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Kidney Clinic, Delhi

Kidney Clinic

Nephrologist Clinic

B5/6, Gate No-5, House No-4532, Vasant kunj Delhi
1 Doctor · ₹1000
Book Appointment
Call Clinic
Kidney Clinic Nephrologist Clinic B5/6, Gate No-5, House No-4532, Vasant kunj Delhi
1 Doctor · ₹1000
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We will always attempt to answer your questions thoroughly, so that you never have to worry needlessly, and we will explain complicated things clearly and simply....more
We will always attempt to answer your questions thoroughly, so that you never have to worry needlessly, and we will explain complicated things clearly and simply.
More about Kidney Clinic
Kidney Clinic is known for housing experienced Nephrologists. Dr. Sudeep Singh Sachdev, a well-reputed Nephrologist, practices in Delhi. Visit this medical health centre for Nephrologists recommended by 106 patients.

Timings

MON-SUN
05:00 PM - 09:00 PM 08:00 AM - 10:00 AM

Location

B5/6, Gate No-5, House No-4532, Vasant kunj
Vasant Kunj Delhi, Delhi - 110070
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Hi!<br/><br/>My name is Dr. Sudeep Singh Sachdev and I m currently working as a consultant in the...

Hi!

My name is Dr. Sudeep Singh Sachdev and I’m currently working as a consultant in the department of nephrology in Narayana Super Speciality Hospital, sector 24, Gurugram. Now there are several methods by which we can reduce the frequency of kidney diseases. So why wait until our kidneys are diseased? Today I’m going to discuss some very important and useful tips to keep your kidneys healthy. Now the first and foremost tip that I would like to say is to drink plenty of water. Drink at least 2.5 liters of water in a day.

This will help to clear the kidney of salt, urea, creatinine and other toxins which have accumulated in the body over the day. The second useful tip I would like to give you is to reduce the salt intake or reduce the sodium in your diet. Avoid taking any package or restaurant foods, avoid addition of any extra salt in the diet. Keep your salt intake over 24 hours to less than 5 to 6 grams in a day. Doing such a day would reduce the load of the kidney and decrease the development of hypertension, hypertension related disorders are also kidney diseases in the future.

The third important tip would be to maintain an appropriate body weight. Keep your cholesterol levels in check because deposition of cholesterol cannot only occur in the heart but can also occur in the renal arteries and is implicated in the pathogenesis of the kidney diseases. Avoid intake of any fatty food, fried foods, eat plenty of fruits and vegetables. The next important tip I would like to give you is to check blood sugar levels. Every year get a fasting and a postprandial blood sugar levels done. Maintain your hba1c under 6 in the body. Avoid taking any sugary items or items which are rich in sweets. This would help to maintain your sugar levels under limits.

If you have been diagnosed to have any impaired glucose tolerance or diabetes mellitus consult a physician, take oral hypoglycemic drugs and keep your sugar levels under control because diabetics develop kidney function very early which can be permanent and irreversible if not corrected. The next important tip would be to monitor your blood pressure regularly and keep it under control that is less than 120 by 80. You can do this by adopting a healthy lifestyle, exercising every day for at least 45minutes, playing granite games, going for swimming and so on. Reduction of salt intake would also help to maintain your blood pressure under control and decrease the chances of development of kidney diseases or delay progression if you are already having one.

Now get your kidney function tests and urine analysis done regularly. This is especially important for the at risk population for kidney diseases which includes diabetics, hypertensives. People above the age of 60 years, obese people, people who have known coronary artery disease or people who have a family history of the same or family history of chronic kidney disease. Get yourself evaluated by blood tests, urine analysis, kidney imaging like an ultrasound of the kidney or a renal artery doppler to rule out causes of kidney diseases. Another important tip which I would like to give you is to quit smoking.

Smoking not only harms the kidneys but also effects the heart and can even cause stroke. Smoking even one cigarette already weakens already harm kidney. So I would request all of you to avoid smoking and stop it if you are already doing so. The next important tip is to maintain an active lifestyle. As I have discussed, one exercise should go for in a day, avoid fatty, fried items. Take a low salt diet and keep oneself healthy by maintaining a BMI of less than 24, especially in the Indian scenario. The next important tip which is actually not followed by majority of us is to avoid unnecessary use of any painkillers or any other sort of alternative medication if it is not required.

Commonly used painkillers like indomethacin,brufen, combiflam can harm the kidney and have been implicated in the causation of chronic kidney disease. So I would request you to use painkillers which are safe from the renal standpoint like paracetamol, tramadol or hydrocet. Last but not the least I would request you all to balance your lifestyle by having a healthy night sleep. Sleep at least 8 hours in a day. This is going to provide adequate rest to the bodies and the kidney and provide time for the recovery and you to be up and about during the next day. Thank you. I hope this would have helped you to garner some information about how why one can keep once kidney and the human body healthy.

read more
Hi!<br/><br/>My name is Dr. Sudeep Singh Sachdev and I am currently working as a consultant nephr...

