Tag Archives: Kidney Specialist in Delhi

Kidney Disease – Major Cause of Death

Kidneys are extraordinary organs. They contain millions of little blood vessels that act as a very effective filter. When blood passes through these vessels, the salt, waste and excess of fluid are held inside the kidney, while protein and red blood cells are simply too big to be “captured” by the kidneys, so they stay in the now purified blood, which continues to circulate. All waste products then become part of urine and are eliminated from the system with it.

Sometimes, certain circumstances may cause the kidneys to malfunction. This is known as Kidney Disease. When this happens, waste accumulates in the blood and causes sickness.

There are several types of kidney disease, and their treatment varies according to their causes and the amount and type of kidney tissue involved. Also, kidney disease increases your risk of having heart and blood vessel disease.

Statistics Of Kidney Disease Patients

In India, kidney disease is the cause of 66.7% death; and is also a cause of severe reduction on the population’s life quality. In 2020, we estimate that about 7.63 million Indian adults died prematurely as a result of kidney disease, representing about 20% of all premature adult mortality.

Causes Of Kidney Diseases

Kidney disease may happen as a consequence of disorders like diabetes, high blood pressure and others. Some kidney diseases are genetically inherited and cannot be prevented.

Symptoms Of Kidney Diseases

Although they can substantially vary from individual to individual and from a specific disease to another, symptoms of kidney disease may include high blood pressure, anemia (low blood count), poor nutritional health, weak bones, ankle swelling and nerve damage.

Treatment Of Kidney Diseases

Treatment of kidney disease is specific to each disease. However, common treatments against unstoppable diseases consist on compensating the malfunction of the kidneys and supplement their function with an artificial kidney. This is known as dialysis. Kidney infection, when present, can be fought against with the help of antibiotics.

Prevention Of Kidney Diseases

As a general rule, keeping a balanced diet, drinking abundant liquid, reduced sodium ingestion (salt) and maintaining an overall healthy life may prevent most preventable kidney diseases. The best way to cure a kidney disease early is to regularly consult your kidney specialist in Delhi.

Chronic Kidney Disease And Delayed Male Puberty: Understand The Relationship

Chronic Kidney Disease is the failure or gradual loss of kidney function. According to the best nephrologist in Delhi, it is estimated that about 20 million people suffer from the condition in India.

The kidneys are the organs responsible for filtering substances and nutrients present in the body. Thus, the necessary components are absorbed and the rest is eliminated in the urine. When they don’t work properly, the body goes out of balance, causing a series of consequences.

Among the problems caused by the failure or partial loss of function of these organs, is the delay of puberty among boys. In this post, we will understand more about the subject. Follow!

Late puberty

Late puberty is when sexual maturation does not begin at the expected time or age. In boys, this is characterized, for example, by the lack of growth of the testicles until the age of 14.

The changes in this stage of life are due to the awakening of the brain endocrine glands, called hypothalamus and pituitary gland. They produce hormones that stimulate the activity of the testicles which, in turn, initiate the production of testosterone, the hormone responsible for the development of male characteristics. The substance is also produced in the adrenal glands, located just above the kidneys.

Some symptoms indicate that the process was not triggered in boys, such as: lack of pubic hair and face, lack of growth of testicles and penis. This delay can occur due to several diseases, such as diabetes, cystic fibrosis, anemia or autoimmune diseases in general. Patients undergoing cancer chemotherapy or radiation therapy may also experience a delay in entering puberty.

Any condition that prevents or disrupts the action of the brain glands and testicles can make it difficult to stimulate puberty. This can occur in boys with Chronic Kidney Disease and is attributed to several factors. Among them is the difficulty in absorbing nutrients, which leads to protein caloric malnutrition, for example.

Psychological stress and anemia, common consequences of treatment, are also situations that make the body’s work more complex, as well as the damage caused to the functioning of the adrenal glands.

The diagnosis

As we mentioned, boys who did not show testicular growth until the age of 14 are considered late puberty. Doctors also observe whether the period of onset and end of growth of Organs sexual organs has exceeded five years.

To give a complete diagnosis, the kidney specialist in Delhi not only evaluates apparent symptoms, but requests more in-depth tests, which will measure blood hormone rates, for example, and identify the adolescent’s bone age.

