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According to the report from The United States Renal Data System (USRDS), Thailand is one of the top 5 countries with the highest incidence of kidney disease, with 11.6 million chronic kidney disease patients. Among them, more than 100,000 require dialysis. Kidney disease prevention can start simply by reducing sodium intake and increasing the consumption of vegetables and fruits.
Thai people consume as much as 3,635 milligrams of sodium per day, equivalent to about 2 teaspoons of salt, which is nearly twice the recommended amount. Ninety percent of sodium in food comes from various seasonings such as fish sauce, light soy sauce, bouillon cubes, salt, shrimp paste, and monosodium glutamate, as well as processed foods, all of which are high in sodium.
<h2>Kidney failure can be acute or chronic 
</h2>
Kidney failure symptoms or disease are divided into two main types:
1. Acute kidney failure is a condition where the kidneys rapidly lose function due to various causes such as severe bloodstream infections, urinary tract diseases, exposure to toxins, side effects of medications, drug overdose, and critically ill patients from various diseases. Patients will show symptoms from the onset even though the kidneys have not yet deteriorated, such as swelling, tea-colored urine, urine tests showing red blood cells and protein, and abnormal high blood pressure. Although acute kidney failure can be life-threatening, if patients receive timely treatment, there is a chance for the kidneys to recover to normal.
2. Chronic kidney failure is a condition where the kidneys gradually lose function continuously, reducing their ability to work. The main causes of deterioration are diabetes, hypertension, obesity, as well as other conditions such as nephritis, polycystic kidney disease, and gout-related kidney disease. In the early stages, patients usually show no abnormal symptoms. If a physical examination is done, doctors will not find any abnormalities except in cases where urine tests reveal red blood cells and protein in the urine. Without treatment, the condition gradually worsens until kidney function is only about 25% or one-quarter of normal. At that point, symptoms of kidney disease begin to appear. If kidney function declines to less than 10% of normal, patients will show clear symptoms in all cases. Most patients are diagnosed when kidney function has significantly decreased, leading to irreversible kidney failure that cannot be restored to normal.
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<td style="width: 48.4715%; height: 22.3958px;">Symptoms of acute kidney failure
1. Swelling or dehydration
2. Fatigue, loss of appetite, nausea, vomiting
3. Urinating less than usual or abnormal urine color
4. Easily tired, feeling faint, irregular heartbeat
5. Muscle cramps at night
6. Pulmonary edema
7. Anemia
Note: These symptoms occur within hours, days, or weeks. If treated promptly, the kidneys can recover to normal.
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<td style="width: 48.4715%; height: 22.3958px;">Symptoms of chronic kidney failure
1. Fatigue, shortness of breath
2. Very little urine output
3. Swelling with pitting edema
4. Itching all over the body
5. Loss of appetite, nausea, vomiting
6. Loss of consciousness, death
Note: The kidneys gradually lose function continuously over months or years and cannot be restored to normal.
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<h2>Diagnosis of kidney failure</h2>
1. Urine test If there is kidney abnormality, urine will contain protein and red blood cells.
2. Blood test If there is kidney abnormality, levels of blood urea nitrogen (BUN) and creatinine (Cr), waste products from muscles, will be elevated. Doctors use these blood test results to assess kidney function or glomerular filtration rate (GFR).
3. Ultrasound and CT scan If there are abnormalities in the kidneys and urinary tract, doctors can clearly observe them along with other laboratory diagnostic tests.
<h2>Reasons for kidney disease screening</h2>
Screening for kidney disease is the best prevention before the disease occurs. If risk factors are detected before the disease develops, proper prevention can reduce the risk. If kidney disease is diagnosed early, treatment can slow kidney deterioration better than treatment at advanced stages. Slowing kidney deterioration early helps prevent or delay complications and the need for kidney replacement therapy.
<h2>Who should be screened for kidney disease</h2>
Chronic kidney disease can occur in all genders and ages, so screening is recommended at all ages, especially for high-risk groups as follows:
<ul>
<li>People aged 60 years and older</li>
<li>People with underlying diseases such as diabetes, hypertension, cardiovascular disease, gout, overweight or obesity</li>
<li>Regular smokers or those with a long history of smoking</li>
<li>People regularly taking herbal medicines or toxins that damage the kidneys</li>
<li>People with a family history of chronic kidney disease</li>
<li>People with symptoms such as swelling of the face, body, or feet; back pain; frequent urination; burning sensation; blood in urine or abnormal foam; loss of appetite; nausea; vomiting; fatigue; easy tiredness; or high blood pressure</li>
<li>People with high blood pressure and over 40 years old</li>
<li>People with a history of urinary tract stones</li>
</ul>
For high-risk groups, doctors recommend kidney disease screening and consultation with a kidney specialist, which is the appropriate method to prevent and reduce the risk of kidney disease. The earlier the disease is detected and treated, the better the chance the kidneys can return to normal function.
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Prof. Dr. Somnuk Damrongkitchaiporn 
Specialist in Internal Medicine, Nephrology 
Dialysis Center, Phyathai 1 Hospital

There are 11.6 million Thai people suffering from chronic kidney disease, and more than 100,000 people require regular dialysis or kidney cleansing. Kidney disease screening helps detect risks and deterioration at an early stage before physical symptoms appear.

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Chronic kidney failure vs. acute kidney failure: What are the differences?

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