“Desha suttabeku, kosha odabeku”in Kannada which means the world is so beautiful, has so many countries, different peoples, cultures, oceans, mountains and many more to know the beauty of the nature and world one should travel then, he will cherish the beauty; similarly ‘kosha odabeku’ means, one should study the human body cell.
The human body is so complex, has many cells, nerves, vessels, organs and each and every minute cell has to function, and it is meant for a specific function. For example, the heart’s function is to pump blood, lungs function to purify the blood, liver function is to metabolism, kidneys function is, removal of waste products from the body, brain function is to monitor and maintain all other organs functions.
So let us known about your kidneys
Each living being has 2 kidneys with some exception certain people will have a single kidney. They are bean-shaped and placed at the back of the abdominal cavity. Their main function is filtration, which is removal of waste products from the blood, maintain electrolyte balance and maintain blood pressure.
Kidneys may stop its function temporarily or permanently due to various reasons and is called kidney failure. There are two types of kidney failure.
1 Acute kidney failure (Acute kidney injury- AKI)
2 Chronic kidney failure (chronic kidney disease – CKD).
In AKI kidneys stop functioning suddenly and it has a specific cause like (severe dehydration, NSAID, hypotension, sepsis, and shock), if a patient takes proper treatment, kidneys will completely improve.
In CKD ( chronic kidney failure) kidneys slow down their work over periods of months to a year. If renal failure remains more than 3 months is known as chronic kidney disease.
If a patient with chronic kidney failure takes proper treatment, the patient will improve, but the kidney may not normalize and may require long term treatment including dialysis support in later days.
When he develops ESRD (end-stage;(stage V). One need not get frustrated by just knowing kidney failure about as AKI and CKD both are kidney failure; AKI potentially treatable and in case of CKD till stage V one can have a good quality of life with regular treatment.
Kidney diseases have good treatment options. If any patient gets AKI, short term treatment is essential and it is completely curable. CKD ( Chronic kidney disease ) treatment prolongs the requirement of dialysis for a long period of time.
Dialytic treatment
Patient having CKD stage V ( ESRD), still, he has treatment options like
Peritoneal dialysis, Hemodialysis, and Transplant.
Peritoneal dialysis is a type of dialysis, where inpatient or relatives can do the procedure at home.
CAPD(continuous ambulatory peritoneal dialysis, it is done at regular intervals throughout the day or at night.
APD(automated peritoneal dialysis – APD).
Peritoneal dialysis has good outcomes as compared to hemodialysis in the first couple of years, here the patient saves time flexibility and greater comfort in many patients.
The other option is hemodialysis where it can be done at the center or at home with his own dialysis machine. With these modalities, a patient can live 1 year to 30 years depending upon other comorbid conditions.
Causes of kidney failure:
Acute kidney failure: 1. Acute GE, NSAID’s, repeated UTI, pyelonephritis, kidney stone diseases, and sepsis, AGN etc.
Chronic kidney disease: Diabetic, HTN, small-sized kidneys, polycystic kidneys, repeated stone disease, chronic glomerular diseases, VUR (vasico-ureteral reflux), repeated kidney infection,
How to protect your kidneys:
1. Drink a minimum of 2 liters water per day
2. Avoid NSAID’s (Nonsteroidal anti-inflammatory drugs)
3. Avoid unnecessary antibiotics
4. Avoid self-medication
5. Keep blood sugars and blood pressure adequately controlled.
6. Daily exercise
7. Avoid junk foods, smoking, and alcohol.
8. Regular follow up with a nephrologist
9. Diabetic patients, if they have diabetic retinopathy, consult nephrologist to rule out Diabetic nephropathy
Myths and facts about kidney disease:
Myth 1.Dialysis is a long term treatment, once started it will be lifelong.
Fact: Dialysis is not always lifelong treatment, many a time patient requires dialysis for a short period of time in case of AKI (acute renal failure). A patient may require only 1-2 weeks of dialysis. As said earlier in AKI kidney s will improve completely.
Myth 2. Chronic renal failure means it will be the end of his life.
Fact: ESRD is not the end of life rather end of the failed kidneys, but the patient can still survive with good quality life for decades.
Myth 3. If you drink more water (4-5lits/day), your kidneys will be normal.
Fact: our body requires a minimum of water 2-2.5lit/day, is enough. No need to drink more water and maybe harmful in the case of DKD( diabetic kidney disease), heart and liver diseases.
Myth 4: If you are on dialysis you cannot travel.
Fact: No even if you are on maintenance hemodialysis you can travel, by adjusting your dialysis schedule if it is the shortest period of travel if it for long duration needs to find dialysis center where you are traveling.
Myth 5: Dialysis is a painful procedure,
Fact: No dialysis is not at all painful procedures, the patient will have just prick pain and the rest of the procedure goes without any pain. If that prick pain is intolerable then there are some anesthetic sprays one can use before putting dialysis needles. Needle pain is also for some days, later you get adjusted.
Myth 6: Coconut water and fruits are good for health
Fact: No for renal failure patients with borderline or increased Potassium; coconut water and fruits are very much harmful. All renal failure patients should not drink coconut water and should avoid certain fruits and juices unless of CKD less than stage III, can have some fruits if their Sr. K remains less than 4m/mEq.
Myth 7: Renal patients if they cannot take normal salt but they can take LONA SALT.
Fact: No all salts are the same, but LONA salt is more harmful than the normal salt because is has high potassium in it. Normal salt has sodium chloride, but LONA salt has potassium chloride which is more dangerous.
Myth 8: A Patient on dialysis has a short period of life span.
Fact: Not at all, a person may live many years to decades; if he is on regular dialysis with proper diet and regular follow up.
About the Author: Dr. M. S. Khanpet(Karishetti) is an M.B.B.S, M.D., DNB is HOD Nephrology, Kidney Transplant Physician
& Dr.Shilpa