Sugar overload: A growing threat to kidney function

Approximately 3.8 million Malaysians suffer from chronic kidney disease, with 80 to 85 percent of these cases linked to diabetes or hypertension.

Consultant Nephrologist and Kidney Transplantation Physician at Sunway Medical Centre, Sunway City (SMC) Dr. Rosnawati Yahya said nearly half of all dialysis patients have diabetes, emphasising the severe health risks associated with excessive sugar consumption.

"High sugar intake leads to obesity as it has calories and that is the main problem. Once you are obese, it is likely to develop into diabetes, hypertension, hyperlipidaemia, fatty liver, and breathing issues as they are all interrelated.

"We just need 1,800 to 2,000 kilocalories (kcal) a day, so any excess will be deposited as fat, resulting in abdominal fat, visceral fat, and the development of insulin resistance," she told Bernama in an exclusive interview here recently.

Dr. Rosnawati, who has more than 25 years of experience in nephrology, explained that insulin resistance occurs when the muscles, fat, and liver fail to respond properly to insulin, preventing them from absorbing glucose (sugar) from the blood, which ultimately leads to diabetes.

She said prolonged diabetes that goes unmanaged can severely damage the kidneys, significantly raising the risk of kidney failure, while genetic factors may also make certain individuals more susceptible to diabetes and kidney disease at an earlier age.

She explained that protein in the urine, or proteinuria, is the first sign of kidney damage from diabetes, with patients being usually asymptomatic at this stage, though some may notice bubbles in their urine.

In the later stages of kidney disease, symptoms like leg swelling, nausea, vomiting, and poor appetite may appear, she added.

"Being diabetic for a long time increases the risk of developing complications such as macrovascular and microvascular complications.

"Microvascular complications affect the blood vessels in the kidneys, resulting in kidney failure, as well as the blood vessels in the eyes known as diabetic retinopathy which may lead to blindness.

Dr Rosnawati highlighted that excess sugar intake not only leads to diabetes but also increases oxidative stress in the body, reducing its ability to fight against diseases.

"Sugar has been shown to drive obesity which may increase the risk of developing some cancers. So the best thing is to reduce your daily sugar intake or, even better, train yourself not to consume sugar at all. The best drink in the world is plain water," she advised.

She also recommended regular exercise, mindful eating, and tracking daily calorie intake to reduce the risk of obesity, diabetes, heart disease, and kidney damage, as well as encouraged at-risk individuals to regularly undergo blood and urine tests to monitor kidney health.

Dr. Rosnawati shared that recent advancements in medicine have led to new treatments aimed at slowing the progression of kidney disease caused by diabetes.

"For many years, we only had one agent (to control blood glucose levels) but in the last few years, we have four agents," she said.

Regarding the recent sugar tax imposed by the government on sugary beverages, Dr. Rosnawati commended the initiative and emphasised the need for greater public awareness of healthy eating habits.

She suggested that food operators should control portions and display calorie counts on menus, helping consumers make more informed choices, and called for broader measures to improve the overall lifestyles of Malaysians and their health.

"It is important to improve work-life balance, ensuring people have time for exercise. Generally, people spend too much time commuting, which leaves them little time for physical activities," she added.

Dr. Rosnawati also recommended that employers develop a healthier workplace by offering nutritious food options and promoting physical activity, such as rewarding employees for reaching a daily step goal before work.

Founded in 1999, SMC is the largest quaternary hospital in Malaysia and the only one with three major international accreditations: The Joint Commission International (JCI) Gold Seal of Approval, the Australian Council on Healthcare Standards (ACHS), and the Malaysian Society for Quality in Health (MSQH), affirming its commitment to healthcare excellence.

The hospital has 28 Centres of Excellence across more than 60 medical specialties and is currently licensed for 724 beds. Plans are in place to expand to approximately 1,100 beds with the completion of its sixth block, Tower F, by the fourth quarter of 2025. - BERNAMA