Kidney Diseases

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The Kidney Dialysis Centre in Faridabad offers a vital service for individuals with kidney-related issues. Within the human body, the kidneys, shaped like beans, serve as essential filtration organs. Their primary function involves the purification of blood, eliminating waste materials, and maintaining proper water and electrolyte levels in bodily fluids. This intricate process ultimately leads to the production of urine, which contains waste, surplus water, and excess electrolytes, and is expelled from the body through the urethra.

There are two kidneys situated on either side in the abdomen. Function of the kidneys :-

  1. Excretion of nitrogenous waste products from the body.
  2. Maintenance of Hb (Hemoglobin) level.
  3. Maintenance of strength of bones by keeping the blood Calcium levels normal

What functions do healthy kidneys perform?

  • They balance the body's water content.
  • They remove waste products from the blood. Waste products come from body cells and foods that are eaten.
  • They help keep body chemicals in balance.

The kidneys work hard to remove extra waste and fluid from your body.

Consider the kidneys as specialized filters within your body. These remarkable organs play a pivotal role in blood purification. On a daily basis, they process approximately 190 liters of bodily fluids, meticulously sifting through this vast volume. Astonishingly, they retain nearly all of this fluid, releasing only one to two liters as urine.

The intricate process of urine formation can be broken down into several crucial steps, namely glomerular filtration, tubular reabsorption, and tubular secretion. At the core of this system is the nephron, which serves as the fundamental functional unit of the kidneys. Located at the inception of each nephron, the glomerulus is a complex network of capillaries responsible for the initial filtration of blood.

Now, let's delve into the workings of this remarkable system, keeping in mind that if you're seeking the expertise of a kidney specialist in Faridabad, you're entrusting your renal health to a highly trained medical professional.

  1. First, the renal arteries supply blood to the kidneys.
  2. Then, inside the kidneys, millions of filters called glomeruli filter the blood to form urine. Tubules attached to these filters save some things the body needs.
  3. The excess waste products and extra fluid that the body does not need are removed.
  4. The clean blood returns to the body through the renal veins.
  5. The waste and extra fluid (urine) is carried from the kidneys to the bladder by tubes called ureters.
  6. The bladder holds the urine until it is passed from the body.

Kidneys also help keep your body chemicals in balance.

Specifically, the kidneys produce different hormones and chemicals that:

  1. Prompt the bone marrow to make red blood cells. Red blood cells help oxygen get carried through your body. Without enough red blood cells, you may develop anemia, which will cause you to feel weak, cold, and tired.
  2. Help the body use vitamin D. Vitamin D keeps your bones strong and healthy.
  3. Keep your blood pressure under control. High blood pressure is a very serious condition. It can lead to stroke, heart disease and kidney disease.

As you can see, it is important to keep your kidneys working well for as long as possible.

Common Kidney Disease

In Children :

  1. Excessive protein excretion in urine i.e. Nephrotic Syndrome.
  2. Infections of urine and kidney e.g. Vesico-Ureteric Reflux (VUR)

In Adults:

  1. Diabetic Nephropathy
  2. Hypertensive nephrosclerosis i.e. Kidney damage due to high blood pressure.
  3. Kidney stone disease i.e. Obstructive Uropathy.
  4. Adult Polycystic disease, Congenital i.e. by birth.
  5. SLE is more common in women.

When someone has kidney disease, the kidneys are damaged.

The kidneys no longer work well enough to remove wastes and excess fluids from the body. Complete kidney failure occurs when less than 10% of your kidneys are working. Toxins, waste products from foods and body cells, plus extra fluids build up in the blood. If the excess wastes and fluids are not removed, the whole body is affected. You will become ill from the build up of waste products and fluid.

CAUSES OF KIDNEY DISEASE

There are several different diseases and conditions that are known causes of kidney failure. For some people, however, the cause is never known.

The most common causes are :

Diabetes can damage the small blood vessels (glomeruli) in the kidneys.

Hypertension (high blood pressure that is not treated) can also damage the small blood vessels (glomeruli) in the kidneys. If the high blood pressure continues, the kidneys may fail.

