Linh developed end-stage renal disease following a stroke six months prior. Initially undergoing regular dialysis at another hospital, he later transferred to the Tam Anh General Clinic in District 7. Dr. Do Thi Hang, Head of the Nephrology - Dialysis Unit, explained that Linh's condition stemmed from acute kidney injury on a background of chronic kidney disease resulting from the stroke. This caused a gradual decline in kidney function. He also had a history of hypertension, type 2 diabetes, mixed hyperlipidemia, hyperuricemia, and coronary artery disease.

"However, the patient was still able to urinate, which offered hope for kidney recovery and the possibility of avoiding dialysis," Dr. Hang said. She added that delaying dialysis for as long as possible increases the chances of a healthier life, free from dependence on machines.

Dr. Hang devised a personalized treatment plan to improve Linh’s overall health. The plan included medications to manage blood sugar and blood pressure, combat atherosclerosis, and prevent blood clots. The treatment goals were to maintain blood pressure below 140/90 mmHg, achieve optimal blood sugar control with HbA1c below 7%, and manage blood lipids with LDL-C below 1.8 mmol/L. According to Dr. Hang, preventing a second stroke was crucial, as another stroke would almost certainly necessitate dialysis.

For 3 months, Linh diligently followed the medical treatment plan and adopted a healthy diet. He reduced his protein intake and limited salt, fish sauce, soy sauce, fatty foods, fried dishes, organ meats, and red meat. He also minimized the use of painkillers and supplements, completely quit smoking, and avoided alcohol.

Dr. Hang attributed Linh’s positive response to the early detection and treatment of his kidney disease during a crucial window when some kidney function remained. His kidney function improved, with his estimated glomerular filtration rate (eGFR) increasing from 24 mL/min/1.73 m2 to 31 mL/min/1.73 m2, effectively moving him from end-stage renal disease to stage 3, eliminating the need for dialysis.

Linh admitted to previously keeping late hours for work, having irregular meals, frequently consuming fast food and processed foods, and heavily using alcohol and tobacco. After experiencing the stroke and initial dialysis, he made significant lifestyle changes, embracing a healthier diet and strictly adhering to his treatment plan.

Linh during a follow-up appointment with Dr. Hang. Photo: *Tam Anh General Clinic, District 7*

Vietnam currently has over 10 million people with chronic kidney disease, accounting for about 12.8% of the adult population. Each year, there are approximately 8,000 new cases, with 800,000 patients requiring dialysis. However, Vietnam only has 5,500 dialysis machines serving 33,000 patients, meeting less than 30% of the actual demand.

According to Dr. Hang, an unhealthy lifestyle is one of the leading causes of kidney failure, even among younger individuals. She recommends a healthy lifestyle: reducing salt intake, increasing consumption of vegetables and fruits, limiting processed foods, carbonated drinks, and sugary beverages, quitting smoking, limiting alcohol, getting enough sleep, increasing physical activity, and reducing stress to lessen the burden on the kidneys. She also emphasizes regular health check-ups every 6-12 months for early detection and timely treatment of kidney problems.

Ha Thanh

*The patient's name has been changed.