Doctor in Pushpawati Singhania Research Institute
Treatment of Kidney Stones
Treatment of Blood in Urine
Treatment of Blood Pressure Changes
Kidney Dialysis Treatment
Kidney Stones Treatment
Treatment of Kidney Failure
Treatment of Kidney Diseases
Treatment of Nephrotic Syndrome
Kidney Transplant Treatment
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Patient Review Highlights
Early kidney disease does not have definite signs and symptoms. Getting tested is the best way to detect how your kidneys are functioning. It is important for you to get checked for early kidney disease if you carry high-risk factors including diabetes, high blood pressure or a family history of kidney problems. Early detection of kidney disease can help slow down its progress and even reverse the damage. Here’s a quick guide to the tests that are used to measure your kidney function:
- Blood Tests:
- Serum Creatinine: Creatinine is a waste product that is excreted because of normal wear and tear in the muscles of your body. If creatinine levels are greater than 1.2, it may be a warning sign that your kidneys are not functioning properly.
- Glomerular Filtration Rate (GFR): How well is your kidney removing wastes and excess fluid from your body? The GFR is a mathematical calculation of kidney function and the lower the GFR, the lower the kidney function. A normal GFR is 90 or above.
- Blood Urea Nitrogen (BUN): The breakdown of protein in the foods you eat is computed by the urea nitrogen value in your blood. A higher BUN value means the kidney is not working right. A normal BUN level is between 7 and 20.
- Imaging Tests:
- Ultrasound: In order to detect any abnormalities in the size or position of the kidneys, an ultrasound can be done as it would give a much clearer picture
- CT Scan: Any structural abnormalities and presence of obstructions need to be examined as well.
- Kidney Biopsy: A thin needle is used to make a small incision in the kidney for microscopic examination. It is done to identify the cause of the disease and assess the amount of damage. This test is needed to select the best treatment option for the patient and know how quickly the disease is progressing.
- Urine Tests:
- Urinalysis: Microscopic examination of the urine is done or a dipstick test can also be done to detect the presence of any abnormalities like excess protein, blood, bacteria, pus or sugar.
- Urine Protein: An excess amount of protein in the urine is called as proteinuria and used to measure the levels of protein.
- Microalbuminuria: A more sensitive dipstick test to detect tiny amounts of a protein called albumin in the urine. This is done for patients with diabetes and high blood pressure.
- Creatinine Clearance: Comparison of the creatinine levels in the blood and urine is done to show how much of waste the kidney is filtering out.
Be well-informed of all the diagnosis that can be done for kidney disease. Prevention is better than cure, so get your kidneys tested periodically to stay healthy.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Chronic kidney disease is categorized under various stages and your doctor will periodically assess the severity of kidney damage. Thankfully, the good news is that kidney disease progresses slowly and early detection will help to deter further complications.
How stages of Chronic Kidney Disease are Determined?
The stages are determined by glomerular filtration rate or GFR that measures kidney function. The glomerular filtration rate is a calculation that estimates how well the blood is filtered by the kidneys. It is usually calculated using a formula that takes into account the individual’s age, gender, race and serum creatinine levels. The lower the GFR, the worse the kidney function and more the damage.
Five Stages of Chronic Kidney Disease
The National Kidney Foundation has created a guideline for nephrologists to help identify the severity of kidney damage and provide the right care accordingly. Each stage calls for different tests and treatments:
|Stage||Description||GFR||What Can Be Done|
|Stage 1||Early kidney damage||90 or above||The exact cause of the kidney disease will be determined by your doctor. Your blood pressure and sugar levels are to be constantly watched out for. Opt for a kidney-friendly diet.|
|Stage 2||Mild kidney damage||60 to 89||Continuously monitor your condition and check how quickly the disease is progressing. Manage high blood pressure and diabetes.|
|Stage 3||Moderate kidney damage||30 to 59||Any complications like anemia, bone disease will be checked and treatment will be administered by your doctor|
|Stage 4||Greater kidney damage||15 to 29||Continue treatment and monitoring. If you are progressing towards kidney failure, consult the best treatment options you have based on your condition|
|Stage 5||Kidney failure||Below 15||Start dialysis, consider kidney transplant and choose the right treatment|
How is Chronic Kidney Disease Treated?