Hi!

My name is Dr. Sudeep Singh Sachdev and I am currently working as a consultant nephrology in Narayana Super Specialty Hospital, Gurugram, Sec-24. Today I will be talking about the early warning signs of kidney diseases. Now millions of people on this earth are suffering from kidney diseases but most of them do not even have the idea about it. Why? Because most of the kidney diseases present with non-specific symptoms and are only prevalent when the patient prevents in advance stages of the disease. While the only way to confirm the presence of kidney diseases is to get confirmatory investigations done which include blood test, urine test and various form of image investigation.

However, the following are the few early signs of kidney diseases. One of the earliest sign is the appearance of swelling over the feet, ankle or legs. One will start to notice edema which pits on applying pressure and often termed as pitting edema. This is usually due to the fact, that when renal dysfunction advances, there is salt retention and accumulation of fluid in the extra vascular spaces of the body. Now another common and early sign is the presence of periorbital puffiness which is the appearance of edema on the upper and lower eyelid. It especially occurs in people who have protein leakage from their kidneys. And in often termed as nephrotic syndrome.

Another one of the early signs is the presence of early morning nausea. Now the patient would classically present to the bathroom at the time of brushing his teeth with the sensation of early morning nausea which leads to a separation of his appetite and decreases in taking of food during the day. This in turn can also be expedited if the patient also complaints during the later stages of disease with the sensation of metallic taste because of which he starts to deny even the most favourite products which he had loved to eat beforehand. Now another one of the early sign is anemia. By anemia I mean there is a fall in hemoglobin without any apparent blood loss from the body. There is no visible site of blood loss but the hemoglobin of the person starts to fall.

The reason for this is that kidney is a site where there is production of erythropoietin in the body. And erythropoietin is required for hemoglobin production. As renal dysfunction advances there is decrease in erythropoietin levels which present as low hemoglobin levels thus leading to anemia. Now another one of the early signs is the change in the frequency of urination of the person. One might start to urinate more often and it is often described as increase in the frequency of maturation during the night termed as notaria. This can also happen during prostate disorder in man and also urinary tract infection or could be the early sign of kidney disease.

Now one should also be very careful about any changes that occur in the nature, consistency or color of urination. As the filtering mechanism of the kidney fails, there is leakage of both protein or blood cells from the kidney. Thus the presence of blood could indicate the presence of prostate disorder, urinary tract infection or even presence of tumors of the kidney, presence of pus in the urine along with fever which indicates the serious infection of kidneys like pyelonephritis or excessive frothiness of the urine would indicate presence of great amount of protein leakage which needs to be evaluated in further detail. Another non-specific sign would be the presence of dry skin or psoriasis. As the renal dysfunction would advance there would be also associated itching and one can notice itch marks on the skin of the person. Now a non-specific early sign could also be either a backache which would present as pain along the side or below the rib or even lower abdominal pain which could be in pubic region.

This will either indicate the presence of stone, maybe in the kidney or in the bladder itself or the respective infections. Last but not the least, another presenting sign of kidney disease could be the high blood pressure. Often when high blood pressure detected it’s not evaluated for kidney etiologies. Thus, it is very important for any person who presents with hypertension to get his kidney function test done along with imaging of the kidney to rule out renal etiology of hypertension. Lastly, I would like to mention that recognition and awareness along with timely intervention would lead to early detection and treatment of a kidney disorder which otherwise, could end up with dialysis, transplant or even an unfortunate circumstance as death.

Thank You!

read more

Doctor in Kidney Clinic

Dr. Sudeep Singh Sachdev

MBBS, DM - Nephrology, MD-General Medicine
Nephrologist
Get ₹125 cashback on this appointment (No Booking Fee)
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14 Years experience
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Chronic Kidney Disease - Factors That Put You At Risk!

MBBS, DM - Nephrology, MD-General Medicine
Nephrologist, Delhi
Chronic Kidney Disease - Factors That Put You At Risk!

What is Chronic Kidney Disease?

Chronic Kidney Disease (also known as Chronic Renal Failure) is the progressive loss of kidney function occurring over a span of several months to several years and is characterised by the replacement of kidney architecture with interstitial fibrosis.

Chronic kidney disease is classified into five stages on the basis or proteinuria (presence of protein in large amounts in the urine) or Glomerular Filtration Rate (GFR) - 1 being the mildest with no distinct symptoms and 5 being end stage renal failure.

