Kidney Failure

Hi

I am Dr. Suresh Kumar Bhagat hai. Aaj hum aapko kidney failure ke bare mein kuch batana chahte hain. Jo kidney failure ke 2 mukhya karan hain. Diabetes aur high blood pressure. India mein diabetes ka incidence bohot jyada hai aur India ko world ka diabetic capital bola jata hai. Ab main aapko thoda bohot diabetes ke bare mein bataun jo aaj kal humare jeevan ki shaili jo hai hum Jyada gaadi use karte hain, paidal kam chalte hain, jo hamara khane peene ka Jo lifestyle hai usme kafi change ho gaya hai. Hum chalte nahi hain, hum exercise bhi nahi karte hain, junk food khate Hain, tel-gheei Jyada kehte hain aur sabse badi baat hai ki aaj kal ka jo jeevan hai wo kaafi (stressed) tanavpurn ho gaya hai to hum diabetes se kaise bache. Sabse pahli baat ki aap santulit khana khayein, aap Jada urja wala khana nahin khaya, jaise ki aapke khane Mein salaad hona chahiye aadhe sex adhik aur carbohydrate kam hona chahiye aur tel-ghee barabar kamm matra mein hona chahiye.

Jo kidney failure hota hai uske do mukhyatar Karan hain, madhumeh Ki bimari aur ucch rakt chaap(Diabetes aur high blood pressure). To hum diabetes ko control rakhen aur high blood pressure wale jo bhi marij hain wo niyamit roop se dawai lein aur namak kam khaye aur jo sabse jaroori cheezein hain wo hai vyayam. Aadmi ko physical activity karni chahi kam se kam aap Saptah(week) mein 4 Din 45 minutes brisk walk karen aur aapko ye dhyaan rakhna chahiye ki aapki Jo kaamr hai aur aap ka jo pet hai, kamar Se Jyada pet ki motayi nahi honi chahiye. Dusra hai diabetes. Diabetes ke liye bhi Jin logo ko diabetes hai madhumeh hai usko diabetes ki dawa niyamit roop se leni chahiye. Blood pressure niyamit roop se janch karni chahyie aur aapko Kidney failure se bachne ke liye aapko apne doctor ki salah leni chahiye aur koi bhi bina salah ke koi bhi dawai nahin khaye. Ab Jo kidney failure hai uske mukhya kya karan hote hain?

Mukhya karan maine aap ko bataye madhumeh ki bimari aur ucch eakt chaap. Iske lakshan kya hai? Shuru mein Jab kidney bimari hoti hai, kidney failure Ki bimari hoti hai to uske bohot lakshan najar nahin aate hain to kaise maloom hoga ki jo patient ko high blood pressure hai aur diabetes ki bimari hai uska kidney failure to nhi develop ho raha unko? Uske liye bohot aasan screening test hai. Blood test karte hain usme serum creatinine dekhte hain, proteinuria dekhte hain proteinuria mein protein to nahin aata hai. Serum creatinine badh to nahi raha hai aur samay samay par ultrasound karte hain kidney ka uski andruni bnawt dekhte hain ki usme koi changes to nahi aa rahe hain, yadi aapka creatinine normal hai, urine mein protien nahi aa raha hai to aapka kidney sahi hai. Kidney failiure ke Mukhyta jo lakshan hai, aapke chehre par sujan aana jo aakh ka eye lid hai usme bhi sujan aata hai, pairon me sujan aata hai, aapko bhukh Lagna kam ho jata hai aur aapko peshab ki matra bhi kam ho jati hai. To is tarah ka yadi lakshan hai to aap kidney ke chikitsak se milen jisko nephrologist bolte hain aur nephrologist ki salah lein aur kuch haad tak kidney failure ko roka ja sakta hai. Nephrologist ki salah se.

