End-Stage Renal Disease (ESRD) is defined as a stage where tissue is destroyed and the kidneys suffer permanent reduced function. At this stage, toxic substances accumulate in the body because they cannot be eliminated by the sick kidneys. The kidneys, in their normal state, produce a hormone known as erythropoietin which is responsible for stimulating the bone marrow to produce red blood cells. In ESRD erythropoietin levels are low, resulting in low hemoglobin levels.
After 30 years of age and as aging progresses, kidney function decreases. Certain medical conditions such as diabetes mellitus, hypertension and abuse of pain relievers can accelerate the loss of kidney function and can eventually pose the need for receiving dialysisor a kidney transplant.
In Puerto Rico the leading cause of ESRD is diabetes mellitus (67.4%) followed by hypertension (12.8%). In our country the majority of the people who begin dialysis are between 60 and 80 years old. It should be clarified that most people who are in this age group will not develop permanent kidney disease and need dialysis.
However, it is important to emphasize that those who are between the ages of 60 and 80 years should be evaluated to determine renal function and whether any albumin or protein is present in urine. Be aware of foam in urine, since this finding may suggest presence of albumin or protein in the urine, a marker of kidney damage and cardiovascular risk.
If we can detect kidney disease, we can also detect in what stage of the disease each person is. More importantly, we may determine if the loss of kidney function is due solely to the aging process of the person and the kidneys.The greatest challenge is working on early prevention or dealing with the disease later. Dr. Rafael Burgos Calderón Medical Director of Atlantis and PR Renal Health & Research, Inc