I'm Dr. Suraj Gupta. I m a consultant nephrologist and practicing in Kidney and hypertension clinic in Gurgaon and Narayana super speciality Hospital, Gurgaon.
Well, I would be going to discuss briefly about chronic kidney disease. Chronic kidney disease or CKD which s stand due to gradual decrease of kidney function. Kidneys are one of the important organs of the body. And the primary function of the kidney is to filter and clear the toxins from the body. What are the overtime conditions like diabetes, hypertension and sticky kidney disease or autoimmune disorders can lead dysfunction in our kidney and can reduce the ability and weakening the ability of our kidneys to filter or remove the toxins from our body. What are the most important causes of chronic kidney disease or CKD? Most important causes of chronic kidney disease of CKD is diabetes or hypertension. These are the most prevalence causes of CKD. Other causes or other people who are at risk are people who have a family history of chronic kidney disease or people who take lot of pain killers or over the counter painkillers, even something as insignificant like a brufen tablet can cause chronic kidney disease if used very (inaudible 1:26) and very long period of time. What are the symptoms of chronic kidney disease? Chronic kidney disease or CKD in majority of time is described as a very silent disease. There are no symptoms in the early stages of chronic kidney disease. Once it advances symptoms are very nonspecific. Most of the time it could be present with vague symptoms like nausea, vomiting, reduced appetite, gradually as it worsen it can cause swelling in your feet, swelling at your face, reduced frequency and alteration in urine. Other symptoms can be severe, can be fatigue ability because of anemia or uncontrolled blood pressure. These all can present as symptoms of chronic kidney disease. And in advance cases of chronic kidney disease they can be clinically present as shortness of breath, inability to lie down, and difficulty in sleeping, severe itching in your body. All these are common symptoms. How to detect chronic kidney disease? Majority of the times it present as a, a lot of time, it present by routine findings in the form of lab investigations. Most common investigation is the serum creatinine which is a routine blood test and it can be instantly detect by elevated serum creatinine. The other most important investigation is a very small investigation with very small and very less costly investigation which is urine routine and any loss of protein urine routine can signify chronic kidney disease or CKD. As we are coming in the era of rising prevalence of chronic diseases like diabetes and hypertension so we see more and more of chronic kidney disease as well. So it is important and it is important to pick up these disease at an early stage because once it reaches the advance stage it becomes irreversible and it becomes untreatable. And the different options which remains are either dialysis of kidney transplant or nothing else can be done further. So it is important to pick them early and that is what my message would be.
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Treatment of Kidney Stones
Treatment of Urinary Tract Infection
Kidney Dialysis Treatment
Kidney Stones Treatment
Treatment of Kidney Transplant
Treatment of Nephrotic Syndrome
Kidney Transplant Treatment
Treatment of Vasculitis
Treatment of Systemic Lupus Erythematosus
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Treatment of Anemia With Renal Insufficiency
Treatment of Diabetic Kidney Disease
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Shashi Kala Lakra
I found the answers provided by the Dr. Suraj Kumar Gupta to be very helpful and knowledgeable. Thank you
Hi I am alfi, make 16 years old, Two months ago, I started to have frothy/foamy urine, but when I consulted a local hospital, they said I have protein level 2+. In urine and its ok, but there weeks before I started swimming for at least 4 hours daily for a week, so from past two weeks I am having high swelling and inflammation in body, I consulted a good hospital this time and after physical examination, kft ,lft and blood and urine test, they said I have nephrotic syndrome, they did a renal biopsy, the results of biopsy will be received within 2 days but I am sacred I am from poor family in india, we don't have any money, how should I control my diet, I used to drink 4 litres above of water daily now I am told to drink only 800 ML and not allowed to eat salty foods or meat, please help there are the things I like, im sad, what diet should I follow? Can I eat chicken or beef, how to reduce the swelling, I am having trouble walking I have all my scan, blood and urine data.
Sir patient age 49 years is on omnacortil medication as he is been diagnosed with IgA nephropathy so does any problem he can in future. Please do advise.
My friend had a kidney transplant 9 years back and now his creatinine level is at 6. His doctor is recommending a dialysis or kidney transplant again, Is there any way to decrease creatinine level.
My mother is on dialysis for the past 6 months. Suggest some home foods to increase haemoglobin levels and reduce creatine level.
I am 46 my annual report shows HbA1C 6.3:EST GFR 78 Uric acid 4.23:Creatinine serum 1.12.I am taking Riomet OD 1gm daily and Covance 50 twice daily my BP is in range. I am worried about kidney.
Will adpkd patient will surely face chronic kidney disease and will need dialysis after 50 years age? They can never live a normal life long life?
My husband have CKd4 What should we do ?his creatinine is 5.1 and bun 94 phosphorus 7.0 don't want to go on dialysis.
