Patna kidney centre

Hi! I am Dr. Suraj Gupta. I am a Nephrologist in Narayana Multisuperspeciality Hospital, Gurgaon. Today we would talk briefly about what is kidney transplant. See Kidney transplantation is modality of treatment when somebody loses almost all the kidney functions of the body. So what are the modalities in such a situation? either dialysis or transplantation. Obviously compared to dialysis, Transplantation is much better. The individual after transplantation regains almost the normal kind of kidney function. So one can perform almost all the day to day activities without any restrictions of dialysis. So how does somebody can undergo transplantation? What are the implications of it and what are the requirements of it?

Somebody to undergo transplantation, one person would need a matching donor in terms of blood group actually. Why there is matching is required because obviously the organ is taken from other individual and is put inside into the patient. So obviously these are two different individuals, so obviously there would be a barrier in between these two. So when we put the different organ into the body of the patient, so the body tries to reject it by producing lot of antibodies, by generating immunity against it. So to reduce these antibodies, to reduce this immunity, we give them immunosuppression, we give them drugs which are called immunosuppressive drugs.

So what are these drugs do? They reduce the immunosuppression of the body. So that leads to a lot of reduction in the immunity, a lot of susceptibility towards, a lot of infections which could be serious in nature. So, the first thing is to get a match donor. And the second thing is the use of drugs which are called immunosuppressive. So these are two very important things. Right now with a lot of advancements, we can in fact without even across the blood group transplantations are also done. So the blood group barrier is not there anymore. So patient with somebody with a different blood group can donate to an individual with a different blood group. So blood group barrier is also not present anymore. The most important issue is the immunosuppression to prevent the rejections to happen. So the most important thing would be how to live life with immunosuppression. Obviously, the initial 6 months is the period when the individual is more immunosuppressed. So, the precautions are most important. One should avoid contact to people who are very infected, or who have some viral diseases or infections.

One should avoid getting into close contact or getting into very crowded atmosphere and try to eat hygienic food, drink boiled water. All these things hygienic precautions should be taken. Beyond 6 months, if somebody’s kidney functions are ok, so we usually reduce the amount of drugs or immunosuppressions the patient would take so. Obviously, the level of immunosuppression would go down. So the restrictions are little less once the patient goes beyond 6 months to 1-year post-transplantation and the restrictions are little less than what it would be within the first 6 months and what should one do about the drugs? see there are major types of immunosuppression. There are three drugs which are called steroid, tacrolimus and mycophenolate. These three are the major immunosuppressant which almost transplant patients would be taking. So, it is very important to take these drugs on time. We would routine the monitor, the levels of the drugs. So the levels of the drugs should be monitored regularly. Initial 3 to 6 months are very crucial for these patients. These patients are at maximum risk for infections.

These patients have a lot of risk for rejections. So close monitoring with your nephrologist is required. So we routinely advise them to follow up with us regularly once a week or twice a week in the initial 2 to 3 months and to stay close to their transplant centers. Once these 6 months period is over, they can go back to their home, even if they are staying somewhere else they can go back there and can stay in communication with the nephrologist. In long term, the risk of infections would reduce but they still should take basic precautions and basic hygiene. Another thing is important is to maintain very good compliance with the immunosuppressions. Lot of times the rejections are quite common. In individuals who are already 4 years, 5 years transplant, they feel that the creatinine level is normal. So why not to switch off the drugs or stop taking the drugs?

That leads to a lot of severe rejections and patient would lose the function of the grafted kidney. So it is very important to maintain the compliance of the treatment. It is very important to maintain basic hygiene and it is very important to follow your nephrologist by directly or by any mode of communication. But following up is very important. So I would hope that this would clarify lot of doubts and if any issues are there you want to consult then always visit my website or contact me or make an appointment to meet me.

Thank you!

Hi all!

I am Dr. Suraj Gupta. I am a Nephroologist and a kidney transplant specialist. I practice in Narayana super-speciality Hospital and my clinic is located in Gurgaon. Today I will talk briefly about end-stage kidney diseases and the option of treatment for such patients. End-stage kidney diseases or CKD (chronic kidney diseases), this is a stage where kidney stops functioning or the kidney function is to the minimum where it requires some form of renal treatment. At this stage, there are two options available for any patient. Either to go for dialysis or opt for the kidney transplant. Dialysis vis-a-vis transplant, there is a significant survival difference as well as the quality of life difference.

Compared to dialysis, renal transplantation offers significant survivability of about 15 to 16 years. Any patient especially in younger age somebody if you take an individual who is at the age of around 30 to 40 years, if he gets a suitable donor, the survival is almost 15 years more than what he can live on dialysis and the quality of life if you compare is significantly better. The person can resume the normal life. The person can start working as a normal individual and the same individual does not have to visit a dialysis unit twice or thrice in a week. So the quality of life is significantly better. Even in the case of an elderly individual if someone is, say 50 or 60 years old, even for them the survival is significantly better. The survival vis-a-vis dialysis is almost 7-8 years. And these are all western data. The quality of dialysis, the kind of flexibility, acceptability for dialysis which India has. Everyone does twice or thrice a week dialysis.

