Preventive aspects for kidney failure-
I am Dr D K Agarwal. I’m senior consultant nephrologists’ from the Indraprastha Hospital, New Delhi. I’m from lybrate. We want to discuss how can we save ourself from a kidney failure.
What steps you have to take to save your kidney?
You understand that kidney is very important part to excrete the toxic materials from the body and the kidney failure, once you have the treatment is very costly in the form of transplantation or dialysis. So we should try to save ourself from kidney failure. Now the steps you have to take care of,
- If you are having diabetes in your family then you should control it. And to control it, we have certain parameters like Glycosylated haemoglobin HBA1C. HBA1C tells about th control of last three months. It should be between 6 to 7%.
- Now if you have blood pressure you should control it in the range of 130/180 or lower down it because controlling the blood pressure relieves the kidney failure.
- The pain killers which are an important cause of kidney failure, we should not take it for too long or now and then by self medication.
- Sometimes you know we go to the chemist, buy the drugs without any consultation from the doctor, these are harmful. So pain killers should be taken cautiously.
- Apart from that if you are having any type of kidney problem like stone, like you are not passing good amount of urine, you are putting force in the urine then you should see the doctor immediately. Because if you take care of the kidney problem immediately it will not change to the chronic state and the last stage.
You can connect with me via lybrate 24 hours and we will answer your question about disease.
Causes and treatments of kidney failure
I am Dr D K Agarwal. I’m senior consultant nephrologists’ from the Indraprastha Hospital, New Delhi. I’m from Lybrate. Today, we will discuss kidney failure.
As you know the kidney failure is a very common problem nowadays. The cases are increasing day by day and treatment is very costly, you know the transplantation, dialysis or CLPD is very costly. So we should know about the kidney failure. Kidney failure is when we say the urea creatinine is high, urine is less in amount. There is swelling, loss of appetite. All these things are there then we say you are suffering from kidney failure.
There are few causes of kidney failure which are very important to know, for example,
- One is diabetes. One of the top most causes of kidney failure is if you are having diabetes then chances of kidney failure are there. So you will have to control it.
- The second is hypertension.
- Third is painkillers, the pain killers are also very important cause so we are having a habit of self-medication. We go the chemist and we take medicines, that is also an important cause of kidney failure.
- Other causes as we know there are stones, cysts and other obstructions in the passage of urine from the kidney to the urethra to the bladder and to outside.
So these are the few important causes of kidney failure.
Now, at last, I want to say that if you have any query you don’t worry at all. You can contact me 24 hours via lybrate. We are at your service.
Lybrate.com has a number of highly qualified Nephrologists in India. You will find Nephrologists with more than 33 years of experience on Lybrate.com. Find the best Nephrologists online in New Delhi. View the profile of medical specialists and their reviews from other patients to make an informed decision.
Book Clinic Appointment with Dr. D.K. Agarwal
Submit a review for Dr. D.K. AgarwalYour feedback matters!
Patient Review Highlights
Almost all doctors suggested surgery for it, but I did not wanted to go for it for my kidney stones. I was shocked to experience the symptoms of kidney stones. He is not just friendly, but also is very motivating. I saw D.K. Agarwal clinic's advertisement in newspaper and that is how we referred him. D.K. Agarwal has expert knowledge in the field. Thanks to the expert care and guidance, I feel much better than before. The interior of the InDraprastha Apollo Hospital was no nicely done, it was so clean.
Even though my problem was very big, the entire experience of undergoing kidney disease treatment was very relaxing. In the past i consulted so many doctors, but nobody was able to help me with my kidney disease, but he has helped me immensely. The guidance Dr Agarwal gave me has helped me immensely with my situation. The lab in the InDraprastha Apollo Hospital was very clean and well managed.
The panic I had severe and unmanageable, as I was undergoing kidney transplant, but my D.K. Agarwal was able to handle it. I was admitted to the InDraprastha Apollo Hospital . He is one of the best physicians in city. I read about the Dr Agarwal on one of the social media platform. he has expert knowledge in the field. I am almost my normal self post the treatment and for that he is the reason.
