Chronic kidney failure is a disease with worrying statistics. Of over 7 billion people in the world, 850 million are reportedly found to suffer from a progressive loss of kidney function. Globally, over 2.5 million people are required to undergo regular haemodialysis, which filters and cleans the blood outside the body, because their kidneys fail to do their job.
In Thailand, 11 million people are stricken with chronic kidney disease. Of this number, 100,000 patients require haemodialysis. Every year, 10,000 more patients need to be treated by the artificial kidney machine.
"Chronic kidney disease is one of Thailand's major public health concerns. While there are various factors that contribute to the development of the disease, medication, herbs and dietary control are among the treatments but, unfortunately, a lot of people have limited knowledge about these options," said Prof Emeritus Dr Supat Vanichakarn, secretary-general of the Kidney Foundation of Thailand, at a public seminar entitled "What To Know About Drugs, Herbs And Kidney Disease".
The seminar was organised last week by the Nephrology Society of Thailand in collaboration with the Kidney Foundation of Thailand, the Royal College of Physicians of Thailand, the Medical Association of Thailand and the Thai Kidney Club.
Due to the gradual loss of kidney function, chronic kidney disease may come with only a few symptoms until eventually it reaches the stage where the kidneys are no longer able to fully filter waste and excess fluids from the blood.
Urban living and societal changes play a part in the development of the ailment, according to nephrologist Dr Manoch Rattanasompattikul of the Jubilee Medical Centre under Mahidol University's Faculty of Medicine.
"Apart from diabetes and high blood pressure, city life where people tend to have unbalanced diets and a lack of exercise also lead to chronic kidney disease," he explained.
A number of patients feel completely numb when they are diagnosed with kidney disease as they think of it as an illness with no cure. Although this may be true to a certain extent, nephrologist Dr Wanniya Meenune of Rajavithi Hospital said there are still measures to help alleviate the symptoms, reduce complications and slow down the deterioration of kidney functions.
"There is no need to be overly anxious over the diagnosis," said Dr Wanniya. "At times, treatments for kidney disease deal with the actual cause of the illness, so somehow specialists do not prescribe medication that directly tackles the affected organ."
Kidney deterioration does not mean patients cannot live, added the kidney specialist. Besides dietary adjustment, patients must be extra careful when it comes to their use of medication and herbs, especially those advertised online as a miracle cure for chronic kidney failure.
The first group of drugs that should be used under watchful eyes is nonsteroidal anti-inflammatory drugs or NSAIDs such as Ibuprofen, Diclofenac, Indometacin, Naproxen, Meloxicam and Celecoxib. Among chronic kidney disease patients, these medicines could potentially lead to swelling, rising blood pressure, poorer kidney function as well as acute kidney failure.
Also antibiotics like Gentamicin, Amikacin and Colistin should be used only under close medical supervision, because they, too, can be toxic to the kidney.
"Medicinal and herbal remedies, such as those advertised online, are often a waste of money," advised Dr Wanniya. "Patients with kidney problems should discuss with their doctors first before taking them, because sometimes these remedies do make things worse."
Asst Prof Dr Supinda Sirilak, kidney specialist from the Faculty of Medicine, Naresuan University, said that a number of people these days opt for over-the-counter medicine -- either universal painkillers or a combination of unlabelled pain-relief drugs sold in small packages especially in rural areas -- as well as traditional medicine which, in her opinion, can increase the risk of kidney disease if taken regularly, especially if the medicine is substandard. "Statistics show that 33% of Thais use traditional medicine. Herbs render medicinal benefits only if used appropriately and not for too long," said Dr Supinda.
A word of warning from Dr Supinda: Firstly, herbal drugs available in general markets might be contaminated with toxic heavy metals or steroids.
Some types of herbal medication can cause complications for kidney disease patients, while some trigger adverse reactions with other drugs. In some cases, patients have confounded particular types of herbs, consequently misused them and possibly harmed their kidneys.
For example, Dr Supinda referred to a study which showed the negative effects of herbs in the Aristolochia family on kidney disease patients. Following the 2012 study, the World Health Organisation (WHO) classified Aristolochic acid as carcinogenic to humans. In Thailand, Aristolochia has been banned from all herbal medicines due to its toxicity to the kidneys.
Various types of herbs and vegetables are high in oxalate, added the doctor, which is likely to form kidney stones if consumed regularly. Some herbal plants are high in potassium, which can also damage the kidneys. In conclusion, kidney disease patients should always consult with their doctors before taking herbs. For non-patients, it is best to check the quality of the product and only buy from a reliable source.
"Nature is not always safe," said Dr Supinda. "Herbs and plants might be grown on contaminated soil or they might be contaminated along the manufacture line. So when it comes to these alternative treatments, use them with care. Check your kidney and liver health regularly. Discuss with your doctors the things you are unsure of."