Interview with Dr. Hasan Al Malki
Hamad Medical Corporation
The kidney works as a vital filter, removing waste products and excess fluids from your body.
No larger than the size of a pear, the kidney is a complicated organ working silently and expecting nothing in return. Your blood flows through it an amazing 36 times every day – filtering about 1300 liters of blood!
Due to its importance, the world celebrates International Kidney Day on the 10th of March. This year, the aim was “kidney disease prevention in children.” We sat down with Dr. Hasan Al Malki, Head of Kidney Diseases Department at Hamad Medical Corporation
1- The kidney plays a huge role in our body, can you tell us more about the function of the kidney?
The kidney is very important in the human body; it has multiple roles. It removes excess fluids from the body and eliminates toxins produced during metabolic function. It also clears away any medicines or other toxic substances in your system. It maintains correct blood pressure and helps regulate acids and minerals in the bloodstream. Other functions of the kidney include hormone regulation and production of red blood cells. It also activates vitamin D, which helps absorb calcium and phosphorous, vital in supporting bone density in the human body.
2- Kidney disease is very dangerous as it affects many people and at different ages. What is chronic kidney disease and what causes it?
Kidney disease is divided into categories: Acute failure or acute illness, which usually happens fairly quickly and improves really quickly as well. However, if the damage is chronic, the functions of the kidney are affected long term with little expected improvement.
As for chronic kidney failure, there are multiple reasons why it occurs, the most common being diabetes and high blood pressure. The disease can be divided into 5 stages depending on the functions of the kidney that are affected – ranging from 90 percent use in the first stage to complete kidney failure in the fifth stage.
Other possible causes of kidney disease are hereditary kidney cysts, kidney stones, chronic kidney infections in the lining of the kidney, imbalance in the immune system and genetic diseases. Sometimes, the kidney can be affected by repeated bacterial infections, which in time can lead to malfunction of the organ. Kidney stones are also another likely cause of problems as they cause blockages in the organ.
3- Nearly 10 percent of the world’s population suffers from chronic kidney disease, how widespread is it in Qatar?
Kidney disease is widespread across the globe. In most countries, the spread is between 10-13 percent and is distributed at all stages from 1-5. It is wide spread in Qatar at nearly the same percentage.
4- Who is more likely to be affected by Kidney failure?
People who have diabetes, high blood pressure, and those with history of dialysis and kidney transplant for themselves or their family. The people more likely to be affected by kidney failure should frequently visit their doctor and find out as much as possible about the disease.
Individuals over 50 years of age should also have regular check-ups to ensure that they don’t have any signs of the diseases. Of course, those patients who have kidney cysts or stones or have reoccurring urine infections should also see a doctor on a regular basis.
5- What causes kidney stones?
Kidney stones are caused by a variety of reasons including a genetic predisposition. Another reason is that people do not drink enough liquids, and this can also cause kidney infections. Some types of bacteria can also cause kidney stones. The high temperatures in Qatar cause dehydration and people tend not to drink enough liquids to keep themselves hydrated, which in time leads to concentration in the urine and that leads to kidney stones.
6- What is a transplant and what does it require of the patient? Is there difficulty finding ideal donors?
Those who have kidney disease in the last phases, with less than 18 percent functionality, have a significant risk of kidney failure within 6 months, even if they start dialysis straight away. So we advise that they start looking for donors from the family to increase the chances of finding a match to the tissue — this makes the operation smoother and faster.
7- Regarding kidney transplants, how damaged must the kidney be before the patient requires a transplant?
Any patient with kidney functionality that drops below 18 percent must go through tests for transplant. Then they must receive official consultation with their doctor about the operation.
8- What percentage in functionality is needed for us to survive kidney failure?
The lowest percentage of functionality needed for a human body to survive is 18 percent.
9- How many kidney transplants have been conducted yearly in Hamad hospital?
The transplant program started in the late 80s, more than 25 years ago. In the last couple of years transplant operations ranged from 5 – 10 per year and in 2015 we had 18 successful transplant operations, and that’s a new record.
10- How many are on the waiting list to receive a transplant?
Our transplant waiting list is reviewed on a monthly basis and currently has about 80 patients.
11- It might be hard to diagnose kidney disease accurately before it becomes too advanced. However, how can we avoid chronic kidney disease?
Avoiding the dangers of getting chronic kidney disease starts with simple steps like eating healthy, exercising, maintaining an ideal weight, drinking more liquids, avoiding smoking, and not taking any medication without a medical prescription. Patients who have a family history of kidney diseases must check with their doctor on a yearly basis at least. Patients who have a high risk of kidney disease like those who have diabetes, blood pressure, kidney infections, kidney stones, and kidney cysts require constant care from their physician.
12- How much does the transplant operation usually cost?
Transplant operations in Qatar are free from an Emir decree. The transplant operation and the preparation for it,
as well as all the care after it is all free to everyone in Qatar.
13- Any last advice about kidney disease and ways to avoid them?
My advice is for people to maintain an ideal weight, eat healthily, exercise regularly, and to those who have a high risk of kidney diseases, to check regularly with their doctor.