Kidney alert! From warning signs to winning strategies, Warning signs of kidney problems

 

Kidney alert! From warning signs to winning strategies

You might have noticed the “eGFR” result in your blood test report. It’s important to know what that number means for your kidneys.

If you’re wondering about your kidney health, don’t worry—it’s normal to have questions. Let’s dive into this together.

CLICK TO ENLARGE

 

 For more information, visit www.chronic-kidney-disease.com. 

Warning signs of kidney problems

You’re Always Tired

KIDNEYS filter waste from your blood and ship it out in your pee.

When your kidneys don’t work right, toxins can build up. One common tipoff is fatigue. You may feel spent, weak, or have trouble concentrating. Kidneys make a hormone that tells your body to create red blood cells. If you have fewer of them, your blood can’t deliver as much oxygen to your muscles and brain as they need.

Poor Sleep

Studies show a possible link between sleep apnea and chronic kidney disease (CKD), which over time damages your organs and may lead to kidney failure. Sleep apnea may hurt your kidneys in part by preventing your body from getting enough oxygen. CKD in turn may cause sleep apnea by narrowing your throat, toxin buildup, and other ways.

Itchy Skin

This may happen if your kidneys can’t flush out toxins and they build up in your blood. That can cause a rash or make you itch all over. Over time, your kidneys may not be able to balance the minerals and nutrients in your body. This can lead to mineral and bone disease, which can make your skin dry and itchy.

Swollen Face and Feet

When your kidneys can’t get rid of sodium well, fluids build up in your body. That may lead to puffy hands, feet, ankles, legs, or a puffy face. You might notice swelling especially in your feet and ankles. And protein leaking out in your urine can show up as puffiness around your eyes.

Muscle Cramps

Cramps in your legs and elsewhere can be a sign of poor kidney function. Imbalance in the levels of sodium, calcium, potassium, or other electrolytes can interrupt how your muscles and nerves work.

Breathlessness

When you have kidney disease, your organs don’t make enough of a hormone called erythropoietin. The hormones signal your body to make red blood cells. Without it, you can get anemia and feel short of breath. Another cause is fluid buildup.

You might have a hard time catching your breath. In serious cases, lying down may make you feel like you’re drowning.

Foggy Head

When your kidneys don’t filter all waste out of your body, the toxins can affect your brain. Anemia also may block your brain from the oxygen it needs. You may feel dizzy and have trouble with concentration and memory. You may even become so confused that you have trouble with simple tasks.

Low Appetite

Kidney disease can cause nausea or vomiting and upset your stomach. That may leave you with little craving for food. That sometimes may lead to weight loss.

Foul Breath

When your kidneys can’t filter out waste, it can cause a condition called uremia. That can make your mouth smell. Also, toxins in your bloodstream can give food a metallic or off taste.

Foamy, Brown, or Bloody Urine

Bubbly pee could be a sign of too much protein called albumin. That can result from kidney issues. So can brownish or very pale urine. Faulty kidney function also may let blood leak into your bladder. Blood in your urine also can be caused by kidney stones, tumors, or an infection.

How It Works

WALKING may be the simplest way to work out.

You can do it almost anywhere, and it’s a snap to get started: Just put one foot in front of the other.

There are many great reasons to walk. Your heart will get stronger, you’ll lower your blood pressure, and your bones will get stronger. Walking also eases stress, helps you sleep better, and can boost your outlook on life.

Walk at a brisk pace for 30 minutes or more on most days. Do it alone or with a friend. Try a walking club or recruit your family for an after-dinner walk. All you need is a pair of walking shoes.

Intensity Level: Low

You can match your pace to your fitness level. For a more intense workout, try walking faster, longer, or uphill.

Areas It Targets

► Core: No. Walking doesn’t specifically target your core.

► Arms: No. This workout doesn’t target your arms.

► Legs: Yes. Walking works the major muscles in your legs.

► Glutes: Yes. Walking uphill is great for your glutes.

► Back: No. This workout doesn’t focus on your back muscles.

Type

► Flexibility: No. This workout is not focused on improving flexibility.