The blood vessels are elastic tubules controlled by valves through which blood flows. Depending on the organ and the distance from the heart, these vessels should be of certain thickness to ensure proper blood supply, this maintains a constant normal pressure of the blood flow. In this condition, the blood vessels are narrowed, which results in reduced blood supply, affecting optimal function.
- With age, the elasticity of these vessels reduce and therefore blood flow and blood pressure can be affected. This is known as arteriosclerosis – hardening of the arteries.
- In parallel, with blood cholesterol levels on the rise, the vessels are narrowing due to the accumulation of plaque in the blood vessels. As blood is flowing through the arteries, the fat molecules, being sluggish and heavier, settle down along the vessel walls. They attract more fat molecules and so the fat deposit layer continues to grow thicker and the vessel narrows further. This is known as atherosclerosis.
Both conditions result in narrowed blood vessels, and when the vessels supplying the kidneys are affected, there is reduced blood flow, which is interpreted as low blood pressure, leading to hormone release which increases the blood pressure. So, one of the main symptoms of renal artery stenosis is uncontrollable blood pressure.
Risk factors: The following factors put an individual at a higher risk of developing renal artery stenosis.
- Advanced age
- Being a female
- Increased cholesterol levels
- Preexisting kidney disease
Symptoms: Though there are no obvious manifestations, uncontrolled high blood pressure can require renal artery stenosis to be ruled out. Some tests to be done include:
- Blood and urine tests to identify abnormal kidney function tests
- Ultrasound to check for structural effects
- Doppler to measure blood flow
- Advanced imaging like MRI to study for structural changes in the kidneys and its blood vessels
Treatment: This would be a two-pronged approach in terms of reducing risks and improving blood pressure.
- Better control of blood pressure levels, either with alternate drugs or increased doses
- Monitor and rigorously control sugar levels
- Cholesterol levels to be controlled
- Quit smoking
In very severe cases, angioplasty and stenting may be required. A catheter (tube) is inserted into the affected blood vessel and a balloon is then inflated to open up the artery. A stent may also be placed to keep the vessel open and ensure optimal blood flow. This comes with its own complications and requires long-term care and monitoring.
- - In very severe cases, bypass of the artery or surgical removal of the affected portion of the kidney may also be required.
In case you have a concern or query you can always consult an expert & get answers to your questions!
The kidneys are the main part of the urinary system, which also includes the bladder, the ureter, and the urethra. Infections reach the urinary system either through the urethra or from the bloodstream when there is an infection elsewhere. Most infections are limited to the bladder and the ureter but when an infection reaches a kidney, it can be a lot more dangerous and require immediate attention.
Pyelonephritis is more commonly known as UTI or urinary infection.
Causes: This can be an acute or a chronic condition.
- Acute condition more often happens subsequent to a bladder infection, which is not completely cured
- Chronic condition develops due to recurrent infections, kidney stones, kidney failure, and impaired renal flow
- People who have impaired immunity, poorly controlled diabetes, and higher blood pressure levels are at risk
- Women and pregnancy in particular increases the risk, as the urethra in women is shorter and puts them at greater risk of developing the infection
Similar to any infection, pyelonephritis also includes general symptoms like:
- High fever with shaking chills
- Abdominal fullness
- General lethargy and fatigue
- Vomiting and diarrhea
- Warm skin with profuse sweating
- Severe cases can present with confusion
More specific symptoms include:
- Abdominal/flank pain on either side
- Bloody or cloudy urine that can be foul-smelling
- Increased frequency and urgency
- Feeling of incomplete emptying
- Painful urination
- Clinical exam can present with tenderness in the flank region
- Blood culture can reveal infection
- Urinalysis reveals impaired urine function including high levels of protein and blood
- CT scan of the abdomen area may reveal swollen kidneys
- Kidney biopsy, scan, and ultrasound may be very rarely required
- This is an acute condition, and when the elderly/pregnant are affected, immediate treatment is required
- Antibiotics are required to control the infection. The blood culture can guide to the most effective antibiotic.
- Pain relief requires the use of pain killers
- Acute cases may require admission to the hospital, with additional hydration support
- If the patient is not able to retain oral medications, they may be given as injections (antiobiotics and pain killers)
- Chronic cases may require longer use of antibiotics. Also, given the risk factors, recurrent infections need to be constantly
- Potential complications include kidney failure, recurrent infections, and chronic sepsis which can result in infection in the other organs
- Hygienic toilet habits, particularly when using public restrooms
- Hygienic sexual habits, to prevent entry of bacteria into the urinary tract
- Adequate hydration to ensure wastes and bacteria are eliminated
- Immediate treatment if you are prone for recurrent urinary infections
In case you have a concern or query you can always consult an expert & get answers to your questions!