Hanoi A 21-year-old girl went to the hospital for glomerulonephritis, liver enzymes 13 times higher than normal, the cause was the habit of drinking alcohol continuously.
Holding the girl's test results, Dr. Nguyen Van Thanh, Department of Internal Medicine, Hanoi Medical University, was surprised because the liver and kidney indexes were at an alarming level. However, the patient appeared quite calm, saying that she had known this from many previous examinations. She refused all the doctor's questions, only saying "the reason is that she drinks alcohol every day and requires treatment".
"Amidst the pressures and temptations of life, many young people lack courage and direction, and have to pay the price with their own health," the doctor said when recounting the above case, adding that more and more young people are suffering from chronic kidney failure, even in the final stage. At this point, patients are forced to undergo periodic dialysis despite their young age.
Like a 17-year-old female student who did not have regular health check-ups. About three months before being admitted to the hospital, she had pain in the joints of both hands and severe hair loss, then gradually developed swelling all over her body, little urination, fatigue, cough, and difficulty breathing. Upon admission, the patient was diagnosed with severe kidney failure due to an acute attack of systemic lupus erythematosus (an autoimmune disease common in young women) accompanied by heart failure, complications of pneumonia, and severe anemia.
Doctors had to transfuse blood, use antibiotics, perform emergency blood filtration, and then plasma exchange to slow the progression of the disease. However, the patient responded poorly to the medication, requiring supportive blood filtration and long-term use of immunosuppressive drugs. This condition did not last long, and the patient had to undergo periodic blood filtration to maintain life or wait for a kidney transplant.
In another case, a 20-year-old man went to the doctor because he felt tired, pale, and nauseous when eating. The diagnosis was that the patient had end-stage renal failure due to chronic glomerulonephritis, and had to have an intravenous catheter inserted for emergency dialysis. After that, the doctor performed an arteriovenous shunt in his wrist for periodic hemodialysis, forcing him to live completely dependent on the "machine kidney" until he received a kidney transplant.
Doctors perform kidney biopsy and check kidney function for patients. Photo: Provided by doctor
Kidney disease and chronic kidney failure are a burden on the healthcare sector as well as the families of those affected. The Inside CKD survey in 11 countries showed that the annual cost of chronic kidney disease is up to billions of USD, accounting for 2.4-7.5% of annual health expenditure. The cost of managing end-stage chronic kidney disease for dialysis and renal replacement therapy is particularly high.
Statistics from the World Society of Nephrology estimate that about three million people are living on dialysis (including hemodialysis or peritoneal dialysis) and kidney transplants. In particular, the rate of young people and people of working age with the disease is high and tends to increase.
Vietnam has recorded more than 10 million people with chronic kidney disease. The annual incidence of new cases of chronic kidney disease is about 8,000 people, 800,000 patients need dialysis, accounting for 0.1% of the population. However, Vietnam only has 5,500 dialysis machines serving 33,000 patients. The mortality rate from this disease ranks 8th among the 10 leading causes of death.
Dr. Nguyen Van Tuyen, Head of the Department of Nephrology and Urology, Duc Giang General Hospital, said that in the past 5 years, the rate of young patients with end-stage chronic kidney disease requiring periodic dialysis has increased by about 5-10%. Many cases were discovered by chance from vague signs such as fatigue, loss of appetite, and nausea.
"When I went to the doctor, I was diagnosed with severe kidney failure, even end-stage kidney failure, requiring dialysis to sustain life," the doctor said.
Currently, this place treats about 130 patients undergoing periodic dialysis, divided into 4 shifts. Of these, 30-40% of the patients are under 40 years old, even 30 years old, or young, healthy people, not addicted to alcohol, and lazy to exercise.
"This reality is the opposite of developed countries because the main causes of chronic kidney failure are high blood pressure and diabetes," said Dr. Thanh. In Vietnam, the causes of kidney failure are often glomerular disease, urinary stones, infections, overuse of prescription drugs or unscientific lifestyles. Therefore, the average age of people with chronic kidney disease in Vietnam is much lower than in developed countries.
In addition, chronic kidney failure is a silent disease with no symptoms, so patients in the early stages may not show any symptoms. When symptoms appear, they are often in the late stages, making treatment difficult and less effective.
In particular, unscientific lifestyles such as lack of exercise, lack of sleep, poor hygiene, and not drinking enough water are also causes. Regularly holding urine, abusing alcohol, smoking, eating salty foods, eating too much meat, eating too much sugar and sweets, eating greasy foods, consuming processed foods, obesity, and indiscriminate use of drugs can also cause kidney failure.
Many young people suffer from end-stage renal failure of unknown cause, putting pressure on the healthcare system and society. Photo: Provided by the hospital
To prevent the disease, people need to practice a healthy lifestyle. Everyone, including young people, needs to have a balanced diet, drink enough water, avoid salty foods, limit fast food and abuse alcoholic beverages.
No smoking, daily exercise depending on individual health condition. Avoid indiscriminate use of drugs, especially non-prescription drugs and herbal medicines of unknown origin.
People with acute diseases such as respiratory infections, skin infections, urinary tract infections as well as well-controlled chronic diseases such as high blood pressure, diabetes, dyslipidemia, malignancy, autoimmune diseases, urinary stones need to monitor their health to prevent disease.
According to Dr. Thanh, just a blood test to check kidney function, a complete urinalysis and an ultrasound of the urinary system can screen and detect chronic kidney failure early. People need to proactively go for regular health check-ups and kidney disease screening at least once a year, especially high-risk groups such as the elderly, people who are overweight or obese, people with diabetes, high blood pressure, cardiovascular disease, and autoimmune diseases such as systemic lupus erythematosus, scleroderma, and rheumatoid arthritis.
There is currently no cure for chronic kidney failure. In the late stages, patients are forced to undergo dialysis or kidney transplant.
"At this time, the patient's life is almost tied to the hospital and the high cost," the doctor said.
Thuy An
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