The first step is to determine the cause of the disease and then take the right measures to alleviate it. In most cases diabetes and high blood pressure are the prime reasons. So, simple lifestyle changes can help to prevent the progression of the disease and reduce your symptoms. Here’s what you can do:
- Follow a diet that is easy on your kidneys: Watch your protein and sodium intake. Drink the right amount of fluids and incorporate super foods that will not deter your kidney function
- Weight Management: Make exercise a routine part and find the right exercise program that works for you. The more active you are, the lesser health problems you will have
- Avoid tobacco, smoking and alcohol
The first four stages of chronic disease focus on preserving the kidney function for as long as possible. The stages will help you analyze where you stand and what can be done to prevent kidney failure.
Having a kidney disease can make it feel as if your life has spun out of control. But having some knowledge about your kidney disease can save you the stress and trauma that you might experience. Knowledge about the same can also help you take better control over your condition. Here are some frequently asked questions about kidney diseases:
1. How do you know if you are at the risk for kidney disease?
Some basic things are to be monitored to keep away from the risk:
- Blood pressure levels to be monitored at least once a year
- Urine analysis to check protein levels
- Creatinine level in your blood
2. What can we do to take care of our kidneys?
The most important thing is to ensure that your blood pressure and blood sugar are under control. Essential lifestyle changes can help keep your kidneys working longer.
3. How long can I live with Kidney disease?
Many people think that if their kidneys fail, it is the end of their life. But with modern advances in health care, this is not the case. How long you live depends on age, your overall health and how involved you are in your care. Even if you reach kidney failure you can continue to live for a long time with dialysis or kidney transplants.
4. What can be done for fatigue when you have kidney disease?
Fatigue is a common symptom of kidney disease, but there are medications to deal with it. Talk to your doctor to assess your condition and deal with it.
5. Is kidney disease hereditary?
Genetical factors can contribute to kidney disease and around 10% of kidney failures are caused by hereditary factors.
6. Do I need dialysis?
If your kidneys don’t perform their function and the serum creatinine levels reach a certain point, dialysis can be done. The dialysis machine will take over the kidney function of filtering out the impurities from your blood.
7. How long can you stay on dialysis while waiting for a transplant?
There is no set upper limit for the amount of time spent on dialysis. Some patients have gone over 25 years and it all depends on your health condition.
8. What questions should I ask my doctor?
No two people are same. Asking questions is the best way to find where you stand. So, discuss with your doctor on what percent of kidney function you have and what can be done to improve.
9. Can Dialysis be done at home?
Yes, discuss with your doctor to know how it can be done and whether it is good for you.
10. Do kidney stones lead to kidney disease?
No, they don’t lead to kidney failure. But long term obstruction of the kidney can cause kidney failure. If you wish to discuss about any specific problem, you can consult a Nephrologist.
Many of us take the role our kidneys play in keeping us healthy and sturdy for granted. Having your kidneys work well can go a long way keeping you in good shape. You can delay the progression of kidney disease and potentially prevent permanent damage to your kidneys. Here are some things that should be kept in mind in order to protect your kidneys:
- Keep your blood sugar and blood pressure in target range: High blood sugar and high blood pressure levels harm the nephrons in your kidneys and prevent them from functioning well. So, get tested periodically to monitor your levels. Improving them and keeping them under the target range will help to prevent further complications.
- Get moving: Being active will get your blood pumping and thereby, boost blood flow to your kidneys. It helps your heart to be fit too. So for your body, exercise is a win-win. It can help to slow the rate of chronic kidney disease. Keep a goal to get at least 30 minutes of physical activity each day.
- Eat less protein: It is good to avoid protein rich foods as they can stress the kidneys and lead to unnecessary problems. It is important to consume the right amount of protein in your diet and stay away from meat rich in proteins.
- Don’t drink soda: Studies have found a positive link between excessive soda drinking and kidney damage. Two or more diet sodas a day can lead to damage and make it progress quicker.
