Good Evening Folks!
I am Dr. Sunil Prakash, nephrology. I want to talk to my friends about how to save our kidneys. Kidney diseases are becoming incrementally explosive in India. It is possible due to bad lifestyle and bad food habits and due to pollution and our food change and water change being poisoned by excessive use of fertilizers, chemicals and pesticides. That is why more and more patients are now coming with advanced renal failure. Some important causes of kidney failure are diabetes, high blood pressure and pyelonephritis. Pyelonephritis means inflammation of the kidneys. To prevent kidney disease, I would give you the small formula which I say avoid 5 S. First S is sugar. Avoid excess sugar because excess sugar causes diabetes.
And diabetes causes 50% of kidney diseases. 2nd S is extra salt to be avoided. Increased salt intake gives rise to high blood pressure which causes again lot of kidney failure. 3rd S is smoking. Smoking is bad for heart and kidney and causes damage of both. 4th S is stress. Modern lifestyle is full of stresses, but it is our ability to cope these stresses positively which will give us benefit in our life and inability to cope with stresses causes lot of damage to our organs. 5th is sedentary lifestyle. Sedentary lifestyle means couch potato. Such people will get high sugar. They will be obese, and they eventually get diabetes. Such patient also gets lot of kidney failure. So, if you can avoid these 5 S. Plus if you can avoid some Ds. What are these Ds? Ds are drugs. Like indigenous drug, homeopathic, ayurvedic and painkillers, allopathy should be avoided.
They damage the kidney. Even now some commonly used drugs like are also being implicated which causes kidney failure. Any drug which is taken without consideration or without consultation is competent to cause kidney damage. It is called interstitial nephritis. And sometimes it leads to irreversible damage. So, avoid drugs, avoid unnecessarily IV, angiography, CT scans. They should only be done when there is enough evidence that by doing this test and diagnosis, the patient will benefit. And the benefit is more than the risk of die. 3rd D is to avoid dehydration. Especially in summers, in India, especially north India, especially elderly people wo are diabetic, if anti-blood pressure medicines, they should avoid dehydration. Sometimes the dehydration will cause fall in blood pressure and will give rise to acute kidney failure.
So, if you can avoid all these things and live the good lifestyle or top of it I would recommend, people who are above 50 years of age, who are diabetic, hypertensive or whose family has the history of diabetes, kidney failure or any other hereditary failure, they should go for a routine check-up at least once in 6 months. And the check-ups are very simple. Like doing your blood pressure, measuring your blood sugar, doing your serum creatinine and ordinary urine examination. In fact, all healthy people, middle age people should also do it. So, at this point of time, I think I want to say that the treatment of chronic kidney disease by dialysis and transplantation is very expensive. In a country where average income is 15,000/- to 20,000/- of a family for four people.
For them, dialysis and transplant are not possible. The future of kidneys diseases and management in our country lies in prevention and that is what friends, let us lead a good healthy lifestyle. Let us avoid pollution. Let us eat normal foods and lead a good active life. Another important thing is to eat little bit less and walk more. Middle-aged people at least should walk 10,000 steps every day. If we can follow these simple rules, we can be safe from dialysis and transplant.
And thank you very much for your time.read more
I’m Dr. Sunil Prakash. I’m director and head of nephrology of renal transplant services at BLK super specialty hospital, New Delhi.
