Dr. Sandip Bhurke is a renowned Nephrologist who has a vast experience of 17 years across various fields in Nephrology (kidney). Currently, he is working as a senior consultant Nephrologist in Bhurke Clinic, Andheri West Lokhandwala, in Mumbai. He also works as a nephrology consultant & Physician in Nanavati Hospital and Thunga Hospital.Prabhakar Bhurke Clinic is the one of the best kidney treatment centre in Mumbai.
Dr Burke opened the clinic with the vision to provide quality treatment at an affordable cost. The clinic provides a wide variety of kidney services.Dr. Bhurke graduated (MBBS) from the prestigious college of TNMC & BYL Nair Hospital in 1996. He earned his MD (PG degree) from KEM Hospital in Internal Medicine in 2002. He was awarded the title of Diplomate of National Board (Nephrology) TNMC & Nair Hospital in 2008. His area of expertise includes Kidney Diseases, Kidney Transplant, Hypertension, Dialysis, Renal Biopsy, Vasculitis and CKD & Chronic Kidney Diseases.
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Treatment of Blood Pressure Changes
Treatment of Urinary Tract Infection
Kidney Dialysis Treatment
Kidney Stones Treatment
Treatment of Kidney Transplant
Treatment of Polycystic Kidney Disease
Treatment of Kidney Diseases
Treatment of Nephrotic Syndrome
Kidney Transplant Treatment
Adult Diabetes Treatment
Treatment of Peritonitis
Treatment of TB in Kidney
Treatment of Nephropathy
Treatment of Nephrolithiasis
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Chronic Kidney Disease (also known as Chronic Renal Failure) is the progressive loss of kidney function occurring over a span of several months to several years and is characterised by the replacement of kidney architecture with nonfunctional fibrotic shrunken tissue. Chronic kidney disease is classified into five stages on the basis or proteinuria (presence of protein in large amounts in the urine) or Glomerular Filtration Rate (GFR) 1 being the mildest with no distinct symptoms and 5 being end stage renal failure.
Causes and Risk Factors of Chronic Kidney Disease
The various reasons (called risk factors) that can increase chances of Chronic Kidney Diseases are:
- Diabetes mellitus, hyperlipidemia (excess fat proteins in the blood)
- Family history heritable renal disease
- Older age smoking
- Autoimmune disease
- Past episodes of acute renal disease
- Kidney Stones
- Excessive self-medication especially pain killers
The direct causes of Chronic Kidney Diseases are:
- Diabetic nephropathy (leading cause)
- Hypertensive nephropathy Glomerulonephritis (swelling of the glomerulus in the kidneys)
- Reno-vascular disease (ischemic nephropathy)
- Polycystic kidney disease
- HIV-associated nephropathy
- Transplant allograft failure
- Exposure to drugs and toxins
Diet that you must maintain in Chronic Kidney Disease:
It is essential to make dietary as well as lifestyle amends once you are diagnosed with CKD. The main purpose of this diet is to maintain the levels of carbohydrates, fluids and minerals. This is done to prevent the buildup of waste products in the body as the kidneys are unable to fulfil its function properly. It is recommended to refer a dietician who can make you a diet chart that helps you adhere to your diet.
Here is a list of food items that you may avoid or may consume if you are suffering from Chronic Kidney Disease:
- Carbohydrates: Carbohydrates are a good source of energy. If the intake of protein has been restricted, then it is recommended to replace that with carbohydrates as a source of energy. Fruits, vegetables, grains and bread can be consumed as they are rich source of fibres, minerals and various types of vitamins. You can indulge in some hard candies or sweets as well.
- Fats: Fats can provide a good amount of calories as well. Ensure that you only stick to healthy fats such as the monounsaturated and polyunsaturated fats that are good for your cardiac health.
- Reduce your phosphorus intake: A diet with no more than 800 mg of phosphorus can help reduce the risk of too much phosphorus building up in your blood. Limit intake of foods with high levels of phosphate or phosphate additives such as organ meats, whole grain breads, processed foods, cola beverages, cheese, dried beans, liver, peanut butter, dairy products and chocolate. Many beverages and processed foods have these additives. Other high-phosphorus foods to limit include:
- Ice cream
- Monitor your potassium levels: Usually, potassium is not restricted in stage 3 CKD unless lab tests show potassium is too high. Your doctor may make medication changes or prescribe a low-potassium diet. Reduce an elevated potassium level by limiting some high-potassium foods and potassium chloride (found in salt substitute and many low-sodium processed foods). Some high-potassium foods to limit or avoid include:
- Honeydew melon
- Dried fruit
- Nuts and seeds
- Oranges and orange juice
- Pumpkin and winter squash
- Tomato products (juices, sauces, paste)
- Proteins: Usually, before undergoing dialysis, it is recommended to adhere to a low-protein intake diet. However, when you are undergoing dialysis, it is necessary to consume a certain amount of class one high-quality protein like nonvegetarian, paneer, soyabean, mushroom. This detailed information can be obtained from your dietician.
