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10 reasons why end-stage kidney disease (ESRD) has become global epidemics.

Written by Patana Teng-umnuay MD PhD


Chronic kidney disease (CKD) is a global problem that can lead to end-stage kidney disease (ESRD) maximizing the financial burden of the healthcare system. Surprisingly, incidences of ESRD seem to outpace the prevalence of chronic kidney disease suggesting that nephrologists are unable to prevent the progression of CKD. The possible reasons the end-stage kidney disease has become global epidemics are:


1. Lack of knowledge and program to identify the early stage of kidney disease.


2. Food additives, chemicals, herbicides, and insecticides.


3. Poorly controlled blood pressure.


4. Continuous usage of certain medication without recognizing the harmful effects these

drugs might have on the kidney. Prolonged usage of proton pump inhibitors, sulfonylurea, statins, and analgesic drugs has shown to cause a decline in renal function.


5. Ignoring the importance of hyperuricemia as another risk factor for kidney failure and CKD progression.


6. Nephrologists routinely ask patients to restrict fluid intake and then prescribe a diuretic to patients who have CKD disregarding the volume status. The complications of unnecessary diuretic usage are dehydration, hyperuricemia which add to a worse kidney function.


7. Most doctors give their patients poor dietary advice that is not only ineffective in delaying the progression of CKD, but also leads to malnutrition that accelerates the progression of the disease.


8. Most doctors don’t realize that acidosis is one of the major causes of the progression of CKD. They don’t understand how acid food like dairy products, soft drinks and reverse osmosis water can have detrimental effects on the kidney. In addition, most refuse to prescribe sodium bicarbonate for early stage CKD.


9. Some nephrologists gain benefits from dialysis treatment.


10. Most importantly, most doctors including nephrologists still believe that once a patients develop CKD, all of them will eventually progress to end-stage kidney disease and require dialysis treatment.


If doctors lost hope in a full CKD treatment and recovery, then how can patient’s keep up theirs?

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Dr. Pitch Pisessith