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Every minute of our lives, as much as one-and-a-half litres of blood flows through our kidneys. These bean-shaped organs have millions of tiny cells called nephrons, sophisticated filters that cleanse our blood, ridding it of wastes and toxins that could be deadly if left unprocessed.

“Our kidneys don’t merely expel these substances as urine; they also control the water and chemical balance in our blood, ensuring that salts like potassium and sodium chloride are present in just the right amounts," says Mahesh Desai, former president of the Urological Society of India and medical director and managing trustee of the Muljibhai Patel Urological Hospital in Nadiad, Gujarat.

“Kidney failure doesn’t happen overnight. It’s a gradual process and we need to be alert to the signs and symptoms," he adds.

The theme this year for 10 March, World Kidney Day, is “Kidney Disease and Children: Act Early To Prevent It." It explores the ways in which kidney disease can be caught earlier; in fact, right at birth. “If the foetus is malnourished in utero, the kidneys don’t receive enough nourishment. The nephrons in the kidney tend to be affected," says Sunil Prakash, a senior consultant and director of the nephrology department at the BLK Super Speciality Hospital in New Delhi. This can put the child at risk of kidney disease as s/he grows.

Some of the more common conditions that threaten the health of kidneys are also ones that we, as Indians, happen to be genetically predisposed to. “Diabetes, high blood pressure, obesity, the tendency to develop kidney stones and kidney infection are all main concerns," says Dr Prakash.

Being aware of these conditions and making small, significant lifestyle changes can ensure that your kidneys stay healthy.

Check for kidney stones

“Nearly 50% of a urologist’s work involves the extraction of kidney stones," says Dr Desai. Our muggy climate, particularly the searing heat of the summer months, can cause intense perspiration and dehydration. This makes one’s urine more concentrated. There are greater amounts of chemicals and minerals in the urine—such as calcium, oxalate and uric acid. Over time, these chemicals crystallize within the kidney to form what doctors call stones.

People living in Punjab, Uttar Pradesh, Gujarat and Rajasthan, which Dr Desai calls the “stone belt of India", need to be more aware of this risk.

If members in your family have been prone to stones, you need to be on the lookout for signs of kidney disease. And, if you experience symptoms such as frequent urination, painful urination, blood in the urine, accompanied by lower back and stomach pain, nausea and vomiting, consult a doctor. He may recommend an ultrasound. The test is inexpensive and non-invasive and will help detect stones at any stage.

Monitor diabetes, BP and obesity

The blood vessels in your kidneys are very sensitive. If conditions such as diabetes and high blood pressure go unchecked for a long time, they have the potential to permanently damage these.

“It is ironic how when someone has blood pressure for the first time, they are often referred to a cardiologist, but their kidneys are probably the first to take a hit," says Dr Prakash. “Keeping your blood pressure and blood sugar under control is exceedingly important for maintaining the health of your kidneys. If you have a family history of either of these conditions, monitor your kidneys closely and take your medication regularly," he says.

Obesity can make you vulnerable to both these conditions, so begin a weight-loss programme not just for the health of your heart, but for your kidneys too.

The early symptoms

Often, the early symptoms of kidney disease are ignored. “An increased output of urine at night, froth-like soap bubbles in the urine, severe aches and pains in your body—all these are early warning signs," says Dr Prakash. “Another condition that signals kidney disease is severe anaemia, especially if there’s no known reason (such as excessive bleeding during a menstrual period or piles) for the blood loss. If a young couple is unable to conceive, kidney problems could be a reason as well and must be thoroughly checked."

A decrease in appetite, swelling in the face and arms and vomiting are symptoms that would require further investigation, says Dr Desai.

Precautions you should take

Two simple, inexpensive tests can help diagnose the problem. Your doctor could either ask for a urine test to detect blood/protein, or a blood test and an ultrasound to reveal abnormalities in the kidney.

For many, lifestyle changes can go a long way. Keep in mind the five S factors, says Dr Prakash—watch your salt, sugar, smoking, stress and sedentariness levels. Physical activity, for both adults and children, is critical.

Adequate hydration can prevent stone formation. But, contrary to popular opinion, you don’t need to down copious amounts of water to keep your kidneys healthy. “Drink as much water as you need to stave off thirst," he says. “Too much fluid will only overwork your kidneys."

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