Causes and Risk Factors of Chronic Kidney Disease-

The various reasons (called risk factors) that can increase chances of Chronic Kidney Diseases are:

  1. Diabetes mellitus, hyperlipidemia (excess fat proteins in the blood)
  2. Hypertension

  3. Family history heritable renal disease

  4. Older age, smoking

  5. Autoimmune disease

  6. Past episodes of acute renal disease

The direct causes of Chronic Kidney Diseases are-

  1. Diabetic nephropathy (leading cause)

  2. Hypertensive nephropathy

  3. Glomerulonephritis (swelling of the glomerulus in the kidneys)

  4. Reno-vascular disease (ischemic nephropathy)

  5. Polycystic kidney disease

  6. HIV-associated nephropathy

  7. Transplant allograft failure

  8. Exposure to drugs and toxins

Diet that you must maintain in Chronic Kidney Disease-

It is essential to make dietary as well as lifestyle amends once you are diagnosed with CKD. The main purpose of this diet is to maintain the levels of carbohydrates, fluids and minerals. This is done to prevent the buildup of waste products in the body as the kidneys are unable to fulfil its function properly.

It is recommended to refer a dietician who can make you a diet chart that helps you adhere to your diet.

Here is a list of food items that you may avoid or may consume if you are suffering from Chronic Kidney Disease:

  1. Carbohydrates : Carbohydrates are a good source of energy. If the intake of protein has been restricted, then it is recommended to replace that with carbohydrates as a source of energy. Fruits, vegetables, grains and bread can be consumed as they are rich source of fibres, minerals and various types of vitamins. You can indulge in some hard candies or sweets as well.

  2. Fats: Fats can provide a good amount of calories as well. Ensure that you only stick to healthy fats such as the monounsaturated and polyunsaturated fats that are good for your cardiac health.

  3. Reduce your phosphorus intake: A diet with no more than 800 mg of phosphorus can help reduce the risk of too much phosphorus building up in your blood.  Limit intake of foods with high levels of phosphate or phosphate additives such as organ meats, whole grain breads, processed foods, cola beverages, cheese, dried beans, liver, peanut butter, dairy products and chocolate. Many beverages and processed foods have these additives. Other high-phosphorus foods to limit include:

    • Cheese
    • Chocolate
    • Ice cream
    • Legumes
    • Milk
    • Nuts
    • Seeds
    • Yogurt
  4. Monitor your potassium levels: Usually, potassium is not restricted in stage 3 CKD unless lab tests show potassium is too high. Your doctor may make medication changes or prescribe a low-potassium diet. Reduce an elevated potassium level by limiting some high-potassium foods and potassium chloride (found in salt substitute and many low-sodium processed foods), such as avocado, bananas, cantaloupe, honeydew, legumes, milk, nuts, potatoes, seeds, tomato products and yogurt. Some high-potassium foods to limit or avoid include:??
    • Avocado
    • Bananas
    • Cantaloupe and honeydew melon
    • Dried fruit
    • Legumes
    • Milk
    • Nuts and seeds
    • Oranges and orange juice
    • Potatoes
    • Pumpkin and winter squash
    • Tomato products (juices, sauces, paste)
    • Yogurt
  5. Proteins: Usually, before undergoing dialysis, it is recommended to adhere to a low-protein intake diet. However when you are undergoing dialysis, it is necessary to consume a certain amount of protein. This detailed information can be obtained from your dietician.
  6. Fluids: In the early stages of CKD, your fluid intake is not monitored. But as the disease progresses, you need to check your intake of fluids as too much fluids may accumulate in your body and create pressure on your kidneys.

  7. Sodium Or Salt Intake: Keeping a check on your salt intake reduces the risks of high blood pressure. Also, having food low on salt can reduce your thirst and prevent fluid retention in your body. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

2930 people found this helpful

Peritoneal Dialysis - Know The Step By Step Procedure!

MBBS, DM - Nephrology, MD-General Medicine
Nephrologist, Delhi
Peritoneal Dialysis - Know The Step By Step Procedure!

No Blood, No needle, No visit to hospital, you can do yourself at home with water. A thin layer of transparent screen like structure hangs in front of the abdominal muscles known as peritoneum. This peritoneum protects the abdominal structures and the muscle. This can also be used for performing dialysis which is carried out when the functioning of kidney gets affected. In peritoneal dialysis a thin and soft catheter is placed in the person’s belly one week before performing the procedure.

The catheter has numerous holes in order to facilitate the transformation of fluids. Dialysis solution is prepared in a bag and the tubing is connected to the catheter placed in the abdomen thereby, the fluids absorb the waste materials from the body. The fluid is allowed to stay in your body for a particular period of time which is commonly referred as dwell time and later the fluid is drained out.