- Balance your blood pH levels: When the kidneys don’t function right, they fail to keep the acid balance in your body. A low acid diet with natural veggies will help the kidneys to last longer and restronger. Also, sodium bicarbonate can help protect your kidneys by neutralizing the acid content of your blood. You can mix a teaspoon of baking soda with a glass of water and consume it regularly. Consult with your doctor about it.
- Skip canned foods and processed foods: Stick with natural foods and avoid the artificial foods of fast-food joints, ready-made foods and more as they can contain high levels of sodium and other chemicals that deter the kidney function.
- Avoid painkillers: Nonsteroidal anti-inflammatory drugs can cause kidney damage. Since kidneys need a strong blood flow to function well, certain painkillers reduce blood flow and make things worse if you have kidney disease.
- Antioxidants to flush out toxins: Consider taking antioxidant foods that can help kidney function and protect your cells.
Follow the above tips and prevent your kidneys from damage to lead a happier and healthier life. If you wish to discuss about any specific problem, you can consult a Nephrologist.
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:
- 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
- When kidney failure is suggested by blood tests but cause is not clear
- To find the cause of bleeding in the urine (haematuria)
- To identify and/or confirm diagnosis after a CT scan or ultrasound
- 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. If you wish to discuss about any specific problem, you can consult a nephrologist.
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
- Albumin/protein in the urine
- High blood pressure
- Ankle and leg swelling, leg cramps
- Going to the bathroom more often at night
- High levels of BUN and creatinine in blood
- Less need for insulin or antidiabetic medications
- Morning sickness, nausea and vomiting
- Weakness, paleness and anemia
What are the possible complications?
- End-stage kidney failure: If this occurs then you would need kidney dialysis or a kidney transplant.
- 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.
- 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?
- It is essential to get your urine checked at least once every year to detect signs of kidney damage.
- Some other symptoms that you may experience are swelling in the ankles, weight gain and a rise in your blood pressure.
- The first step to treat kidney damage caused by diabetes is to get your blood sugar levels under control.
- You should also avoid consuming medications that can cause damage to the kidneys.
- A kidney transplant or dialysis may be advised if the damage to kidneys is significant. If you wish to discuss about any specific problem, you can consult a nephrologist.
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. If you wish to discuss about any specific problem, you can consult a doctor.
Nephrotic syndrome is a type of kidney disorder wherein, the body passes out excess amount of proteins through urine, owing to the damage caused to the tiny clusters of blood vessels in the kidneys. The symptoms include putting on excessive weight as a result of fluid retention, foamy urine and severe swelling around the region of the feet, ankles and eyes.
Common causes behind it
- Minimal change disease (also known as nil disease) leads to the abnormal functioning of the kidneys
- Excess deposit of amyloid proteins in the organs, thus taking a toll on the filter mechanism of the kidneys.
- Diabetes affecting the glomeruli (capillaries present in the nephrons of the kidneys).
- Systemic lupus erythematous causing chronic swelling of your kidney.
- Membranous nephropathy wherein the membranes in your glomeruli thicken.
- Infections such as malaria, hepatitis C, hepatitis B and HIV.
- Medications to combat infections and nonsteroidal anti-inflammatory drugs.
- Kidney Biopsy is an essential part of disease assessment.
- Angiotensin-converting enzyme inhibitors bring down blood pressure levels as well as the amount of protein discharged from the urine.
- Water pills help control sweating, thus, increasing the fluid flushed from the kidneys.
- Statins reduce cholesterol levels.
- Blood thinners such as anticoagulants lower the risk of blood clots.
- Corticosteroids regulate the immune system and ease the inflammation that results from kidney disorders.
- Incorporating certain lifestyle changes such as opting for lean proteins, cutting on the intake of fat in the diet and consuming lesser amounts of salt can treat inflammation and swelling. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
The presence of red blood cells in the urine is called hematuria. If there are sufficient red cells, the urine turns to a bright red, pink or cola shade. Frequently, the urine looks totally ordinary because there is insufficient blood to change the colour. In this situation, the condition is called 'microscopic' hematuria.
