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Patient Review Highlights
Brig V K Saxena
He was nephrologist to my wife late Rekha Saxena for over 8 years. She was on dialysis thrice a week and many other complications. He handled her extremely well with lot of care and passion. He is very approachable when needed even in odd hours. I wish him great success.
Dr Ashok Singh
Dr Jha is my classmate . He has implacable personal integrity and professional ethic. He is competent clinician and would approach him for any personal medical opinion. I wish him best of luck in the future.
Dr. Jha is patience personified. Once you consult him there is no need for a second opinion.
A diseased kidney is one that has lost its ability to carry out the filtration process in a proper manner. This process of filtration usually sends the waste and toxins out of the body in a routine manner. In such cases, a kidney disease manifests which requires a number of treatment measures. Dialysis is something that enters the treatment plan at a later stage as chronic early stage kidney disease can remain in the patient’s body for many years. When the kidney function comes down to 15%, then most doctors recommend the start of dialysis which is basically a process that removes the excess waste and fluid from the blood. This can be a process that will leave the patient fatigued and in a mental state that is not exactly stable and positive at all times. It is common to see dialysis patients battling depression due to the chronic nature of the treatment as well as the low chances of recovery.
So, let us find out how dialysis patients can cope with depression.
- Professional Help: Depression is said to be like a common cold when it comes to mental diseases. The state of a person’s body can very well affect the balance in his or her mind and lead to depression. Starting from pressing circumstances to hormonal changes as well as chronic ailments, depression can affect people due to a number of reasons. Dialysis patients who are undergoing depression must consult a professional specialist like a psychiatrist who will help the patient understand and cope with the situation with the use of therapy based counselling.
- Medication: The patient can also be given medication that will prevent the build up of unnecessary stress by blocking the production of those hormones that result in a negative state of mind. This medication must be prescribed after speaking the patient’s nephrologist about what kind of medication will suit the patient specifically.
- Psychotherapy: Long term psychotherapy is also known as talk therapy that can help the psychiatrist or clinical psychologist in talking the patient through the problems. Besides giving the patient the scope and platform to air out the problems and reach solutions regarding normal day to day functioning despite the troubles, this kind of therapy also aims at equipping the patient with a better perspective and improved attitude.
While going through this kind of therapy and medication, it is important to keep a team of nephrologists and psychiatrists in the loop so that the patient may reach out at any time in order to avail help in the most trying situations. This will give a blanket of security to the patient as well. If you wish to discuss about any specific problem, you can consult a doctor and ask a free question.
Chronic kidney disease or CKD is the decreased function of the function of the kidney for a minimum of three months or more. In this the end stage renal disease usually refers to the end of the kidney function where the kidneys work for less than 15% of what they are supposed to. The kidneys play a vital role in the human body and if they do not function properly then a person can die. The functioning of many organs depends on the kidneys. However, the main function of the kidneys is to remove the products and regulate blood and water, control blood pressure, promote healthy and strong bones, and produce hormones.
Here are 5 facts about kidney disease you should know about:
1. Causes of the kidney disease: There are two main common causes of the end-stage kidney disease. These are preventable causes. These are diabetes and high blood pressure, but then kidney disease can be caused by other inherited diseases such as infection, trauma or polycystic kidney disease.
2. Serious Stages: The kidney disease has five stages and stage 5 is known as the end stage renal disease; this is the point where patients usually need dialysis or kidney transplant to lead a sane life. The stages of kidney disease are:
Stage 1 – Slight kidney disease
Stage 2 – Mild decrease in kidney function
Stage 3 – Moderate decrease in kidney function
Stage 4 – Severe decrease in kidney function
Stage 5 – End stage renal disease
3. Detection of the disease: Kidney disease is usually difficult to detect because of the presence of very few symptoms. Age, gender along with the blood test is one way to determine information regarding kidney function. The people who are at a risk of getting kidney disease are:
- Over the age of 55 years
- People who suffer from hypertension and diabetes
- Ethnic groups such as Asians, Africans, Americans, Pacific Islanders and Hispanics
4. Signs and Symptoms: CKD is usually considered to be a silent disease and many people don’t know that they are suffering from the disease. The signs and symptoms of the disease are:
- Fatigue and weakness
- Nausea, vomiting and loss of appetite
- Numbness and headaches in hand and feet
- Frequent urination
5. Renal Replacement Treatment: This is the treatment for the end stage of the kidney disease. Dialysis involves the replacement of some part of the lost function of the kidneys and is usually continued throughout life. There are 2 types of dialysis:
- Hemodialysis: This cleans the blood via an artificial kidney which is hooked to the machine
- Peritoneal Dialysis: This removes the excess water and waste products and cleans the blood of the body by using the peritoneal cavity as a filter.