There are two types of peritoneal dialysis, continuous ambulatory peritoneal dialysis and automated peritoneal dialysis. This is the simple form of dialysis which anybody can perform after a short training period and this can be done anywhere in clean private place like hotels, home and even in office.


Procedure followed during Peritoneal Dialysis
All you need to perform a peritoneal dialysis is catheter and transfer set, cycler, dialysis solution and safety precautions materials to stay away from getting infections.
Step 1 - Perform a sterile aseptic technique. Wear a glove and surgical mask before connecting the catheters and transfer set. Clamp the tubing and remove the catheter once the dialysis solution enters your abdomen
Step 2 - Allow the solution to remain in your abdomen for a particular period of dwell time
Step 3 - Drain the fluid from the abdominal cavity into the drain bag. You may feel a mild tugging sensation when adequate amount of fluid is drained.
Step 4 - After drain close or clamp the transfer set and later flush a fresh solution directly to drain bag so as to remove the air from the tubing.
Step 5 - Close your drain bag and open your transfer set and refill your belly with fresh solution.

Make sure you perform without giving way for infection and excess fluid and dextrose absorption. In case you have a concern or query you can always consult an expert & get answers to your questions!

 

2918 people found this helpful

Diabetes - How Fatal It Is For Your Kidneys?

MBBS, DM - Nephrology, MD-General Medicine
Nephrologist, Delhi
Diabetes - How Fatal It Is For Your Kidneys?

Diabetes is a disorder that is characterized by an inability of the pancreas to produce enough insulin or effectively utilize the insulin produced by the body. Insulin is the hormone that is produced by the pancreas to metabolize sugar in the body, the sugar that is present in the food that you consume.

Diabetes is commonly classified into two types: Type 1 and Type 2 diabetes.

In Type 1 diabetes, the cells in the pancreas do not produce insulin in the required amounts; this disorder usually tends to occur in children. Type 2 diabetes generally occurs in people who are above 40 years of age; this type is characterized by an inability of the body to efficiently utilize the insulin produced by the pancreas.

How can diabetes affect your kidneys?

Too much glucose, also called sugar, in your blood from diabetes damages your kidneys’ filters. If the filters are damaged, a protein called albumin, which you need to stay healthy, leaks out of your blood and into your urine. Damaged kidneys do not do a good job of filtering wastes and extra fluid from your blood. The wastes and extra fluid build up in your blood and make you sick.

Diabetes is a leading cause of kidney disease. Diabetic kidney disease is the medical term for kidney disease caused by diabetes. Diabetic kidney disease affects both kidneys at the same time.

Signs of Kidney Disease in Patients with Diabetes

  1. Albumin/protein in the urine
  2. High blood pressure
  3. Ankle and leg swelling, leg cramps
  4. Going to the bathroom more often at night
  5. High levels of BUN and creatinine in blood
  6. Less need for insulin or antidiabetic medications
  7. Morning sickness, nausea and vomiting
  8. Weakness, paleness and anemia
  9. Itching

What are the possible complications?

  1. End-stage kidney failure: If this occurs then you would need kidney dialysis or a kidney transplant.
  2. Cardiovascular diseases: Diabetics have an increased risk of developing cardiovascular diseases, such as heart disease, stroke and peripheral arterial disease. If you have diabetes and diabetic kidney disease, your risk of developing cardiovascular diseases is increased further. 
  3. High blood pressure: Kidney disease has a tendency to increase blood pressure. In addition, increased blood pressure has a tendency to make kidney disease worse. Treatment of high blood pressure is one of the main treatments of diabetic kidney disease.

What to do?

  1. It is essential to get your urine checked at least once every year to detect signs of kidney damage.
  2. Some other symptoms that you may experience are swelling in the ankles, weight gain and a rise in your blood pressure.
  3. The first step to treat kidney damage caused by diabetes is to get your blood sugar levels under control.
  4. You should also avoid consuming medications that can cause damage to the kidneys.
  5. A kidney transplant or dialysis may be advised if the damage to kidneys is significant.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2815 people found this helpful

Prevalence Of Chronic Kidney Disease

MBBS, DM - Nephrology, MD-General Medicine
Nephrologist, Delhi
Play video

Hi!

My name is Dr. Sudeep Singh Sachdev and I’m currently working as a consultant in the department of nephrology in Narayana Super Speciality Hospital, sector 24, Gurugram. Now there are several methods by which we can reduce the frequency of kidney diseases. So why wait until our kidneys are diseased? Today I’m going to discuss some very important and useful tips to keep your kidneys healthy. Now the first and foremost tip that I would like to say is to drink plenty of water. Drink at least 2.5 liters of water in a day.