The treatment

Boys with Chronic Kidney Disease, that is, who are affected by late puberty, should initially receive treatment focused on correcting nutritional deficiencies and metabolic changes.

For that, adjustments and supplements are indicated in the diet in order to replace calories, proteins or other nutrients. Only after this protocol, hormonal therapy is usually recommended with due medical monitoring.

Want to know more? I am available to answer any questions you may have and I will be very happy to respond to your comments on this matter.

Symptoms And Causes of Renal Failure

Acute renal failure

We say that we are facing acute renal failure when its onset is relatively early, less than three months. It can be reversible if it is treated in an appropriate and timely manner.

The chronic renal failure, the acute exacerbation is the installation of acute renal failure in a patient with chronic renal failure.

Chronic renal failure

We say that we are facing chronic kidney failure ( CRF ) when it is possible to determine that kidney failure has existed for more than three months.

The name of this entity was changed to chronic kidney disease as there are situations of kidney disease/injury without failure. Examples of such situations are albuminuria/proteinuria, changes in urinary sediment, renal ultrasound changes, anatomopathological kidney lesions in renal biopsy or even a kidney transplant.

Stages of chronic renal failure

Chronic kidney disease has several stages or phases, causes, and degrees of albuminuria. The stages of chronic renal failure are as follows:

Stage 1 – Glomerular filtrate> = 90 -normal or elevated renal function;

Step 2 –  glomerular filtrate 60-89 – decreased renal function with mild;

Stage 3a –  Glomerular filtrate from 45 to 59 – renal function with mild to moderate decrease;

Stage 3b –  Glomerular filtrate from 30 to 44 – renal function with moderate to severe decrease;

Stage 4 –  Glomerular filtrate from 15 to 29 – renal function with severe decrease;

Stage 5 –  Glomerular filtrate <15 -Renal failure (add D if the patient is on dialysis).

Glomerular filtrate values ​​in (mL / min / 1.73 m2).

Pathophysiology of renal failure

The pathophysiology of renal failure, acute or chronic, can have different levels. If the pathology that damages the kidneys is found “before” the kidneys, it is called the renal failure of a pre-renal cause, as for example in cases associated with heart failure or the removal of volume in the vessels.

In turn, if the pathology is intrinsic to the kidneys, as is the case of acute glomerulonephritis or pyelonephritis, renal failure is considered to be of renal cause.

Finally, if the cause of renal failure is related to obstruction of urinary drainage, such as prostate hypertrophy, it is called post-renal.

Find out below what the symptoms of kidney failure are.

Symptoms in renal failure

The signs and symptoms of kidney failure are usually late, so they appear in the more advanced stages of chronic kidney disease. They can result from decreased glomerular filtration, such as edema (swelling), decreased urinary elimination or high blood pressure.

In stage 4, or more commonly in stage 5, more evident signs or symptoms may appear, such as generalized weakness (asthenia), lack of appetite (anorexia), nausea, vomiting, and changes in the central nervous system (slowness of reasoning, drowsiness) and rarely seizures).

These initial symptoms of chronic renal failure are explained to patients who are already being followed up with nephrologist in Delhi. In most cases, however, kidney disease is detected in routine tests without previous suspicion of its existence.

In India, cases of chronic renal failure that are diagnosed only at stage 5, using the emergency service to start hemodialysis on an emerging basis, have decreased. This improvement is mainly due to the improvement of primary health care with timely referral to kidney specialist in Delhi.

Causes of kidney failure

The causes of renal failure are multiple and vary according to the age group. As an illustrative example, the etiology of chronic kidney diseases that led to the beginning of regular dialysis in Delhi: diabetes mellitus 33.9%, arterial hypertension 13.1%, glomerulonephritis chronic 11.2%, polycystosis 4.9%, hypoplasia / renal dysplasia 0.7%, other causes 18.5% and unknown causes 17.7%.

Children only reach “normal” kidney function at two years of age, so below that age, the classification of chronic kidney failure at the stages mentioned above cannot be applied.

The vast majority of cases of kidney failure in early stages are, in general, related to congenital kidney diseases. However, the causes of kidney failure in pediatrics, requiring dialysis or kidney transplantation, also include glomerular diseases.

