Diabetes and High Blood Pressure Fuel Kidney Disease: Experts

The impact of kidney disease in Bangladesh has been steadily worsening, but specialists assert that, with proper awareness and lifestyle changes, these conditions can be effectively prevented.

In an interview with BSS, Professor Dr. Md. Shahidul Islam (Selim), former chairman of the Kidney Disease Department at BSMMU and a renowned kidney specialist, explained that the number of kidney patients in Bangladesh has been rising steadily. He pointed out that uncontrolled diabetes, high blood pressure, and nephritis are the three primary causes of kidney ailments in the country.

"Uncontrolled diabetes and high blood pressure are major contributors to kidney disease. Despite treatment efforts, the prevalence of these conditions continues to rise. Of these three causes, diabetes is the most significant," Dr. Shahidul Islam emphasized.

He further explained that even when diabetes is under control, kidney problems can still emerge after 5 to 10 years due to the long-term effects of the disease. "In such cases, protein starts to leak into the urine, and the creatinine levels in the blood rise gradually," he noted.

Dr. Shahidul Islam highlighted that ten years ago, nephritis was the leading cause of kidney disease. However, due to improvements in treatment for nephritis, its prevalence has decreased. Nonetheless, kidney disease prevention remains unattainable without effectively controlling diabetes.

“To prevent kidney disease, it is crucial to first identify its root causes. Once the underlying condition, such as diabetes or high blood pressure, is identified, it should be managed effectively. If these factors are left uncontrolled, kidney problems will continue to develop,” he advised.

Dr. Shahidul Islam went on to explain that if kidney disease is not addressed, protein will continue to be excreted in the urine, leading to water retention in the body. A rising creatinine level despite treatment indicates chronic kidney disease. However, if treatment leads to improvements, it indicates acute kidney disease, which can often be reversed with proper care.

He added that while acute kidney disease patients can often recover with treatment, chronic kidney disease patients face a progressively worsening condition, and their kidneys cannot return to normal function.

When discussing advanced stages of kidney disease, he mentioned that a kidney transplant is often necessary for patients with nephrotic syndrome (NS). If a person has NS, they will need to undergo dialysis initially until a transplant can be arranged.

On the current state of kidney disease treatment in Bangladesh, Dr. Shahidul Islam noted that available treatment options remain limited. Treatment is typically carried out at medical college hospitals and BSMMU, although efforts to bring the country's practices in line with international standards are ongoing. Significant research is also being conducted in Bangladesh to address the specific needs of its population.

Professor Dr. Harun-ur-Rashid, founder president of the Kidney Foundation, echoed Dr. Shahidul Islam’s concerns, pointing out that, like many other countries, the prevalence of diabetes and high blood pressure is rising in Bangladesh.

He cited alarming statistics, noting that diabetes rates have increased from 6% in 2010 to 11% today. Dr. Harun-ur-Rashid also explained that around 50-60% of diabetics and 55-65% of people with high blood pressure are unaware of their conditions. If these diseases are not controlled, the prevalence of kidney disease will continue to soar in the country.

According to experts, approximately 85 crore people globally suffer from chronic kidney disease, with about 3.8 crore people in Bangladesh affected by various forms of the disease. Poverty, lack of awareness, inadequate medical care, and unhealthy lifestyles are exacerbating the situation.

Uncontrolled diabetes, high blood pressure, obesity, nephritis, poor diet, smoking, excessive painkiller use, hereditary kidney diseases, urinary system inflammation, and kidney stones are all contributing factors to kidney disease.

Every year, approximately 40,000 kidney patients in Bangladesh depend on dialysis. Kidney disease, which ranked 19th in terms of prevalence in 1990, now ranks 7th, reflecting its growing burden on public health. Unfortunately, many patients die without receiving treatment due to the high costs and inadequate access to care.

This alarming trend, which affects more people than diabetes and cancer combined, not only disrupts the lives of individuals but also creates significant economic pressure on families, communities, and the state.

However, experts believe that if kidney disease is detected early and if more public awareness is raised about its causes, severity, and potential consequences, the disease can be effectively prevented. Educating the population on the importance of managing diabetes, controlling blood pressure, and adopting healthier lifestyles could be the key to reversing the rising tide of kidney disease in Bangladesh.