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It is estimated that 10 percent of the global population is suffering from chronic kidney disease (CKD). The US
National Kidney Foundation (NKF) says millions die each year due to complications from this illness.

It further noted that only 2 million receive dialysis or undergo kidney transplants annually, yet that number is likely
just 10 percent of those afflicted with CKD who need treatment to prolong life.

In the Philippines, the numbers are just as disturbing. Three years ago in 2013, there were only 10,000 Filipinos
developing kidney problems annually, but it has since jumped to 14,000 at present.

Kidney disease cases on the rise

Even before arriving at those numbers, the Department of Health (DOH) has already noted a dramatic increase in the
number of people either starting or undergoing dialysis, with 23,000 going through the procedure due to kidney
failure in 2013 compared to only 4,000 in 2004.

The DOH has since estimated an increase in the number of kidney disease cases between 10 to 15 percent a year.

While it does not rank the highest among the top causes of death and diseases in the country, it brings with it one of
the heaviest functional and financial burdens on an individual.

Kidney problems, however, consistently rank among the top 10 causes of morbidity (7th) and mortality (8th),
according to the Philippine Statistics Authority.

Based on the Philippine Renal Disease Registry, there are over 28,000 Filipinos undergoing dialysis.

According to the Philippine Council for Health Research and Development, many Filipinos damage their kidneys
because of diabetes and hypertension.

Complication of other major diseases

In 2009, then director of the National Kidney and Transplant Institute (NKTI), Dr. Enrique Ona, had a similar
observation, noting that some chronic kidney diseases, notably End-Stage Renal Disease (ESRD) usually result as a
complication of other major illnesses like poorly-managed diabetes or hypertension.

It remains the reality today. In the province of Negros Occidental in southern Philippines, provincial health officers
reported that kidney disease as a result of poor diabetes control and HPN was the 6th leading cause of death this
year. And 2016 is not even over yet.

Kidney failure is the gradual loss of the organs functions. A damaged kidney is unable to filter body wastes and lead
to a buildup of toxic fluids and electrolytes that eventually affect the function of other vital organs.

The general public is rarely aware of symptoms indicating kidney damage, but they are among the most obvious. An
individual with a damaged kidney feels more tired, is often fatigued and has trouble sleeping. Physically, they
experience swollen ankles and feet, puffiness around the eyes and dry, itchy skin.

Costly disease
Financially, it is a burden not only on the sick individual but on the family, as well. Dr. Susan Jorge, manager of the
Renal Disease Control Program (REDCOP) of the NKTI, the state-run Philippine Insurance Health Corp (Philhealth)
allocates the biggest share for patients being treated with kidney disorders.

The cost of treatment is simply exorbitant, and even with Philhealth coverage, there is often out-of-pocket expenses
for the patient.
Dialysis and transplantation carry such huge financial burdens that a study noted that most patients who receive
kidney treatments are those residing in Germany, United States, Japan, Brazil, and Italy.

As the elderly population increases, NKF predicts so will the cases of kidney disease and its treatments, especially in
developing countries.

Unhealthy lifestyle a big factor

Today, both diabetes and hypertension - leading precursors in the development of kidney diseases in the country -
account for 60 percent of patients undergoing dialysis treatment.

Glomerulonephritis was once the leading precursor of kidney disease until it was overtaken by HPN and diabetes
both of which are lifestyle diseases.

Likewise, familial history of kidney and heart diseases can also contribute to the development of kidney malfunction.

A 20-year study headed by Dr Alexander Chang of the Loyola University Medical Center found that lifestyle habits
such as a combination of poor diet (obesity), smoking, and lack of exercise increases the risk of kidney disease by a
staggering 300 percent.

However, it is not clear if stopping those habits can reverse the progression of the disease. Instead, experts
recommend that it is better to not develop any of the habits at all.

According to National Nutrition Council, 16.6 percent, the obese rate jumped to 31.1 percent in 2013. Presently, 3
out of 10 Filipinos are obese.

Additionally, 17.3 million Filipino adults are smokers. These smokers light an average of 7 to 11 sticks per day.

Since these habits are largely modifiable, the NKTI is strongly advocating for cessation of smoking, regular exercise,
eating healthy diet (avoidance of excessive salt) and drinking water.

In managing HPN or diabetes, the Institute stresses that patients should take their medication regularly, visit their
provider, set goals for their sugar or blood pressure, and most importantly, make sure these goals are met.

Treatment for kidney diseases is focused in slowing the progression of the disease, and the DOH recommends those
who experience the symptoms to consult their care providers the soonest time possible.

Too few kidney donors

As in many other countries, Filipino patients succumb before a donor for a kidney transplant is found. The supply just
cant meet the demand, and names on the waiting list simply get crossed out due to death.

Many simply opt to undergo dialysis, rather than wait in line for a donor. Unfortunately, not all patients respond well
to dialysis treatment and really require transplantation.

In Hong Kong, it was reported that the chances of getting a kidney donation is as low as 5 percent. In Singapore, the
situation is even more dire, with the average wait for a suitable kidney donation usually taking 9 to 10 years.

Over 19,000 Malaysians, meanwhile, are under the kidney waiting list, although there are 300,000 who pledged to be
organ donors.

Of the over 28,000 Filipino patients undergoing dialysis, only about 300 to 500 kidney transplantations are performed
annually and with an estimated 2,500 cases in 15 hospitals, many are left waiting. In fact, one patient dies each week
while waiting for a suitable organ.
According to NKTI, there are 7,000 End-Stage Renal Disease (ESRD) patients in the renal waiting list, one which
continues to grow longer every year.

Burdens of the disease

Age is critical factor in the successful management of kidney diseases. The growth of children who undergo dialysis at
a very young age do is often affected, the NKTI noted.

On the other hand, adults suffering from renal disease often have to give up or lose their role as providers. This is
especially true for those suffering from ESRD, because it is likely to be comorbid with another condition that is
debilitating like chronic anaemia, muscle wasting, extensive bone deterioration and peripheral nerve damage.

And then there is the cost of a kidney operation, which ranges from 600,000 to 1 million pesos. Fortunately, in 2012,
PhilHealth announced it will be subsidizing the full cost of kidney transplantation up to 600,000 pesos for ESRD
patients. Philhealth also subsidizes 45 sessions of dialysis treatment annually.

NKTIs Human Organ Preservation Effort (HOPE) is the in-organization body in charge of retrieving organs. It was
established in 1983, and works closely with the Renal Disease Control Program and follows the organ donation
guidelines set by the Department of Healths Philippine Organ Donation Program.

Other than kidneys, HOPE can also procure liver and pancreas.MIMS