What is the treatment?
Nephritis is inflammatory kidney disease caused by infection but is mostly caused by autoimmune disorders and nephrosis is noninflammatory kidney disease. Treatment and management of nephritis depends on the cause provoking the inflammation of the kidney. In case of lupus nephritis, hydroxychloroquine can be used. Immunotherapy is most significant methods for patients to recover from lupus nephritis. Chronic kidney disease is loss of kidney function. It is a long term form of kidney disease. The main aim in case of chronic kidney disease is to slow down or stop the progression of chronic kidney disease. Control of blood pressure and treatment of original disease are the principles of management. At the last stage replacement therapy is done. Acute kidney injury is a sudden loss of kidney function that develops within seven days. Treatment depends on the cause. The main goal is to prevent cardiovascular collapse and death.
How is the treatment done?
Chronic kidney disease can be classified into five stages. Stage one is the mildest and stage five is the most severe condition. If the cause of CKD is vasculitis or obstructive nephropathy , it may be treated directly to delay the process of damage. In advanced stage treatments for anaemia, kidney bone disease or chronic kidney disease-mineral bone disorder may be needed. Treatment of blood pressure is also required. Usually, angiotensin converting enzyme inhibitors or angiotensin II receptor are used which slow the progression and reduce the risk of cardiovascular events like heart failure, stroke, etc. At stage five, renal replacement therapy is applied in the form of either dialysis or a transplant. In prerenal acute kidney injury without fluid overload, administration of intravenous fluids is the first step to improve kidney function. Myriad causes of intrinsic AKI require some specific therapies. Intrinsic AKI due to vasculitis or glomerulonephritis may respond to steroid medication, and in some cases plasma exchange. Renal replacement therapy such as with hemodialysis may be used in some cases of AKI. Dialysis is used in those who are suffering acute kidney injury or stage 5 chronic kidney failure. There are three types of dialysis- hemodialysis, peritonial dialysis, and hemofiltration.
Who is eligible for the treatment? (When is the treatment done?)
If a patient is detected with an increase in serum createnine or protein in the urine, then the patient must undergo treatment of chronic kidney failure. If there is accumulation of urea in the body which can lead to fatigue, loss of apetite, headache, nausea, vomiting and if there is increased potassium level leading to abnormal heart rhythms then the patient must consult a doctor. In order to get kidney transplantation patients must meet some standardized criterias which are based on lab tests and amount of waste product in a man’s blood. Age and health conditions are also considered.
Who is not eligible for the treatment?
As there are some adverse effects of certain treatments like low pressure is the most common complication of haemodialysis, it is better to consult a doctor. Patients with serious medical histories should seek suggestion before any treatment. Like if a patient has high sugar, liver transplantation may not be suggested to him.
Are there any side effects?
There are some side effects of dialysis and kidney transplantation. Low blood pressure is the most common side effect of dialysis. Nausea and vomiting are also associated with this. Patients undergoing dialysis in winter can experience dry or itchy skin. Another common side effect is that a patient keeps on moving their leg because their leg nerves and muscles create a crawly or prickly sensation. It also leads to muscle cramping. Hernia is a potential side effect of peritoneal dialysis. Patients also had to deal with anxiety and depression. Kidney transplantation carries risk of significant complications like- blood clots, bleeding, infection, failure of donated kidney, rejection of the donated kidney etc. Anti-rejection medicines have side effects like diabetes, bone thinning, high blood pressure, high cholesterol, infection, etc. Angiostenin-converting-enzyme inhibitor shows some adverse effects like hypotension, cough, hyperkalemia, fatigue, dizziness, nausea.
What are the post-treatment guidelines?
Some post treatment guidelines are required especially after transplantation and dialysis. In case of transplantation, anti-rejection (immunosuppressant) medications are given to prevent the body from rejecting new kidney. Treating infections is the best way to keep transplanted kidney healthy. As there remains a risk of getting heart disease, so it is better to control high blood pressure. Maintain healthy weight, stop smoking. In case of dialysis, a patient will need to limit certain food intake, doctors may recommend certain vitamins. Smoking is prohibited and medicines like ibuprofen, naproxen should be avoided unless the doctor prescribes.
How long does it take to recover?
Medications will be given in accordance with the disease. Time of recovery will thus depend on the disease and its stage. Dialysis does not cure kidney disease but does the function of normal kidney in case of kidney failure. Hemodialysis is generally done 3 times a week for four hours each. In case of chronic kidney failure patient will have to take dialysis for the rest of their lives. Nephritis is curable and will recover after right medication. If the symptoms recur then recovery will take time. Nephritis resolves completely in 60% adults and 90% children.
What is the price of the treatment in India?
Cost of treatment depends on the method chosen to treat the kidney disease and the health condition of the patient and the stage of the kidney disease. The cost of getting haemodialysis is around Rs.12000-15000 per month while in case of peritoneal dialysis it is around Rs.18000-20000 per month. Getting a transplant done costs around Rs.4 lakhs on an average.
Are the results of the treatment permanent?
There are various methods of treatment of kidney disease. In case of dialysis, it is usually permanent but not always. Acute kidney failure can get better with treatment but in case of chronic kidney failure the kidneys are severely damaged and cannot get better even after dialysis. In case of kidney transplant patient’s own body can reject the new organ.
What are the alternatives to the treatment?
There are some alternative treatments for chronic kidney diseases. Emphasis should be laid on dietary modifications. Foods rich in protein especially pulses, spinach should be taken in moderation. Use natural diuretics like Celery leaves, cucumber, tomatoes, grapes, watermelon when swelling is profound. There are certain herbal remedies used in treating kidney diseases. Punarnava is very useful herbal diuretic; varun is another excellent care for kidney failure; gokshur is used as a diuretic and a herbal tonic for genitor-urinary system. These herbal remedies are very useful for maintaining kidney health.