If you wish to discuss about any specific problem, you can consult the doctor and ask a free question.
Renal hypertension is a disorder, which is characterized by a rise in the blood pressure that results from kidney disease. The blood flow to the kidney is impaired due to the narrowing of the arteries and this leads to renovascular hypertension.
The various symptoms of renal hypertension are:
- You may experience symptoms of high blood pressure.
- Your kidneys may not function properly due to the impaired supply of blood
- It may lead to presence of blood in your urine
- You may be affected by pulmonary edema that results in accumulation of fluid in the lungs
- It may result in severe headaches and confusion
- You may experience blurred vision
- You may have nosebleeds
- The impaired kidney function may also lead to chronic kidney damage.
The various causes of renal hypertension are:
- Accumulation of cholesterol in the body may lead to blockage of the artery due to plaque buildup
- Smoking may increase your chances of getting affected by narrow arteries
The narrowing of the arteries causes a reduction in the blood supply to the kidneys. This results in the kidneys to release various hormones that instruct the body to hold on to water and sodium. This causes the fluid to accumulate in the blood vessels, thus resulting in high blood pressure.
The various risk factors renal hypertension are:
- Excessive alcohol consumption
- Substance abuse
- High blood pressure
- High cholesterol
Medications used to treat high blood pressure are used to treat renal hypertension. It is important that you get your blood pressure levels checked on a regular basis. You need to make certain lifestyle changes such as:
- Exercise on a regular basis to keep your heart and body healthy
- Limit consumption of alcohol and reduce smoking
- Eat well balanced meals to keep obesity at bay
- Keep your mind free of stress
- Restrict consumption of salt
- Maintain optimal weight levels
A pancreatic transplantation or pancreas transplantation refers to the surgical procedure, which involves replacing a dysfunctional pancreas with a healthy one. The donor of the pancreas is usually a deceased person. Pancreas is an important organ of the body as it produces several important hormones, which play significant roles regulating in our body cycles. Pancreas transplantation is usually performed for the treatment of type 1 diabetes which is linked to the inability of the pancreas to produce the insulin hormone.
A pancreas transplant is considered as one of the potential cures for type 1 diabetes. However it is not considered to be a standard treatment due to complications, such as:
- Rejection of graft by the recipient body or similar complications
- The medications which are given to prevent the rejection can have serious side effects too
- Certain complications like blood clots or infections can occur following the procedure
- Failure to control the blood sugar levels and rejection of the graft or complete pancreatic failure are Common complications that occur after a pancreas transplant.
These are the primary reasons why pancreas transplant is often considered to be one of the last measures of treating diabetes. Nevertheless, there are certain conditions where a pancreas transplant is worth considering. Some of the conditions include diabetes which cannot be controlled with the usual treatment procedure, chronic poor blood sugar control, insulin reactions which turns chronic or a serious kidney disease.
Certain medications are also prescribed for anti rejection purposes. These medications need to be taken after the operation for the rest of your life to prevent rejection of the donor graft. These medications can have a few adverse side effects. Some of the side effects include hypertension, thinning of your bones, unwanted weight gain and a rise in your cholesterol levels. Swollen gums or acne are also observed in several cases.
Often a pancreas transplant is carried out along with a kidney transplant, especially if you have a serious kidney condition. It helps to provide a healthy kidney and a pancreas and also reduces a risk of kidney damage caused due to diabetes later in the future.
