Silent Kidney Diseases Progressing in Vietnam, Driven by Diabetes and Hypertension

Common diseases such as diabetes and hypertension are silently eroding kidney function in Vietnam, leading to a concerning increase in patients requiring dialysis. Dr. Hong Vĩnh Tường, a reputable nephrologist, warns that most patients on dialysis have undergone a prolonged period of accumulated damage spanning 20 to 30 years, attributing this to decades of complacency. According to annual kidney disease reports, the number of patients with chronic kidney disease (CKD) requiring renal replacement therapy (dialysis) is rising at an alarming rate. Dr. Hong has identified five major "culprits" silently stealing kidney function: 1. Diabetes Mellitus: Prolonged high blood sugar directly attacks and damages the microvasculature of the glomeruli, causing protein to leak into the urine (proteinuria). Over time, this process leads to diabetic nephropathy. Currently, over 40% of new dialysis patients have diabetes as their underlying cause. 2. Hypertension: Long-term high blood pressure causes hardening and narrowing of the renal arteries, leading to insufficient blood supply to the kidneys and a rapid decline in function. Many mistakenly believe hypertension only causes stroke or heart attack. 3. Chronic Glomerulonephritis: This group of diseases is closely linked to immune system abnormalities (e.g., IgA nephropathy or minimal change disease). Early signs can include persistent foamy urine or blood in the urine. Severe cases may require a kidney biopsy. The lack of distinct pain or discomfort makes it easily overlooked, contributing to its role as a leading cause of dialysis in younger individuals. 4. Tubulointerstitial Diseases: Common causes of damage to the renal tubules and interstitium include prolonged abuse of painkillers, self-medication with unverified traditional or herbal remedies, gout, recurrent urinary tract infections, or kidney stones causing obstruction. These factors act as silent "knives" gradually depleting the kidney parenchyma. 5. Hereditary Kidney Diseases (e.g., Polycystic Kidney Disease): Individuals with genetic defects develop numerous small cysts in their kidneys from adolescence. These cysts enlarge over time, compressing and destroying surrounding healthy kidney tissue. Approximately half of patients with polycystic kidney disease progress to kidney failure and require dialysis before the age of 50. Dr. Hong emphasizes that the destructive process of these five diseases typically spans 20 to 30 years or more, meaning there is ample time to reverse the situation. Proactive periodic screening of blood pressure, blood sugar, kidney function, proteinuria, and performing urinary system ultrasounds can detect the early signs of these chronic conditions. Close collaboration with physicians for early treatment is the key to avoiding dialysis and preserving overall kidney health.