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Early Diagnosis Key in Fight Against Kidney Disease

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Early Diagnosis Key in Fight Against Kidney Disease

Dr. Tasnim Khan, a nephrologist at Gov. Juan F. Luis Hospital, says the onset of kidney disease is often hard for patients to detect.Once kidneys begin failing, the disease progressively worsens; but with early diagnosis and proper care, patients can often delay organ failure and dialysis treatments indefinitely. That’s according to two kidney specialists from Gov. Juan F. Luis Hospital who spoke Thursday to Rotary of St. Croix members at Gertrude’s Restaurant.

Dr. Jan Tawakol and Dr. Tasnim Khan are specialists in the field of Nephrology and Interventional Nephrology, a branch of medicine focusing on the study and treatment of kidney diseases. The two, who are married, have been with Juan Luis about four months now.

Kidney disease, a major health concern in the territory, is often caused by high blood pressure or by diabetes, which are themselves serious problems in the territory.

The number of patients needing life-saving dialysis to purify their blood after kidney failure is expected to steadily increase in upcoming years, and Juan Luis’s kidney dialysis clinic is operating near capacity.

Kidney disease often has few symptoms until the situation is serious, said Khan. "A shocking number of the patients we’ve seen in the Virgin Islands, by the time they present themselves to a physician with symptoms, they were already in kidney failure," she said.

Once in kidney failure, patients need dialysis, and the average life expectancy once dialysis begins is about eight years, Khan said. So preventing kidney disease and failure, and delaying the onset of dialysis is crucially important for the health and longevity of the patient, she said.

When patients are suffering from diabetes or from hypertension, the kidneys are affected along with other organs. But hypertension is often symptomless, while diabetes can slowly progress and cause damage before serious symptoms appear.

So getting checked for all three diseases is critically important. And patients who already have either diabetes or hypertension need to be aware they have a greater risk of kidney disease, too.

Exercising, eating fewer sugary and processed foods, and losing weight are all helpful with delaying and preventing diabetes, and are still important once diabetes is established, she said.

Preventing kidney disease from taking hold may be most ideal, followed by delaying kidney failure. But even when kidney failure is coming, preparing in advance can help a patient survive dialysis with fewer problems over a longer time frame, according to Tawakol.

If a patient comes in with acute kidney failure and has to have dialysis right away, the hospital will use a catheter in the patient’s neck. But that method, while easy to do, causes dangerous scarring of the veins over time and is more prone to infection, Tawakol said. It can also lead to swelling in the head and hands, from distortions in the body’s blood flow.

Instead, if a patient expected to need dialysis in the near future undergoes minor surgery to create a fistula (a vein strengthened to make it more tolerant of repeated puncturing by a catheter), the patient will have a better long-term prognosis, increasing the chances a matching kidney will become available.

"A new kidney is the ultimate solution of course," he said.

Kye Martin, a former Luis dialysis patient who received a kidney transplant last year, showed the group of Rotarians what a fistula looks like—essentially like an enlarged vein on the lower arm—and said her own experience confirmed Tawakol’s advice.

"I had problems with the neck catheter," but her health was much better after the fistula was put in place, she said.

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