March 10 is World Kidney Day, which launched in 2006 to promote kidney health. This year’s theme is “Bridge the knowledge gap to better kidney care”, in the hope that narrowing the gap will help prevent deaths related to kidney disease, which rise every year. Kidney disease is predicted to be the fifth leading cause of death by 2040. “Whenever you can bring awareness to a subject that affects people and doesn’t get much attention, it’s always good,” says Lori Hartwell, founder of the national Renal Support Network in the United States, based in California. Run by kidney patients like Hartwell, the non-profit organisation aims to benefit others affected by chronic kidney disease. “Kidney disease is affecting a greater number of people,” Hartwell says. “We’re living longer, and our kidneys age along with us and don’t work as well over time. We have to take care of them.” People are often surprised to learn that diabetes and high blood pressure – a condition that affects more than a quarter of adults in Hong Kong, according to a 2020 study – are the primary causes of kidney failure, she says. Hartwell suffered kidney failure as a child, the result of a bacterial infection. The kidneys: how they work and the best ways to keep them healthy She spent 13 years on dialysis and wrote a book describing her experience, Chronically Happy: Joyful Living in Spite of Chronic Illness . She is encouraged by developments in the treatment and management of kidney disease, particularly in kidney transplants . “I received my fourth transplant a little over 11 years ago, but a few years earlier than that, it would have been impossible for me,” she says. “Because of new technology, testing and antibody-treatment options, I was able to have a relatively uneventful transplant.” Professor Richard Yu, a nephrologist (kidney specialist) at Hong Kong’s 813 Medical Centre, agrees that treatment has come a long way in drug regimens such as immunosuppressant drugs, as well as in dialysis, transplants and in treating glomerulonephritis – the inflammation of the tiny filters in the kidney. How diabetes shapes one woman’s life, and warning signs to look for American kidney specialist Dr Blake Shusterman from the US state of South Carolina, who is popularly known as The Cooking Doc, notes that even if someone already has kidney disease, diet can help them effectively manage their illness. “Diet can help slow the progression of kidney disease, lower medication burden, delay the time until dialysis and kidney transplant, and keep people out of the hospital if they are already on dialysis,” he says. In 2020, Shusterman published The Cooking Doc’s Kidney-Healthy Cooking: A Modern 10-Step Guide to Preventing and Managing Kidney Disease . He notes that because the kidneys are involved in processing waste products from the foods we eat, it’s important to eat foods that the kidneys can manage, especially if their function is limited by disease. “The kidneys are involved in processing the sodium, protein, phosphorus and potassium in the foods that someone eats. If a person has mild kidney disease, they may be able to process these easily, but as that kidney disease worsens, people have to adjust how much of each they consume,” he says. Shusterman confirms that hypertension (high blood pressure), which affects 1.3 billion adults globally, is a huge contributing factor to kidney disease. The other culprit is diabetes mellitus, which affects more than 500 million adults worldwide. Both of these conditions are directly affected by diet. Diabetes is frequently a consequence of obesity and eating high-sugar foods and drinks and refined carbohydrates. “By choosing a diet that limits these high-sugar foods, a person can better manage their diabetes, maintain a healthy weight, and lower their risk of developing kidney disease,” Shusterman says. As for hypertension, a diet high in salt can adversely affect blood pressure, causing it to rise, which may increase the risk that someone will end up with kidney disease. Many processed foods contain huge amounts of hidden salt – so learning how to cook, says Shusterman, is one way to be aware of, and manage, the amount of salt in your diet. Know your family medical history: your heath could depend on it The DASH diet (Dietary Approaches to Stop Hypertension) is a healthy eating plan advocated by The Hong Kong Nephrology Group that can help prevent hypertension in well people and also help patients suffering with the condition. A 2019 study published in medical journal The Lancet indicated that more deaths globally were attributed to poor diets than tobacco: 10.9 million deaths versus tobacco’s association with 8 million deaths . Increasingly we are beginning to understand that what we put on our plates can either promote, or compromise, good health: the choice is often ours. 5 historical facts about kidneys 1. The Ancient Egyptians may have been the first people to describe the kidneys. Until recently, it was thought that they had no knowledge of this organ at all, despite their advanced understanding of the human body. In 2018, though, an ancient papyrus script dating back 3,500 years was found to illustrate the earliest description of the kidneys. 2. The kidneys are mentioned more than 30 times in the Bible – even more often than the heart. A 2005 article in the Journal of the American Society of Nephrology by Professor Garabed Eknoyan said it was not uncommon for Middle Eastern texts to attach symbolic significance to organs. “Unlike most ancient literature, however, the kidneys receive special attention in the Bible as the seat of conscience, emotions, desire and wisdom,” the article said. 3. At the start of World War II, Dutch doctor Willem Kolff attempted to develop the first artificial kidney – a crude contraption that evolved into today’s kidney dialysis machine. Due to limited wartime supplies, he wrapped sausage casings around a wooden drum to create his kidney machine. A patient’s blood was pumped into the casings, and the drum was rotated to remove impurities. 4. The first human kidney transplant was undertaken in Ukraine in 1933 by Yuri Voronoy. Sadly, it failed; his patient died two days post-transplant because of ABO (blood type) incompatibility. A, B, AB, and O are the four major blood types. When a person with one blood type receives blood from someone with a different blood type, it may cause their immune system to react – known as ABO incompatibility. It was considered a contraindication to transplants due to the significant risk of graft loss or failure. Today, with huge strides in medicine, these risks can be eliminated or much better managed. 5. The first successful kidney transplant was achieved by Joseph E. Murray and his team in Boston in 1954. Decades later, on winning the Nobel Prize for Medicine in 1990, he told The New York Times : “Kidney transplants seem so routine now, but the first one was like Lindbergh’s flight across the ocean.” Like what you read? Follow SCMP Lifestyle on Facebook , Twitter and Instagram . You can also sign up for our eNewsletter here .