How much do you know about your 'water pipes?' The answer matters
It's hard to understate the role of kidneys in human health. These two bean-shaped organs that lie just below the rib cage each filter about 120 milliliters of blood a minute, removing excess water and waste to form urine.
They also balance fluids and electrolytes in the body, and produce hormones that keep blood cells and bones healthy.
Giving these vital organs their due recognition, we observe World Kidney Day on March 14. This year's theme is "kidney health for all – advancing equitable access to care and optimal medication practice."
It's a theme that resonates with Dr Cui Xingang, the 48-year-old chief physician and head of the Urology Department at Xinhua Hospital who likens the kidney to a "water pipe."
For him, the message of World Kidney Day means further research into early diagnosis of kidney cancer and the preservation of as much kidney as possible when tumors are removed.
"That was unthinkable some 20 years ago, when I was still in medical school," said the renowned urologist. "Back then, a kidney tumor basically meant removing the entire kidney."
He added, "Thanks to rapid technology development in the field, it is now more common to preserve as much kidney as possible, hence less chance of chronic disease and a higher quality of life for patients after the surgery."
Dr Cui Xingang attributes advanced technology for better surgery options.
According to the World Kidney Day campaign, chronic kidney disease affects an estimated 850 million people worldwide and resulted in over 3.1 million deaths in 2019.
Kidney disease presently ranks as the eighth most common cause of death, and if left unaddressed, it could become the fifth leading cause of life loss by 2040.
Cui has a reputation for operating on patients turned away by other doctors, either because they are unable to master the complexity of the surgery or because they lack the confidence to preserve part of the organ. His team has managed to preserve part of the organ in 80 percent of kidney tumor patients.
It is easier for surgeons to remove the entire kidney. Trying to preserve part of it means more risk of bleeding and requires finishing the core operation within half an hour – often times, within minutes.
"Your kidney is like a water pipe; operating on it requires switching off the tap," Cui explained to Shanghai Daily, using a 3D-printed, actual size kidney model from his bookshelf to illustrate his point.
"Turn it off for too long, and it may never function again," he said. "So most of my surgeries, for the core part, are counted in minutes."
Beware of your "water pipes!"
Many patients are referred to him by colleagues from other hospitals. Some patients even travel from abroad to seek his help.
"This is such a common occurrence," Cui said. "Almost every week, I have patients who have been turned away by other hospitals, including some abroad. Many of them have only one kidney left, due to previous surgeries. That makes the remaining one even more important and the surgery more challenging."
He said he feels great satisfaction when a surgery, especially on a patient feeling desperate, is successful.
Cui attributes advanced technology for making shorter-duration operations possible. Among those technologies are the increasing use of robotic surgeries that enable more precise, minimally invasive operations. With enhanced digital programs, he can examine the kidney in 3D more clearly and prepare better surgery plans.
Cui explains kidney disease with 3D printed, actual size kidney models on a local TV program.
On this World Kidney Day, he also stresses the importance of regular health checkups, early diagnosis and continuing research into kidney tumors.
Cui recalled one example. Last year, a woman in her 20s, who was studying abroad, was completely oblivious to telltale signs of her illness. The surgeon had to remove a rare, large tumor close to major blood vessels. The operation was successful, but Cui said she would have had a better quality of life going forward if the tumor had been diagnosed earlier.
Kidney tumors, unlike many other forms of cancers, can't be detected by available blood tests. Cui and his team have been working on developing such a test. Despite some positive early results, there's still a long way to go, he said.
He has also been working on improving early diagnosis of prostate cancer, which includes collaboration with a local Shanghai technology company to experiment with a prostate biopsy assistant robot. Such a device would prove more precise and less painful for patients, he said.
"Early diagnosis is very important in major diseases like cancer and greatly increases the survival rate," Cui explained. "Thanks to public awareness about early diagnosis of diseases like colon cancer, breast cancer and others, life expectancy in Shanghai has greatly increased."
Indeed, Shanghai leads China in life expectancy at 84.11 years – higher than in many developed countries, including the United States.
Cui's prescription for healthy kidneys? Try to maintain a regular pattern of life, avoid gluttony, beware medicines that could damage kidneys, pay attention to your body, and don't neglect to seek medical help if something doesn't seem right.
In short: "Healthy lifestyle."
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