- Fluids: In the early stages of CKD, your fluid intake is not monitored. But as the disease progresses, you need to check your intake of fluids as too much fluids may accumulate in your body and create swelling in your legs and cause pressure on your lungs and heart.
- Sodium Or salt intake: Keeping a check on your salt intake reduces the risks of high blood pressure. Also, having food low on salt can reduce your thirst and prevent fluid retention in your body. 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 and harmful waste products and toxins begin to accumulate in the body. Following this, the patient has to go through treatment measures like hemo 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 as dialysis stops and person can go back to job. 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 special immunosuppressive medications life long like steroids, tacrolimus, mycophenolate.
- Prevention of infection: Stay away from a person suffering of cough, cold, fever, skin rash. Alternatively you can use face mask.
- Other medication: To control diabetes, Hypertension etc.
- Family Only: The donors are from family or emotionally related (Spouse) or cadavers deceased donor (after brain stem death). HLA-matched donors are better because of less chances of rejections and faster 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.
- Need for Kidney Transplant in End Stage Renal Diseases: These diseases includes diabetes mellitus, Hypertension, polycystic kidney disease, chronic glomerulonephritis or interstitial nephritis etc. If you wish to discuss about any specific problem, you can consult a Nephrologist.
Can chronic kidney disease be be arrested and is there any restriction of water intake or protein intake which may reduce the intensity?
Nephrotic Syndrome is a condition which is characterised by the loss of protein into the urine (called proteinuria) as a result of increased glomerular permeability and oedema. This results in low protein level in the blood. The low levels of protein in blood result in the drawing of fluids into soft tissues. A severe form ‘hypoalbuminemia’ can cause scores of secondary diseases such as ascites (retention of fluid in the abdominal cavity), pleural effusion (build-up of fluids between the lungs and the chest), or high cholesterol. It can also result in retention of fluid in other parts of the body such as eyelids, lower extremities etc.
What can cause this?
Nephrotic syndrome is mainly caused by damage to the kidneys. This leads to an increase in the concentration of protein in the urine. In adults, it can be caused due to glomerulonephritis or damage to the glomerulus of the kidneys while in children it is likely caused by minimal change disease (kidney disease marked by the abnormal loss of protein through the urine).
The other common causes of nephritic syndromes are:
- Genetic disorder
- Immune disorder
- Use of specific drugs
- Certain diseases such as diabetes mellitus, lupus
- The incidence of this disease is seen more often in males than in females.
Diet that is recommended in Nephrotic Syndrome:
In patients diagnosed with Nephrotic syndrome, the intake of salt, fat and protein must be checked. There should be emphasis on the consumption of dietary fibres that are present in vegetables and fruits.
The intake of protein and fluid should also be monitored, but this solely depends on personal factors such as age, weight and condition of the patient. It is recommended to consult a renal dietician who can guide you appropriately.
- Sodium/salt intake: The sodium or salt intake must be restricted as it leads to high blood pressure and results in fluid retention in the body, thus causing oedema (build-up of fluids within the body cavities and tissues) in the body. Avoid processed food as it contains a lot of salt.
- Protein intake: Protein is an essential part of the diet as it helps in the general makeup of the body and development of muscles. The consumption of protein must be kept under check and it is the best to consult your dietician for this. Loss of protein in urine needs to be replaced by class 1 high quality proteins in nephrotic syndrome.
- Limit fat and cholesterol intake: It is always good to curb on bad cholesterol as it is the reason behind several heart diseases. But, with patients diagnosed with Nephrotic Syndrome, it is highly recommended to avoid food rich in fats. This means staying away from unhealthy fatty meat or junk food.
- Fluid intake: Fluid intake does not have to be necessarily reduced, but it is always good to consult your doctor for the same.
“You are what you eat”. Nephrotic syndrome can slowly progress to chronic kidney disease if the necessary steps are not taken to curb it in an early stage, and diet control is a major way to do so.
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:
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
If you wish to discuss about any specific problem, you can consult a nephrologist.