Category Archives: Kidney Specialist

Kidney Disease – Major Cause of Death

Kidney Specialist,

Kidneys are extraordinary organs. They contain millions of little blood vessels that act as a very effective filter. When blood passes through these vessels, the salt, waste and excess of fluid are held inside the kidney, while protein and red blood cells are simply too big to be “captured” by the kidneys, so they stay in the now purified blood, which continues to circulate. All waste products then become part of urine and are eliminated from the system with it.

Sometimes, certain circumstances may cause the kidneys to malfunction. This is known as Kidney Disease. When this happens, waste accumulates in the blood and causes sickness.

There are several types of kidney disease, and their treatment varies according to their causes and the amount and type of kidney tissue involved. Also, kidney disease increases your risk of having heart and blood vessel disease.

Statistics Of Kidney Disease Patients

In India, kidney disease is the cause of 66.7% death; and is also a cause of severe reduction on the population’s life quality. In 2020, we estimate that about 7.63 million Indian adults died prematurely as a result of kidney disease, representing about 20% of all premature adult mortality.

Causes Of Kidney Diseases

Kidney disease may happen as a consequence of disorders like diabetes, high blood pressure and others. Some kidney diseases are genetically inherited and cannot be prevented.

Symptoms Of Kidney Diseases

Although they can substantially vary from individual to individual and from a specific disease to another, symptoms of kidney disease may include high blood pressure, anemia (low blood count), poor nutritional health, weak bones, ankle swelling and nerve damage.

Treatment Of Kidney Diseases

Treatment of kidney disease is specific to each disease. However, common treatments against unstoppable diseases consist on compensating the malfunction of the kidneys and supplement their function with an artificial kidney. This is known as dialysis. Kidney infection, when present, can be fought against with the help of antibiotics.

Prevention Of Kidney Diseases

As a general rule, keeping a balanced diet, drinking abundant liquid, reduced sodium ingestion (salt) and maintaining an overall healthy life may prevent most preventable kidney diseases. The best way to cure a kidney disease early is to regularly consult your kidney specialist in Delhi.

The Kidney And Kidney Disease In Pregnancy

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Pregnancy is a very special period in the life of a couple and in particular, a woman, but it may seem like a difficult dream to achieve in kidney patients.

THE IMPACT OF PREGNANCY ON THE KIDNEY

In women without kidney disease, the urinary system undergoes anatomical and functional changes to adapt to the new state: blood flow to the kidney increases up to 60%, which causes creatinine to drop slightly and proteinuria to rise (parameters that usually serve to evaluate renal function). It also increases the amount of water in the body which leads to a dilution of hemoglobin (anemia of pregnancy that is physiological) and blood pressure drops slightly. These normal changes may not happen in women with kidney disease.

PREGNANCY IN CHRONIC KIDNEY DISEASE

Kidney patients have a harder time getting pregnant. When it happens, the pregnancy itself may be subject to more complications than in a healthy woman, which always means a risky pregnancy and implies a closer follow-up by the obstetrician and the nephrologist. Usually, kidney disease does not worsen during pregnancy, but it can get significantly worse after delivery. The baby also requires special monitoring. The cause of kidney disease and the stage (severity) of it also determine the evolution of pregnancy.

DIALYSIS PREGNANCY

Pregnancy in women on dialysis is rare.

There are reports of pregnancies occurring on peritoneal dialysis, but the increase in abdominal volume due to pregnancy makes exchanges on peritoneal dialysis difficult, so if a woman on peritoneal dialysis becomes pregnant, she should consider switching to hemodialysis (albeit temporarily, during gestation).

When women on hemodialysis become pregnant, they see the treatment changed. Among other technical changes, they must undergo dialysis daily (five to six sessions/week) so that the toxics do not accumulate and suffer as little variation as possible so as not to affect the baby.

In both peritoneal dialysis and hemodialysis, the risk of miscarriage is greater than in a patient who does not undergo dialysis, and as such, the follow-up must be done by the obstetrician and the best nephrologist in Delhi on a regular and careful basis.

PREGNANCY IN KIDNEY TRANSPLANTATION

In kidney transplant women, fertility is partially restored, making it easier to get pregnant. These pregnancies must be planned and monitored, as they are still risky pregnancies. One of the main precautions is the choice of immunosuppression. Some drugs can affect the baby, so the medication schedule may have to be changed. In this context, there may be a higher risk of rejection of the transplanted kidney. With regard to childbirth, this should preferably be done vaginally so that there is no risk of injuring the transplanted kidney during a cesarean section.