Here are some tips to keep you away from kidney diseases
The 4 types of kidney stones and their common symptoms
Defined as hard and small mineral deposits that develop inside your kidney, kidney stones are made up of acid salts and minerals. The causes of this disease are not well-defined, although risk factors include drinking very little amounts of water and having a diet rich in sodium, protein and oxalate (chocolate and green leafy foods for example). However, knowing the type of kidney stone you suffer from can help ascertain the cause.
Here are the common types of kidney stones.
This type of kidney stone is usually a response to certain kind of infection, such as a urinary tract infection for example. Characterised by rapid growth and a large size, struvite stones can develop without any warning signs.
These are the most common type and are caused by a diet rich in oxalate. Risk factors for calcium stones include a diet consisting of plenty of nuts, chocolates and certain fruits and vegetables; metabolic disorders, high doses of vitamin d and intestinal bypass surgery, all of which can increase the amounts of calcium or oxalate in your urine, indicating the development of kidney stones.
Those individuals with a hereditary disorder that causes their kidneys to produce certain amino acids (cystinuria to be precise) in excess are most likely to get cystine stones.
Uric acid stones
These are common in those whose diets are lacking in water or those who suffer from the excess fluid loss. People with a high protein diet and those who suffer from gout are also at risk. Genetic factors play a major role as well in increasing your risk of getting uric acid stones.
Apart from these, there are other rarer types of kidney stones that can also arise depending on a combination of an individual's lifestyle and genetic make-up.
However, to determine whether you're suffering from any of the aforementioned types of kidney stones, you must first know its common symptoms, which are:
- excruciating pain in your sides, and back, especially below your ribs
- feelings of pain in the groin and the lower parts of your abdomen
- intense and fluctuating pain that comes and goes in waves
- pain while urinating
- urine that is red, brown or pink in colour
- urine that's cloudy or has a foul odour
- vomiting and nausea
- constant urge to urinate
- increased frequency of urination
- urinating in small amounts
- chills and fever in case of an infection
Changes in the colour of your urine can reveal important information about your health. If your urine takes on a hue beyond what's normal, it can be indicative of something wrong with your health. In general, the normal urine colour varies from pale yellow to deep yellowish-brown, which is a result of a chemical pigment in the urine called urochrome.
1. Red or Pink
- When your kidneys, urethra, bladder or any other urinary tract organ gets infected or inflamed, blood cells get leaked into the urine, giving it a red hue. The causes behind the presence of blood can be urinary tract infections, kidney cysts, kidney stones, enlarged prostate and even cancer. Taking blood thinners can also cause you to have blood in your urine.
- Certain foods like blackberries, rhubarb and beets can cause your urine to turn pink.
- The use of certain medications like a particular class of antibiotic used in the treatment of tuberculosis can turn your urine red. Likewise, a drug used to numb discomfort in the urinary tract can cause a red/pink discoloration of your urine.
2. Blue or Green
- The consumption of coloured food dyes containing green or blue pigments can cause you to pass urine of such hues.
- Certain anti-depressant and anti-inflammatory medications can turn your urine green/blue.
- A very rare medical condition called familial benign hypercalcemia (fbh), characterised by high levels of calcium in thE blood and low levels of the mineral in the urine can cause your urine to turn blue.
- Green urine can also occur if your urinary tract gets infected by the pseudomonas bacteria.
3. Dark Brown
- Having large amounts of these foods - aloe, rhubarb (a type of leafy green) and broad beans can cause you to pass dark brown urine.
- Certain anti-malarial drugs, laxatives and muscle relaxants can darken the colour of your urine as well.
- Dark brown urine can also be caused by disorders of the kidney or liver as well as infections of the urinary tract.
- Injury of the muscle as a result of excessive training can result in dark brown urine.
- Problems with the bile duct (the duct through which bile from the gall bladder and liver passes before entering the duodenum) or liver along with the passing of light coloured stools can result in orange urine.
- A cause of orange urine may also be dehydration as fluids bring about a decrease in the concentration of compounds present in the urine.
- The presence of calcium or phosphate sediments in the urine can give it a white hue.
- White urine can also be a result of funguria infection (a form of fungal urinary infection wherein the fungus produces white sediments) or a bacterial infection.