by KT Leong
According to the International Diabetes Federation (IDF) 2024 data, Malaysia has an adult diabetes prevalence of 21.1 %, which ranks it among the highest in the Western Pacific region according to the IDF and is considered the country with the highest diabetes prevalence in Southeast Asia.
When we think of diabetes, we think of blood sugar, but we don’t really think about what that blood sugar means for our kidneys, hearts or lifespan. Diabetes is a major cause of heart disease and kidney failure
Ipoh Echo has recently had the opportunity to speak with Dr. Chow Yok Wai, a consultant nephrologist at Pantai Hospital Ayer Keroh, Melaka and an associate professor to Manipal University College Malaysia. Where we spoke about the topic, particularly as it relates to the kidneys. He provided DOs and DON’Ts for kidney health, as well as other practical advice.
As a nephrologist, Dr. Chow is a doctor who specializes in kidney care and treating diseases of the kidneys, such as chronic kidney disease (CKD), acute kidney injury and glomerulonephritis. As well as managing common causes of CKD, such as diabetes mellitus and hypertension (high blood pressure), as well as other kidney conditions such as kidney stones and urinary tract infections (UTIs).
- How does diabetes relate to kidney health?
Dr. Chow: High blood sugar damages blood vessels in the kidney that are essential in filtering the blood, causing toxins to remain circulating in the blood and protein to leak into the urine. Diabetes is actually the leading cause of chronic kidney disease in Malaysia and globally. In Malaysia, Diabetes is the cause of more than 50% of all new dialysis patients
- What are the signs that we should look out for, that might indicate that there could be something wrong with our kidneys?
Dr. Chow: Kidney disease is often called a “silent killer” because symptoms typically appear only in advanced stages. Most people with early stages of CKD do not have any symptoms, which is why many people do not know they have it.
However, there are some signs CKD patients may notice themselves, or that doctors may notice when testing for kidney damage.
Warning signs can include:
- Persistent fatigue or weakness
- Swelling in the legs, ankles, or around the eyes
- Changes in urination frequency or colour
- Foamy or bloody urine
- Loss of appetite or nausea
- Generalised dry and itchy skin
If you experience any of these, it’s important to seek medical advice promptly.
- For kidney health, what are the dos and don’ts?
Dr. Chow: Your kidneys are vital for removing waste, controlling blood pressure, balancing electrolytes, and keeping bones healthy and maintaining optimum red blood cells in our body. As many kidney problems progress silently until it’s too late, prevention is the most important strategy.
DOs: Healthy Habits for Kidney Protection
- Stay Hydrated (But Don’t Overdo It)
- Drink 6–8 glasses of water a day, unless advised otherwise.
- Look for light-yellow urine as a good hydration indicator.
- Eat a Kidney-Friendly Diet
- Choose:
– Fruits and veggies like berries, apples, cabbage, cauliflower.
– Whole grains like oats and brown rice
– Lean proteins like fish, chicken, and plant proteins (in moderation)
– Healthy fats like olive oil and avocado
- Limit: Salt, sugar, and processed foods.
- Control Blood Pressure
- Keep blood pressure to target as determined by your doctor.
- Reduce salt to less than 5g a day.
- Manage Blood Sugar
- Keep glucose levels within target.
- Limit sugary drinks and refined carbohydrates.
- Get Regular Exercise
- Aim for 30 minutes of activity most days which will help control weight, blood pressure and insulin sensitivity.
- Get Screened If You’re At Risk
- If you have diabetes, hypertension, or a family history of kidney disease—see your doctor to assess your kidney health. Check your creatinine, eGFR and urine albumin levels regularly.
- Use Medications Wisely
- Avoid overusing painkillers like the non-steroidal anti-inflammatory drugs (NSAID) such as ibuprofen and naproxen.
- Use safer alternatives like acetaminophen.
DON’Ts: Habits That Damage Your Kidneys
- Excess Salt and Processed Foods
- High sodium raises blood pressure and damages the kidney.
- Excessive Protein Intake
- High protein intake will “overwork” the kidneys and lead to accumulation of waste products.
- Avoid Smoking and Excessive Alcohol
EARLY SCREENING CAN SAVE YOUR KIDNEY!
Diabetes is no longer just a personal health issue — it is a national crisis. With 1 in 5 Malaysian adults living with diabetes and many more undiagnosed, the disease is silently straining the healthcare system and burdening families.
Kidney disease can be detected by performing blood tests to measure glomerular filtration rate (GFR), which shows how well the kidneys are filtering. GFR of less than 60 may indicate kidney disease. GFR less than 15 is considered kidney failure, requiring dialysis or a kidney transplant.
Urine test is also routinely done to measure presence of albumin or protein leakage which is also a sign of kidney damage.
Managing diabetes effectively requires more than medication. It demands collective action from individuals, communities, healthcare providers, policy-makers, schools and industries. What you can do as an individual or family is to know your risk and get screened early, especially if you have a family history. See your doctor for early treatment should you have kidney issues.
Ipoh Echo would like to thank Dr. Chow for his time and Elliot & Co (Elliot Communications) for making this discussion possible.