► Aerobic: Yes. Keep up a brisk pace to make it a good cardio workout.

► Strength: Yes. Your legs will get stronger from walking regularly.

► Sport: No. Race-walking is a sport, and you can often find charity walks to do with a group of people, but for most people, walking is not competitive.

► Low-Impact: your joints.

What Else Should I Know?

►

Cost:

Good for beginners?

Free.

Yes. Walking won’t jar

► Yes. Walking is an ideal type of exercise when you’re just getting started. You can go as fast or as slow as you need. It’s easy to bump up your pace and go longer distances as you get better.

► Outdoors: Yes. You can walk around your neighborhood, on a school track, or through a nature trail. If the weather is bad, try walking in a mall.

► At home: Yes. You can walk anywhere. If you have a treadmill, you can even walk indoors.

Equipment required?

► None, except for your walking shoes. Opt for shoes that support your arch and slightly elevate your heel.

What Dr. Melinda Ratini Says

No special equipment. No gym fees. You can shed pounds and lower your blood pressure and your cholesterol -- all in your own neighborhood, mall, park, or on your treadmill.

You can start slowly with just 5 or 10 minutes a day and work up to at least 30 minutes on most days of the week to get the full cardio benefits.

You should also do strength-building exercises at least twice a week. You might want to carry light weights or cans to help build up your upper body while you walk.

Whether you like to walk alone or in groups, you can build a walking program that you are sure to enjoy. If you’re already in good shape, work up a sweat with a power walk. You can use it as your main workout, or use it along with another program to mix things up and avoid boredom.

If you walk outside, walk in safe areas, stay cool, drink water, and wear sunscreen!

Is It Good for Me If I Have a Health Condition?

Walking is the perfect exercise for many people.

If you have diabetes, walking can help lower your blood sugar and your weight. Take care if you have diabetes-related nerve damage. Your doctor or foot doctor can tell you if walking is your best exercise choice and, if so, what type of shoe is best.

Walking can help protect against heart disease. It can lower your blood pressure and your “bad” (LDL) cholesterol while ramping up your “good” (HDL) cholesterol.

If you already have heart disease, your doctor may suggest starting your walking program in a cardiac rehab setting. The rehab staff will monitor your heart and blood pressure as you build stamina.

Knee, hip, and back problems may put a cramp in your walking plans. Ask your doctor or physical therapist for advice before lacing up your walking shoes. Other problems that might hinder walking include balance issues, muscle weakness, and other physical disabilities.

Walking is also a great way to get fit and stay healthy if you are pregnant. As long as you have been active before the pregnancy and are not having any medical problems, then you should be good to go. To prevent falls, avoid uneven ground as your belly grows and your center of gravity shifts.

World Kidney Day

About kidney health - World Kidney Day 2025

https://www.worldkidneyday.org › about-kidney-health

The main job of your kidneys is to remove toxins and excess water from your blood. Kidneys also help to control your blood pressure, to produce red blood cells and to keep your bones healthy. Each roughly the size of your fist, kidneys are located deep in the abdomen, beneath the rib cage.

About kidney health - World Kidney Day 2025

Rethinking housing maintenance charges: KPKT’s pay-per-use proposal

 Striking the right balance to make housing affordable amid rising costs

By Sulaiman Saheh 

The Ministry of Housing and Local Government (KPKT) has recently unveiled a proposal to introduce a pay-per-use model for maintenance fees in future affordable housing developments. Spearheaded by Minister Nga Kor Ming, the initiative aims to reduce the financial burden on residents by shifting from fixed monthly maintenance charges to a usage-based maintenance fee system. This is a significant departure from the traditional strata living model and has sparked concerns about its potential benefits weighing against its drawbacks. The proposal warrants further studies to identify the specific contexts and the actual needs between various target markets, with a keen eye to weigh its risks and mitigation measures before its widespread implementation.

