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Overview

Kidney Disease: Treatment, Procedure, Cost and Side Effects

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.

Safety: Medium Effectiveness: Medium Timeliness: Medium Relative Risk: Medium Side Effects: Medium Time For Recovery: Medium Price Range: Rs.500-Rs.5 lakhs

Popular Health Tips

Chronic Kidney Disease: Causes You Need To Know

MCh Urology, DNB Urology, MS-General Surgery, MBBS, Diploma In Laproscopy & Urology, Basic & Advance Robotic Urology Training
Urologist, Delhi
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Kidney disease can affect the body’s ability to clean blood, filter extra water out of blood, and help control blood pressure.Without treatment, the damage can get worse, and kidneys may eventually stop working. It can be life-threatening.

4 people found this helpful

How Can You Treat A Kidney Infection?

MD, MBBS, FRCP - Nephrology
Nephrologist, Delhi
How Can You Treat A Kidney Infection?

Kidneys are responsible for the removal of waste and unwanted particles from the bloodstream. They are part of the urinary tract and are responsible for the formation and excretion of urine. It is the filtration and waste disposal system of the body. And as such plays a pivotal part in our health and well-being.

A kidney infection, more often than not, starts with a bladder infection and then spreads to the kidneys. It is caused by the presence of bacteria, specifically a bacteria called E.Coli. Though extremely rare, it is possible to get a kidney infection through your skin. It might make its way into your blood and then travel to the kidneys. You might contract an infection after surgery but that is extremely uncommon as well.

A kidney infection is diagnosed by running a urine test to check it for the presence of bacteria, blood or pus. Other tests may include a CT scan, an ultrasound or a kind of X-ray called voiding cystourethrogram, which involves injecting a contrast dye to image the bladder while urinating.

Treatment :

  1. Antibiotics: The first lines of treatment for a kidney infection are antibiotics. Depending upon the bacteria that has been found in your urine tests and your personal health, your physician will prescribe you specific drugs. The symptoms usually abate after a few days of treatment, or you might need to continue the antibiotics for a week or so more. It is advisable to continue with the entire course of the drugs even if you feel better after only a few days. Another sample of your urine will be tested afterwards to ensure that the infection has cleared up.
  2. Hospitalization: For a severe case of kidney infection a physician will insist on hospitalization. The treatment will include antibiotics and a copious amount of fluids that will administered to you intravenously. The severity of the infection would dictate the length of the course of drugs required.
  3. Surgery: Kidney infections can be symptomatic of a much more serious underlying medical condition. Kidney infections may recur with increasing frequency due to a structural defect of the urinary tract. A nephrologist or a urinary surgeon (urologist) should be consulted for an evaluation. You will most likely need surgery to repair the structural abnormality to ensure that the infections desist.

Kidneys are vital organs that perform important functions of waste removal, and maintain the balance of the body’s fluids. Infections should thus be diagnosed and treated promptly.

In case you have a concern or query you can always consult an expert & get answers to your questions!

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Dialysis - Why It Is Required?

DM - Nephrology, DNB (Nephrology), MD, MBBS
Nephrologist, Delhi
Dialysis - Why It Is Required?

Kidneys are a pair of organs that are located on either side of the spine, each about a size of a fist. The kidneys help in purifying blood by removing toxins, waste materials and excess fluids from the human body. Disorders and dysfunctions of the kidney can lead to severe and often fatal consequences. When the kidneys stop functioning as they are supposed to, dialysis is performed to resume normal functioning in the body.

Dialysis is a type of treatment, which filters and purifies the blood with the aid of a machine. It is an artificial way of purifying blood. There are two types of dialysis, namely hemodialysis and peritoneal dialysis. Hemodialysis, the most common form of dialysis, which involves using a manmade kidney called a hemodialyzer, which removes toxins and waste materials from blood.

Peritoneal Dialysis, on the other hand, is a type of treatment which involves implanting a catheter in the stomach. During the procedure, a fluid called dialysate flows into the abdomen that absorbs all the waste material, which is consequently drained out of the body.

You may need a dialysis if:

  1. Your kidneys are dysfunctional
  2. When waste materials and toxins start to accumulate in the body
  3. In an event of an injury or accident to the kidney such as internal lacerations (wound caused by the tearing of a tissue)
  4. If the creatinine (a type of a chemical waste product) level falls to 10-12 cc/minute
  5. In an event where the kidneys aren't able to work properly leading to accumulation of toxins, irregular amounts of chemicals in the body and other dysfunctions


Weakening of the abdominal muscles and weight gain are some of the risks involved in dialysis. Dialysis is a temporary treatment and serves to function till the time the actual kidneys get repaired. In chronic cases of kidney disease, kidney transplant may perhaps be the last resort.
 

Prolonged Use Of Antacids Hits Kidney

BSc - Home Science, Diploma In Health & Nutrition, MSc - Dietitics/Nutrition
Dietitian/Nutritionist, Delhi
Prolonged Use Of Antacids Hits Kidney

Prolonged Use Of Antacids Hits Kidney

Recent global studies suggesting that prolonged use of widely prescribed anti-acidity pills to treat “gas” and heartburn may be linked to long-term kidney damage, acute renaldisease and chronic kidney disease have sparked fresh debate among doctors.

