NEPHROLOGY

Nephrology is a medical discipline that undertakes the diagnosis, treatment, and administration of kidney diseases. Nephrologists commonly perform treatments for kidney stones and kidney failure disorders. Nephrology also focuses on comprehensive care for kidney problems associated with other medical conditions and ailments, like diabetes and hypertension.

Chronic kidney disease (CKD)

CKD means your kidneys are damaged and can’t filter blood the way they should ideally be functioning. This damage can cause wastes to build up in your body. The disease is called “chronic” because the damage to your kidneys happens slowly over a long period of time. CKD can have a ripple effect and cause other health problems as well.

When your kidneys are not working as well as they should, waste and fluid begin to buildup in your body. Over time, the waste and extra fluid can cause heart, bone and other health problems. A kidney-friendly meal plan limits how much of certain minerals and fluid you should eat and drink. This can help keep the waste and fluid from accumulating and causing problems.

Ideally limiting the potassium, phosphorous and fluid intake is recommended depending on how badly the kidneys have been affected.

The way doctors measure how well your kidneys filter waste from your blood is by the estimated glomerular filtration rate or eGFR. Your eGFR is a number based on your blood test for creatinine, a waste product in your blood.

The various stages of CKD are :

GFR Categories in CKD
Stage Description Glomerular Filtration Rate (GFR)
At increased risk With risk factors for CKD (diabetes, high blood pressure, family history, older age, etc.) More than 90
1 Kidney damage (protein in the urine) and normal GFR More than 90
2 Kidney damage and mildly decreased GFR 60-89
3 3a Mildly to moderately decreased GFR 45-59
3b Moderately to severely decreased GFR 30-44
4 Severely decreased GFR 15-29
5 Kidney failure Less than 15

AKI – Acute Kidney Injury

When your kidneys stop working suddenly, over a very short period as an increase in creatinine or decreased urine in a matter of a few hours to days, it is called acute kidney injury (AKI). AKI is sometimes called acute kidney failure or acute renal failure. It is very serious and requires immediate treatment.

Stage Serum Creatinine (SCr) Criteria Urine Output Criteria
1 1.5 to 1.9 times baseline
OR
≥26 ㎛ol/L (≥3.0 mg/dL) increase
<0.5 ml/kg/hr for 6-12 hrs
2 2 to 2.9 times baseline <0.5 ml/kg/hr for ≥12 hrs
3 Serum creatinine increase 3.0 times baseline
OR
Increase in serum creatinine ≥354 ㎛ol/L (≥4.0 mg/dL)
OR
Initiation for RRT
OR
In patients <18 years, decrease in eGFR to <35 ml/min per 1.73 m2
<0.3 ml/kg/hr for ≥24 hrs
OR
Anuria for ≥12 hrs

DIALYSIS

Dialysis is performed externally when the internal kidneys fail – which means they are performing at only 10 to 15% of their normal function.

Kidneys not just prevent extra water, waste and other impurities from accumulating in the body, but they also help in regulating the blood pressure and chemical elements in the blood. So not performing timely dialysis can even be fatal as all the accumulated deposits of salts and waste can poison the body.

Sanjivi will soon facilitate the dialysis procedure at our Hospitals and ensure the patient care is a priority, as is for all our services offered.

RENAL DIET

Is subjective to the stage of kidney disease, blood work results, medications, and any other dietary needs :

To prevent a build-up of the toxins that healthy kidneys normally clear out of the blood;
To reduce the workload of the kidneys (before dialysis);
To prevent complications that can occur from a build-up of toxins;
To meet all your nutritional needs working around this.

Foods should restrict or avoid sodium, potassium, phosphorus. We help with the exact diet through our dieticians and consultants who can advise based on the blood works and stage of kidney disease.

Kidney Transplant

There are 4 kinds of kidney transplants :

Cadaveric renal transplantation
Cadaver-donor kidney transplantation
Living donor kidney transplants
Laparoscopic donor Nephrectomy

Living donor kidney transplants can be done from both unrelated and related donors.

What is a kidney transplant?

When a person’s kidneys don’t function properly, a surgical procedure is performed to place a kidney into the patient from a living or deceased donor.

In a healthy human body, kidneys are responsible for removing excess fluid and waste from the blood. When the organ loses its filtering ability, dangerous levels of waste and fluid build-up leading to kidney failure or end-stage kidney disease. In such cases, kidney transplant is the best treatment for the patient.

A single donated kidney can be used to replace two failed kidneys. Therefore, living-donor kidney transplantation is a viable option. In certain cases when the patient is unable to find a compatible living donor, their name is added to a kidney transplant waiting list until a matching deceased donor can be identified.

A kidney transplant is a treatment for kidney failure (end-stage kidney disease). In this condition, kidneys can function only at a fraction of normal capacity. Patients suffering from end-stage kidney disease must either get waste removed from their bloodstream via dialysis or a kidney transplant.

At Sanjivi though we do not perform kidney transplants yet, we educate the patients and the caregivers about the risks they pose about kidney-related problems because the symptoms are very subtle and most often detected after it is too late and will require dialysis or transplant. It is always better to have regular check-ups done either through a nephrologist or via Master Health Checkups that help in keeping a regular tab.

Reasons for kidney failure

Diabetes
Severe, uncontrolled high blood pressure
Polycystic kidney disease
Chronic glomerulonephritis

In very few cases, patients can manage kidney disease with diet, medication, and treatment of the illnesses and underlying medical conditions. If the kidney does not resume to original functioning despite these steps and blood cannot be filtered adequately, the only treatment that remains is a kidney transplant.

Our team of expert nephrologists will be able to guide you through the procedure and ensure that the utmost care is taken at the time of diagnosis and during and after surgical procedures.

Sanjivi Hospitals has been the best choice I have made, and the treatment suggested and performed by the doctors gave me immense relief.

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