Be mindful of the food you put into your mouth.
That was consultant nephrologist Dr Tan Li Ping’s advice on food intake.
“As Malaysians, we love to eat but we cannot bear to walk for 10 minutes.
“This probably contributes to the prevalence of overweight adults in Malaysia, a whopping 44%, the highest compared with our South-East Asian neighbours,” he said.
Dr Li Ping was one of the speakers at the StarLIVE talk titled “Diabetes and Your Kidney”, organised by The Star and Ramsay Sime Darby at Menara Star in Petaling Jaya.
He emphasised that unhealthy food would lead to various health conditions, including obesity, diabetes and hypertension which are the biggest threats to kidney health.
Dr Li Ping said more than 60% of kidney failure stems from diabetes.
He explained, “Food goes into the stomach and breaks down into glucose (sugar), which is then sent into the blood. Insulin takes the sugar from the blood and puts it into cells that need it.
“Diabetes is when insulin cannot move the sugar in the blood into cells.
“The blood with excess sugar flows through the filtering units of the kidney and in the long run, it will exhaust and damage the kidneys.
“Other than the kidneys, blood flows everywhere in the body and may cause damage to other parts including the eyes, heart and brain.
“Also, when blood sugar spikes, the excess sugar in the blood would then be stored as fat.
“Fat, diabetes and obesity are all linked to each other.”
The attendees were surprised to learn that the human body contains about five litres of blood, with the amount of sugar diluted in the blood equivalent to just about a teaspoon.
Dr Li Ping pointed out that early symptoms of kidney disease might not be obvious, so it is best to do regular testing and monitoring.
“It is easy to measure your blood sugar, just remember 7/11. When you fast, the normal blood glucose level is less than seven and it should be less than 11 when measured two hours after a meal.
“Do a three-month blood glucose monitoring. The normal haemoglobin A1c level is less than 6.5%.
“You can get a glucose device or go to any pharmacy to get your glucose level measured.”
Dr Li Ping also spoke on ways to protect the kidney through healthy eating and exercise.
“Most importantly, be aware of what you put into your body and drink lots of water,” he said.
Joining Dr Li Ping at the talk was consultant vascular and endovascular surgeon Dr Tan Kia Lean, who focused on preparing patients for dialysis.
Dr Kia Lean pointed out that the prevalence of end-stage renal failure (ESRF) was increasing rapidly in Malaysia with almost 40,000 dialysis patients currently.
“There are three types of treatment for ESRF.
“Haemodialysis is performed at renal care centres by experienced medical staff while peritoneal dialysis, involving the peritoneum of the abdominal cavity, can be carried out by the patients themselves in the comfort of their homes.
“The most common is haemodialysis while we put aside renal transplant as an option as it is near to impossible until there is a suitable kidney donor,” explained Dr Kia Lean.
A vascular access to the bloodstream has to be surgically created before starting haemodialysis treatment.
There are three types of access – arteriovenous (AV) fistula, AV graft and vascular catheter.
AV fistula is a simple connection between a vein and an artery on the forearm.
“Many patients misunderstand that their kidneys will further deteriorate if they get their AV fistula created. So they delay the dialysis treatment which could lead to other complications, including death,” Dr Kia Lean pointed out.
He emphasised that AV fistula takes six to eight weeks to mature for haemodialysis, which many patients are not aware of, and often there is no access when it comes to emergency cases.
If a patient’s veins are too small to create an AV fistula, an AV graft, which is a synthetic tube, will be placed under the skin as an artificial vein.
“When patients come in with a kidney condition that is so bad it needs acute dialysis, a vascular catheter needs to be implanted on the neck,” he said, adding that it was a short-term solution as this method is prone to complications such as infection and blockage.
Dr Kia Lean stressed that 70% of renal failure patients die from catheter-related infection.
He urged patients not to delay treatment after being diagnosed with chronic kidney disease.
“It is not the end of your life if you need to undergo dialysis. It is also not necessarily true that once you are on dialysis, it will be for life.
“It is very important for patients to consult a suitable doctor for correct medical direction so that they are well-prepared to adapt and not suffer from bad outcomes.
“Unnecessary stress and tension can be avoided if patients are prepared with adequate medical knowledge.
“With technology, together, we can make things possible if patients come forward for treatment. The earlier the better,” added Dr Kia Lean.
The first 100 attendees had the opportunity to do a free microalbuminuria test which measures the amount of albumin in the urine.
Albumin is a protein that the body uses for cell growth and repair of tissues. It is normally present in the blood. A certain level of it in your urine may be a sign of kidney damage.
A regular attendee at StarLIVE talks, Peter Chew, 65, from Cheras, found the session informative.
“More of these talks should be held. It would definitely benefit the community,” he said.
His wife, Patricia Lee, 65, concurred.
“It is good to have such talks on weekends rather than weekdays,” she said.
The couple arrived early to take the microalbuminuria test.