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Chronic kidney disease on the rise

Raphael Loutoby (Photo by Akil Simmons)

Early detection and prevention is the key to tackling chronic kidney disease in Bermuda.

Nephrologist Raphael Loutoby said that while chronic kidney disease (CKD) is on the rise both locally and internationally, efforts could be made to address the issue.

Speaking to the Hamilton Rotary Club yesterday, Dr Loutoby said: “Early detection and prevention helped to reduce the burden of chronic diseases such as lung cancer and cardiovascular disease. The same can be done for chronic kidney disease.”

He said that CKD is becoming more common throughout the world, with end stage renal disease rising locally by around 15 per cent per year.

“CKD has been growing steadily because of multiple reasons,” Dr Loutoby explained. “The ageing population by increased life expectancy, epidemic of type two diabetes, epidemic of worldwide obesity. The westernisation of the lifestyle and people’s eating habits have made some populations more vulnerable to these things. This is now a global issue and some populations are affected more than others.

“When I was a medical student they used to tell us that you can get type one diabetes when you are about 10 years old or even younger and type two diabetes when you are in your late 40s or mid 50s if you are a little bit obese. All of that has changed now, with the way people eat and their lifestyles its very common to see youngsters of 15 to 18 years old with type two diabetes. This is a major health concern.

“Type two diabetes and hypertension is fuelling kidney disease. This is a problem the planet is facing.”

He also noted the financial cost of CKD, saying that around $30 million a year is spend on dialysis locally.

Despite the growing threat of the ailment, Dr Loutoby said medical experts are using their experience tackling other chronic ailments to address the issue. One important element is early screening, which he said could make a major difference if cost effective.

Another element in the battle is preventive care, encouraging healthy lifestyles so that patients never develop CKD.

“A healthy lifestyle is very important, exercise on a regular basis, not eating too much salt or sugar and working with doctors to keep diabetes under control if you have it,” he said. “If you know that you have high blood pressure you should work with your physician to keep it under control because it can help decrease CKD.”

“Sometimes in Bermuda you may find it difficult to eat fresh food. The concept of an urban garden can help this. We can also learn from the initiative of First Lady Obama and the White House Garden which she has shared to different high schools and communities to encourage them to eat better and exercise more.”

He also called for the launch of a national renal registry to help give information to the medical community and policymakers about the causes of CKD, and antismoking campaigns and rules limiting smoking could also have a positive impact as smoking has been linked to kidney damage.