The pay-per-use model is a key component of KPKT’s broader Reformasi Perumahan agenda, which seeks to modernise Malaysia's housing sector. The ministry's intentions are centred on promoting financial equity, encouraging responsible use of shared facilities and improving affordability, particularly for first-time homebuyers in the B40 and M40 income groups. By tying costs directly to usage, the model intends to ensure that residents who rarely utilise amenities like swimming pools or gyms are not subsidising those who use them frequently. According to the Minister of Housing, this approach is also aligned with the Malaysia MADANI and UN-Habitat goals of promoting sustainable urban development, as the tracking of usage can lead to more mindful consumption of resources and a reduction in wastage. The pilot project for the concept will be implemented for the Rumah Bakat Madani project in Penang by SkyWorld Pearlmont. It features a pay-per-use clubhouse with various recreational facilities like an infinity swimming pool, pickleball and badminton courts, a children’s playground and gyms that are accessible via tracked access cards.

Positive feedback

Arguments in favour of the proposal highlight its potential for cost efficiency and transparency. Residents who do not use shared amenities would see a direct reduction in their monthly maintenance charge expenses, which could make home-occupation and ownership more accessible. The use of digital access cards provides clear, auditable records of facility usage, which could improve trust and accountability in property management. Furthermore, the model offers developers a degree of customisation, allowing for tiered access or optional packages that cater to different resident demographics. There are some who are looking at the concept’s adaptability for various types of stratified buildings, from affordable housing to commercial properties.

Not without critics

However, the proposal is not without its critics. A major concern is the potential for community fragmentation that could jeopardise the spirit of communal living. Shared spaces are traditionally seen as crucial for fostering social cohesion and interaction among residents. Monetising access to these areas may discourage their use and, in the long run, weaken the sense of community. Another significant challenge is operational complexity. Implementing and managing robust access card systems, billing platforms and usage audits would add a layer of administrative overhead that could be costly and open to disputes among residents. Joint Management Bodies (JMBs), Management Corporations (MCs) and property managers need to address this added layer of complexity by ensuring transparency, fairness and consistent maintenance across both open-access and paid facilities. Overcoming such challenges lies in maintaining clear communication with residents regarding the pricing structures, usage policies and access rights to avoid misunderstandings or perceptions of inequity. Managers must also ensure that paid-for amenities remain in excellent condition to justify the additional cost while simultaneously upholding the cleanliness and functionality of common areas that are freely accessible to all. This dual responsibility can strain operational resources and require more sophisticated tracking, billing and maintenance systems. Moreover, balancing the expectations of paying users with those of non-paying residents - especially in shared environments - demands careful policy design and proactive community engagement to prevent division or dissatisfaction.

There are also valid equity concerns, as families with children or elderly residents may rely more heavily on shared facilities like playgrounds and community halls, potentially leading to higher costs for those who need these amenities most. Critics also fear the risk of underfunding for essential, non-usage-based maintenance, such as lift upkeep, security and waste disposal, which could suffer if the revenue from pay-per-use facilities is insufficient. This is even if there were to be a multi-tier maintenance charge regime with a differentiation between core facilities and services like lifts and open-access basic communal facilities and optional-access facilities like function halls, badminton courts and gymnasium. 

Challenges to overcome

While the technological aspects of the model are feasible, successful implementation hinges on a number of factors. A robust infrastructure for tracking and billing is essential, as is a clear governance framework that defines usage and fee calculation. Legal clarity is also paramount, as the model may necessitate amendments to existing laws that relate to strata management to accommodate variable charges and modes of billing. While the pay-per-use model could potentially address concerns about fairness and affordability, particularly for residents who do not utilise all amenities, it would require amendments to the Strata Management Act 2013 (SMA) or other relevant legislation. At present, Joint Management Bodies (JMBs) and Management Corporations (MCs) are legally obligated to collect maintenance fees based on share units, which are assigned to each property. This means a fixed monthly charge is applied to all owners, regardless of their usage of shared facilities. As such, the existing laws would have to be amended.

