The online news portal of TV5
MANILA, Philippines -– Pascual, a man in his 50s, had been undergoing dialysis treatment for nearly nine years -– undoubtedly causing a major dent in family savings -– when the end came.
He was among at least 10,000 Filipinos, some hobbled by unhealthy eating habits, who each year require kidney replacement, according to the Quezon City-based National Kidney and Transplant Institute.
While Pascual, by his own account while living, never had any bad habits in the dining room or elsewhere, did not risk kidney transplant, the stretch he went through the treatment spoke volumes about kidney failure affecting a rising segment of the country’s population of some 98 million.
According to medical sources, kidney failure has become the ninth leading cause of death among Filipinos at present.
Majority of the patients are said to survive less than two years because of cardiovascular disease that increases due to renal failure.
One trouble faced by medical care givers is that some people display no visible symptoms, at least in the initial stages, suggesting the symptoms may be subtle.
Among those with acute kidney failure, the following may be recognized: decreased urine production; body swelling; problems concentrating; confusion; fatigue; lethargy; nausea; vomiting; diarrhea; abdominal pain; and metallic taste in the mouth.
Seizures and coma may jab in very severe acute kidney failure, according to medical sources.
Many are asking what the kidneys are for.
Medical sources say the kidneys have the ability to monitor the amount of body fluid, the concentrations of electrolytes like sodium and potassium, and the acid-base balance of the body.
They filter waste products of body metabolism, like urea from protein metabolism and uric acid from DNA breakdown.
Two waste products in the blood can be measured: blood urea nitrogen (BUN) and creatinine (Cr). These are initials in a doctor’s slip that are not always explained during an executive medical check.
According to medical sources, when blood flows to the kidney, sensors within the kidney decide how much water to excrete as urine, along with what concentration of electrolytes.
For example, if a person is dehydrated from exercise or from an illness, the kidneys will hold onto as much water as possible and the urine becomes very concentrated.
When adequate water is present in the body, the urine is much more dilute, and the urine becomes clear, the sources say.
This system is controlled by renin, a hormone produced in the kidney that is part of the fluid and blood pressure regulation systems of the body.
At the same time, kidneys have a vital function, being the source of erythropoietin in the body, a hormone that stimulates the bone marrow to make red blood cells.
Medical sources paint a grim picture of less than 90 per cent only of Filipinos with kidney failure can undergo dialysis and the remaining per cent only can afford transplants because of the rather prohibitive expenses.
Sources say, without dialysis or kidney transplant, patients with kidney failure can die.
Why is dialysis important?
Sources say dialysis helps the body by performing the functions of failed kidneys.
One of the essential jobs of the kidney is to regulate the body's fluid balance by adjusting the amount of urine that is excreted on a daily basis.
On hot days, the body sweats more. Thus, less water needs to be excreted through the kidneys.
On cold days, the body sweats less. Thus, urine output needs to be greater to maintain the proper balance within the body, according to medical sources.
According to the Philippine Renal Disease Registry, the top causes of kidney failure in the Philippines is diabetes (44.6 percent), followed by high blood pressure (23 percent), and inflammation of the kidneys (19.3 percent).
To avoid kidney failure, medical sources say the public must eat healthy and avoid drinking too much alcohol, as well as having a yearly urinalysis and blood sugar level tests.
Keeping the blood pressure at normal level will also prevent or delay development of kidney problems, they add.
Meanwhile, the cold figures are sending ripples across the archipelago – from Batanes to Tawi Tawi.