Other causes

Glomerulonephritis is inflammation of the small blood vessels in the kidney. This disease usually affects both kidneys and causes steady damage. It may be hereditary.

Other diseases such as lupus may also damage the kidneys.

A blockage is any condition where urine cannot flow out of the kidney. The blockage makes it difficult for the kidneys to remove wastes and extra fluids. Obstructive uropathy is a blockage of urine flow out of the kidney, which may be caused by kidney stones or a birth defect of the kidney.

Infection is the most common disorder of the urinary tract. Cystitis is a bladder infection. Symptoms include urgent, frequent, painful urination. If not treated, cystitis may lead to a kidney infection.

Pyelonephritis is a kidney infection that may be caused by a kidney birth defect. Someone who has this infection may or may not feel sick. Possible symptoms include fever, back pain, and chills.

Polycystic kidney disease (PKD), a hereditary condition, can lead to kidney failure. When someone has this disease, cysts grow and damage the kidneys. Then the kidneys enlarge, and eventually they stop working.

SYMPTOMS

Early on, people may not have any symptoms to tell them that their kidneys are not working well.

That is why regular physical check up, with blood tests and urine tests, are so important. Test results may show signs of kidney disease even when a patient feels fine.

As the kidney disease progresses, a person may feel sick sometimes. But the change may be so slow that he or she does not do anything about these feelings. Symptoms may also be due to another illness or problem.

Complete kidney failure, however, causes many changes in the body, and people feel some stronger symptoms.

Symptoms vary from person to person.

Feeling generally sick

When the kidneys begin to fail, waste products will build up in the blood. This may cause a person to feel generally sick. Symptoms may include fatigue, nausea, vomiting, loss of appetite, itching, and/or disturbed sleep.

Fluid retention

The kidneys may produce less urine, which may cause extra fluid to build up in the body. This is called edema. People with this problem may have swollen hands and ankles. They may gain fluid weight, and/or may be short of breath doing activities such as walking or climbing a few stairs.

Anemia

The body will not produce as many red blood cells when the kidneys are not working. This is called anemia. People with anemia may feel weak and tired. A drug that acts like the body's own hormone, erythropoietin, stimulates the production of red blood cells. The drug may be used to treat this type of anemia.

Toxin build up

When the kidneys are not working to clean the blood, waste products called toxins will build up in the body. This may cause fatigue, loss of appetite, and may make the person's skin feel itchy.

Other symptoms

Other symptoms may include:

  • Headache
  • Diarrhea
  • Decrease in frequency of urination
  • Drowsiness or confusion
  • Puffiness around the eyes
  • Decreased interest in sex
  • Feeling cold
PREVENTION OF KIDNEY DISEASE

Just as we have measures to prevent heart disease, kidney disease can also be prevented.

  1. Keep body weight normal and not allow obesity.
  2. Balanced diet, low in salt and sugar and low in saturated fats. Use mustard oil and sunflower oil for cooking.
  3. Regular exercise e.g. brisk walking, aerobics.
  4. No Smoking.
  5. Regular medical check ups every 6 months or after one year.

If kidney disease has developed, then in the early stages a lot can be done to prevent further progression of kidney disease.

People get very alarmed when they find that their blood urea or Serum creatinine are elevated or if the protein/albumin excretion in urine is increased.

  1. If the patient is a diabetic and hypertensive, then control of diabetes and hypertension and addition of certain medication can control the disease. Certain medication should be absolutely avoided if kidney disease has set in e.g. certain pain killers, antibiotics e.g. aminoglycosides etc.
  2. Acute renal failure can occur due to many reasons e.g. (i) dehydration following severe gastroenteritis especially in small children and the elderly. (ii) Blood loss due to injuries or diseases.
  3. Acute Renal Failure (ARF) may be fully reversible if the primary cause resulting in kidney failure has been adequately treated.
  4. Sometimes Acute renal failure may need support for dialysis. There is a major misconception that once acute renal failure has set in then the patient will always need dialysis for the rest of his life. This concept is very wrong. As I have already mentioned, once the basic cause of Acute Renal failure has been adequately treated the renal failure can be fully reversed.
  5. In non-diabetics, if blood urea and serum creatinine are elevated and kidney size is normal or near normal then we may plan to do a kidney biopsy. Kidney biopsy is a fairly safe procedure done under local anesthesia and ultrasound guidance. Once we have the pathology report of the kidney biopsy and we have the exact diagnosis of kidney diseases then we may be in a position to provide specific treatment to the patient and the rising trend of blood urea and serum creatinine may be reversed.
WAYS TO CHECK KIDNEY HEALTH