The long-term risks are also a major consideration, especially if the proposed model results in a lower collection of funds due to a significant portion of owners or residents opting to reduce their usage of these optional access-based facilities. Underfunding could lead to a decline in the quality of facilities and with time, the cost for repairs can snowball, hence forcing JMBs/MCs to re-prioritise their maintenance budget. Consequently, the decline in quality of facilities will risk a decrease in property values – this would threaten property owners’ asset preservation and long-term financial well-being. Arguably, the pay-per-use fees could be inflated to compensate for this or even the opening of such facilities to non-resident visitors. The downside to this is that we could see wealthier residents start monopolising premium amenities while lower-income residents are priced out or security erosion due to re-aligned policy changes to open access for public use. Indirectly, it has relinquished the exclusivity of use amongst residents – unless it is at the onset, during the purchase consideration, buyers are made aware of such provisions and policies. Either way, this would further erode the inclusive spirit of community living, hence risking a socioeconomic divide.

In conclusion, KPKT’s pay-per-use proposal represents a progressive and innovative attempt to address the challenges of urban living and affordability in Malaysia. It promises greater financial flexibility and transparency but also raises serious questions about equitability, community cohesion and long-term sustainability. Before the model is finalised and tabled for implementation, it is crucial to conduct a thorough evaluation of the concept, engage in extensive dialogue with all stakeholders and explore hybrid models with transparency to homebuyers before their decision to purchase. A comprehensive engagement and proper planning are needed with the long-term effectiveness and implications in check. The concept may not be a one-size-fits-all. It requires a multi-faceted consideration from the end-user needs profiling, built environment and layout design involving potentially separated-but-interlinked plots planning and ultimately the long-term management for a harmonious community living and the sustenance of the property’s value as a place of residence and investment. A robust regulatory framework and comprehensive public education campaigns will also be vital to ensure that this groundbreaking initiative strikes the right balance between financial sustainability and social equity, paving the way for a new era of urban living in Malaysia.

Sulaiman Akhmady Mohd Saheh is the director of research and consultancy services at Rahim & Co International.

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When peeing interrupts sleep

This visual is human-created, Ai-aided

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How many trips to the toilet at night is one too many and should start worrying you?

IT’S a nightly nuisance many of us are familiar with: waking up, getting out of bed and going to the toilet because we need to pee.

For some it’s not just one trip to the toilet, but two, three, four, or even five.

Waking up more than once each night to pass urine can create a great deal of psychological stress, as it robs you of restful sleep.

In the following Q&A, two experts answer central questions about the condition, the medical term for which is nocturia.

What causes nocturia?

Going to the toilet at night sometimes has nothing to do with pressure on your bladder.

“Your sleep quality may be poor, and to pass the time as it were, you get up and go to the toilet,” says urologist Dr Daniela Schultz-lampel, director of the South-west Continence Centre at Schwarzwald-baar Hospital in Villingen-schwenningen, Germany.

In many cases, however, there’s indeed pressure on your bladder.

There are various possible causes, which include:

> Heart problems

Heart failure may be behind nocturia, says urologist Dr Guan Zhenghua, who works at the St Elisabeth Medical Care Centre in Bad Kissingen, Germany.

If your heart doesn’t pump blood properly, fluid can build up in your legs during the day.

At night, when you’re lying down, the fluid is absorbed into the bloodstream, filtered by your kidneys and then fills your bladder as urine. > Medications

“Taking a heart medication too late in the day can also lead to nocturnal urinary urgency,” says Dr Schultz-lampel.

Diuretics (water tablets), which help the body remove excess fluid and salt, and are often prescribed to treat high blood pressure, are a frequent culprit.

Other antihypertensive agents, namely ACE (angiotensin-converting enzyme) inhibitors and AT1 (angiotensin II receptor type 1) receptor blockers, can cause frequent urination at night too.

> Reduced bladder capacity

This usually has nothing to do with size, but means your bladder is unable to fill or empty fully, triggering an urge to urinate more often.

It can be due to a bladder outlet obstruction.

“In men, nocturnal urinary frequency can indicate an enlarged prostate gland,” Dr Guan says.

The prostate pressing on your urethra – the tube that carries urine from the bladder out of the penis – prevents your bladder from emptying properly, so you need to pee more often.

In women, an overactive bladder can be caused by pelvic organ prolapse, a condition in which one or more pelvic organs (e.g. the uterus) sag because of weakened pelvic floor muscles and tissues due – for example – to childbirth or ageing.