Today I would like to share with you some newer things that are happening on nephrology. You all know that if somebody has a kidney failure they will eventually land up on dialysis. Dialysis is of 2 types: peritoneal dialysis which is done at home by person themselves or your relatives. It is also called colo-colic or water dialysis. Another is blood dialysis. This can also be done at home which is called home hemodialysis and there are simple machines which are available and there are people who can be trained who can come at home and do dialysis for such patients. Or these patients come to hospitals or dialysis centers for regular dialysis. Dialysis is normally give it to 2-3 times a week. Itis certainly a cumbersome procedure and it is also costing money. But at the end of the day the decision is either dialysis or death. So if somebody reaches the end stage kidney disease then he/she will require dialysis. The other option is to go for kidney transplant. The biggest problem of kidney transplant is how to get donors? How to get kidneys? Now friends everybody has 2kidneys. And if somebody is healthy and he doesn’t have diabetes, blood pressure or stone in the kidney and he is leading a good healthy life then by doing some test it can be found that person may be able to live on one kidney. So if we are certain that a donor if he can give one kidney to its relative to make him rehabilitate then he can live on one kidney and the recipient or the patient who gets the kidney will live on another kidney. This is called life-related donor program. This is a legal program. Now what is not legal? What is totally illegal is when somebody tries to buy kidneys for poor people by force or money or greed or whatever. This is illegal act and it is punishable by law. Another thing in transplant which we must encourage and our country is lacking very badly is deceased donor transplant. What is deceased donor transplant? It means unfortunately if somebody gets an accident. Young person leaves his house on bike or going for a job or something meets with the accident sometimes if the brain is irreversibly damaged but the organs like heart kidney and liver are functioning well these are called brain death patients. They are basically cadavers. Cadavers means death although technically, legally they are living at that point of time because there heart is beating but if somebody’s brain is death then that person ceases to be that person. And certainly within a day the all organs will also stop functioning because their master is gone the command center is gone. And all the organs of the body requires impulses from brain to survive. So now in such a situation a person’s heart is beating but it is certain to die in next 6-8-10 or maximum24 hours. So in this interim the organs of the patients are taken out and give it to people who are waiting on the organ list to be able to get these organs and get rehabilitated. In Spain the rate of donation is 50/million. In India it is 0.5/million. So we can very well imagine that how much organ shortage we are having and Indians or top of it have more proclivity of having kidney diseases and end stage kidney stages. So we badly needs these kidneys. So I request to all my listeners that let us join hands, let us do more social work, advertise and tell people that unfortunately if somebody has got brain damage then he/she is about to die then they must pledge their organs to people who are waiting below. Nothing can be better than this act of altruism and donation. Friends let us not take our organs to heaven because heaven knows that we need these organs here. Thank you for your time. I’m available at BLK super specialty hospital. For any issues, consulting dialysis refers to blood pressure and transplantation center.
Thank you! Again.read more
Doctor in BLK Super Speciality Hospital
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The kidneys are a pair of bean-shaped organs responsible for blood filtration. It also eliminates waste products from the body. The kidneys are located in the abdomenal cavity of the body and help in keeping a check on the electrolyte level in the body.
Polycystic kidney disease or PKD is a condition in which a number of cysts grow on the kidneys. The cysts are filled with fluid, and if the number or the size of the cyst increases, it can lead to kidney damage and kidney failure. 5% of kidney failures are caused by PKD. PKD does not affect only the kidneys. It can also cause the cyst to grow on other organs, such as liver, pancreas, ovaries, spleen and large bowel. The brain and the heart can also be affected by PKD. If it reaches the brain, an aneurism is caused. Heart murmurs may occur if PKD affects the heart.
Symptoms are visible for those in the 30 to 40 age group; however, it differs from person to person. Back pain or side pain, enlargement of the abdomen, blood in the urine, high blood pressure, and frequent bladder or kidney infections are some of the common symptoms of PKD.
An ultrasound is the most dependable, affordable and non-invasive way to diagnose PKD. MRI and CT scans can be used to detect the volume of the cyst. It also helps to determine small cysts which cannot be detected by ultrasound.
There is no specific treatment for PKD at present. But certain steps and measures can be taken to slow down the growth of the cyst and to control the symptoms.
Keeping a check on blood pressure, use of prescribed antibiotics to treat kidney or bladder infection, restricted use of caffeine, and medications to control pain are some of the treatments for relief and for arresting the growth of the cyst. Research also shows that drinking plenty of water throughout the day can also slow down the growth of the cyst. A diet low in fat and moderate in calories is recommended.
Types: Autosomal dominant kidney disorder is a genetic disorder and is passed on to the child from the parent by dominant inheritance. It is the most common type of PKD. The symptoms are visible after the age of 30 to 40. Infantile or autosomal recessive PKD is a genetic disorder and is inherited by the child from the parent by recessive inheritance. The symptoms are visible during the early months of life or in the womb. It is a rare form of PKD and occurs in 1 out of 25,000 people. Acquired cystic kidney disease occurs due to long-term kidney damage and is linked with kidney failure and dialysis. The bleeding of the cyst causes the bleeding in the urinary system and leads to urine discolouration.