This will help to clear the kidney of salt, urea, creatinine and other toxins which have accumulated in the body over the day. The second useful tip I would like to give you is to reduce the salt intake or reduce the sodium in your diet. Avoid taking any package or restaurant foods, avoid addition of any extra salt in the diet. Keep your salt intake over 24 hours to less than 5 to 6 grams in a day. Doing such a day would reduce the load of the kidney and decrease the development of hypertension, hypertension related disorders are also kidney diseases in the future.

The third important tip would be to maintain an appropriate body weight. Keep your cholesterol levels in check because deposition of cholesterol cannot only occur in the heart but can also occur in the renal arteries and is implicated in the pathogenesis of the kidney diseases. Avoid intake of any fatty food, fried foods, eat plenty of fruits and vegetables. The next important tip I would like to give you is to check blood sugar levels. Every year get a fasting and a postprandial blood sugar levels done. Maintain your hba1c under 6 in the body. Avoid taking any sugary items or items which are rich in sweets. This would help to maintain your sugar levels under limits.

If you have been diagnosed to have any impaired glucose tolerance or diabetes mellitus consult a physician, take oral hypoglycemic drugs and keep your sugar levels under control because diabetics develop kidney function very early which can be permanent and irreversible if not corrected. The next important tip would be to monitor your blood pressure regularly and keep it under control that is less than 120 by 80. You can do this by adopting a healthy lifestyle, exercising every day for at least 45minutes, playing granite games, going for swimming and so on. Reduction of salt intake would also help to maintain your blood pressure under control and decrease the chances of development of kidney diseases or delay progression if you are already having one.

Now get your kidney function tests and urine analysis done regularly. This is especially important for the at risk population for kidney diseases which includes diabetics, hypertensives. People above the age of 60 years, obese people, people who have known coronary artery disease or people who have a family history of the same or family history of chronic kidney disease. Get yourself evaluated by blood tests, urine analysis, kidney imaging like an ultrasound of the kidney or a renal artery doppler to rule out causes of kidney diseases. Another important tip which I would like to give you is to quit smoking.

Smoking not only harms the kidneys but also effects the heart and can even cause stroke. Smoking even one cigarette already weakens already harm kidney. So I would request all of you to avoid smoking and stop it if you are already doing so. The next important tip is to maintain an active lifestyle. As I have discussed, one exercise should go for in a day, avoid fatty, fried items. Take a low salt diet and keep oneself healthy by maintaining a BMI of less than 24, especially in the Indian scenario. The next important tip which is actually not followed by majority of us is to avoid unnecessary use of any painkillers or any other sort of alternative medication if it is not required.

Commonly used painkillers like indomethacin,brufen, combiflam can harm the kidney and have been implicated in the causation of chronic kidney disease. So I would request you to use painkillers which are safe from the renal standpoint like paracetamol, tramadol or hydrocet. Last but not the least I would request you all to balance your lifestyle by having a healthy night sleep. Sleep at least 8 hours in a day. This is going to provide adequate rest to the bodies and the kidney and provide time for the recovery and you to be up and about during the next day. Thank you. I hope this would have helped you to garner some information about how why one can keep once kidney and the human body healthy.

2678 people found this helpful

Early Warning Signs of Kidney Disease

MBBS, DM - Nephrology, MD-General Medicine
Nephrologist, Delhi
Play video

Hi!

My name is Dr. Sudeep Singh Sachdev and I am currently working as a consultant nephrology in Narayana Super Specialty Hospital, Gurugram, Sec-24. Today I will be talking about the early warning signs of kidney diseases. Now millions of people on this earth are suffering from kidney diseases but most of them do not even have the idea about it. Why? Because most of the kidney diseases present with non-specific symptoms and are only prevalent when the patient prevents in advance stages of the disease. While the only way to confirm the presence of kidney diseases is to get confirmatory investigations done which include blood test, urine test and various form of image investigation.

However, the following are the few early signs of kidney diseases. One of the earliest sign is the appearance of swelling over the feet, ankle or legs. One will start to notice edema which pits on applying pressure and often termed as pitting edema. This is usually due to the fact, that when renal dysfunction advances, there is salt retention and accumulation of fluid in the extra vascular spaces of the body. Now another common and early sign is the presence of periorbital puffiness which is the appearance of edema on the upper and lower eyelid. It especially occurs in people who have protein leakage from their kidneys. And in often termed as nephrotic syndrome.