Due to my kidney stones i was feeling very depressed and had no hope. No matter how critical be the situation, he is always very calm. As someone I knew, consulted Dr Agarwal and they referred us.I am really grateful as his kidney stones treatment has give me a ray of hope. The InDraprastha Apollo Hospital is designed in such a manner that all requirements of patients are taken care of.
I was having this stomach pain, but the symptoms were not very visible. I consulted Dr Agarwal, he doesn't just randomly prescribes medicines, but first properly diagnoses the problem.I am almost my normal self post the treatment and for that Dr Agarwal is the reason. I found the InDraprastha Apollo Hospital itself quite pleasant.
I was suffering from kidney problem. It was very difficult to cope with with this as I was in so much pain. Dr Agarwal treated me well for this and also he told me about the healthy plan which meant to be beneficial for me. I must say that he the best nephrologist . He treated me very patiently and I am much better than before.
dr D.K.Agarwal gave me treatment for my issue of back pain which was making my life terrible day by day even after doing continous excercises. i am very much benefitted with his treatment that I recieved from him at Indraprastha Apollo Hospital in Delhi.
He is not just friendly, but also is very motivating. Dr Agarwal with great ease handled my serious case of kidney transplant . he is an amazing and a very nice doctor. It was so quite pleasant in the InDraprastha Apollo Hospital.
I found the answers provided by the Dr. D.K. Agarwal to be practical and inspiring. Thanks for your valued advice. I will certainly follow your advice and inform you accordingly.
I found the answers provided by the Dr. D.K. Agarwal to be helped me improve my health. Excellent .I appreciate Dr's concern and his suggestion was useful.
Dr. D.K. Agarwal provides answers that are very helpful. Thank you very much
Dr. D.K. Agarwal provides answers that are very helpful. Thank you sir
The main job of the kidneys is to balance the electrolytes in the blood and maintain the pH homeostasis. The kidneys also remove waste products from the blood and boost your metabolism.
To prevent injuries and diseases in the kidneys, you can undertake the following steps to keep your kidneys healthy:
- Hydrate yourself: You need to drink sufficient water to improve kidney function and the ability of the kidneys to flush out the toxins from the body. Drinking at least 6-8 glasses of water will help in keeping your kidneys fighting fit.
- Eat healthy: The kidneys need to be healthy to perform their regular function. In order to keep them healthy, you need to eat the right kind of foods for sufficient nutrition. Include foods such as watermelons, oranges, parsley in your diet for better kidney function.
- Cut down on your salt intake: Consuming too much salt increases the quantity of sodium in your meals. It increases the sodium content in your blood and increases your blood pressure which might lead to the formation of kidney stones.
- Quit smoking: If you want to take care of your kidneys, you must quit smoking immediately. Smoking harms the blood vessels and hampers the flow of blood to the kidneys. When the flow of blood to the kidneys is obstructed, they cannot function properly. Excessive smoking also increases the chances of high blood pressure and kidney cancer.
- Urinate when you need to: Filtration is the most important kidney function as the wastes and water are eliminated through the bladder. Although your bladder is well-equipped to hold in urine for a long time, you start feeling the urge to urinate once it is filled. If you resist the urge, your bladder starts stretching more than necessary and affects the filtration function of the kidneys.
- Engage in physical exercise: A lot of medical practitioners believe that obesity and kidney issues are very closely linked. Being obese increases the chance of kidney injuries. Thus, engaging in some form of physical exercise is advisable as it keeps your weight under check and releases anti-stress hormones.
In case you have a concern or query you can always consult an expert & get answers to your questions!
When function of both kidneys are lost, Renal transplantation is needed. Kidney transplantation is performed by making use of a donor kidney and replacing the diseased one with it. Kidney transplantations are not conducted on patients suffering from other severe infections or life threatening diseases such as cancer, major lungs or heart condition. Diabetic or obese people usually cannot donate their kidneys as they bear a risk of malfunctioning in future.