Though a few initial reports about the association of these drugs-also called PPIs (proton pump Inhibitors) with kidney disease have been published in reputed medical journals ,It is now that there are studies suggesting it’s more serious and linked to both acute kidney injury and chronic kidney disease doctors told.

Contrast Induced Nephropathy - What's The True Risk?

MBBS, DM - Nephrology, MD-General Medicine
Nephrologist, Delhi
Contrast Induced Nephropathy - What's The True Risk?

Contrast-induced nephropathy (CIN) is a serious complication that may arise during angiographic procedures and is elaborated as the impairment of renal function. It is estimated as either a 25% increase in the serum creatinine (SCr) from baseline or a 0.5 mg/dL (44 µmol/L) increase in absolute creatinine value within two to three days after intravenous contrast administration of intravascular radiographic contrast material that is not attributable to other causes.

To simplify, contrast-induced nephropathy (CIN) is a form of kidney damage in which there has been recent exposure to medical imaging contrast material without another apparent cause for the acute kidney injury. CIN is considered the 3rd most common cause of hospital-acquired renal dysfunction. There are emerging concerns that the importance of CIN has been greatly overstated. Here discussed are the risk factors with concerns comprised in (CIN) Contrast induced nephropathy.

Complications in consideration of Contrast induced nephropathy
One of the leading causes of hospital-acquired acute kidney injury (AKI), CIN is associated with longer hospital stay and while the incidence is low (0-5%) in patients with normal renal function, trials report that it is as high as 26% in patients with impaired renal function. Also, studies report that about 15% of the affected patients needed dialysis.

There is a complex association between CIN, mortality, and comorbidity. Majority patients who receive CIN do not die from renal failure. Death, if a patient at all dies, is more usually from a procedural complication or a pre-existing non-renal complication.

Risk concerns
Many physicians who refer patients for contrast procedures and some who perform the procedure themselves are not entirely informed about the risk of CIN. Individuals with diabetes mellitus, chronic kidney disease, hypotension, reduced intravascular volume, or who are over 75 years of age are at increased danger of evolving CIN after exposure to iodinated contrast. A survey found that most of referring physicians were not aware of potential risk factors, including ischemic heart disease and diabetes mellitus. However, acute kidney injury (AKI) can happen from a variety of causes, or their succession, during severe illness and no trial which is randomized has established the risk of contrast induced nephropathy.

The overblown risk factor
When there is a need to diagnose a suspected arterial thrombus, pulmonary embolism, or intra-abdominal catastrophes, treatments and tests require intravenous contrast and these are often suspended in patients with raised creatinine levels. The diagnostic rift leaves their physicians with less than the best knowledge to make decisions regarding the treatment.

A notable percentage of hospitalized patients experience AKI and an even greater percentage gain IV contrast during their stay in the hospital. There will thus forever be the explanation for observed anecdotal instances of "contrast-induced nephropathy." Whether or not contrast-induced acute kidney injury persists, or has been exterminated by the use of lower-osmolarity contrast agents, would require a comprehensive randomized analysis to sort out.

In most cases, the condition is self-limiting with the creatinine levels peaking for 2-3 days and returning back to baseline within 7-10 days, there are indeed concerns due to the limitation in treatment options.

In case you have a concern or query you can always consult an expert & get answers to your questions!

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Popular Questions & Answers

How dangerous is SERUM CREATININE value 5.55 mg/dl for an 55 years male. I had heart stent last year and admitted in hospital this week.

MBBS, MD - Internal Medicine, DM - Cardiology, Fellowship in EP
Cardiologist, Delhi
Sometimes it is temporary increase, at other times it persists. Take good treatment, and hope it improves.

I have one kidney large and other small. I am planning to take lean gainer protein powder .Will it be harmful for my kidneys?

MD, Fellowship in Intergrative Medicine, MBBS
Integrated Medicine Specialist, Kochi
Advice can be given based only on your Kidney function test reports as well as Ultrasound reports and your detailed dietary history only for all these things you need to get a consult. You are young and overweight so please do not get into health issues at this young age and spoil your future Get educated and never medicated.

My current SERUM CREATININE reading is 1.3 mg/dl. About year back it was only 1.08 mg/dl only. What can I do to see that it does NOT go UP any further?

MBBS
General Physician, Mumbai
Few tips on Diet for kidney disease - have a low protein diet (decrease in milk and its products and also decrease in the intake of pulses and nuts etc)- can use corn oil, sunflower oil, olive oil for cooking -decrease the intake of butter, ghee, cream,coconut etc - avoid farsan food items - whole grain cereals are best for carbohydrate intake - get your blood checked for electrolyte levels regularly and adjust salt in diet as per the report values.
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Table of Content

What is the treatment?
How is the treatment done?
Who is eligible for the treatment? (When is the treatment done?)
Who is not eligible for the treatment?
Are there any side effects?
What are the post-treatment guidelines?
How long does it take to recover?
What is the price of the treatment in India?
Are the results of the treatment permanent?
What are the alternatives to the treatment?