PREGNANCY IN KIDNEY DONORS

If a woman donates a kidney to a kidney patient, her fertility is not affected and pregnancy does not involve greater risks than if she had both kidneys.

Habits That Affect Your Kidneys

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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.

Learn How To Take Care Of The Kidneys And Stay Away From Kidney Diseases

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Kidney Health for All is the theme of World Kidney Day 2019. But, do you know how important this organ is for the proper functioning of the body? First, for those who do not know yet, the word kidney goes to the plural because we have two. And they are in the posterior abdomen, one on the right and one on the left.

Their main function is to filter blood to control the amount of water and salt in the body, eliminate toxins, help control high blood pressure and produce hormones that prevent bone anaemia and decalcification, and eliminate medications and other ingested substances.

It is precisely for its numerous functions that the kidneys need to be healthy. Sick kidneys cause so-called kidney disease, which is a cause of concern worldwide because of the growing number of cases.

According to the best nephrologist in Delhi, 850 million people have kidney disease worldwide. Chronic Kidney Disease causes at least 2.4 million deaths annually, with an increased mortality rate. And the most affected are people living in low- and middle-income countries.

According to Dr. Vinant Bhargava, kidney specialist in Delhi, the main risk factors for kidney disease are hypertension, diabetes, and a family history of kidney disease. But obesity, smoking and the use of toxic medications can also affect kidney health.

“In India, one in 10 Indians will have some kind of kidney disease. He has and does not know, because kidney disease is silent. It has no major symptoms. And since diabetes and hypertension are prevalent diseases in India, and also remembering obesity, these diseases lead to chronic kidney disease. And if the person has a very poor kidney function, below 10%, he will go on hemodialysis, peritoneal dialysis or need a transplant, ”explains the nephrologist

Preventing

Kidney care means staying away from kidney disease. For prevention, one of the main tips is to adopt a less salty diet. “We here in India eat around 12 grams of salt per day when adequate would be around 2 grams of salt/day. Salt has a retaining effect on water. This causes the kidneys to work at higher blood pressure, leading to kidney disease or chronic kidney disease. And for those who are diabetic, the diet should also be controlled, especially in relation to sugar, ”draws the attention of Dr. Vinant Bhargava.

Hydration is indispensable. “We should not wait for thirst to drink water. Thirst already means dehydration. An increased amount of fluid should be taken to further filter the urine. The pathologies that can be harmed by lack of water are those who already have kidney stones, the kidney stone. You have to drink a lot more water, always trying to prevent the crystals from getting too long in the urine, forming increasing leg formation.”

Elderly people, patients with cardiovascular disease and patients with a history of kidney disease in relatives have great potential to develop kidney injury and should be investigated with urine screening and blood creatinine levels. “These are simple tests available that provide valuable information to tell how the kidneys are working. The recommendation is to take the exam once a year. And anyone who already has a family history, hypertension or diabetes is at least every six months.”

Serum Protein Analysis

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Definition of serum proteins

The proteins are in some ways the essential building blocks of our cells; they play a role in all the reactions of the body.

There are more than a hundred different proteins circulating in the blood, although albumin accounts for 60% of them.

In addition to transporting many substances (hormones, lipids, etc.), blood proteins are involved in coagulation, immunity, maintenance of blood pressure, and so on.

It is possible to perform a total serum protein assay, which provides information on the functioning of many organs.

Why do serum protein analysis?

The analysis of serum proteins (serum) is useful in many situations to guide diagnosis, specify the severity of a disease or monitor the effectiveness of treatment.

It is a very common examination that can assess the function of certain organs (liver, kidneys) and highlight certain abnormalities (inflammatory syndrome, autoimmune diseases, lymphoma, etc.).

Thus, this dosage may be prescribed, inter alia, in the case of:

  • inflammatory syndrome
  • alteration of the general condition
  • CBC abnormalities (blood test)
  • unexplained bone or joint pain
  • liver problems
  • renal failure

What results can we expect from a serum protein analysis?

The serum or plasma proteins are measured by electrophoresis, after a simple blood test: the blood (serum) is placed in an electric field, which “migrates” the proteins. They separate according to their electrical charge and their weight, which makes it possible to distinguish them from each other and to identify anomalies.

