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Hypertension

Hypertension Treatment in Delhi

Hypertension means having high blood pressure and is very common. One in three adults in India has high blood pressure. Without proper Hypertension Treatment in Delhi, hypertension can lead to serious health problems, such as heart disease or stroke, which are common causes of death in India.

What are the symptoms of hypertension?

Usually, people with hypertension do not feel any symptoms. Hypertension is known as “the silent killer” as it can cause deep damage to your body, even when you feel nothing. The only way to know if you have hypertension is to measure your blood pressure.

How do I know if I have high blood pressure?

Diagnosing high blood pressure is as simple as taking your blood pressure. Your nurse or doctor will place an inflatable bracelet around your arm while they listen to your pulse. It is fast and painless. Sometimes you can also check your blood pressure at a pharmacy or drugstore or use a home test.

What do the blood pressure numbers mean?

The blood pressure reading has 2 numbers. The first is known as systolic blood pressure, which is the pressure in your blood vessels when your heartbeats. The second number is called diastolic blood pressure, which is the pressure in your blood vessels when your heart is resting between beats. The combination of these two numbers is your blood pressure.

  • Normal blood pressure: 120/80 or less
  • Hypertension or at risk (near hypertension): between 120-139 / 80-89
  • Hypertension: 140/90 or higher

If the numbers that measure your high blood pressure are high twice in a row, your nephrologist in Delhi may diagnose you with high blood pressure.

How can I prevent hypertension?

The most important thing you can do to prevent hypertension is to eat a healthy diet, maintain a healthy weight, exercise regularly and avoid smoking.

How is hypertension treatment in Delhi done?

Hypertension treatment in Delhi is usually done with a combination of diet, exercise, and medications. Changes in diet may include eating vegetables, fruits, and whole grains and reducing the consumption of salt, alcohol and red meat. Exercising regularly can also help. This means exercising for at least 30 minutes a day, 5 days a week. This may include things like walking, going to the gym, cycling or swimming. Anything that makes you sweat and breathe quickly.

If you don’t have time to exercise 30 minutes in a row, you can do it for 10 minutes, 3 times a day. You can also find small ways to stay active during the day, such as climbing the stairs instead of taking the elevator. The important thing is that you move regularly throughout the day. The best nephrologist in Delhi can help you determine what “exercising on a regular basis” means in your case.

Your nephrologist in Gurgaon may also recommend some medication if changes in diet and exercise are not enough to lower your blood pressure. Your doctor will help you determine which pressure medication is right for you.

How hypertension affects our kidneys?

Although not everyone knows the close relationship between high blood pressure (hypertension) and the kidneys, it is necessary to remember that hypertension is the second cause of kidney failure. To do this, Dr. Vinant Bhargava, from the Nephrology and Hemodialysis Service of Sir Ganga Ram Hospital, Delhi, has revealed the relationship between blood pressure and kidneys, explaining how hypertension can cause chronic kidney disease.

In the kidney, the arteries that irrigate it deteriorate, generating ischemia of its functional units (nephrons) which, together with hypertension transmitted to these units, generates progressive and irreversible destruction. This hyper pressure will favor an increase in the elimination of proteins in the urine, which can be assessed as a marker of renal damage.

“According to the pressure with which the blood reaches them, the kidneys behave in one way or another to manage to control the tension of the whole organism. If very high blood pressures arrive, the kidneys begin to resent and, little by little, they become stiffer to resist this high tension. This can lead to a loss of function and, in specific cases, if the progression continues, a renal replacement therapy such as dialysis or renal transplantation may be necessary, ”said Dr. Vinant Bhargava.

How to detect kidney disease in cases of hypertension?

Hypertension Treatment in Delhi
The detection of renal disease related to hypertension is described in hypertensive patients through the detection of a series of substances in the blood and / or proteins in the urine. Specifically, kidney disease in these cases can be diagnosed by detecting the decrease in glomerular filtration or the presence of albumin in urine:

  • The decrease in glomerular filtration is diagnosed by detecting in blood a substance generated by the body itself: creatinine. This substance is only eliminated through the kidney, so if it increases, it means that the kidneys should not be working well.
  • The decrease in glomerular filtration is usually accompanied by the loss of protein in the urine, specifically albumin – sometimes being the first defect detected.

