Monthly Archives: August 2024

Habits That Affect Your Kidneys

Best Nephrologist, Kidney Specialist,

The kidneys are two organs located in the upper abdominal cavity, just below the chest, one on each side of the spine.

They play a role in cleaning the blood and help the body filter waste products through the urine. When they are not functioning properly, the whole body suffers.

The kidneys produce hormones, filter blood, absorb minerals, produce urine and maintain a healthy balance between acidity and alkalinity in the body.

Common symptoms that indicate kidney problems

changing the color and quantity of urine;

  • dizziness;
  • vomiting;
  • anemia;
  • breathing problems;
  • cold sensation;
  • fatigue ;
  • itching of the skin;
  • bad breath.

What causes kidney problems

A number of habits are meant to affect the proper functioning of the body.

1. Drug overdose

Consumption of certain drugs, such as non-steroidal anti-inflammatory drugs that are known to relieve pain, can affect the kidneys, especially if there is already a sensitivity at this level. Therefore, it is important that the recommended dose should never be exceeded.

2. Salt abuse

Diets high in salt mean a high sodium intake in the body. It can increase blood pressure and, in turn, damage the kidneys. Being difficult to remove, the kidneys have to put much more effort into cleansing the body, which can lead to their disease.

3. Consumption of processed foods

Processed foods are important sources of sodium and phosphorus. Some studies have shown that high phosphorus consumption can be harmful to the kidneys and bones.

4. Insufficient water consumption

One of the main functions of the body is to remove metabolic waste from the body. In this way, the number of red blood cells becomes balanced.

But this can only happen in the presence of water because in its absence the kidneys do not work properly. High water consumption also has the role of avoiding the formation of kidney stones.

5. Lack of sleep

Good sleep is very important for the well-being of the body and, implicitly, of the kidneys. The renal function is regulated by the sleep-wake cycle.

During sleep, the kidney cells regenerate, so that they can function properly and at maximum capacity during the active period.

6. Delay urination

Maintaining, for too long, the bladder causes kidney problems. Specifically, kidney injury.

In addition, bacteria in the urine multiply and can cause urinary tract infections or kidney infections. Maintaining urine increases the pressure on the kidneys, which can lead to kidney failure and incontinence.

7. Too much alcohol consumption

Toxins found in alcohol accumulate in the liver, damaging them. But a negative effect also has on the kidneys. Large amounts of alcohol can cause kidney failure or other chronic kidney diseases, warns a nephrologist in Delhi.

8. Lack of magnesium

Magnesium is a very important mineral for the body. It plays an important role in the production of energy, in the synthesis of acids and proteins, relaxes the muscles and regulates the metabolism.

The lack of magnesium leads to the crystallization of calcium in the body, thus favoring the appearance of stones in the kidneys.

Chronic Kidney Disease in The Elderly

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Renal physiological ageing is characterized by a reduction in the renal glomerular filtration rate. In other words, the kidney does its filtration work in a slower way, in the same way, that the locomotion of an elderly person is also slower, but maintains the preserved function, that is, reaching the same place.

“The elderly are the biggest consumers of medication.”

This situation must be distinguished from the effective presence of kidney disease in the elderly, a situation in which the functioning of the kidneys is not adequate and is not related to the physiological decline of age. In situations of illness, and as in any other young or adult patient, kidney malfunction can be so severe that some interventions are needed. One is the medication review.

The elderly are the biggest consumers of medication, as they also accumulate more pathologies, and some medications can impair kidney function. Pain medications from the group of non-steroidal anti-inflammatory drugs, often taken by the elderly due to their degenerative osteoarticular pathology, can be very harmful and their indications and alternatives reviewed.

The other substantial intervention by the nephrologist is to prepare the patient for renal replacement treatment if and when the kidneys “stop”.