Another one of the early signs is the presence of early morning nausea. Now the patient would classically present to the bathroom at the time of brushing his teeth with the sensation of early morning nausea which leads to a separation of his appetite and decreases in taking of food during the day. This in turn can also be expedited if the patient also complaints during the later stages of disease with the sensation of metallic taste because of which he starts to deny even the most favourite products which he had loved to eat beforehand. Now another one of the early sign is anemia. By anemia I mean there is a fall in hemoglobin without any apparent blood loss from the body. There is no visible site of blood loss but the hemoglobin of the person starts to fall.

The reason for this is that kidney is a site where there is production of erythropoietin in the body. And erythropoietin is required for hemoglobin production. As renal dysfunction advances there is decrease in erythropoietin levels which present as low hemoglobin levels thus leading to anemia. Now another one of the early signs is the change in the frequency of urination of the person. One might start to urinate more often and it is often described as increase in the frequency of maturation during the night termed as notaria. This can also happen during prostate disorder in man and also urinary tract infection or could be the early sign of kidney disease.

Now one should also be very careful about any changes that occur in the nature, consistency or color of urination. As the filtering mechanism of the kidney fails, there is leakage of both protein or blood cells from the kidney. Thus the presence of blood could indicate the presence of prostate disorder, urinary tract infection or even presence of tumors of the kidney, presence of pus in the urine along with fever which indicates the serious infection of kidneys like pyelonephritis or excessive frothiness of the urine would indicate presence of great amount of protein leakage which needs to be evaluated in further detail. Another non-specific sign would be the presence of dry skin or psoriasis. As the renal dysfunction would advance there would be also associated itching and one can notice itch marks on the skin of the person. Now a non-specific early sign could also be either a backache which would present as pain along the side or below the rib or even lower abdominal pain which could be in pubic region.

This will either indicate the presence of stone, maybe in the kidney or in the bladder itself or the respective infections. Last but not the least, another presenting sign of kidney disease could be the high blood pressure. Often when high blood pressure detected it’s not evaluated for kidney etiologies. Thus, it is very important for any person who presents with hypertension to get his kidney function test done along with imaging of the kidney to rule out renal etiology of hypertension. Lastly, I would like to mention that recognition and awareness along with timely intervention would lead to early detection and treatment of a kidney disorder which otherwise, could end up with dialysis, transplant or even an unfortunate circumstance as death.

Thank You!

2898 people found this helpful

Contrast Induced Nephropathy - What's The True Risk?

MBBS, DM - Nephrology, MD-General Medicine
Nephrologist, Delhi
Contrast Induced Nephropathy - What's The True Risk?

Contrast-induced nephropathy (CIN) is a serious complication that may arise during angiographic procedures and is elaborated as the impairment of renal function. It is estimated as either a 25% increase in the serum creatinine (SCr) from baseline or a 0.5 mg/dL (44 µmol/L) increase in absolute creatinine value within two to three days after intravenous contrast administration of intravascular radiographic contrast material that is not attributable to other causes.

To simplify, contrast-induced nephropathy (CIN) is a form of kidney damage in which there has been recent exposure to medical imaging contrast material without another apparent cause for the acute kidney injury. CIN is considered the 3rd most common cause of hospital-acquired renal dysfunction. There are emerging concerns that the importance of CIN has been greatly overstated. Here discussed are the risk factors with concerns comprised in (CIN) Contrast induced nephropathy.

Complications in consideration of Contrast induced nephropathy
One of the leading causes of hospital-acquired acute kidney injury (AKI), CIN is associated with longer hospital stay and while the incidence is low (0-5%) in patients with normal renal function, trials report that it is as high as 26% in patients with impaired renal function. Also, studies report that about 15% of the affected patients needed dialysis.

There is a complex association between CIN, mortality, and comorbidity. Majority patients who receive CIN do not die from renal failure. Death, if a patient at all dies, is more usually from a procedural complication or a pre-existing non-renal complication.

Risk concerns
Many physicians who refer patients for contrast procedures and some who perform the procedure themselves are not entirely informed about the risk of CIN. Individuals with diabetes mellitus, chronic kidney disease, hypotension, reduced intravascular volume, or who are over 75 years of age are at increased danger of evolving CIN after exposure to iodinated contrast. A survey found that most of referring physicians were not aware of potential risk factors, including ischemic heart disease and diabetes mellitus. However, acute kidney injury (AKI) can happen from a variety of causes, or their succession, during severe illness and no trial which is randomized has established the risk of contrast induced nephropathy.

The overblown risk factor
When there is a need to diagnose a suspected arterial thrombus, pulmonary embolism, or intra-abdominal catastrophes, treatments and tests require intravenous contrast and these are often suspended in patients with raised creatinine levels. The diagnostic rift leaves their physicians with less than the best knowledge to make decisions regarding the treatment.

