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.
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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
While most of the health issues that arise in our body show prominent symptoms, some do not, and the patients discover the problem accidentally. One such condition is Ectopic kidney which is a congenital abnormality wherein the organ is located out of normal place. Generally, the kidneys start forming within the pelvis and then move into their position behind the rib cage. In case of the ectopic kidney, one of the two kidneys does not move to the right place but may remain in the pelvis. Or it may move upward, but fails to reach its desired position. What's more, a kidney may cross over so that both the kidneys are located on the same side of the body.
How is the condition diagnosed?
An ectopic kidney may be able to function normally without causing any symptoms, and the diagnosis happens by chance. Sometimes, the health care provider may discover ectopic kidney after feeling a lump in the unusual position in the abdomen or may notice it due to urinary problems and pain in the abdomen.
What are the complications?
The most common complications of an ectopic kidney include problems in the drainage of urine from the kidney. At times, the urine may flow backward from the bladder to the kidney, an issue which is medically termed as vesicoureteral reflux or VUR. This, in turn, can lead to a host of health issues such as:
- Infection: Through urine, the human body can wash out bacteria and inhibits their growth in the kidneys as well as the urinary tract. When the kidney is out of its normal position, the urine gets trapped in the kidney itself or the ureter. The remaining urine allows the bacteria to grow and spread. Hence, an affected individual may suffer from back pain, abdominal pain, fever and chills and foul-smelling urine.
- Formation of stones: Calcium and oxalate stones may form in the kidney due to the ectopic kidney. This happens when the urine remains in the urinary tract for a long span of time. It could lead to extreme pain on the sides of the body, blood in the urine, fever or chills, vomiting, burning sensation while urinating.
- Trauma: When the ectopic kidney is present in the pelvis, it could become susceptible to injury from blunt trauma. Such people are required to wear protective gear while performing body contact sports.
What are the treatment options for an ectopic kidney?
If tests show evidence of an obstruction, then surgery may be required for correcting the causes of obstruction for allowing better drainage of urine. Also, reflux can be fixed with the help of operation for altering the ureter. When there is extensive damage to the kidneys, then surgery may be required for complete removal of the kidney. So, depending on the condition of the patient, the necessary treatment process would be adopted by the nephrologist.
In case you have a concern or query you can always consult an expert & get answers to your questions!
You must be aware of renal stones more commonly known as kidney stones as it is a widely known condition that is common among men and women in the age bracket of 30 to 60. To gain an insight into these small hard deposits that are formed in the kidneys, which cause pain when they pass through the urine read on.
How do you know if you have renal stones?
This could be a tough question to answer in a straightforward manner because experiencing any signs of renal stones is very unlikely until it they start moving around within the kidney or pass in the tube that connects the bladder with the kidney. At this point some of the most common symptoms of renal stones are, pain radiating to the groin and lower abdomen, severe pain in the back and a side portion of the bell, right below the ribs, pain during urination, vomiting, and nausea. In case there's a presence of an infection, chills, and fever may also be evident.
What are the types?
Depending on the crystals that the renal stones are made of, there are four different types of kidney stones, namely, cysteine, uric acid, struvite, and calcium. While calcium renal stones are the most common in people, cysteine renal stones are quite rare. And it is the uric acid stones that are more common in men and the struvites that are mostly found in women who have urinary tract infections.
What are the probable factors that cause the issue?
No definite reason has been found for causing renal stones. However, there are a number of factors that are considered to increase the risk of developing kidney stones, including not drinking enough water, taking certain medications, or having a medical condition that is responsible for increasing the levels of certain substances in urine.
What is the possible course of action?
When the kidney stones are diagnosed in their early stages when they are still small, they can be easily passed in the urine with the help of certain medications. But when the renal stones are found to be large ones, either surgical removal or breaking them up with the help of laser energy or ultrasound may be the only way of getting rid of them.
Remember, there is no straight formula to avoid developing renal stones. However, there are indeed a few factors associated with it by controlling which you can reduce the risks of suffering from renal stones, such as, controlling your weight, staying hydrated and eating healthy. Visit your nearest nephrology specialist right away in case you experience any of the renal stone symptoms as early detection is essential for avoiding surgical treatment.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Hunner's ulcers, simply put are painful ulcers in your urinary bladder. These ulcers are inextricably linked to another disorder called the painful bladder syndrome or intestinal cystitis. They occur in 10 to 15 percent of people with interstitia cystitis. These, in fact, are red patches or lesions on the bladder wall which can stiffen tissue and cause reduced bladder capacity. Hunner’s ulcers bleed, ooze pus and can be of different sizes. The ulcers in the bladder can be extremely painful and uncomfortable.
These are called Hunner’s ulcers because they were first described by Dr. Guy LeRoy Hunner, a Johns Hopkins gynecologist, in 1915. Since Hunner’s ulcers are seen only in people with intestinal cystitis, it’s important to know more about this painful life-altering bladder disorder before we can even understand how to deal with them.
Interstitial cystitis (IC)
IC is also called painful bladder syndrome. Another important thing to know about IC is that it strikes more women than men. IC is a chronic disorder and there’s no cure for it. It causes recurring bouts of pain and pressure in the urinary bladder and the pelvic area. This is often accompanied by an urgent and frequent need to urinate. Sufferers may have to rush to the ‘loo’ as much as 40, 50, or 60 times a day.
Hunner's ulcers can only be accurately diagnosed by doing a cytoscopy which involves inserting a fibre-optic tube through the urethra to look at the bladder wall closely. During this procedure, a tissue sample from the bladder wall is usually also taken to rule out bladder cancer. Cytoscopy is usually done with hydrodistention under local anesthesia. This involves filling the bladder with a liquid for stretching it to provide a closer view of the bladder wall. Usually, a urologist performs this surgery along with a gynaecologist. IC and also Hunner’s ulcers are both a diagnosis of exclusion. This means that they’re diagnosed only after a number of other conditions have been ruled out.
Hence, the urologist will first take your thorough medical history, followed by a physical exam and a pelvic exam for women patients and perform tests for ruling out infection, and other disorders like bladder stones and cancer, kidney disease, multiple sclerosis, endometriosis, sexually transmitted diseases amongst others. Only after these tests are inconclusive or uncertain and if there is blood in urine, will the urologist go for cystoscopy.
There's no cure for IC, but Hunner’s ulcers can be cured by burning them off the bladder wall. Called fulguration, the process uses electricity or laser to burn the ulcers on the bladder wall. Resection is also used in which skin from around the Hunner’s ulcer is cut for removing both the ulcer and the inflamed tissue around it. The problem is that ulcers may recur in the same location.
So, managing IC becomes critical. Your doctor can try to treat the patient with one treatment or with a combination of treatment depending on the condition of the patient.
Pain medicines are the first line of treatment to manage Hunner’s ulcers and IC both, and many patients do go in for this. Patients also find relief by modifying their diet to remove foods and drinks like caffeinated beverages- tea, coffee, colas etc. Sodas, artificial sugars and fruit juices, especially Cranberry juice can trigger intense pain and discomfort, so these are usually contraindicated. Another important aspect is patient education about normal bladder function and tips on self-care and behavioural modifications like stress control to manage Hunner’s ulcers.
In case you have a concern or query you can always consult an expert & get answers to your questions!
I have to go to the urine repeatedly, it has been long before, but this time it has increased, I drink too much water, it feels too much, and if I drink more then it takes time and again.Please suggest me How to overcome form that.
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.
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.