Your kidneys filter waste and extra water from your blood, control blood pressure, balance minerals and help make red blood cells. Chronic kidney disease (CKD) develops slowly and silently, and many people in Uganda only discover it when the kidneys have almost failed and dialysis is needed. Early detection can slow or stop the damage.
Early signs of kidney disease
In early stages there may be no symptoms at all. As kidney function falls, you may notice:
- Swelling of the feet, ankles, legs or around the eyes
- Foamy or bubbly urine (a sign of protein in urine)
- Blood in urine
- Passing urine more often at night, or much less urine than usual
- Tiredness and weakness, often from anaemia
- Itchy skin
- Poor appetite, nausea or vomiting
- Muscle cramps
- Shortness of breath
- Difficulty concentrating
- High blood pressure that is hard to control
Main causes
- High blood pressure: damages small blood vessels in the kidneys.
- Diabetes: high blood sugar damages the kidney filters over time.
- Glomerulonephritis: inflammation of kidney filters, sometimes after infections.
- HIV related kidney disease in some people, which is why regular monitoring in HIV care matters.
- Overuse of painkillers such as ibuprofen and diclofenac (NSAIDs).
- Unregulated herbal medicines, some of which contain substances toxic to kidneys.
- Kidney stones and urinary obstruction, including enlarged prostate in men.
- Sickle cell disease and inherited kidney conditions.
Who should be tested?
- Anyone with high blood pressure or diabetes, at least once a year
- People living with HIV
- People with a family history of kidney disease
- People over 40, as part of routine checks
- Anyone with the symptoms above
Simple tests that detect kidney disease
- Serum creatinine and eGFR: a blood test that estimates how well the kidneys filter.
- Urinalysis: checks for protein, blood and infection.
- Urine albumin to creatinine ratio: detects small amounts of protein early, especially in diabetes.
- Blood pressure measurement.
- Kidney ultrasound: checks size and structure, stones or blockages.
These tests are available at many hospitals and laboratories in Uganda and are relatively affordable compared with the cost of late treatment.
Treatment
- Controlling blood pressure, often with specific medicines that protect the kidneys
- Controlling blood sugar in diabetes
- Treating anaemia and bone mineral problems
- Diet changes, including reducing salt and, in some stages, adjusting protein and potassium
- Avoiding kidney toxic medicines
- Dialysis or kidney transplant for kidney failure
How to protect your kidneys
- Know your blood pressure and sugar numbers and keep them controlled.
- Drink enough clean water, especially in hot weather and during physical work.
- Avoid frequent painkillers like ibuprofen and diclofenac. Ask a pharmacist about safer options.
- Avoid unregulated herbal mixtures and "detox" products.
- Reduce salt and processed foods.
- Do not smoke and limit alcohol.
- Treat urinary infections promptly and complete the full course of medicine.
- Get tested regularly if you are in a high risk group.
Acute kidney injury
Kidneys can also fail suddenly due to severe dehydration (for example from diarrhoea or vomiting), severe malaria, infections, certain medicines or toxins. This is often reversible with quick treatment. Seek care urgently if someone passes very little urine during a severe illness.
Frequently asked questions
Can kidney disease be cured?
Chronic kidney disease usually cannot be reversed, but its progression can often be slowed or stopped with early treatment.
Does drinking a lot of water cure kidney disease?
No. Adequate water is good, but too much can be harmful in advanced kidney disease. Follow your doctor's advice.
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