Once renal disease linked to hypertension is detected, therapeutic measures should be carried out to study and control the possible progression of renal disease, taking into account all the factors that may impair the normal functioning of the kidneys and taking hypertension treatment in Delhi.

Prevention of renal disease due to hypertension

The way to prevent tension from causing kidney disease and more importantly, slowing down its progression, is by leading a healthy lifestyle:

  • Moderate physical activity 20-30 minutes every day.
  • Follow a Mediterranean diet.
  • Do not consume pre-cooked products.
  • Avoid toxic habits such as smoking or alcohol consumption.
  • And, in the case of stress, the most important habit change is to reduce salt consumption.

Thanks to the control of sodium excretion in the 24-hour urine it is possible to know what the actual salt consumption of a person is. By obtaining these precise data, top nephrologist in Delhi can make better recommendations for reducing salt intake. And, another fundamental measure for good blood pressure control is the use of antihypertensive drugs.

“Its use is widespread in today’s society and the different existing groups help to make the most ideal combination for each patient; in very relevant studies, there is a demonstrated decrease in cardiovascular events and a slowing of renal damage, although this should not lead us to forget that prevention is a very important part of treatment, ”explained nephrologist in Delhi.

For all this, it is so important to perform a blood test and urinary sediment in the annual or semi-annual controls and, in the case of hypertensive patients with chronic kidney disease (CKD), to carry out an exhaustive control of blood pressure (BP) to minimize progression.

Urinary Tract Infection

Urinary Tract Infection (UTI)
A urinary tract infection (UTI) is an infection in the urinary tract, which includes the bladder and urethra. Anyone can have an infection of this type, but it is more common in the case of those who have a vulva.

What is a urinary tract infection (UTI)?

A urinary tract infection is an infection in the urinary tract, which includes the following:

  • The bladder: the organ that collects and stores urine
  • The urethra: the tube that carries urine from the bladder to the outside of the body

There are two types of urinary tract infections: cystitis and urethritis. Cystitis is an infection in the bladder. Urethritis is an infection in the urethra. If left untreated, they can spread and cause a kidney infection. For this reason, urinary tract infections should be taken seriously no matter how common they may be.

What causes urinary tract infections?

Getting these infections is quite easy. Bacteria that live in the vagina, genitals, and areas near the anus can enter the urethra, travel to the bladder and cause an infection. This can happen during sexual activity when bacteria that reside in the genitals, anus, your partner’s fingers or in a sex toy enter the urethra. These infections can also be caused by chlamydia, gonorrhea or other microorganisms.

Although urinary tract infections are not transmitted from one person to another like sexually transmitted diseases ( STDs ), having sex can lead to acquiring these infections or making them worse. You don’t have to have sex to get these infections. Everything that causes bacteria to come into contact with the urethra can cause a urinary tract infection.
The propensity to acquire these infections is greater in the following cases:

  • You already had a urinary tract infection.
  • Do you have diabetes?
  • You suffer from obesity.
  • You use spermicide or a diaphragm.
  • You have kidney stones or other obstructions in the urinary tract.

Most people are not able to identify the exact cause of the infection because there are many things that can lead to acquiring it.

What are the symptoms of a urinary tract infection?

One of the most common symptoms is a frequent and urgent need to urinate. You may have the feeling of wanting to urinate all the time, even if you have just gone to the bathroom. Other symptoms of urinary tract infections include:

  • Pain or burning when urinating
  • Cloudy or smelly urine
  • Blood or pus in your urine
  • Pain, pressure or cramping in your abdomen, back or sides

If the urinary tract infection goes to the kidneys, symptoms may include the following:

  • Pain in the middle of your back (to the right or left of the spine)
  • Fever
  • Shaking chills
  • Sickness
  • Vomiting
  • Feeling tired

If you have any of these symptoms, tell the nephrologist in Delhi as soon as possible. Kidney infections are serious and should be treated immediately. These symptoms are not always caused by a urinary tract infection. Other infections, such as sexually transmitted diseases or vaginitis can cause frequent and painful urine. Only a nephrologist in Gurgaon can tell you for sure if you have a urinary tract infection.