Jab aapko kidney failure ka lakshan najar aane lage to aap kidney ke physician ki salah lete hain aur dheere-dheere uska ilaaj karte hain. Lekin ek samay aisa ataa hai ki jab aapka kidney permanently fail ho jata hai usko bolte hain CKD stage 5 aur usme aapka kidney ka jo kam karne ki shmta Hai vah 10% se bhi kam ho jata hai us samay aapko dialysis ki jarurat padti hai. Dialysis ki jarurat Kabh padti hai yadi aapka saans full raha hai, aapke shareer mein potassium ki matra jyada ho gayi hai aur aapke poore body mein sujan ho gaya Hai. Is tarah ke lakshan jo hote hain usme dialysis ki jarurat padti hain. Dekhiye dialysis ki jarurat aap temporary dialysis kar sakte hain. Jo Kidney failure ka last stage hai uska end stage renal disease ya CKD 5 stage bolte hain. Uska jo best treatment hai wo kidney transplant hai, Gurde ka pratyaropan. Ab mai ye batana chahta hoon Ki dialysis aur kidney transplant mein kya antar hai. Dekhiye dialysis se aap sirf khoon ki safai karte hain lekin jo transplant hai usme aapko ek normal kidney aap ke shareer mein lagaya jata hai kyunki blood filtration ke alawa kidney jo blood ko saaf karne ka kaam karta hai uske alawa kidney se khoon banne mein bhi sahayata hoti hai.

kidney se ek hormone bhi release hota jisko erythropoietin bolte hain wo khoon banne mein sahayata karta hai, fir vitamin D ke synthesis ko bhi madat karta hai kidney aur kaafi saare cheezein hai jo ki aapki normal kidney se nikalta hai. To normal kidney or dialysis mein bohot fark hai. Yadi aap dialysis par rehte ho toh aapko hafta-hafta khoon banne ka injection diya Jata hai aur fir vitamin D ki goli khani padti hai aur dialysis ke liye aapko hafte mai 3 bar hospital jana padta hai aur aapke saath ek adami hota hai. Jiska bhi kam apna rojgar band karke aapke sath hota hai. To dialysis ka jo kharcha hai kaafi jyada hota hai mahine mein kam se kam to 30,000 rupaya jata hai ek admi ko dialysis karne mein kyunki aapko injection lagta hai aur aap ka jana aana aur aap ke saath jo aadmi jaate hain unka bhi jo kaam hota hai wo kaam band karke jana padta hai. Yadi aap dialysis par rehte hain jo diabetic patient hai usme dialysis mein logon Ko 4 ya 5 saal ya 6 saal mein logon ki death ho jati hai. Kafi logon ki kam se kam 30% se 40% logo ki death ho jati hai aur jo transplant hota hai usko karne ke 2 tarike hote hain.

Ya to aapke family member, aapke mata, pita, bhai, behen, aapki patni aapko ek gurda de se agar wo normal hai to. Normal kahane ka matlab ki jo donor hai jo aapko gurda dena chahte hain unko diabetes ki bimari nahi honi chahiye, high blood pressure hai to bhi de sakte hain to bhi gurda de sakte hain bas shart hai ki unka end organ damage nahi hai. End organ damage ka matlab hota hai unko aankh mein retina mein koi bimari na ho, urine mein protein na aa raho ho aur yadi aap ECG karte hain ya echo karte hain to usme heart mein koi soojan nahi ho, left ventricular hypertrophy bolte hain wo nahin hona chahiye aur aapka blood pressure ek single medicine par control hai to aap kideny de sakte hain. Abhi aapke pass 2 kidney hai or koi bhi adami, normal aadmi jiski umar 18 se 65 saal tak hai apni 1 kidney donate ker sakta hai isko bolte hai live related kideny transplant aur dusra tarika hota ha dusra hota hai cadaveric transplant iska matlab hua ki yadi kisi bhi vayakti ka road-traffic accident mein head injury hota hai ya kisi ko brain hemorrhage ki wajah se behosh ho jata hai aur vah ICU main admit rehta hai aur usko neurosurgeon intensivist sab log braindead ghoshit kar diya jata hai.

