When Kidneys Go Bad

There are those who say Chinese love to take medications. When you flip on the TV, one of the most frequent images is that of the medicine jar. When you glance through the newspaper, there are pages covered with ads for secret formulas; it seems there's one for even those illnesses that give science the most trouble, from cancer to uremia to AIDS.

Or just take a look at the main lobby at Chiang Kai-shek International Airport. Simply watch the travelers from Taiwan returning from mainland China, Singapore, or Japan--a great deal of space in their luggage was preserved just for bringing medicines back. According to estimates of the Department of Health, when national health insurance is implemented, total annual expenses for prescriptions for the whole country could reach anywhere from NT$50 billion up to NT$100 billion. We consume the equivalent of a superhighway in pharmaceuticals each year.

The menu for a uremia sufferer who has not had dialysis is extremely simple. They can practically only eat boiled green vegetables and steamed meat, and they must strictly limit amounts and seasoning.

Don't take compound medication carelessly!

Many people stuff their faces with compound medications. That's looking for trouble!

Crunching the numbers, there has been a constant increase in recent years of people suffering from uremia who require dialysis to stay alive. According to the ROC Kidney Foundation, in March 1989 there were 5,049 people on dialysis. By the end of last year, the number was 9,410, and it is expected to break the 10,000 barrier this year.

There are many factors which can destroy the functioning of a kidney: diabetes, streptococcus, excessive eating or drinking . . . . too many to keep track of.

Professor Yang Ling-ling of the Taipei Medical College points out that Chinese are in the habit of taking composite medications rather carelessly In particular there are many so-called "informal recipes" for Chinese traditional remedies that include diuretic ingredients which are potentially toxic. Diuretics can create a false impression of increased urine flow, which can make uremia sufferers careless, when in fact they may be extending the illness and even worsening the damage to the kidneys.

"The threat of uremia is increasing all the time, and excessive use of composite medications is very possibly one reason why," she offers.

Also, many pain relievers and antibiotics are harmful to kidney function. Take what are sometimes called "the American panacea"--steroids--for example: They have miraculous curative powers, but extended use can lead to infections and damage the tubules in the kidneys, making them a major kidney killer.

Many misconceptions:

Besides being fearful of having something go wrong with them, most Chinese have little or no understanding of their kidneys.

Despite the fact that doctors repeatedly stress that the kidneys have no relationship to sexual performance, many people still inquire, "will an overactive sex life lead to 'kidney collapse'?" ("Kidney collapse" is the literal translation of the Chinese term for impotence.) Or, "isn't impotence just the same as uremia?" These reveal that most people still have many misunderstanding about kidney ailments.

Li Cheng-min, a kidney specialist at Ching Sheng Hospital, points out that the kidneys are located at the back of the waste, with one on each side. Each pair of these organs is composed of a million tiny blood vessels. All the blood and fluids in the body pass through them continually at a rate of 1,100 cc per minute in order to cleanse the body of excess waste. Most of the water in the body goes through here to become urine and then is sent on to the bladder and from there expelled. But once the kidneys are damaged, they can no longer clean the toxins out of fluids and blood, and over time a person will die from poisoning.

Unwittingly infected:

"Most patients are infected without even sensing it," states Dr. Li. Because patients often do not feel discomfort in the process of suffering kidney damage, they only discover that they are in the final stages of kidney disease--which is to say uremia--when they experience overt symptoms like fainting or vomiting.

Uremia is not in fact the name of a specific disease, but refers to a weakening in the functioning of the kidneys so that they can no longer fulfill their task of cleaning the body of wastes. If an affected individual does not rely on dialysis or get a kidney transplant, he or she can develop pulmonary edema or hyperpotassemia, or die of severe metabolic acidosis. In the end, the only passive treatment for uremia sufferers is dialysis; and if you want to take active measures to get back to health, the only choice is a kidney transplant.