How are urinary tract infections treated and avoided?

These infections can be diagnosed with a simple urine test, and are treated with antibiotics. The type, dose, and duration of treatment of a urinary tract infection depend on what causes the infection and your medical history.

How do I get tested for a urinary tract infection?

You have to check with a nurse or a doctor to know for sure if you have such an infection. Usually, it begins with a talk with the doctor or nurse in which your medical history and the symptoms you have been analyzed. A simple test called “urinalysis” is also done: all you have to do is urinate in a glass; This is then sent to the laboratory for tests to detect any bacteria or determine if there is any sign of infection.

In addition, the kidney specialist in Delhi may have to test you for a sexually transmitted disease ( STD ) that can cause a urinary tract infection or that has similar symptoms.

Is there a treatment for urinary tract infections?

Most of these infections are easy to treat. Urinary tract infection treatment in Delhi usually includes antibiotics, which end it. If you want, you can also take over-the-counter pain relievers. Antibiotics are usually quick and effective: most symptoms disappear on the first or second day of taking the medication.

In any case, be sure to finish all the indicated treatment, even if the symptoms disappear. If you stop urinary tract infection treatment early, it may remain in the body or come back If the symptoms do not go away after a few days or if you have more serious infections in places such as the prostate or kidney, your doctor for kidney in Delhi may recommend that you have more tests, change the medication.

Where can I get tested or treated for a urinary tract infection?

In the local health center, as well as in many other private clinics and medical offices, tests are performed and treatments are offered for this infection.

How can I avoid a urinary tract infection?

urinary tract infection treatment in Delhi

If you ever had a urinary tract infection, you know that once is more than enough. The good news is that they can be avoided. Try these simple tips:

  • Drink plenty of fluids (including water).
  • Urinate when you feel like it. Do not contain urine.
  • Urine before and after having sex.
  • Wash the skin around the anus and genitals with hot water and mild soap.
  • Use barriers such as condoms and oral latex barriers during sex, especially during sexual contact with the anus.

You should also thoroughly wash everything that has touched or been inserted into your anus (such as a finger, penis or sex toy) before it touches the genitals. If you have a vulva, clean it from front to back after using the bathroom and keep it clean and dry. For this, wear underwear with a cotton crotch and avoid using vaginal showers, talcum powder and spray deodorants in the vagina.

If you have urinary tract infections frequently, take cranberry juice (no sugar, not sugary drink) or cranberry pills as a dietary supplement; Both can help prevent infection. If none of these things help, your nurse or doctor can give you a low-dose antibiotic so you can take it regularly after having sex. It is also a good idea to talk with the best nephrologist in
Delhi to see if there is any other reason why you might be getting urinary tract infections.

Kidney Transplant

Kidney transplant in Delhi consists of the extraction of a kidney from a previously healthy individual (cadaver or live) and its placement in a patient with chronic end-stage renal failure and incompatible with life. A kidney transplant surgeon in Delhi performs the operation. Technically, the operation is simple and consists of three anastomosis or joints (arterial, venous and urinary). The duration of the intervention in the recipient is about 3-4 hours. It allows the integral recovery of renal function and normal life. It requires the taking of anti-rejection or immunosuppressive medication for life and frequent medical checks from a kidney transplant doctor in Delhi.

Kidney Transplant in Delhi

Depending on the origin of the graft, it can be a living relative donor (parents, siblings, children, cousins), an emotionally related living donor (for example, between spouses) and a cadaver donor (due to previous brain death or standing heart). The best results are obtained with a live donor kidney transplant.

When is it indicated?

