Every second Thursday of March is declared World Kidney Day, with the aim of drawing the attention of the world public to the rapid and active spread of kidney diseases and the subsequent complications leading to kidney failure
Kidney damage is established not only with already proven pathology of the kidney, but also with other concomitant diseases - diabetes mellitus, arterial hypertension, gout, high overweight, obesity
10% of the world's population suffers from chronic kidney disease. In 2010, 2.6 million people had proven end-stage renal disease, and in 2030, this number is expected to reach 5.4 million. Over 250,000 new patients with chronic kidney failure are diagnosed each year.
The frequency of chronic kidney disease increases with increasing age and associated comorbidities. In women, the incidence is 12.9-13.8%, and in men - 17.1%. The frequency of these diseases is 120 people per 1 million population, and a large part of patients do not suspect the existing kidney damage. There are about 750,000 patients with kidney failure in Bulgaria.
Our well-being depends on the he alth of the kidneys, as they are a natural filter that removes more than 150 toxins and harmful substances from the body and pumps 1700 liters of blood per day.
“This important organ is given to us once and for life. Like nerve cells, nephrons - kidney cells - do not regenerate. With the loss of 95% of the nephrons, the human body can only exist on dialysis or after a kidney transplant.
Kidney disease is called the "silent killer" because for a long time they do not give symptoms and do not cause complaints, but undermine the body from the inside. The main enemies of the kidneys are improper nutrition and bad habits. If there is an excess of protein in the diet, the kidneys are under increased load and stones are formed. The cause of stones can also be an abundance of sour, s alty and spicy foods, alcohol, cigarettes", explains nephrologist Prof. Dr. Emil Paskalev, head of the Nephrology and Transplantation Clinic at Aleksandrovsk Hospital.
Prof. Paskalev, do Bulgarians care about the he alth of their kidneys?
- The Bulgarian should know that if he has high blood pressure, he should also be examined by a nephrologist. It is noteworthy that he has learned and is tracking his cholesterol level, but does not know what creatinine is, which is an indicator of kidney function. People are not aware of what a nephrologist does and neglect to see him to find out how he althy their kidneys are. Their idea of diseased kidneys is only the pain in the lower back. Kidney stone disease is a disease that gives signs, but there are other diseases that ravage the kidneys and cause early disability and loss of ability to work at the age of 25-45.
High blood pressure after 5-10 years leads to kidney function damage. Bulgarians, watching the advertisements on TV, especially those about the prostate gland and night rising, do not think that the reason for this could be the kidneys. It is good to increase the attention of patients, but also of personal doctors regarding the detection and clarification of kidney diseases.

Prof. Dr. Emil Pascalev
What can remind us that we should see a nephrologist?
- The majority of these people are diabetics and hypertensives - about one and a half million in Bulgaria. They may come to us, referred by fellow endocrinologists and cardiologists. Most often, kidney diseases occur with very early and short-lived symptoms that are elementary and people do not pay attention to them.
Which are the main ones?
- For example, if there are more frequent and stronger urges to urinate, if it is accompanied by burning, but these signs pass in a day or two, we usually forget about the problem. But it is there, smoldering. Other symptoms are changes in urination. If, for example, a person starts to get up at night, to urinate more often, or if he only went 2-3 times with a small need. Normal is 5-8 times a day. One should monitor one's urine in terms of color, quantity, and frequency. To know which foods he goes for more often for a small need. It is necessary for a person to observe himself, to know himself, and everything that is out of the ordinary for him should make an impression on him.
You mentioned hypertension and diabetes, but they are also very often associated with stress…
- Stress has a neurological mechanism that affects the blood vessels. They become inelastic and blood pressure rises. Immobility is associated with increased risk of hypertension, high cholesterol, heart attack. It is necessary to pay a lot of attention to the concept of hygiene of life. It includes stress, diet and exercise. To this, we must also include attention to our own he alth, which is also a key point, to be concerned about those around us.
As well as the s alt…
- S alt is a major cause of kidney damage. Even in the bread in the store there is s alt, which is in large quantities. We prescribe medication to treat hypertension but forget to remind that s alt intake should be stopped.
The case of a Japanese man who had high blood pressure values is illustrative. He started consuming only rice and from 200 to 120 blood, after the regime and the complete exclusion of s alt, achieved arterial values from 120 to 80.
The heart is loaded by the s alt that contains the water in the body. By learning not to eat s alty food and drink water, we will not have high blood pressure. The kidneys are also hindered by the excessive intake of proteins. It is not good to eat 10 kebabs for dinner, which are the main menu. I am not a supporter of vegetarianism, especially in childhood, but when the organism is mature, the intake of proteins can be reduced, not to overdo it with meat. And if the Bulgarians do at least these three things, they will meet less with us, the nephrologists.
People should learn and drink enough fluids. By taking a glass of water, we torture the kidney and strain it. It will be much easier for them if we provide water so that the kidneys can release urine within 1-1.5 liters per day. The normal intake of water is 1-1.5 liters, and for people with problems liquids should be more than two liters.
What we don't know
► In one day, a quarter of the volume of all blood circulating in our body passes through the kidneys
► There are special filters in the kidneys - nephrons, "waste" is collected in the form of urine and thrown out, and purified blood enters the arteries
► Nephrons are about 2 million
► During filtration, 180 liters of primary urine are formed in the kidneys. This is naturally not the final product, because otherwise we wouldn't be leaving the toilet
► Kidneys look like beans, in an adult their length is 10-12 cm, and the weight - from 120 to 150 grams
► In addition to filtering, the kidneys have other functions. One of them is the production of the hormone renin, which is responsible for the regulation of blood pressure
► The kidneys take part in blood formation processes, regulate the basic-acid and water balance in the body. They are responsible for the normal ratio of electrolytes
► Unlike many other organs, almost all animals, including fish and amphibians, have kidneys

Green salad is contraindicated for stone patients
High-protein diet provokes a bunch of kidney diseases and brings severe crises. However, a balanced diet with more fruits and mineral water on the table balances the work of the kidneys and improves the excretion of kidney stones.
Just disposing of them is not a simple task. The only remedy that works equally well for both urate sufferers and those with phosphate and oxalate stones is the fruit and roots of rose hips, which help to flush them out of the kidneys in the urine. The roots of this plant not only remove formations, but are also used as an anti-inflammatory and strengthening agent for diseased organs and the ureter.
If you suffer from oxalate stones, it means that the exchange of minerals in your body is disturbed. To correct this disorder, it is necessary to limit the intake of oxalic acids in the body. They are contained in spinach, in green salads, in chocolate and, of course, most of all in lapada. These four products are absolutely contraindicated for patients with kidney stones. In addition, it is advisable to stop taking vitamin C, even if you are suffering from a cold or acute flu, because it stimulates the formation of oxalic acid.