In India, kidney transplant is rarely performed in patients over 65/70 years old, since the risk of intervention and immunosuppression is greater than its benefit. But aging in the elderly is highly heterogeneous: age is of little significance for the decisions to be made, since other more important factors can overlap, such as: associated diseases, functionality, autonomy and independence. Thus, an elderly person may be a candidate for transplantation, despite not being the norm.

“ There are kidney patients who, due to the advanced comorbidities they have, do not benefit, in terms of time or quality of life, from any renal function replacement therapy. “

As for dialysis modalities (hemodialysis or peritoneal dialysis), there is no difference between them, similarly to what happens in young patients. The only point to note is that peritoneal dialysis is a modality that depends on the patient to be performed, unlike hemodialysis that is performed by a nurse in a hemodialysis center. Therefore, if the patient is not able to perform the technique, he may need a caregiver to do it for him, or, if he does not have it, this modality should not be an option.

Finally, there are kidney patients who, due to the advanced comorbidities they present, do not benefit, in terms of time or quality of life, from any renal function replacement therapy. These patients should be offered palliative care. Therefore, patients should be followed up by nephrologist in Delhi in order to control the symptoms of kidney disease, promoting quality of life, but without being subjected to more invasive techniques.

The choice of these options should always be made in conjunction with the assistant kidney specialist in Delhi, who should clarify the particularities of each elderly person, in order to better adapt the treatment to the person in question.

Symptoms And Causes of Renal Failure

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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.

Chronic renal failure, 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 aetiology 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.

Surprising Habits That Can Affect Your Kidneys

Nephrologist,

A number of habits can damage the health of the kidneys. Thus, in addition to alcohol consumption or insufficient fluid intake, increased protein intake, lack of exercise, vitamin and mineral deficiency can affect the kidneys.

The kidneys have the role of filtering blood, producing hormones, absorbing minerals, neutralizing acids and removing toxins and excess water from the body. Surprisingly, many of the daily behaviors actually affect the proper functioning of the kidneys.

Exaggerated use of analgesics

Medications used for pain, such as non – steroidal anti-inflammatory drugs, can damage the kidneys, especially in people who already have kidney disease. Therefore, it is recommended by nephrologist in Delhi never to exceed the maximum recommended dose.

Increased salt consumption

Salt can increase blood pressure and, in turn, can affect the kidneys. Processed foods are important sources of sodium and phosphorus.

Insufficient fluid intake

Proper hydration helps the kidneys cleanse the body of toxins. Abundant water consumption is also one of the best ways to avoid kidney stones formation. A healthy diet is considered the one in which the water supply rises to two liters per day.

Lack of sleep

Rest at night is very important for general well-being and even for the kidneys.

The functioning of the kidneys is regulated by the sleep-wake cycle, which helps to coordinate their action during the 24 hours. Lack of sleep causes disorders of the functioning of the kidneys.

High meat consumption

Animal protein generates large amounts of acid in the blood, which can be harmful to the kidneys, causing proteinuria.

Foods high in sugar

Sugar contributes to obesity, which increases the risk of high blood pressure and diabetes, two of the main causes of kidney disease.

Beyond desserts, sugar is often added to foods and beverages that are not considered sweet. Breakfast cereals and bread contain significant amounts of carbohydrates.

Smoking

People who smoke are more likely to have protein in their urine, which is a sign of kidney damage.

Diseases that affect the kidneys, such as diabetes and high blood pressure, are also exacerbated by smoking, and smokers have a higher risk of requiring kidney transplants and dialysis.

Excessive alcohol consumption

Kidneys help the body filter out harmful substances, including alcohol. The kidneys of a person who consumes a lot of alcohol are subjected to very high pressure, which can cause damage to the kidney system.

Increased alcohol consumption – over four servings a day – doubles the risk of kidney disease. Alcohol is a dehydrator and interferes with the regulation of blood flow to the kidneys, explains nephrologist in Delhi.

Coffee consumption

Coffee raises blood pressure, which can trigger kidney disease. Also, consumed in large quantities, it increases the level of calcium in the urine.