In all patients with end-stage chronic renal failure and without contraindications, prior to the start of dialysis or once included in hemodialysis or peritoneal dialysis program. It requires the performance of a series of analytical, immunological studies, various imaging techniques, assessment of cardiac, pulmonary, neurological, urological, etc., being subsequently included in the waiting list for kidney transplantation in the transplant unit of your area of influence.

What are the results?

At present, the results of renal corpse transplantation are very good, achieving a graft survival of around 90% per year, 70-75% at five years and 50-60% at 10 years. The main causes of long-term graft loss are chronic rejection and death of a patient with a functioning graft in relation to cardiovascular problems, infections, tumors, and liver disease. The results of renal transplantation of living donors are higher than those of cadavers and are characterized by a lower incidence of acute rejection and superior results in terms of graft survival that can be 98% per year, after five years of 85% and at 10 years of 75%.

What advantages does it offer?

The main one is that it restores or normalizes all kidney functions, including the production of erythropoietin-like hormones (necessary for the production of red blood cells), vitamin D (for normal bone maintenance), etc., and not just the function of uropoiesis or elimination of water and waste products such as urea, creatinine, potassium, phosphorus, etc. … that perform the different peritoneal dialysis or hemodialysis techniques.

It also allows a better physical and psychic state, a better quality of life and is the cheapest therapeutic option from the year with a functioning graft.

What are the complications?

The most frequent early complications are those related to surgery (urinary obstruction, urinary fistula, liquid collections, surgical wound infection, urinary tract infections, lung infections, etc.). The incidence of high blood pressure, an increase in uric acid, increase in cholesterol is high. In the longer term, the main complications are infections, malignant tumors, chronic rejection, and cardiovascular complications.

Who can be transplanted?

kidney-transplant-doctor-in-delhi

Not all patients with terminal chronic renal failure can be transplanted due to problems or limitations of a medical or surgical nature. This is the case of patients older than 70-75 years (valuing biological age rather than chronological age) and those with significant problems of cardiac, hepatic, neurological, pulmonary origin, chronic infectious pathology, unresolved tumor diseases, etc. Any patient in whom the vital risk of the operation and of the complications associated with the anti-rejection medication is considered excessive or important, it is better to contraindicate the kidney transplant in Delhi.

What is the waiting list?

Once all the relevant studies have been carried out and it has been verified by the doctor for kidney transplant in Delhi that the patient meets all the requirements and indications for renal transplantation, the data is sent to the reference hospital where the renal transplant unit is located and from where the patient will be notified (through the kidney transplant doctor in Delhi responsible for its follow-up) as soon as a suitable kidney is available due to its characteristics.

Among the necessary data are age, dialysis unit, blood group, tissue typing, cytotoxic antibody results, type of nephropathy, hemodialysis program start date, location telephones, etc. … and the results of the various pre-transplant studies. In India, it can only be included in a waiting list for kidney transplantation.

What is expected of the receiver?

  • To take the medication correctly with the dose and interval indicated by the nephrologist in Delhi responsible for its follow-up.
  • That blood pressure, weight, and temperature be monitored periodically.
  • That you consult quickly before episodes of fever, edema, decrease in urine output or any other complication related or not with kidney transplantation.

It is also important to perform daily physical activity, eat a proper diet, avoid tobacco, maintain the ideal weight, etc.

What is the anti-rejection treatment?

It consists of taking immunosuppressive medication to avoid rejection and achieve graft tolerance. There are various immunosuppression protocols depending on age, degree of immunological risk, depending on whether they are first or more grafts, etc, suggests nephrologist in Delhi.

Dialysis

Dialysis-in-delhi

The main function of dialysis is to “clean” the blood of the toxins generated, excess water and electrolytes, such as sodium and potassium, which is caused by a defect in its elimination by the kidney. Dialysis in Delhi is applied in patients with acute renal failure (reversible) and mainly in those patients with chronic renal failure in the terminal phase and incompatible with life.

It is based on the movement of solutes (ions, urea, creatinine, uric acid, etc.) and solvents (water) through the pores of a semipermeable membrane in relation to the different concentrations of substances following diffusion phenomena, Osmosis, and filtration.

What are the indications of dialysis?