Diagnosis of renal failure

The diagnosis of renal failure can be made by family doctors, taking into account some aspects, namely:

  • The complete absence of diuresis (anuria) is not a characteristic of chronic renal failure, but of acute renal failure or acute chronic kidney failure;
  • Elevated creatinine and serum urea are characteristic of renal failure;
  • To better characterize the stage of chronic renal failure, creatinine clearance is used using 24-hour urine collection (determination of urinary volume and creatinine) and blood (determination of serum creatinine): creatinine clearance = urinary creatinine (mg / dl) / serum creatinine (mg / dl) X urine volume of 24 hours (ml) / 1440 (minutes). It is expressed in ml / minute (normal values: men> 90 ml / minute; women> 80 ml / minute). Formulas can also be used to calculate creatinine clearance, avoiding the 24-hour urine collection that is often not performed correctly or is not feasible;
  • The signs and symptoms of chronic kidney disease should lead to an assessment of renal function (serum creatinine and urea, as well as creatinine clearance using mathematical formulas or with 24-hour urine collection as already described);
  • Elevated serum potassium values ​​are not essential for diagnosis;
  • Other common analytical changes in chronic kidney disease in advanced stages (3 to 5) are anemia, metabolic acidosis, low serum calcium, and elevated parathormone;
  • Summary analysis of urine may reveal albuminuria and urinary sediment may show changes such as hematuria and erythrocyte cylinders;
  • Renal ultrasound is the exam indicated for initial imaging evaluation in suspected chronic kidney disease. It may reveal a decrease in kidney size, although in diabetes mellitus this change may not exist even in advanced stages of CRF. Another echographic abnormality typical of chronic kidney disease is the decrease in differentiation between the cortex and the renal medulla. If multiple bilateral renal cysts appear, we may be in the presence of a polycystic disease.

The early referral of patients with chronic renal failure to the best nephrologist in Delhi has had an impact on improving their follow-up, with implications for delaying their progression as well as for the adequate treatment of the various complications of chronic renal failure.

How to prevent kidney failure?

Renal failure can be prevented, essentially through the following measures:

  • Lifestyle changes to prevent frequent causes of chronic renal failure, such as type 2 diabetes or cardiovascular disease including high blood pressure;
  • Obesity (overweight) can also be associated with chronic kidney failure. Lifestyle should be changed in order to avoid obesity;
  • Avoid exposure to nephrotoxic drugs, especially non-steroidal anti-inflammatory drugs.

Health Care for a Chronic Kidney Patient on Hemodialysis

Why kidney care is important

We know that the kidneys are organs that make up the excretory and osmoregulatory system, performing vital activities for our health. They are responsible for filtering the blood, eliminating toxins from our body through the urine. Avoiding the increase in blood pressure and the appearance of edema, among other functions that contribute to the proper functioning of our body.

How the chronic kidney patient keeps the kidney healthy

The kidney patient, like anyone else, must have a normal life in order to be able to carry out their day-to-day activities without worrying about health. For this, balance is the keyword to keep the kidney healthy

Care that chronic kidney patient should take with food

Care in feeding should start with liquids. The renal patient undergoing hemodialysis should be careful with the excess fluid ingested since it can accumulate in the body and force the activities of the lungs and heart.

Knowing this, some tips for curbing thirst are important;

  • Avoid salty or very sweet foods;
  • Rinse with water;
  • Use a small glass to drink liquids;
  • Suck ice;

kidney specialist in Delhi

Sodium – The care that chronic kidney patients should take with salt intake

Reducing the amount of salt that is ingested can decrease chronic kidney failure. To reduce salt consumption, it is important to avoid processed foods, such as: preserved foods, sausages (ham, sausage, bologna, salami), ready-made spices and salty cheeses. At mealtime, give preference to natural spices that are healthier and give more flavor to foods: onion, garlic, pepper, bay leaf, basil, etc.

Chronic kidney patient and blood pressure 

The patient with renal failure tends to raise his blood pressure for two reasons. The first occurs because the kidney cannot properly eliminate the ingested salt, and the other happens due to the kidney’s disruption of hormone production, which regulates our blood pressure. Therefore, hypertensive patients or those with chronic kidney disease should avoid salt intake, suggests nephrologist in Delhi.

Renal patient and the consumption of Calcium and Phosphorus

Kidney failure causes the levels of phosphorus and calcium in our body to be altered, so it is important to be aware of their intake. This is because the kidney is unable to expel these elements properly, causing them to accumulate in our body, which can be very harmful to health.