This assay is usually performed at the same time as other basic tests, such as blood count or sedimentation rate. Indeed, the level of proteins in the blood (protidemia) does not only depend on the proteins, but also on the blood volume (the dilution may be greater or smaller).

What results can we expect from a serum protein analysis?

As an indication, the normal value of total serum proteins is between 65 and 80 grams / L. The albumin/globulin ratio is between 1.2 and 1.8.

An increase in total plasma protein (hyperproteinemia) is observed in many situations, such as dehydration (“heat stroke”, diarrhea, vomiting) or during various diseases such as myeloma that cause an increase in the mass of circulating proteins.

Decreases in total protein concentration (hypoproteinemia) may be caused by a lack of intake (malnutrition) or a lack of absorption, a lack of synthesis (liver failure), abnormal loss of kidney or by water overload (hemodilution).

The electrophoretic analysis shows the distribution of the main blood proteins and traces a characteristic “profile”, which can be interpreted by the doctor.

Thus, in the case of an inflammatory syndrome, for example, the “pattern” will be typical, showing an increase in alpha-globulins and a decrease in albumin.

The increase in beta-globulins, meanwhile, may mean the presence of iron deficiency, hypothyroidism or biliary obstruction.

The nephrotic syndrome (kidney dysfunction) will be characterized by hypoalbuminemia and hyperalphaglobulinemia.

Only the nephrologist in Delhi will be able to identify an abnormal line and prescribe the case of complementary examinations to make a diagnosis.

Diabetic Kidney Disease

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More and more people are suffering from diabetes globally. The prevalence of increasing diabetes means that the prevalence of diabetic kidney disease, one of the dangerous complications that increase mortality worldwide, also increases, explains nephrologist in Delhi.

What is diabetic kidney disease?

If high blood sugar persists, it will damage small blood vessels in the kidney. This can cause the protein to escape into the urine, resulting in symptoms such as hypertension, edema, and kidney damage. Finally, these injuries lead to serious kidney disease, end-stage kidney disease. Kidney disease caused by diabetes is called diabetic kidney disease.

Why is it important to know about diabetic kidney disease?

  • The worldwide prevalence of diabetes is increasing rapidly.
  • Diabetic kidney disease is the most common cause of chronic kidney disease, and 40-45% of newly diagnosed patients with end-stage kidney disease are diabetic.
  • Treatment of end-stage renal disease is more costly for patients in developing countries.
  • Early diagnosis and treatment can prevent diabetic kidney disease. Even with chronic kidney disease, proper treatment can delay the treatment of renal replacement therapy such as dialysis or kidney transplant in Delhi for a considerable period of time.
  • Management of diabetic kidney disease is more important because of the high mortality from cardiovascular disease.

Therefore, early diagnosis of diabetic kidney disease is very important in the treatment of patients, says the best nephrologist in Delhi.

How many diabetic patients lead to diabetic kidney disease?

There are two categories of diabetes, depending on which category it is likely to progress to diabetic kidney disease.

1) Type 1 diabetes-insulin-dependent diabetes mellitus

Type 1 diabetes occurs mainly in children, and insulin is essential for the treatment. Approximately 30-35% of patients are known to lead to diabetic kidney disease.

2) Type 2 diabetes – non-insulin dependent diabetes mellitus

Type 2 diabetes mellitus is predominantly in adults and is often treated without insulin in most patients. It is known that about 10-40% lead to diabetic kidney disease. Type 2 diabetes is the most common cause of chronic kidney disease in more than one of three chronic kidney disease patients, says kidney specialist in Delhi.

What type of diabetes leads to diabetic kidney disease?

Although it is difficult to predict which diabetes will lead to diabetic kidney disease, several key factors are known.

  • Type 1 diabetes mellitus that occurred before the age of 20
  • Unregulated blood sugar (high glycated hemoglobin)
  • Uncontrolled blood pressure
  • In the case of visual impairment such as diabetic retinopathy or nerve damage such as diabetic neuropathy
  • Proteinuria, obesity, smoking, hyperlipidemia

When does diabetes mellitus (diabetes) develop in diabetics?