Blood and urine tests can tell us how well someone's kidneys are working.

Our doctor may decide to do blood and urine tests if you are at risk for kidney failure or kidney disease. For people who have started dialysis to replace the functions of their kidneys, these tests let their doctors know how well dialysis is working.

Urine tests

There are two types of urine tests. One type requires a small amount of urine. It tells a doctor if there is blood, infection, protein, or cells in the urine. The other type requires collecting all the urine produced for a certain amount of time, usually 24 hours. This test will show how much urine your kidneys produce in one day. It also measures how much protein is passed from the kidneys into the urine in one day. Your doctor will be able to see if your protein levels are normal. Your doctor may also measure the amount of waste from muscle cells (called creatinine) or from the protein you eat (called urea) in your urine to see how well the kidneys are working.

Blood tests

Everyone's blood test results are different. They are affected by 3 things

  1. What the person eats.
  2. How well the person's kidneys are working.
  3. 3. How much urine the person passes and how much waste leaves the body through the urine.

Your doctor or nurse will give you your latest blood test results. Different labs test blood differently, but this section can help explain some of the terms you will see on your blood tests.

Ask your doctor what he or she would consider to be normal results.

Some of the levels described can be affected by diet. Someone on dialysis usually has a renal dietitian and/or a nurse to talk to about what to eat.

Your blood (or the part of your blood called serum) may be tested for several things including:

Serum Creatinine

Creatinine is a waste product of muscle activity. The kidneys normally filter out this waste. Blood (serum) levels of creatinine are the most common numbers used by doctors to determine kidney function.

When the kidneys are not working, dialysis helps to remove the extra creatinine. Dialysis is usually started when creatinine clearance falls to less than 14 milliliters per minute (mL/min).

Steps to be taken to keep your Kidney Healthy

For people who still have some kidney function, there are many ways to keep the kidneys working longer.

We are lucky to live today at a time when dialysis makes living without kidneys possible. But there is no substitute for the real thing.

Where to begin?

Visit your doctor regularly. If your doctor finds you are at risk for kidney disease, or are showing signs of kidney disease, he or she will take several steps to improve your health. You will have a common goal: to slow progression of the disease, and to delay dialysis. First, your doctor will want to determine the cause, and if the cause is reversible. If the cause is an underlying condition like diabetes or hypertension, your doctor will help you better control this condition. Lifestyle and diet changes may also be initiated - dietitians play a significant role in helping patients delay kidney failure. This kind of intervention, however, may be effective only if the signs of kidney disease are caught early.

Take a good look at your personal priorities in life. Personal health should be a top priority. Everyday, personal health must come first, whether it is deciding what to eat, or how late to work. This is especially true for people who have diabetes or hypertension. These are the top 2 conditions that can lead to kidney failure.

Other ways to maintain your kidney health include:

  • Visiting your doctor early, and regularly
  • Following your doctor's advice
  • Maintaining good blood glucose control, if you are diabetic
  • Following your doctor's orders to control your blood pressure, if you have high blood pressure
  • Learning about symptoms of kidney disease
  • Taking prescribed medications
  • Taking dietary supplements or vitamins only with the approval of your doctor
  • Staying positive

For people with early kidney disease, taking these steps may help delay kidney failure.

Remember: managing illness early is much better for your health...

...and much better for you than waiting until your kidneys have stopped working. When it comes to kidney disease, most patients prefer to have as little change to their lifestyle as possible, and a sense that they have some control over this situation.