Procedure of Kidney Transplant
- Kidney transplant surgery takes about 3 hours time.
- Tests are conducted to make sure tissue typing match with the new kidney. This decreases the chance of the body rejecting the donor kidney and causing serious complications.
- Thorough evaluation of the medical history is made for both the receiver and the donor. This is to make sure that the donor kidney is healthy, functional and free of disorders.
- The procedure of the surgery includes placing the donor kidney in the lower abdomen. The blood vessels, important arteries are connected to the donor kidney. The bladder will also be connected to the ureter from the donor kidney.
- The new kidney generally begins to function immediately after the surgery is completed successfully.
- The blood begins to flow through the kidney, and it begins to function normally. It filters the blood, collects the waste that is then passed through the bladder as urine.
- A patient who has had a kidney transplantation surgery will need to remain in the hospital for a few days under intense care and observation.
- Medications to prevent the body from rejecting the new kidney will be prescribed. It is important that you continue with these medicines for the rest of your life.
Risks of Kidney Transplantation
- Rejection of the new kidney by the body. Acute rejection in the initial days of surgery can be treated with medications and injections. However, chronic rejection is a serious condition that causes gradual loss of kidney function.
- There can be severe infections caused by the immunosuppression. It can also occur during the course of surgery, due to the inclusion of foreign tissues
- Reaction to the drugs or anaesthesia used for the purpose of transplantation surgery
- Excessive bleeding or haemorrhage caused due to injuries during surgery
- Any kind of leakage from the ureter or blocking of the ureter tubes, causing an obstruction in the smooth functioning of kidneys 6. The anti rejection drugs may lead to a decline in calcium, causing osteoporosis and other calcium deficiency infirmities
- Fluctuations in blood sugar, blood pressure levels
- Increased risk of cancer
- Infections in internal organs
Simple renal cysts are often found even in normal kidneys. In fact, they are so common that they are rarely considered as a disease. Certain lifestyle traits or genetics can be the cause of renal cysts occurring in adults as well as children, though no conclusive reasons have yet been confirmed for the occurrence of the same. Medical imaging technology such as ultrasound, X-ray, and CT scanning are being extensively used to discover these lesions.
In various surveys of people undergoing ultrasound for evaluation of non-kidney-related problems, generally 15% men and 7% women over the age of 50 were detected with renal cysts. Once the radiologic imaging of the cyst is obtained, the doctor can determine what further examination will be required.
There are basically two types of renal cysts, simple and complex.
- Simple cysts are usually round, have a thin outer wall, are filled with fluid and are rarely required to be treated.
- Complex cysts, however, can have thicker walls with solidified mass or can also be a collection of small cysts. These are definitely required to be examined further as they can be cancerous.
With the latest radiological approach to renal cysts, i.e. the Bosniak classification, observation of lesions is preferred to biopsy. Even though biopsies nowadays are largely non-intrusive, they are still recommended under very specific circumstances.
This classification uses a complicated algorithm of CT scan features like size, density and perfusion and places cystic renal masses into one of the five different categories. Categories I and II are generally simple cysts, not requiring further analysis. Still, an ultrasound is repeated at intervals of 6-12 months to ensure that the cyst is not growing. However, Bosniak category IIF cysts indicate complex cysts which are required to be observed. Lack of change with time indicates that the mass is benign, while any increase indicates the possibility of cancer. Through observation, one can prevent unnecessary surgeries.
It is mostly recommended that lesions falling under Bosniak III category should be immediately surgically removed as 40-50% have the possibility of becoming cancerous. However, close follow-up with magnetic resonance imaging can be used to avoid unnecessary surgeries as it is useful for characterizing the internal content of a cyst which may be is indeterminate even after the ultrasound and CT scan. Category IV lesions necessarily require surgical removal of the kidney, as nearly 85-100% of these are cancerous. More than 90% of those diagnosed with renal cancer which is confined to the kidney can hope to become disease-free within five years after diagnosis.