The most common causes of hematuria are given below:
- Urinary tract infection (UTI)
- Kidney stones
- Tumours in the kidney or bladder
- Exercise: In this case, the blood is produced in the urine after strenuous activity. It is more commonly experienced by male patients.
- Injury: Traumatic damage to any part of the urinary tract, from the kidneys to the urethral opening, can cause hematuria.
The symptoms of hematuria vary depending upon the condition. These are as follows:
- Glomerulonephritis: If the glomerulonephritis is not serious, it may not show any signs. If the symptoms do show up, they can cause swelling, particularly in the lower furthest points(the thighs, legs, feet, and toes), decreased urine, and hypertension.
- Kidney or bladder infection: Symptoms rely on the site of the diseaseand can even cause extreme pain on one side of the lower back, fever, chills, nausea with vomiting, and pain in the bladder.
- Prostate infection: There can be pain in the lower back or in the region between the scrotum and rearend. Pain with discharge, blood in the semen, andfever and chills can also occuronce in a while.
- Tumour in the kidney or bladder: Most kidney and bladder problems develop without bringing about any pain or uneasiness. At the point when side effects build up, abdomen pain may be persistent.
- Kidney stones: When a kidney stone gets attached to the ureters, it can bring about extreme pain in the back, side or crotch, with nausea and difficulties in urination.
Based upon the suspected cause of hematuria, some of the treatments may include the following:
- Urine culture: In this test, a urine sample is extracted and examined to check whether bacteria has developed. This test is used to find a case of a kidney or bladder disease.
- Computed tomography (CT) of the kidneys, ureters and bladder: For most cases,a CT scan is conducted. This helps in viewing the internal organs and finding the areas that may have been affected by the condition. It also shows the extent of the damage and the spread of the disease so that a proper treatment plan may be laid out.
- Ultrasound: This test uses sound waves to create images that can show whether or not a kidney mass is a non cancerous. This method can also be used to find out whether or not there are any kidney stones, which may be causing hematuria.
- Cystoscopy: In this test, the specialist embeds an adaptable telescope into the urethra and passes it into the bladder to investigate the bladder lining for tumours or different issues.
Kidney is a crucial detoxifying organ that performs a lot of functions including, absorption of minerals, filtration of blood and production of hormones and urine. It also helps your body to maintain a healthy pH level. Since kidney failure can prove to be fatal, it is essential to keep it healthy, to ensure smooth functioning of your system.
The following are the tips to ensure the health of your kidneys:
- Adequate intake of water: It is advised to drink a minimum of 8 glasses of water daily, to help your kidneys function properly. Adequate intake of water ensures that your body is able to flush out the harmful toxins at regular intervals. However, in case if you are already suffering from kidney disease, this point is not applicable.
- Control your blood pressure and blood sugar level: Diabetes is one of the major causes of kidney failure. It is recommended to control your blood sugar level on a regular basis to ensure healthy functioning of your kidney. People who have high level of blood sugar and blood pressure are more susceptible to suffer from kidney disorders.
- Quit tobacco: Accumulations of toxins in your body tend to have a harmful impact not only your kidneys, but also on your overall health. It is strictly recommended to quit smoking and use other forms of tobacco to protect your kidneys from damage.
- Reduce weight: Obesity and the problem of excessive body fat are harmful for your body in more ways than one. Being overweight makes you more susceptible to develop kidney cancer. Therefore, it is advisable to lose a few kilos to ensure the proper functioning of your kidneys.
- Avoid intake of analgesics without prescription: Most analgesics have the tendency to be harsh on your kidneys. Ingestion of analgesics increases your risk of developing kidney cancer. Non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, ibuprofen, naproxen and acetaminophen are some of the analgesics, which are known to affect your kidneys in the long term. Therefore, it is necessary to avoid taking them without consulting a doctor.
- Include healthy food in your diet: If you increase the intake of green vegetables in your diet, it will help your body to accelerate the process of detoxification. Fruits and vegetables including watermelon, cranberries, blueberries, strawberries, apples, cabbage, cauliflower, peppers, garlic and onions provide considerable aid in removing the toxins out of your system. However, in case if you are already suffering from kidney disease, this point is not applicable.