Kidney Angiomyolipoma is also known as AML of the kidney, renal angiomyolipoma or kidney AML. This is a benign tumor that can lead to hemorrhagic complications. A tumour can crop up in the medulla or the cortex of the kidney. A small proportion of this condition can happen in conjunction with tuberous sclerosis. The symptoms vary according to the size of a tumour. The treatment differs from case to case, for some patients, radical nephrectomy may work while for some, invasive wedge resection and partial nephrectomy may work better. The prognosis of this condition is excellent owing to its benign nature.
How is kidney angiomyolipoma medically dealt with?
The treatment option depends on the criticality of a tumour and the general health of the patient. A vast majority of the tumors that are asymptomatic in nature doesn’t require a surgical intervention. After the diagnosis is made, a doctor might want to take the wait and watch approach. If the tumor size is small, only medications can cure the condition. On the other hand, surgical intervention can cure the disease and limit any chances of recurrence. Some of the preferred surgical methods include complete or partial nephrectomy, endoscopic surgery, nephron-sparing surgery and tumor embolization. A nephrectomy is only considered when the tumor size is quite large. In case the kidney function is severely impaired, dialysis is necessary. If the tumor results in abdominal bleeding, emergency surgery should be considered.
If a person has been diagnosed with kidney angiomyolipoma, it is important to follow a healthy lifestyle. Refraining from salt, potassium is a must. A stressed kidney, in general, is better off without foods such as potato, salt, fast food, processed food, various kind of meat etc. The dietary restriction gets waived off by the doctor once the patient is cured. Lifting heavy weight is a strict no in these circumstances. Adequate rest and enough hydration are necessary to be in shape. Timely consumption of medicine is equally important to get cured.
How can this disease be prevented?
Medical research has not fetched any result over the possible prevention method of renal AML. This condition is often connected with a genetic disorder. The following prevention method is necessary to mitigate the risk of this disease.
- A genetic test of the expecting parents or molecular testing of the fetus can help a doctor understand whether there is a risk involving the baby.
- If the disease runs in the family, a genetic counselling can help parents to understand to assess the risk before planning a child.
- Frequent medical checkups are also necessary for a person who has a family history of this disease.
- Aggressive medical research is being done to get a possible cure for this problem.
By Lifestyle changes, you can be healthy. Lifestyle changes include a healthy diet, exercise and discipline. Most of the people work on the diet part but do not do exercises. So you should take your health seriously.
Needless to say, your kidneys play an incredibly important role in filtering waste from your blood, and therefore maintain healthy functioning of the body. Blood pressure, production of red blood cells, and electrolyte balance, all of these are regulated by the proper functioning of the kidneys. Kidney failure causes too much build-up of waste nitrogen products,acids and/or excess fluid,which causes major cardio respiratory problem to the patient.
- Shortness of breath
- A reduced amount of urine
- Swelling of your legs, ankles, and feet
- Excessive drowsiness or fatigue
- persistent nausea
- Pain or pressure in your chest
How can it be treated?
End-stage of Kidney disease
In the case that your kidneys are unable to keep up with fluid and waste clearance as is normally expected, then there’s a good chance that you have developed a near-complete or complete case of kidney-failure, and are afflicted by end-stage kidney disease. If this is indeed the case, then you have two options to resort to:
- Dialysis: This helps remove the extra waste products that the kidneys fail to do. In haemodialysis, fluid and waste filtering takes place with the aid of a machine that drives these excesses from the blood. In peritoneal dialysis, catheters are employed to rid the body of the accumulated waste products.
- Transplant: Kidney transplants involve a surgical placement of a healthy kidney in your system from a compatible donor, either living or dead. Medications will be a necessity since the body has to be prevented from rejecting this new organ.
You may also opt for treating the condition with conservative measures in case you don’t want to resort to the aforementioned procedures.
Most people believe kidneys to be organs solely responsible for the filtration of blood and production of urine. But the truth is that the kidneys perform a host of vital functions in the body which include regulation of blood pressure, blood volume, and blood Ph. Around half of the individuals affected by lupus suffer from kidney problems, and the most affected part is the glomerulus whose function is filtering substances from the blood.