> Psychological issues

Stress, anxiety, pre-exam jitters, unprocessed experiences, etc can also lead to an overactive bladder that disrupts your sleep.  

Polyuria

Your body producing an excessive amount of urine is another possible cause of nocturia.

It can be a sign of poorly managed, or as yet undetected, diabetes.

Do certain behaviours affect having to get up to pee at night?

Yes.

“If you drink a comparatively small amount of fluids during the day and then two litres after 6pm, feeling pressure on your bladder multiple times a night shouldn’t surprise you,” Dr Schultz-lampe says.

Keeping a bladder diary can help.

For two days at least, record how much you drink and when, and how often you pee and when.

This will quickly show links between the two and point to adjustments you could make to your fluid intake habits.

They include peppermint and nettle tea, and cola on account of its caffeine content. Beer can also act as a diuretic.

Other things you can do depend on what’s causing your need to pee at night.

If you take a prescribed diuretic medication in the evening, you should ask your doctor whether you can take it earlier in the day.

And for women, Dr Guan says that “special pelvic floor muscle exercises can help to counteract an overactive bladder”.

Under an instructor’s supervision, you learn to prolong intervals between trips to the toilet by contracting these muscles.

What medical treatments are available?

“Medications can help in cases of an overactive bladder or enlarged prostate gland,” says Dr Guan.

Botox injections can also be effective in subduing an overactive bladder.

A urologist injects Botox into your bladder, relaxing the muscles there.

The effects last for several months, after which the procedure must be repeated.  

If your body makes too much urine at night, you can take a medicine with the active agent desmopressin before bedtime.

A synthetic analogue of a hormone produced in the body, it acts on the kidneys to reduce the flow of urine.

“This requires regular blood checks and shouldn’t be given to elderly persons and those with heart conditions though,” Dr Schultz-lampel says.

Is it OK to simply hold in your urine and go back to sleep?

Better not.

“It’s unhealthy since over time, it causes your bladder muscles to lose their elasticity,” warns Dr Guan.

Then your bladder is no longer able to contract and fully empty, which can have painful consequences. – dpa

Publication:The Star Malaysia

Author:By SABINE MEUTER

Penang to roll out second phase of iSejahtera payments from Aug 6,2025

 

GEORGE TOWN: The Penang government will proceed with the second phase of iSejahtera payments for this year via electronic funds transfer to 9,405 recipients from Wednesday (Aug 6).

State social development, welfare and non-Islamic affairs xommittee chairman Lim Siew Khim (pic) said the disbursement, amounting to RM1,721,300, reflects a continued commitment to the people’s welfare.

She said Phase 2/2025 payments will only be made to new applicants who registered before June 30 each year, while applications received after that date will be processed for Phase 1/2026.

"For Phase 2/2025, the breakdown and number of recipients are as follows: the senior citizen appreciation schene covers 7,187 recipients totalling RM1,437,400; single mother assistance is for 317 recipients, amounting to RM317,000;

"The golden housewife appreciation scheme involves 1,280 recipients totalling RM1,280,000; and aid for persons with disabilities will be given to 621 recipients amounting to RM124,200,” she said in a statement on Tuesday (Aug 5).

Lim said the state government has disbursed RM53.83mil to 285,816 recipients across various categories under Phase 1 and Phase 2 from January to July.

This included RM41,987,600 for the senior citizen appreciation scheme to 209,938 recipients, and RM1,064,400 for single mother assistance to 10,644 recipients.

"Other categories comprise the golden housewife appreciation scheme with RM4,423,100 for 44,231 recipients; RM3,121,600 for 15,608 persons with disabilities; the Anak Emas one-off payment of RM540,200 to 2,700 recipients; and the one-off death benefit contribution totalling RM2,695,000 for 2,695 recipients,” she added.

She urged all applicants to promptly update their bank account details to ensure smooth disbursement for Phase 1/2026.

Further information on the iSejahtera programme can be obtained by contacting the Kemara Unit at 04-650 5699 / 5700, visiting the iSejahtera office on Level 44, Komtar, during working hours from 9am to 5pm, or registering online via the official portal. – Bernama