On 18/4, sisters Hoai and Huong had a follow-up appointment together at Tam Anh General Hospital Ho Chi Minh City. Results showed that both their kidney functions were well-controlled. The doctor adjusted their medication and scheduled their next appointment in five weeks. Previously, their brother also experienced acute kidney injury on a chronic kidney disease background, and his kidney function recovered after treatment.
According to Doctor of Clinical Biochemistry II Ta Phuong Dung, Deputy Director of the Urology - Nephrology - Andrology Center and Head of the Nephrology - Dialysis Department, kidney failure is not a hereditary disease. However, multiple family members suffering from the condition can be linked to environmental risk factors such as a habit of consuming salty foods, excessive protein intake, a sedentary lifestyle, or underlying conditions like hypertension, diabetes, and glomerulonephritis.
Both Hoai and Huong have a history of hypertension. Hoai’s condition started subtly and progressed rapidly, with kidney damage advancing before hypertension became clearly apparent. In 2016, she was diagnosed with chronic kidney disease stage 3, which later progressed to end-stage, requiring regular dialysis. Thanks to a successful kidney transplant, Hoai stopped dialysis three years later, gradually recovered her health, and was able to become pregnant as she wished.
For Huong, hypertension progressed more slowly, manifesting over many years, accompanied by frequent recurrent urinary tract infections, increasing kidney damage over time. Eight years after her younger sister developed the disease, Huong was diagnosed with chronic kidney disease stage 3b, with an estimated glomerular filtration rate (eGFR) of approximately 50 mL/min/1,73m² – indicating a loss of nearly half of her kidney function.
According to Doctor Dung, the treatment approach for both cases is individualized according to each disease stage but is based on the principle of controlling risk factors and preserving kidney function. To protect her transplanted kidney, Hoai must take immunosuppressants for life. If she becomes pregnant, she faces risks of miscarriage, premature birth, or fetal abnormalities. Doctor Dung prescribed a special medication regimen that helped Hoai deliver a healthy baby, though close monitoring was required to prevent side effects.
Huong was prescribed medication and advised on a suitable diet. Doctor Dung stated that in kidney failure stages 3-4, if blood pressure is well-controlled, infections are prevented, nutrition is appropriate, and follow-up appointments are regular, Huong’s kidney function can remain stable for many years, slowing the risk of needing dialysis.
During the years Hoai underwent dialysis, Huong helped her sister manage household affairs and drove her to appointments. Since Huong’s diagnosis, Hoai has shared her experience with proper eating habits to protect kidneys and reminded her sister to take medication on time daily. On one occasion, Huong self-medicated for a sore throat, which led to a sudden decline in kidney function, causing fatigue and exhaustion. Hoai had to rush her sister to the emergency room that night. After two days of treatment, Huong’s kidney function returned to its previous level.
Currently, both sisters' health is stable. They adhere to a shared low-salt diet, control protein intake, drink enough water, and do not self-administer unverified medications or functional foods. They attend monthly follow-up appointments together for Doctor Dung to monitor their kidney function and adjust their prescriptions as needed.
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Huong at a follow-up appointment at Tam Anh General Hospital Ho Chi Minh City. Photo: Dinh Lam |
Chronic kidney failure is the ultimate consequence of prolonged kidney damage, most commonly caused by hypertension, diabetes, chronic glomerulonephritis, or the uncontrolled abuse of painkillers and anti-inflammatory drugs. If these factors persist subtly and for many years, they can lead to glomerular fibrosis and a gradual decrease in glomerular filtration rate, often without the patient's knowledge.
Doctor Dung advises that when a family member is diagnosed with chronic kidney disease, it may signal a warning to others living in the same environment who share common risk factors. The patient’s family should undergo gene sequencing to identify common gene mutations causing kidney disease. If a disease gene is present, doctors can provide a plan for early screening and kidney protection for other family members.
Dinh Lam
*Patient names have been changed