Effects of lupus nephritis on the kidneys
Lupus itself doesn’t lead to kidney infection or inflammation. But lupus nephritis, which is the Systemic lupus erythematosus (SLE) that affects the kidneys and the medications used for treating the condition tend to suppress the immune system. It makes the person affected with lupus vulnerable to the infections of various types. It is one of the most severe conditions of that could be encountered by a person wherein the immune system starts attacking various parts of the body as they would tackle a disease.
Lupus nephritis makes the kidney unable to remove the waste materials effectively from the blood. This leads to loss of control over the amounts of fluids regulating in the body. As a result, an abnormal amount of waste can build up in the blood resulting in edema or swelling.
When left untreated, these conditions can cause scarring along with permanent damage to the kidneys and end-stage renal disease. When a person has end stage renal disease, he or she needs regular filtering of the waste products of the body with the help of a machine. In severe cases, a kidney transplant may be required to ensure that at least one kidney is working properly.
Individuals who are susceptible to developing lupus nephritis:
A person with lupus may see the symptoms of lupus nephritis within 5 years and the people aged between 20 and 40 years are most vulnerable to it. In some common instances, it is seen that lupus nephritis is leading to unexplained weight gain along with swelling and puffiness in different parts of the body such as ankles, hands, eyelids, legs, and feet. During the first stages, these symptoms are often ignored which causes worsening of the condition. The urine may also become frothy or foamy with a reddish tinge in it. It is estimated that about 40 percent of children having lupus would develop kidney complications. Lupus nephritis may also cause increased urination, blood in the urine and elevated blood pressure.
If you have lupus, it is imperative to consult with a nephrologist. Testing a sample of the urine can help in showing the problems in the functioning of the kidneys. Your doctor will advise you about the diagnostic tests that can help in determining whether the disease has progressed to severe levels and start with the treatment process accordingly.
I am suffering from Nephrotic Syndrome and hyper tension since 1996. My weight is 80 kg. Please advice diet for me.
At a point when our bodies process the protein we eat, the procedure creates waste products. In kidneys, millions of tiny blood vessels act as filters since they have even tinier holes in them. As blood flows through these vessels, little molecules such as waste items may press through the gaps. These waste items turn out to be a part of the urine. Helpful substances, such as protein and red blood cells are too enormous to go through the gaps in the filter and stay in the blood.
Diabetes and kidneys: Diabetes can harm the kidneys. Abnormal amounts of glucose make the kidneys filter a lot of blood. After a couple of years, they begin to spill and helpful protein is thereby, lost in urine. Having low protein levels in the urine is called micro albuminuria.
Medication: When kidney disease is analyzed on time, during micro albuminuria, a few medications may keep kidney disease from getting worse. Having elevated levels of protein in the urine is called macro albuminuria. When kidney disease is looked up some other time during macro albuminuria, end-stage renal disease (ESRD) usually follows.
Causes: Strain on the organs may cause the kidneys to lose their filtering capacity. Waste items then begin to develop in the blood. Finally, the kidneys start to fail. This failure, ESRD, is intense. A patient with ESRD needs a kidney transplant or a blood filtration by a machine (dialysis).
Other complications: Individuals with diabetes will probably have other kidney-related issues such as bladder infections and nerve damages in the bladder.
Preventing complications: Not everybody with diabetes goes through a kidney disease. Elements that can impact kidney disease improvement include genetics, blood-sugar control and blood pressure. The more a person keeps diabetes and blood pressure under control, the lower the chances of getting a kidney disease.
Keeping your glucose level high can counteract diabetic kidney problems. Research has demonstrated that blood glucose control diminishes the danger of micro albuminuria by 33%. For individuals who suffer from micro albuminuria have now a reduced danger of advancing to macro albuminuria. Different studies have recommended that blood glucose control can reverse micro albuminuria.
Treatment: Essential treatments for kidney infection include control of blood glucose and blood pressure. Blood pressure dramatically affects the rate at which the condition progresses. Indeed, even a gentle increase in blood pressure can rapidly aggravate a kidney infection. Four approaches to bring down your blood pressure are:
- Shedding pounds
- Eating less salt
- Maintaining a strategic distance from liquor and tobacco
- Exercising regularly
A low-protein diet can decrease the amount of lost protein in the urine and increase the protein levels in the blood. Never begin a low-protein diet without talking to your physician or nephrologist. In case you have a concern or query you can always consult an expert & get answers to your questions!