Hyperpotassemia in chronic renal patients

Potassium levels in the blood increase when the kidney cannot eliminate its excess from the body, causing hyperkalemia. Because it is a mineral that acts on muscles and nerves, the accumulation of potassium can cause muscle weakness and change in a heartbeat.

Is carambola toxic to chronic kidney patients?

Chronic kidney patients should not eat star fruit because it is toxic. Research indicated that carambola’s toxicity was due to the presence of oxalate in the fruit. However, new studies show that the fruit is toxic due to the caramboxin toxin. This toxin contributes to the inhibition of GABAergic, the main inhibitory system of the central nervous system, which can cause serious complications for the health of chronic kidney patients, warns kidney specialist in Delhi.

Chronic kidney patient and skincare

Some chronic kidney patients may experience some discomfort due to dry and itchy skin. This can occur due to high levels of minerals and hormones in our body or due to changes in sweat and oil glands. As a way to prevent itching it is important to be aware of the levels of calcium and phosphorus that are being ingested in the diet.

Venous access is done before hemodialysis, which can be permanent or temporary. Chronic kidney patients tend to choose definitive access because it allows treatment to be long-lasting and to have a low rate of complications. To prevent complications from happening some care with the fistula is necessary. In the first sessions, it is important to save as much as possible the member who receives the access, avoiding sudden movements and great efforts. On a daily basis, nephrologist in Delhi recommends avoiding impacts and trauma in the area, so as not to hurt or infect the area.

Physical activity and chronic renal patient

In general, patients with chronic renal failure on hemodialysis have little tolerance for physical activities, due to some weakness or because they are inactive. There are still no in-depth studies on the risk of physical exercise in these patients, but there are no reports of serious problems resulting from physical training. There are descriptions of aerobic training interventions that have been used to increase maximum oxygen capacity in pre-selected patients. Studies suggest that aerobic training can improve blood pressure and mental health in chronic kidney patients. The study also concludes that physical and aerobic exercise benefits the patient in the dialysis and interdialytic phase, benefiting the cardiorespiratory capacity, physical conditioning, muscle strength, and functional capacity.

We can see that the care that the chronic kidney patient must have covered different situations in our life. Following these steps, the quality of life of the chronic renal patient tends to increase considerably. The care, balance, and monitoring of a qualified and specialized medical team is an important differential for effective renal treatment and a happier life for the patient.

Kidney Pain May Indicate Infections or the Presence of Calculus

Back pain is very common and, in most cases, it is not of renal origin but of spinal diseases, generically called low back pain.

Renal pains are usually on one side (right or left) and project in the lower back. They are cramps of varying intensity, which can go down the front of the belly to the groin and genital region, in addition to being accompanied by other symptoms such as nausea, vomiting, and changes in the urine.

To be sure that the pain originates from the kidney, it is necessary to look for a sign called Giordano, a situation in which the nephrologist in Delhi gives small pats with the closed fist on the lumbar region (percussion fist), from top to bottom, which provokes the appearance of pain. In this case, the signal is positive, that is, the pain is probably due to kidney disease.

What are the possible causes of this pain?

The most frequent cause is the presence of stones (lithiasis), which clog the urinary tract and dilate the affected kidney (hydronephrosis), causing very severe pain that requires administration of analgesics, antispasmodics, and injectable anti-inflammatories. They are the famous renal colic that, according to popular culture, are maddening and worse than those that women feel during labor.

Also, infections of the upper urinary tract, which directly affect one or both kidneys (pyelonephritis) are causes of pain such as those described. Typical cases are accompanied by changes in urine and general symptoms such as fever, cloudy and dark urine, malaise, poor appetite, nausea, and vomiting.

Acute nephritis due to kidney inflammation can also be responsible for pain. They are bilateral and accompanied by changes in urine and even high blood pressure.

Less frequent causes are real polycystic disease, kidney tumors, and trauma, for example.

kidney pain

When to get the kidney specialist in Delhi?

In the case of pain in the lumbar region of acute appearance, in colic, with the characteristics already described, especially if they are accompanied by dark or cloudy urine, with dust, in addition to pain or burning in urination, the urge to urinate all the time with the leaving small amounts of pee, personal or family history of eliminating stones or polycystic kidneys and the presence of general signs and symptoms are indicative that a nephrologist in Delhi should be sought.