The whole nation was shocked by the death of the fifteenth President of the Philippines. The former President Benigno “Noynoy” Aquino III died of End-Stage Renal Disease, as a complication from diabetes. How informed are we about Diabetes and End-Stage Renal Disease (ESRD)? How informed are we about diabetes and end stage renal disease?
Diabetes Leads to ESRD
Diabetes is the 6th leading cause of death among Filipinos, according to Philippine Health Statistics. While COVID-19 has been killing many people since last year, Diabetes is one of the top killer diseases for a decade now. The common symptoms of diabetes are having more body infections, blurry vision, slow healing of wounds and sores, and frequent thirst and hunger. There is Type I and Type II Diabetes. The people with Type I and Type II Diabetes should avoid high glycemic foods. This type of food can react badly against the insulin or medication that they are taking. Foods containing high glycemia or glucose include corn flakes, white rice, white breads and baked potatoes. Type I Diabetes is usually diagnosed in very young adults and children. Type I Diabetes does not produce insulin at all. Both Type I and Type II Diabetes can lead to Diabetes Mellitues. Diabetes Mellitus is a condition characterized by high blood glucose (sugar) levels. This can cause kidney failure, resulting to End-Stage Renal Disease.
End-Stage Renal Disease
End Stage Renal Disease or ESRD happens when chronic kidney disease worsened to the point that the kidney functions less than 10% of normal. There are symptoms when the chronic kidney disease progresses to end-stage renal disease. Some of these are chest pain, if the fluid builds up around the lining of the heart, sleep problems, persistent itching and loss of appetite. Other signs are shortness of breath, if fluid builds up in the lungs, hypertension or high blood pressure, swelling of feet and ankles, decreased mental sharpness, muscle twitches and cramps, nausea, vomiting and changes in how much you urinate.
There is a build-up of waste products and fluid in the body when the patient is affected by ESRD. The waste products affect most body systems and functions. The functions include electrolyte balance, red blood cell production, calcium levels and Vitamin D levels. Management of ESDR includes dialysis treatment, kidney transplant and dietary management.
A special diet is important. This is because dialysis alone cannot effectively remove all the toxins in the body. Dietary management also helps to minimize the amount of waste build-up. A special diet also sustains the electrolyte, fluid and mineral balance in the body between the dialysis. The patient’s weight must be monitored and managed with a proper balanced diet to avoid unreasonable weight loss. The ESRD patient’s average calorie intake reduces to lower than 30-35 kg/day. This leads to malnutrition. Malnutrition directly affects the patient’s mortality and morbidity. To prevent malnutrition, the ESRD patients undergoing dialysis need to have a periodic nutrition screening and tests, comparing initial body weight with usual and ideal body weight, food diary assessment and dietary reviews. So, there is a need to do lots of dietary changes, specifically on low sodium, restricted fluid intake and potassium and phosphorus diet.
Low Sodium and Fluid Intake
Salt is used as preservatives. This can be found in canned food and processed smoked meat. These must be avoided. The ESRD patient must also avoid ketchups, pickles and sauces. When cooking food, herbs can also replace the salt. It is also important not to use salt substitute because it might contain potassium. Potassium is also restricted for those with kidney disease.
To reduce fluid intake, the patient must avoid eating food with too much water. Examples of these are Jell-O, ice cream, popsicles, soups and celery. The ESRD patient is also advised to avoid getting too hot or going out in the sun because of the fluid intake process of the body.
Potassium and Phosphorus Levels
When affected by chronic kidney disease, the patient must avoid fruits high in potassium. These fruits are bananas, kiwis, cantaloupes, prunes, tomatoes, avocados, oranges, raisins, and melons. The vegetables that are high in potassium are spinach, pumpkin, sweet potato, asparagus and potatoes. The patient can opt to eat fruits and vegetables like pineapple, watermelon, peaches, apples, eggplant, cabbage, broccoli, cauliflower and carrots. The phosphorus level of the patient must also be regulated. This can be reduced by the physician who prescribes the phosphorus binders.
The death of former President Noynoy Aquino sheds light to what we are often oblivious about- food habits. In this particular story, those foods are sugar for diabetes and salt for kidney disease. If you observe that you might have symptoms of diabetes or kidney disease, you can avail of telemedicine service 24/7 by calling the MyPocketDoctor. The MyPocketDoctor has been actively delivering both health information and telemedicine services. You can certainly enjoy these conveniences right at your fingertips by downloading the MyPocketDoctor APP and talking to our team of doctors about your health concerns. MyPocketDoctor can be contacted through its Facebook page and/or agent chat on the website www.MyPocketDoctor.com. You may check the Frequently Asked Questions (FAQs) through this website.