Kidneys play an important role in the body: they filter the blood, removing waste products and excess salt and water. “If the kidneys become diseased, they fail in their task, leaving the blood polluted. Finding out that you have early kidney disease can alert that your kidneys are in danger. It is important to take steps to protect your kidneys before the problem advances,” says Dr.Dilip M Babu, consultant nephrologist and transplant physician, Apollo Hospitals, Hyderguda.
The common causes of kidney disease are diabetes, blood pressure, stone disease, infections, inappropriate medications, drug abuse, dehydration, genetic disorders, heart disease and liver disease. “Some of these like genetic disease and diabetes are not in our control. But even here one can prevent or limit damage by taking care of the primary problem,” says Dr V Ravi Andrews, senior consultant nephrologist, Apollo Health City.
He further states, “Leading a healthy and balanced life with a sensible diet, appropriate fluid intake, adequate sleep, regular exercise, avoidance of unnecessary medications and good control of any underlying diseases are the keys to kidney health.”
Kidney transplant
Kidney failure can happen in the acute (sudden) or chronic (over a period of time). While dialysis may be required for both types of kidney failures, a majority of the acute kidney failures will recover, and it is the chronic renal failures that will require kidney transplant.
Medically, the overall survival of patients with kidney failure is much better after kidney transplantation as compared to long term dialysis. In addition to their role in filtering waste products and toxins from the blood, kidneys have an important role to play in the synthesis of blood and metabolism of calcium and vitamin D. Dialysis is an effective way to filter waste products and toxins, but does not substitute the other functions of the kidneys. Hence, people on long term dialysis have problems like anemia and weak bones which are not seen in patients after transplant.
Maintenance
Hemodialysis will require the patients to be connected to a dialysis machine three times a week. In addition to restricting the activities of the patient resulting in compromised quality of life, this takes away important working hours and hence decreases the productivity of an individual. It is true that patients need to take medicines all their life after transplant, which will have cost implications.
Cost
The costs of maintenance drugs comes down significantly after the first 1.5-2 years and becomes similar to or even less than that of maintenance hemodialysis. Additionally, many government and insurance schemes provide financial support to patients for transplantation as well as post transplantation medicines.
The most important thing to understand is that although dialysis and kidney transplant are, both, treatments for kidney failure, they are not substitutes for each other. For patients who are medically fit for transplantation and who have an active and productive life ahead of them, dialysis should be considered as a bridge to transplantation. The availability of dialysis as an option should enable patients to undergo kidney transplant at the right time with the right organ, rather than deter them from undergoing a transplant altogether.
Risk factors .
Having elevated blood sugar levels Hypertension Being overweight or obese Smoking
Having a diabetes - related vision problem (Diabetic retinopathy) or nerve damage (Diabetic neuropathy)
Having a family history of kidney disease
Symptoms
People who develop kidney disease usually have no symptoms early on, although the condition puts them at risk of developing more serious kidney disease.
Symptoms like swelling of lower limbs, face swelling, difficulty in breathing, loss of appetite, nausea, vomiting, decrease in hemoglobin level and bone disease develop at very late stages of kidney disease.
DIAGNOSE
Urine tests for protein called albumin are recommended once per year in people with diabetes and hypertension, staring at the time of diagnosis. If there is albumin more than 30mg/day in urine or urine albumin creatinine ratio more than 30mg/g of creatinine, it means you may have kidney disease. Blood chemistry abnormalities like rise in creatinine and blood urea develop at late stages of kidney disease.
Prevention & Treatment
Consult kidney specialist (Nephrologist) before starting treatment
Limit the amount of salt you eat If you smoke, quit smoking Lose weight if you are overweight
Keeping blood sugars close to normal (Target blood glucose levels before each meal 80 to 120mg/dl and HbA1C of 7percent of less)
Manage high blood pressure (blood pressure reading below 130/80 is recommended)
Use Angiotensin converting enzyme inhibitor (abbreviated ACE inhibitor) or a related drug known as an angiotensin receptor blocker (ARB) to control blood pressure and proteinuria.
Avoid pain killers (like Ibuprofen, Diclofenac, and Nimesulide - NSAIDS).
Inform your family Global Kidney Support Group Launched doctor that you are having kidney disease.
Diet as per your doctor’s advice.
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