Thus, complex renal cysts have a higher possibility of developing into cancer if they are found to be malignant during the period of observation and steps should be taken for immediate removal. Consult an expert & get answers to your questions!
Located right under the rib cage, kidneys are a very important organ of the body. They are not only responsible for purifying your blood from wastes and excess fluid but are also involved in maintaining electrolyte balance, regulating blood pressure and producing red blood cell in the body.
In many cases, due to some medical condition, one or both kidneys may stop functioning properly. If not treated in time, it may lead to complete kidney failure and if the kidneys fail completely, dialysis or transplant may be the only treatment options available.
Dialysis is a treatment in which the blood is filtered and purified artificially using machines. This process is beneficial for those whose kidneys are not able to do their job properly.
Need for dialysis
A functioning kidney prevents the accumulation of excess water, impurities, and wastes inside the body. They also work to maintain the blood pressure level and control the presence of certain chemicals like sodium and potassium.
When the kidneys fail to perform these critical functions, maybe because of some disease or injury, dialysis helps to keep up the healthy functioning of the body as much as possible. As without dialysis all the wastes and fluids will accumulate and poison the body, resulting even in death. However, it must be kept in mind that dialysis is not a cure for kidney diseases; it is just an alternative to their functions.
Types of dialysis
Dialysis is an artificial process of purifying your blood using machines. There are two types of dialysis:
This is one of the most common types of dialysis, where an artificial kidney, known as a hemodialyzer, is used to remove waste and chemicals from the blood. The doctor surgically creates a vascular access into the blood vessels allowing the artificial kidney to perform.
This is a surgical procedure, where a catheter is implanted in the belly area. The treatment involves a special fluid called dialysate which is flowed into the abdomen to clean the blood. Once the blood is cleaned, the fluid is drained from the abdomen. The benefit of this treatment is that you can perform it in your home, without going to a hospital.
Risks in Dialysis
Even though either of these two treatment procedures is life-saving and there is hardly any alternative, these two can also come with risks. The risks include peritonitis, abdominal muscle weakening, high blood sugar level, weight gain, low blood pressure anemia, muscle cramping, insomnia, itching, depression, increased potassium level and pericarditis. If you experience any of these symptoms of the risks involved, then immediately consult your doctor and explain in details.
A patient who is going through dialysis for a long time also has a chance of succumbing to the medical condition called amyloidosis. When the amyloid proteins, which are produced in bone marrow, collects in kidneys, hearts, liver and other organs, amyloidosis occurs. This results in joint pain, stiffness and even swelling.
When your kidney function falls below a certain point, it is referred to as a kidney failure or renal failure. Fortunately, you can still continue to lead a normal life with the right treatment for renal failure. Here are the three best treatments that you can choose depending on your condition and lifestyle:
1. Dialysis: Dialysis is the process that takes over the function of your kidneys to filter out the waste from your blood and maintain the proper balance of chemicals in the blood. You may use dialysis for many years or as a short-term treatment while waiting for a kidney transplant. Dialysis is not a cure for kidney disease, rather it helps you deal with renal failure. It is life-saving and without it, the kidneys will no longer function.
There are two types of dialysis treatments that you can choose from:
- Hemodialysis – This type uses a machine to remove waste from the blood and sends it back to your body. It can be done at home or at a dialysis center.
- Peritoneal Dialysis – This type uses the lining of your belly called the Peritoneum to do the work of your kidneys. A catheter and dialysis solution is used to carry out the function.
There are benefits and complications for each type of dialysis. The treatment decision will largely depend on the patient’s illness and their past medical history. Discuss with your doctor to decide the best option for you.
