Kidney Clinic

Hi!

My name is Dr. Sudeep Singh Sachdev and I’m currently working as a consultant in the department of nephrology in Narayana Super Speciality Hospital, sector 24, Gurugram. Now there are several methods by which we can reduce the frequency of kidney diseases. So why wait until our kidneys are diseased? Today I’m going to discuss some very important and useful tips to keep your kidneys healthy. Now the first and foremost tip that I would like to say is to drink plenty of water. Drink at least 2.5 liters of water in a day.

This will help to clear the kidney of salt, urea, creatinine and other toxins which have accumulated in the body over the day. The second useful tip I would like to give you is to reduce the salt intake or reduce the sodium in your diet. Avoid taking any package or restaurant foods, avoid addition of any extra salt in the diet. Keep your salt intake over 24 hours to less than 5 to 6 grams in a day. Doing such a day would reduce the load of the kidney and decrease the development of hypertension, hypertension related disorders are also kidney diseases in the future.

The third important tip would be to maintain an appropriate body weight. Keep your cholesterol levels in check because deposition of cholesterol cannot only occur in the heart but can also occur in the renal arteries and is implicated in the pathogenesis of the kidney diseases. Avoid intake of any fatty food, fried foods, eat plenty of fruits and vegetables. The next important tip I would like to give you is to check blood sugar levels. Every year get a fasting and a postprandial blood sugar levels done. Maintain your hba1c under 6 in the body. Avoid taking any sugary items or items which are rich in sweets. This would help to maintain your sugar levels under limits.

If you have been diagnosed to have any impaired glucose tolerance or diabetes mellitus consult a physician, take oral hypoglycemic drugs and keep your sugar levels under control because diabetics develop kidney function very early which can be permanent and irreversible if not corrected. The next important tip would be to monitor your blood pressure regularly and keep it under control that is less than 120 by 80. You can do this by adopting a healthy lifestyle, exercising every day for at least 45minutes, playing granite games, going for swimming and so on. Reduction of salt intake would also help to maintain your blood pressure under control and decrease the chances of development of kidney diseases or delay progression if you are already having one.

Now get your kidney function tests and urine analysis done regularly. This is especially important for the at risk population for kidney diseases which includes diabetics, hypertensives. People above the age of 60 years, obese people, people who have known coronary artery disease or people who have a family history of the same or family history of chronic kidney disease. Get yourself evaluated by blood tests, urine analysis, kidney imaging like an ultrasound of the kidney or a renal artery doppler to rule out causes of kidney diseases. Another important tip which I would like to give you is to quit smoking.

Smoking not only harms the kidneys but also effects the heart and can even cause stroke. Smoking even one cigarette already weakens already harm kidney. So I would request all of you to avoid smoking and stop it if you are already doing so. The next important tip is to maintain an active lifestyle. As I have discussed, one exercise should go for in a day, avoid fatty, fried items. Take a low salt diet and keep oneself healthy by maintaining a BMI of less than 24, especially in the Indian scenario. The next important tip which is actually not followed by majority of us is to avoid unnecessary use of any painkillers or any other sort of alternative medication if it is not required.

Commonly used painkillers like brufen, combiflam can harm the kidney and have been implicated in the causation of chronic kidney disease. So I would request you to use painkillers which are safe from the renal standpoint like paracetamol, or hydrocet. Last but not the least I would request you all to balance your lifestyle by having a healthy night sleep. Sleep at least 8 hours in a day. This is going to provide adequate rest to the bodies and the kidney and provide time for the recovery and you to be up and about during the next day. Thank you. I hope this would have helped you to garner some information about how why one can keep once kidney and the human body healthy.

Hi!

My name is Dr. Sudeep Singh Sachdev and I am currently working as a consultant nephrology in Narayana Super Specialty Hospital, Gurugram, Sec-24. Today I will be talking about the early warning signs of kidney diseases. Now millions of people on this earth are suffering from kidney diseases but most of them do not even have the idea about it. Why? Because most of the kidney diseases present with non-specific symptoms and are only prevalent when the patient prevents in advance stages of the disease. While the only way to confirm the presence of kidney diseases is to get confirmatory investigations done which include blood test, urine test and various form of image investigation.

However, the following are the few early signs of kidney diseases. One of the earliest sign is the appearance of swelling over the feet, ankle or legs. One will start to notice edema which pits on applying pressure and often termed as pitting edema. This is usually due to the fact, that when renal dysfunction advances, there is salt retention and accumulation of fluid in the extra vascular spaces of the body. Now another common and early sign is the presence of periorbital puffiness which is the appearance of edema on the upper and lower eyelid. It especially occurs in people who have protein leakage from their kidneys. And in often termed as nephrotic syndrome.

Another one of the early signs is the presence of early morning nausea. Now the patient would classically present to the bathroom at the time of brushing his teeth with the sensation of early morning nausea which leads to a separation of his appetite and decreases in taking of food during the day. This in turn can also be expedited if the patient also complaints during the later stages of disease with the sensation of metallic taste because of which he starts to deny even the most favourite products which he had loved to eat beforehand. Now another one of the early sign is anemia. By anemia I mean there is a fall in hemoglobin without any apparent blood loss from the body. There is no visible site of blood loss but the hemoglobin of the person starts to fall.

The reason for this is that kidney is a site where there is production of erythropoietin in the body. And erythropoietin is required for hemoglobin production. As renal dysfunction advances there is decrease in erythropoietin levels which present as low hemoglobin levels thus leading to anemia. Now another one of the early signs is the change in the frequency of urination of the person. One might start to urinate more often and it is often described as increase in the frequency of maturation during the night termed as notaria. This can also happen during prostate disorder in man and also urinary tract infection or could be the early sign of kidney disease.

Now one should also be very careful about any changes that occur in the nature, consistency or color of urination. As the filtering mechanism of the kidney fails, there is leakage of both protein or blood cells from the kidney. Thus the presence of blood could indicate the presence of prostate disorder, urinary tract infection or even presence of tumors of the kidney, presence of pus in the urine along with fever which indicates the serious infection of kidneys like pyelonephritis or excessive frothiness of the urine would indicate presence of great amount of protein leakage which needs to be evaluated in further detail. Another non-specific sign would be the presence of dry skin or psoriasis. As the renal dysfunction would advance there would be also associated itching and one can notice itch marks on the skin of the person. Now a non-specific early sign could also be either a backache which would present as pain along the side or below the rib or even lower abdominal pain which could be in pubic region.

This will either indicate the presence of stone, maybe in the kidney or in the bladder itself or the respective infections. Last but not the least, another presenting sign of kidney disease could be the high blood pressure. Often when high blood pressure detected it’s not evaluated for kidney etiologies. Thus, it is very important for any person who presents with hypertension to get his kidney function test done along with imaging of the kidney to rule out renal etiology of hypertension. Lastly, I would like to mention that recognition and awareness along with timely intervention would lead to early detection and treatment of a kidney disorder which otherwise, could end up with dialysis, transplant or even an unfortunate circumstance as death.

Thank You!