The fundamental indication of dialysis in Delhi is the chronic renal failure treatment in Delhi, which should always be comprehensive, this is with options for changing from one technique to another and the possibility of kidney transplant in Delhi in case there is no contraindication.

The diseases that lead to renal failure are multiple, but the main ones are glomerulonephritis, pyelonephritis, interstitial nephritis, vascular nephropathies, and diabetic nephropathy. Dialysis is also indicated in acute renal failure and in some poisonings.

Type of Dialysis in Delhi

1. Hemodialysis

When the semipermeable membrane is artificial. These can be cellulosic or synthetic in nature and because of their structure they can be capillary fiber or flat membrane. They vary by their permeability, surface, thickness, electric charge and adsorption capacity.

What is required and how is hemodialysis performed?

A permanent access route to the intravascular torrent is required (preferably an internal arteriovenous fistula, possible a cannula, etc.), an artificial kidney (consisting of a blood pump, a monitor and the dialyzer where the semipermeable membrane is located and where the exchange between the fluid or dialysis bath and the blood takes place).

Usually, the dialysis session in chronic patients takes place three days a week (Monday, Wednesday and Friday; or Tuesday, Thursday and Saturday), with a duration of 4 hours per session, in morning, afternoon or evening shifts. It can be carried out in the hospital, in an outpatient dialysis unit or even at the patient’s own home under the guidance of a nephrologist in Delhi.

What complications can occur in hemodialysis?

The main complications are insufficient blood flow (the ideal is greater than 300 cm./min.), Dialysate rupture with blood loss, hypotension, dizziness, headache, nausea or vomiting, itching, cramping, etc. Currently, with modern automatic machines and various variants of bicarbonate dialysis, complications are minimal and largely rectifiable.

2. Peritoneal dialysis

When the semipermeable membrane is natural, as in the case of the patient’s peritoneum (a layer that covers the internal organs of the abdomen and that has multiple capillaries and large surface area).

What is required for peritoneal dialysis?

dialysis-in-delhi
Peritoneal dialysis requires the placement of a soft multi-perforated catheter in the abdomen, through which dialysis solution (similar to the liquid part of the blood but without waste products) is infused, about two liters with replacement every 4-6 hours during the day and about 8 hours at night, every day of the year.

This method of dialysis in Delhi is called continuous ambulatory peritoneal dialysis and is performed by the patient himself after a period of hospital learning. It can also be done with a machine or cycler that performs the spare parts on a scheduled basis at night, allowing the patient to be free throughout the day and this is called automated peritoneal dialysis.

What complications can occur in peritoneal dialysis?

The main ones are the loss of fluid through the catheter access tunnel, the tunnel or catheter infection, catheter obstruction, peritonitis, abdominal hernias, protein losses, etc. All of them are solved with treatment.

Can the patient choose the type of dialysis in Delhi?

The patient can and should choose, with the help of the treating nephrologist in Gurgaon, the dialysis method (peritoneal dialysis or hemodialysis and its multiple variants) that best suits him by his characteristics (age, work, family circumstances, distance to the unit dialysis, type of kidney disease and other concomitant diseases, possibilities or not of access to the intravascular torrent, previous abdominal operations, etc.).

The best nephrologist in Delhi must inform you about all the differences between the different dialysis modalities and the advantages and disadvantages in general and in the specific case of the patient. In addition, since the treatment of terminal chronic renal failure is integrated, it is always possible to switch from one type of dialysis to another in case of intolerance or unresolvable problems.

Acute Renal Failure

Acute renal failure is the sudden loss of the ability of the kidneys to remove excess fluid and electrolytes, as well as waste material from the blood. Proper diagnosis and acute renal failure treatment in Delhi can control and reverse the damage of the kidney.

Acute Renal Failure Treatment in Delhi

acute-renal-failure-treatment-in-delhi

It is more common in people who are already hospitalized, particularly those who need intensive care. In addition, it is usually secondary to complicated surgery, a generalized infection, after a serious injury or when blood flow to the kidneys is interrupted. Although it is usually reversible by acute renal failure treatment in Delhi, the severity is variable and may require renal replacement therapy for a period of time.