2. Kidney Transplant: Kidney transplants can provide a better quality of life than dialysis and can be seen as a potential cure for kidney failure. A healthy kidney from a live donor or deceased donor is surgically placed in your body as a replacement to the failed kidneys. Although this may be a better option for you, it has certain shortcomings. There is an element of rejection and you may have to wait for a long time to get a donor. Extensive testing and anti-rejection medications are prescribed with this treatment.
3. Palliative Care: Rather than cure, it is the care that people with serious illness need. With so much to deal with, the patients have an array of tough questions and challenges to deal with. Patients need to take into account all medical options and care options based on their condition and severity of the renal failure.
Making the right treatment choice is difficult and that too when you are ill. It is normal to be fearful and worried about the risks involved. Get support from your family and doctor to help you make the right treatment choice. It may also be helpful to visit a dialysis or transplant center to talks to others who have been through these treatments. If you wish to discuss about any specific problem, you can consult a Nephrologist.
Hello Dr. My wife, aged 54 years, is a Type 2 Diabetic patient for > 8 years. An expert opinion from Urologist is requested for the condition mentioned below: We had taken (at Anderson Diagnostics & Labs, Nungambakkam Centre) whole abdomen CT on 23.7.2017. And FDG P.E.T. WHOLE BODY & Mr. SCREENING on 3.8.17. Both reported that" ill-defined heterogeneously enhancing hypodense lesion (size 34*25*20 mm) was noticed in the anterior parapelvic region of her Left Kidney near the lower pole" In these two reports, there is no word about malignancy, tumor or cancerous growth. Then, > 3 nephrologist had stated that, it is up to the Urologist to decide about further course of action. As per Urologist's opinion, (without removing her left kidney), the lesion must be surgically removed. My questions are: (1) Is it necessary to do nephrectomy at the earliest or can we wait and do a short term review after about one month? (2) What will be the side effects of the surgical procedure? (3) For how many days the patient may be required to be hospitalized and what will be the approx. Total expenditure for this in any standard hospital in Chennai? (4) What could happen in future, to the left kidney of my wife, if she simply, as usual remains at house, without undergoing this surgery? P.S. The size of both her kidneys had shrunk by one sq. Cm. During the past 2 years. The old reports, dated 30.11.2016. And 30.05.2015. Did not indicate any mass or lesion. After 2014, she had lost > 20 kg of her body weight. There is no physical discomfort to her till date and she is able to carry on her daily routine. Thank you.
I am 51 years old. There is problem in urine discharge system, discharge pressure is very slow and many times. I have also problem of very fast discharge during sex.
Kidney stones are often small enough and pass through urine without much bother. Most kidney stones are smaller than 4 mm in diameter. Having said this, even the smallest of kidney stones can be really painful until they pass through urine (learn more what Urine Says about Your Health). It typically takes a couple of days for the body to get rid of it. While medication and self-care are the foremost options, there are a range of other options as well available for treating kidney stones.
Admission to a Hospital
You must get admitted to a hospital if the stone moves to the ureter, thereby resulting in severe pain. Typically kidney stones which are more than 6 mms in diameter need to be surgically removed through procedures such as ureteroscopy, percutaneous nephrolithotomy (PCNL), open surgery and extracorporeal shock wave lithotripsy (ESWL). A doctor takes a call on any of the above procedure if:
1. The patient is inching towards a kidney failure.
2. The pain doesn’t go away even after taking pain killers.
3. If the patient is pregnant (learn more about for healthy pregnancy)
4. If the patient is more than 60 years.
Extracorporeal Shock Wave Lithotripsy (ESWL)
ESWL is one of the simple and most preferred stone removing procedures. It involves the usage of ultrasound shock waves to break the bigger stones into smaller ones. The latter is then passed through urine. A patient is given a few painkillers since this mode of treatment could be a little uncomfortable. A patient might need multiple ESWLs to successfully get rid of all the stones.
