As the population ages and people with high blood pressure and diabetes increase, end-stage renal disease has become a global health issue. In Taiwan, nephritis (the inflammation of the kidneys), nephrotic syndrome (collection of symptoms due to kidney damage) and kidney pathological changes was ranked 9th amongst the top ten causes of deaths in 2015;about 4700 persons died of kidney related diseases every year. There are many reasons that can lead to kidney diseases; studies have shown that obesity will increase the likelihood of chronic kidney diseases, and also aggravate the disease progression. In order to decrease the harm from obesity, the theme of the World Kidney Day this year is “Kidney Disease & Obesity – Healthy Lifestyle for Healthy Kidneys”, emphasizing the importance of maintaining kidney health through healthy lifestyles.
According to research by the Health Promotion Administration (HPA), 1 in every 10 persons aged 20 and over in Taiwan is diagnosed with chronic kidney disease. Additionally, the prevalence of overweight and obese adults reached 43%. The relation between weight and kidney disease is something the public should not ignore. According to President Lu, Kuo-Cheng, President of Taiwan Society of Nephrology (TSN), obesity can result in glomerular over-filtration and glomerular hypertension, and subsequently aggravate the condition of chronic kidney disease. Obesity increases the risk of high blood pressure, diabetes and hyperlipidemia (the “3 Highs”), which are also the risk factors of kidney diseases. The HPA suggests everyone to not underestimate the acceleration of kidney pathological changes caused by obesity. Not only could it impact personal health, but also have significant social and economic influences. If the kidney isn’t protected with care, it may ultimately lead to dialysis; in 2016, the cost of dialysis from NHI-contracted hospital reached NTD 35.5 billion, accounting for 5.7% of the NHI budget.
Do not underestimate obesity: up to 56% patients with kidney disease are overweight or obese
According to the HPA, the rate of overweight and obese in chronic kidney disease patients (40 years old and over) reached 56.3% (male: 62.8%; female 45.9%) (chart1). In addition, nearly half of chronic kidney disease patients with overweight and obese issues do not engage in weight control. Among them, female patients with chronic kidney disease accounted for 58.7%, which is more than male (45.9%, chart2). Moreover, in chronic kidney disease patients with overweight and obese issues (40 years old and over), 43% did not do any physical activities in the past month (female with chronic kidney disease, 54.1%; male with chronic kidney disease, 38%) (chart3).
Tackle obesity and keep kidney healthy
Obesity can result in glomerulus hypertrophy, glomerular over-filtration and the increase of proteinuria (protein in urine), which subsequently lead to segmental glomerulosclerosis increases the incidence of chronic kidney disease and end-stage kidney disease. In addition, obesity is also a risk factor of the “3 Highs” (high blood pressure, diabetes, hyperlipidemia), and the 3 Highs can also aggravate kidney disease. Therefore, tackling obesity can help in controlling blood pressure, blood sugar and blood lipid, and slow down the progress of kidney disease. As a reminder, in order to prevent kidney diseases, tackling obesity is the first thing to do!
Patients with chronic kidney disease should counter obesity by starting with regular exercise, healthy diet and weight control, in order to decrease the burden of the kidney and stop or slow down the progress of kidney diseases. For patients with chronic kidney disease, HPA proposes the “3 Rules for Health: Regular Exercise, Healthy Diet, Weight Control” to protect your kidney, hoping everyone will embrace a healthy lifestyle.
Regular Exercise
HPA recommends engaging in moderate to rigorous exercise (such as walking, jogging, bicycling, swimming, dancing, etc.) at least 5 days a week. The exercise should be at least 30 minutes per day, and the heart rate should reach 130bpm after the exercise. It’s best to do exercises that can improve pulmonary function. For those who are older, overweight (or obese), do not engage in regular exercises or have cardiac diseases, we suggest to go through evaluation and exercise tests by physicians or other medical professionals first to choose the safest and most efficient way to exercise.
Healthy Diet
At the initial stages of chronic kidney disease (stage 1-3a), low-protein diet is not required, but avoiding excessive protein intake is necessary. It is suggested that no more than 1.0gm/kg of protein intake per day. Patients and families can consult physicians and nutritionist to come up with the most suitable diet plan according to your height, weight, sex, age and condition, and slow down the progress of disease and maintain health by abiding the rules of balanced diet, eating fixed amount of carbohydrates and high fiber, and the right amount of fat and less salt.
Weight Control
You can choose to control your weight under the guidance of nutritionist, join a peer support group and lose weight together, or call the HPA’s healthy weight management hotline at 0800-367-100. Nutritionists and exercise professionals offer free exercise consultation services every day from 9:00am to9:00pm, in both Mandarin and Taiwanese languages. We welcome patients with chronic kidney diseases to make good use of the resources above and eliminate threats from obesity and chronic kidney disease.
Love Your Kidney, Protect Your Kidney, Healthy Your Life: advocacy activities and seminars
The International Society of Nephrology (ISN) and the International Federation of Kidney Foundation (IFKF) have set the second Thursday of March every year as the World Kidney Day. This year the World Kidney Day falls on March 9th, and the theme is “Kidney Disease and Obesity & Healthy Lifestyle for Healthy Kidneys”. The official website suggests 8 golden rules for kidney health, which includes:
- Keep fit and active
- Keep regular control of your blood sugar level
- Monitor your blood pressure
- Eat healthy and keep your weight in check
- Maintain a healthy fluid intake
- Do not smoke
- Do not take over-the-counter pills on a regular basis
- Get your kidney functions checked if you have one or more of the ‘high risk’ factors
In order to advocate the World Kidney Day in Taiwan, the HPA cooperated with the TSN, cities and counties health bureau, NGOs and health institutions. Starting from March 3, fun fairs will be held in every city and county. There will be examination service, health education posters, healthy food court, prize quizzes, sweepstake draws and other activities, promoting the public’s knowledge on protecting kidneys and providing free kidney examination service. Additionally, seminars on prevention of kidney disease will also be held in various places. For more details, please go to the HPA’s official website.