A notable percentage of hospitalized patients experience AKI and an even greater percentage gain IV contrast during their stay in the hospital. There will thus forever be the explanation for observed anecdotal instances of "contrast-induced nephropathy." Whether or not contrast-induced acute kidney injury persists, or has been exterminated by the use of lower-osmolarity contrast agents, would require a comprehensive randomized analysis to sort out.

In most cases, the condition is self-limiting with the creatinine levels peaking for 2-3 days and returning back to baseline within 7-10 days, there are indeed concerns due to the limitation in treatment options.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2509 people found this helpful

Renal Biopsy - When Should You Go For It?

MBBS, DM - Nephrology, MD-General Medicine
Nephrologist, Delhi
Renal Biopsy - When Should You Go For It?

Kidneys play an important metabolic role and are essential for balancing salt, minerals and water in the body. They also play a significant role in removing waste products from the body. They make urine, which contains all the waste materials that are eliminated from the body. They also play an important role in blood pressure regulation and in maintaining the balance of various minerals in the body. Any suspected kidney damage should be confirmed by a kidney biopsy, which will reveal the exact disease, thereby directing towards the appropriate treatment. 

Why and when is it done? 

A renal or kidney biopsy is done in the following situations: 

  1. When there is abnormal protein in the blood or urine, which is indicative of a kidney disease, and the exact cause needs to be found out
  2. When kidney failure is suggested by blood tests but cause is not clear 
  3. To find the cause of bleeding in the urine (haematuria) 
  4. To identify and/or confirm diagnosis after a CT scan or ultrasound 
  5. To check how well a transplanted kidney has been received 

Know about the procedure 

A renal biopsy is mostly done as an outpatient procedure and is a type of biopsy known as percutaneous biopsy (biopsy where a needle is inserted through the skin into the renal tissue). Very rarely, it may be combined with the CT scan or ultrasound and be done in the radiology department. This may be done on inpatients. The patient is made to lie on his/her back and a local anesthetic is used on the area of the injection. A thin, long needle is directed towards the area of the kidney from where some kidney tissue is removed for sampling.

In some cases, the direction of the needle may be decided by a CT scan or ultrasound. While this is a closed biopsy procedure, in some cases, as a part of the surgery, open biopsies may also be obtained, where a sample of tissue is extracted for analysis. 

Recovering from a biopsy 
The person would need some time to recover from the procedure, as there would be some discomfort at the site of a needle insertion. Vital signs would be monitored for the next couple of hours during which the person would also be monitored for internal bleeding. A pain reliever can be used if required. Haematuria or blood-tinged urine can be seen disappearing within the next 12 hours. Very rarely the bleeding can be severe and require angiography and further procedures. The person should also avoid strenuous activities for the next few days. 

In case you have a concern or query you can always consult an expert & get answers to your questions!

2942 people found this helpful

Best Ways Polycystic Kidney Can Be Treated!

MBBS, DM - Nephrology, MD-General Medicine
Nephrologist, Delhi
Best Ways Polycystic Kidney Can Be Treated!

Polycystic kidney disease is a disorder that is inherited; it is characterized by development of cysts in the kidneys. These cysts are round sacs that contain a water like fluid. Initially, the size of the cysts are small, they tend to increase in size after the fluid accumulation. This disorder can also cause cysts to develop in the liver and other parts of the body.

Symptoms and Complications
The most common symptoms of this disorder are back pain, headache, high blood pressure and kidney failure. It can also lead to formation of stones in the kidney, presence of blood in the urine and an urge to urinate frequently. It also make your kidney prone to various bacterial infections.

Causes
The disease is caused because of the presence of defective genes in the body, implying that this disorder is primarily hereditary. In some cases, the disease is caused by a genetic mutation. Based on the causes, it is classified into two types:

  1. Autosomal recessive polycystic kidney disease: This disorder causes the symptoms to appear immediately after birth, although the symptoms are delayed until adolescence. This disorder only occurs when both the parents carry the defective gene which is passed to the offspring.
  2. Autosomal dominant polycystic kidney disease: This disorder usually tends to occur only after the age of 30. Unlike the previous type, here only one parent needs to carry the defective gene that is passed on to the offspring.

Treatment
The treatment of polycystic kidney disease generally involves dealing with the following signs:

  1. PainChronic pain, usually in the sides of the body or the back, is a common symptom of this disorder. You can opt for pain reliving medication such as ibuprofen. If the cysts are large, then surgery is required to ease the pain.
  2. High blood pressure: High blood pressure is best controlled by a following a healthy diet and lifestyle. High blood pressure can damage the kidneys severely. Medications may also be required to control blood pressure, if it rises abnormally.
2631 people found this helpful

Depression - How Dialysis Patients Can Manage It?

MBBS, DM - Nephrology, MD-General Medicine
Nephrologist, Delhi
Depression - How Dialysis Patients Can Manage It?

