying. In an interview with Jornal da USP in Ar 1st edition , specialist Hugo Abensur, head of the Dialysis Service at Hospital das Clínicas, Faculty of Medicine, USP, discusses the matter on World Kidney Day.

There has been an increase in the number of patients on dialysis in recent years. According to data from the Brazilian Society of Nephrology (SBN), Brazil has approximately 140,000 patients undergoing treatment. Hospital das Clínicas de São Paulo has 150 patients who depend on therapy for a living.

“The number is growing, because the two main causes that lead to chronic kidney disease — diabetes and high blood pressure — are two very common conditions, especially now that the population is aging and the population is becoming more obese. So, increasing the number of diabetics and hypertensive patients, if they are not properly treated, one of the complications of these conditions is chronic kidney disease”, attests Abensur.

slow evolution
Chronic kidney disease has a slow evolution, according to the doctor: “Patients adapt to the loss of various functions that the kidney plays and do not realize it and, sometimes, the diagnosis is made late. The patient only goes on dialysis when he loses 90% of kidney function, so this path between 100% and 10% of kidney function is slow and sometimes the patient doesn’t realize that he is getting a little paler, because the kidney produces a hormone that activates the medulla and prevents the patient from becoming anemic, he does not realize that he is starting to become hypertensive because he did not go to the doctor to measure the pressure, that the urine is more foamy. Everything that happens slowly he thinks is normal.”

The identification of the disease is an essential factor for the treatment to be carried out as soon as possible. “It is very easy to know if the individual has a kidney problem”, comments Abensur, who explains better: “All you need to do is measure a substance called creatinine in the blood. Creatinine is produced in the muscle and the kidney has to clean it from the blood, if the individual loses kidney function, the level of creatinine in the blood increases; normal is around one milligram per deciliter, but then it goes to one and a half, to two, to three milligrams, when it reaches around five mg per dl, it corresponds to a loss of 90% of kidney function, then there is the need to start dialysis. Another important test is the urinalysis, normally we do not lose protein in the urine, the appearance of protein in the urine indicates that there is a loss of kidney condition,

There are approximately 30,000 patients on the transplant waiting list in Brazil, but the country makes around 5,000 a year. The list is usually lengthy due to compatibility with the donor, and for the population to avoid experiencing these complications, Abensur says: “The important thing is for us to have a healthy life, so we don’t get hypertensive or diabetic; once you are hypertensive or diabetic, you have to take good care of these conditions. You have to be taking care of your health.”

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