Braindead ka matlab hua ki aap bina life support ke ventilator ke aur blood pressure maintain karne wali dawa ke bagair aap nahi raha sakte hain aap ka jo saans ki parkriya hi nahi chal rahi hai aur aap ka blood pressure nahin maintain ho raha hai to us patient ko braindead bolte hain. Uske liye hum log apnea test karte hain aur yadi ye test positive hota hai to usko braindead declare karke aur unke family walon se unki consent ya sehmati karke aapka kidney transplant ho sakta hai Jisko cadaveric transplant bolte hain to mai yahan par kafi transplant karta hoon, cadaveric bhi karta hoon aur live related bhi karta hun aur sabse badi baat hai ki jo donor nephrectomy hai, mai laproscopic method se nephrectomy karta haun jisme ki marij ko pain kam hota hai aur 3 din se 4 din ke andar uski chutti ho jati hai aur kafi accha patient ki recovery hoti hai Kafi achha hota hai.

To jo transplant hota hai, transplant karne ke baad aapko 3 se 4 din ICU mein rakha jata hai. Transplant ICU mein aur dheere-dheere aapka jo serum creatinine hai. Urine output sab measure karte hain, blood pressure monitor karte hain aur aap haft-din mein chutti hoke ghar chale jate hai. To transplant ke kitne fayde hain ki aapko dialysis se chutkara mil jata hai aur ek normal zindagi vyatit karte hain to kidney transplant ke bohot fayde hain lekin Yehi hai ki aapko zindagi bhar immunosupression wali dawa Di jati hai jisko khana padta hai aur Iske alawa dialysis aur kidney transplant mein kafi difference hai. Mai yahi samajhta hoon ki kidney transplant jo hai kidney failure ke liye sabse best ilaaj hai sabse uttam ilaaj hai aur logon ko kidney transplant ke liye aage aana chahiye aur jo aapki family hai unko acche se council karke ek gurda de sakte hain normal aadmi usme koi takleef nahi hoti hai logon ko.

Ek aur mahatvapurna baat batana chahta hoon ki India mein kaafi saare patient kidney transplant ke hote hai jinko ki organ nahi milta hai ya to unke family mein diabetic patient hote hain aur kyunki aajkal to jo family ka size hai kafi chhota ho gaya hai wife, husband, ek ya do bacche to jyadatar live donor milne mein takleef hoti hai isliye mera ye aapse nivedan hai ki aang-daan kare aap 1 organ donor bane jisse ki aap 5 se 6 logo ka jeevan bacha sakte hain aur logon ko jeevan daan de sakte hain yadi bhagwan na kare kisi road traffic accident mein aapko head injury ho aur apka bachana mushkil ho jaaye to us condition mein aap 1 organ donor bane aur un logo ko jeevan daan dein. To kidney failure se bachne ke liye kya upay hai main aapko shortcut mein, bohot brief mein batana chahta hoon ki aapko yadi diabetes hai to diabetes yani blood sugar ka control kare. Regular apna routrin urine dekhte rahe, blood urea, serum creatinine check karte rahe aur BP (blood pressure) ko control rakhe aur koi bhi aadmi yadi dard ki dawa regular khate hai to ek isko nonsteroidal anti-inflammatory Jaise combiflame hua, ibuprofen hua, diclofenac hua ye sab dawa khaane se bhi kidney par bhi iska nuksandeh asar hota hai aur mera to yahi sujav rahega ki jab aapko jod aur ghutne ka dard ho to bina doctor ki salah se dawa na khaye aur apna blood urea, creatinine hamesha karte rahe. Apne man se kabhi bhi dard ki dawa naa lein adhik matra mein kyunki wo aapke gurde ke liye hanikarak siddh ho sakti hai. Main asha karta hoon ki meri baat aapko samajh mein aayi hogi.

Thanks!