A diseased kidney is one that has lost its ability to carry out the filtration process in a proper manner. This process of filtration usually sends the waste and toxins out of the body in a routine manner. In such cases, a kidney disease manifests which requires a number of treatment measures. Dialysis is something that enters the treatment plan at a later stage as chronic early stage kidney disease can remain in the patient’s body for many years.

When the kidney function comes down to 15%, then most doctors recommend the start of dialysis which is basically a process that removes the excess waste and fluid from the blood. This can be a process that will leave the patient fatigued and in a mental state that is not exactly stable and positive at all times. It is common to see dialysis patients battling depression due to the chronic nature of the treatment as well as the low chances of recovery.

So, let us find out how dialysis patients can cope with depression.

  1. Professional Help: Depression is said to be like a common cold when it comes to mental diseases. The state of a person’s body can very well affect the balance in his or her mind and lead to depression. Starting from pressing circumstances to hormonal changes as well as chronic ailments, depression can affect people due to a number of reasons. Dialysis patients who are undergoing depression must consult a professional specialist like a psychiatrist who will help the patient understand and cope with the situation with the use of therapy based counselling.
  2. Medication: The patient can also be given medication that will prevent the build up of unnecessary stress by blocking the production of those hormones that result in a negative state of mind. This medication must be prescribed after speaking the patient’s nephrologist about what kind of medication will suit the patient specifically.
  3. Psychotherapy: Long term psychotherapy is also known as talk therapy that can help the psychiatrist or clinical psychologist in talking the patient through the problems. Besides giving the patient the scope and platform to air out the problems and reach solutions regarding normal day to day functioning despite the troubles, this kind of therapy also aims at equipping the patient with a better perspective and improved attitude.

While going through this kind of therapy and medication, it is important to keep a team of nephrologists and psychiatrists in the loop so that the patient may reach out at any time in order to avail help in the most trying situations. This will give a blanket of security to the patient as well.

In case you have a concern or query you can always consult an expert & get answers to your questions!

2673 people found this helpful

Diabetic Nephropathy - Ways That Can Help You Manage It!

MBBS, DM - Nephrology, MD-General Medicine
Nephrologist, Delhi
Diabetic Nephropathy - Ways That Can Help You Manage It!

Diabetic nephropathy (Diabetic Kidney Disease) is defined as the progressive damage to the kidneys caused by diabetes. It is characterised by the scarring of the glomeruli in the kidneys due to prolonged diabetes mellitus.

What Causes Diabetic Nephropathy?

Diabetes is a condition characterized by high concentration of blood sugar. Although the cause of Diabetes Nephropathy is not yet well defined, it is likely that the high sugar levels in the blood damage the blood vessels present in the kidneys that help to filter waste products, thus resulting in decreased kidney function and ultimately, kidney failure.

Not everyone with diabetes suffers from diabetic nephropathy. Although, factors that can increase your chances of getting diabetic neuropathy are-

  1. Smoking

  2. Poor control of blood glucose

  3. High blood pressure

  4. History of kidney diseases

What are the symptoms of diabetic nephropathy?

In the early stages, there may be no symptoms at all, but as the disease progresses, you may notice swelling in the extremities like your feet. Thus it is recommended to get your blood albumin levels tested on a regular basis. If it is diagnosed in early stages, the damage can be reversed. Other symptoms that can indicate damage to the kidneys are-

  1. Severe malaise

  2. Headaches

  3. Nausea

  4. Lack of appetite

  5. Frequent voiding

  6. Itchiness of skin

  7. General feeling of illness

Diagnostic tests that can confirm diabetic nephropathy are-

Routine urine test (urinalysis) - Kidney diseases are detected by the presence of a protein in the urine called albumin and this condition is called albuminuria. Other parameters that must be regularly monitored are-

  1. Blood pressure

  2. Cholesterol levels in your blood

How can you treat/ manage diabetic nephropathy?

If this type of nephropathy is diagnosed in the early stages, the damage to the kidneys can be reversible. The key to managing diabetic nephropathy are-

  1. Diet: Reduce the dietary intake of salt, phosphorous and potassium in the advanced stages.

  2. Glycemic Control: Monitor your blood glucose levels regularly

  3. Management of Hypertension: It is important to manage your blood pressure as it can have a direct effect on the coronary blood vessels which in turn pump blood to the various blood vessels of the body

  4. Renal Replacement Therapy: In chronically ill patients, renal replacement therapy is the best option. This can include haemodialysis (a procedure to flush out toxins from the blood, such as urea), peritoneal dialysis or ultimately renal transplantation. Consult an Expert & get answers to your questions!

2527 people found this helpful
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