If we see that, the survival would be much better because we're almost giving an individual a normal kidney so he regains almost a normal kidney function and can live a normal healthy life. This is what transplantation can offer to you but yes it is not always possible for an individual to have transplantation. There are certain problems, either the donor is not available, the matching donor is not available or the person is too sick or has other illnesses like any other organ failure like heart failure or any liver disease which excludes the person from having the kidney transplant. For such individual dialysis is a very good modality of treatment provided the dialysis is done well, provided adequate dialysis is done and providing dialysis is started early.

There are two kinds of dialysis which are available - either it is a Peritoneal Dialysis or it is a Hemodialysis. Peritoneal dialysis can be done very well at home. You can do exchanges, water exchanges, fluid exchanges three times or four times in a day and individual can very well do it on their own. They do not need to go to the hospital. It can be done independently and once in a month or if any complication gets developed at that time they need to visit a hospital and consultant their nephrologist. Hemodialysis is in fact by all means and in-center dialysis. Majority of hemodialysis is done in-centre. So they need to visit a dialysis unit where they are connected to a unit machine.

They have to sit there for 4 hours and do hemodialysis, and almost for 4 hours thrice in a week. This dosing is very important. 12 hours in a week is the minimum amount required, the minimum duration required for any individual. Because reducing the amount/duration of dialysis per week would have serious consequences on the quality of life as well as the survivability of the individual. This is what we can do for any patient who has already reached this stage but still all said and done, transplantation is probably the best modality to treat any individual who reaches a stage of renal failure because obviously, we would be replacing the diseased kidney with a normal functional kidney. So that is what is my message is- start treatment if someone reaches a stage where they need treatment, the Kidneys are not functioning. They should reach the nephrologist at the earliest. Choose wisely, start whatever the option you have and get enrolled in a good program where you follow either transplantation or dialysis whatever the option you have.

Thank you!

Hello!

I'm Dr. Suraj Gupta. I m a consultant nephrologist and practicing in Kidney and hypertension clinic in Gurgaon and Narayana super speciality Hospital, Gurgaon.

Well, I would be going to discuss briefly about chronic kidney disease. Chronic kidney disease or CKD which s stand due to gradual decrease of kidney function. Kidneys are one of the important organs of the body. And the primary function of the kidney is to filter and clear the toxins from the body. What are the overtime conditions like diabetes, hypertension and sticky kidney disease or autoimmune disorders can lead dysfunction in our kidney and can reduce the ability and weakening the ability of our kidneys to filter or remove the toxins from our body. What are the most important causes of chronic kidney disease or CKD? Most important causes of chronic kidney disease of CKD is diabetes or hypertension. These are the most prevalence causes of CKD. Other causes or other people who are at risk are people who have a family history of chronic kidney disease or people who take lot of pain killers or over the counter painkillers, even something as insignificant like a brufen tablet can cause chronic kidney disease if used very (inaudible 1:26) and very long period of time. What are the symptoms of chronic kidney disease? Chronic kidney disease or CKD in majority of time is described as a very silent disease. There are no symptoms in the early stages of chronic kidney disease. Once it advances symptoms are very nonspecific. Most of the time it could be present with vague symptoms like nausea, vomiting, reduced appetite, gradually as it worsen it can cause swelling in your feet, swelling at your face, reduced frequency and alteration in urine. Other symptoms can be severe, can be fatigue ability because of anemia or uncontrolled blood pressure. These all can present as symptoms of chronic kidney disease. And in advance cases of chronic kidney disease they can be clinically present as shortness of breath, inability to lie down, and difficulty in sleeping, severe itching in your body. All these are common symptoms. How to detect chronic kidney disease? Majority of the times it present as a, a lot of time, it present by routine findings in the form of lab investigations. Most common investigation is the serum creatinine which is a routine blood test and it can be instantly detect by elevated serum creatinine. The other most important investigation is a very small investigation with very small and very less costly investigation which is urine routine and any loss of protein urine routine can signify chronic kidney disease or CKD. As we are coming in the era of rising prevalence of chronic diseases like diabetes and hypertension so we see more and more of chronic kidney disease as well. So it is important and it is important to pick up these disease at an early stage because once it reaches the advance stage it becomes irreversible and it becomes untreatable. And the different options which remains are either dialysis of kidney transplant or nothing else can be done further. So it is important to pick them early and that is what my message would be.

If you have any of these symptoms or if you want to contact me in person you can either book an appointment through lybrate.com or get the personal appointment by the contact details available on the site. Thank you!