What are the symptoms?

It can be manifested by an alteration of the analysis, producing an increase in creatinine and urea levels, or by the appearance of certain symptoms such as a reduction in the volume of urine that can be accompanied by changes in appearance (dark urine, concentrated or with the presence of blood). That reduction in volume can lead to the absence of urine or anuria. Due to this decrease in the volume of the urine, if there is an uncontrolled entry of liquids, there is water retention that leads to the appearance of edema or even a cardiorespiratory overload that triggers.

Uremic syndrome: It is the main consequence of renal failure. There is an accumulation of uremic toxins that produce alterations in various systems. It is capable of causing gastritis with loss of appetite and disorders in the intestinal rhythm. Anemia is caused by a decrease in the formation of red blood cells, as well as an increase in losses, even by some ease for bleeding.

It causes a certain immunodeficiency that facilitates the appearance of infections. There are hormonal changes such as certain hypothyroidism. Among the most affected systems is the neurological one with the development of neuropathy and, above all, progressive metabolic encephalopathy with a deterioration of the cognitive capacity that leads to coma in severe cases.

Of course, the appearance of all these symptoms will depend on the baseline state of the patient, his age and nutritional status, as well as the presence of other organic failures.

What are the causes?

Acute renal failure can occur because some or all of the mechanisms involved in glomerular filtration fail. A decrease of the filtrate can occur when the filtration pressure decreases due to a reduction in blood pressure or significant hypovolemia (absolute due to hemorrhage or dehydration, or relative due to poor distribution of vascular euvolemia as occurs in septic conditions, ascites, intestinal occlusions ).

This acute renal failure can occur due to loss of functional units, such as in glomerulonephritis or by the action of toxic substances such as some medications (including intravenous contrast).

Other causes of acute renal failure are those that occur when an obstructive condition occurs that does not allow the removal of the filtrate, such as when there is a prostatic obstruction or ureteral compression by masses or ganglia.

Risk factor’s

There are several factors that can predispose to the appearance of this disease, such as advanced age, chronic infection, diabetes, high blood pressure, immune disorders, kidney and liver problems, prostatic hypertrophy and bladder obstruction. The signs and symptoms that these patients present and explained by a nephrologist in Delhi are:

  • A decrease in urine production.
  • Failure to dispose of waste products through the urine
  • Fluid retention, causing edema (swelling) in the legs, ankles or feet.
  • Drowsiness, respiratory distress, fatigue, confusion and even coma in very serious cases and usually associated with other diseases.

DIAGNOSIS AND ACUTE RENAL FAILURE TREATMENT IN DELHI

dialysis

Because acute renal failure is usually a complication of other serious diseases, sometimes the signs and symptoms may go unnoticed or be attributed to the underlying disease. When this disease is suspected, a blood and urine test should be performed. The alterations that may appear are: decrease in the volume of urine (less than 500 milliliters), an increase in the blood of urea and creatinine and elevated electrolytes such as potassium. It is usually necessary to perform an abdominal ultrasound and, sometimes, even a renal biopsy to determine the cause of acute renal failure. The earlier it is resolved, the more likely it is to recover renal function. Occasionally, acute renal
failure causes permanent loss of renal function and people require permanent dialysis or a kidney transplant in Delhi to survive.

Acute Renal Failure Treatment in Delhi

Acute renal failure treatment in Delhi begins by correcting the cause that has caused renal failure. This can be clearly observed when there is dehydration or hypotension, replenishing volume, or when there is an obstruction, in this case, the use of a probe or nephrostomy is the solution suggested by a nephrologist in Delhi.

When there has been an important involvement of the kidneys, and there has been no recovery after stabilizing the patient, it is necessary to keep a watch on the vital signs, control the balances to avoid an overload, the use of medications that must be adjusted regarding the dose or its suppression if they can influence negatively In certain cases, resorting to diuretics if it is necessary to increase the rate of diuresis or in some cases start by replacing renal function by using dialysis techniques.