If a stone gets stuck in the ureter, a medical procedure known as the ureteroscopy is performed. In this procedure, a thin telescope is passed through the urethra and bladder to the ureter. Either a second instrument is used or the telescope itself has laser energy to break the bigger stone into smaller ones.
Percutaneous Nephrolithotomy (PCNL)
PCNL is an alternative to ESWL for removing big stones. This procedure involves the usage of nephroscope that is routed into the kidney through a small incision made behind the back of the patient. This procedure requires general anesthesia and is effective for breaking stones that have a diameter of 20 mm or more. It has a success rate of 86%.
This is one of the older methods to eradicate kidney stones. Unless the stone size is abnormally large and other procedures cannot be performed, open surgery is generally avoided. An open surgery involves making an incision and getting access to the ureter and the kidney. The surgeon then removes the stone from the kidney. This procedure requires general anesthesia. If you wish to discuss about any specific problem, you can consult a nephrologist.
A kidney transplant is a procedure that employs an operation to transplant properly functioning kidney in the body. The main job of the kidneys is to remove the excess waste from a person’s body with the help of a filtration process. When the kidneys stop filtering the toxins properly, they become diseased as harmful waste products and toxins begin to accumulate in the body. Following this, the patient has to go through treatment measures like dialysis or kidney transplant.
Read on to know the five things you should keep in mind about a kidney transplant.
- Treatment: Transplant is one of the best ways to treat chronic kidney disease stage-V, until unless it is contraindicated. Life becomes near normal after transplant, though there is a possibility of rejection of transplant kidney. Patient has to take immunosuppressive medication life long.
- Medication: Medications are mainly for:
- To prevent rejection: Patient takes immunosuppressive medications life long.
- Prevention of infection: Patient has to take care all the measures to prevent infections as they are more prone to infections.
- Other medication: To control diabetes, HTN etc.
- Family Only: The donors are from family or emotionally related or cadavers (after brain death). HLA-matched donors are better because of less chances of rejections and first reduction of immunosuppressive.
- Doing Your Part: Once transplant is done - patient becomes normal and he/she lives a normal life. However, they have to take regular medications and to protect themselves from various infection.
- End Stage Renal Diseases: These diseases includes diabetes mellitus, HTN, polycystic kidney disease, chronic glomerulonephritis or interstitial nephritis etc.
Consult a Nephrologist before going for renal transplant for detailed check up or line of action.
Nephropathy is also known as renal disease. It is any type of damage or disease relating to the kidneys. Though not everyone with diabetes has nephropathy, however, diabetic nephropathy can cause kidney failure.
How does diabetes affect the kidney?
Kidneys are responsible for taking waste out from your blood. They have a lot of tiny blood vessels to do this. High blood sugar may kill such blood vessels. Once these blood vessels are destroyed, the kidneys may not function as well or it may even lead to kidney failure.
What increases your risk of getting diabetic nephropathy?
There are several factors which increase your risk of getting diabetic nephropathy including: \
- High blood pressure
- High cholesterol
- Being Native American, African American or of Hispanic origin, for whom risk factors have proved to be magnified
- If you have family history of diabetic nephropathy
Symptoms and diagnosis:
There are very few noticeable symptoms, which appear when you have diabetic nephropathy, except swelling in your arms and legs. The diagnosis is done by checking for a type of protein in your urine known as albumin, which is not supposed to be there. Getting the diagnosis done early is crucial.
You can prevent kidney damage by doing the following:
- Keeping your blood sugar levels under control - keep HbA1C < 6-7%
- Keeping your blood pressure under control in the range of 130/80
- Eating healthy food
- Exercising regularly
- Not eating too much protein
- Not eating too much salt
- Reducing smoke or excessive tobacco usage
Medicines for treatment:
If you do get diabetic nephropathy, here are some medicines, which can help cure it
- ACE inhibitors which are also called angiotensin-converting enzyme inhibitors
- Angiotensin II Receptor Blockers (ARBs)
- Blood pressure may rise
- Triglyceride levels and cholesterol levels may rise.