Diabetic kidney disease (sickness) takes years to develop, so it rarely develops within the first 10 years. In type 1 diabetes, soybean red mildew symptoms occur between 15 and 20 years after the onset, and if it has not progressed to kidney disease for 25 years after the onset, the likelihood of developing kidney disease is lowered, says a doctor for kidney in Delhi.

When should a diabetic patient suspect a diabetic kidney disease?

Diabetic kidney disease (sickness) can be suspected if you have any of the following symptoms.

  • When foamy urine or urinary albumin/protein is present (observable early on)
  • Worsening of high blood pressure or previous hypertension
  • Edema of the ankle, foot or face; Decrease in urine volume or weight gain (due to the accumulation of water)
  • The decrease in insulin or diabetic drug requirements
  • Frequent hypoglycemia, or diabetes that has not been controlled in the past,
  • Drug-free diabetes: Many people think that diabetes has been cured because of good blood-sugar control, but in fact, it can mean kidney disease. In kidney disease, the duration of action of the diabetes drug is long.
  • Symptoms of chronic kidney disease at the end-stage (helplessness, fatigue, anorexia, nausea, vomiting, itching, pale, shortness of breath)
  • Elevation of creatinine and urea nitrogen in the blood test

How do you diagnose diabetes (kidney disease)?

  • Ideal: Diabetic patients should be tested for microalbuminuria and blood creatinine (or glomerular filtration rate) every year.
  • More practical: every three months blood pressure and urine dipstick tests are done. And every year we perform a blood creatinine (or glomerular filtration rate) test.

How can I prevent diabetic kidney disease?

The following are important to prevent diabetes (kidney disease).

  • Receive regular medical care from top nephrologist in Delhi.
  • Blood sugar control thoroughly. It is advisable to keep the glycated haemoglobin below 7%. Maintain blood pressure below 130/80 mmHg. Antihypertensive drugs such as angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are used to control blood pressure and albuminuria.
  • Sugar, salt, protein and fat intake should be reduced.
  • The microalbuminuria test and blood creatinine test (or glomerular filtration rate) should be performed at least once a year to determine the function of the kidneys.
  • Lifestyle therapy: Regular exercise and maintain ideal body weight. Do not smoke with alcohol, and avoid indiscriminate use of drugs such as an analgesic.

How do I treat diabetes (kidney disease)?

  • Thorough management of diabetes
  • Proper management of blood pressure is most important in protecting the kidneys. Therefore, blood pressure should be routinely measured and maintained below 130/80 mmHg. Treatment of hypertension is known to slow the deterioration of chronic kidney disease.
  • Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are antihypertensive agents that have particular advantages in diabetic patients. These antihypertensive agents have the advantage of slowing the deterioration of nephropathy and should be initiated from early nephropathy in which microalbuminuria is present for maximum benefit.
  • To reduce facial or back swelling, you should administer a drug that increases urine, such as diuretics, with salt and water restriction.
  • Diabetic patients with renal insufficiency have a greater risk of falling into hypoglycemia and need appropriate controls for diabetic agents. Fast-acting insulin is preferred for controlling glucose and persistent oral formulations are contraindicated. Metformin is at increased risk for lactic acidosis and should not be used in patients with plasma creatinine> 1.5 mg / dL.
  • In diabetic patients with high plasma creatinine, all treatments for chronic kidney disease should be performed (listed in Chapter 12).
  • Risk factors that can cause cardiovascular diseases such as smoking, lipid elevation, hyperglycemia, and hypertension should be assessed and managed.
  • Patients with advanced diabetic kidney disease eventually need treatment such as dialysis or kidney transplant in Delhi.

When should a diabetic kidney patient consult a doctor?

Diabetic patients with microalbuminuria must consult the best kidney specialist in Delhi. You should consult your doctor immediately if:

  • The sudden increase in body weight, sudden decrease in urine volume, worsening of the face or leg edema, or difficulty breathing
  • Chest pain, aggravation of hypertension, and very fast or slow heart rate
  • Severe placebo, anorexia, vomiting or pale
  • Persistent fever and chills, and pain or burning fever during urination, urine or hematuria
  • When there is frequent hypoglycemia or reduced demand for insulin or diabetes
  • When confusion, drowsiness or convulsions of consciousness occurs

Sexual complaints in men suffering from kidney disease

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Many men with chronic kidney damage experience sexual problems. Like less sense of sex and erection problems.

Sex hormones play a role in sexual excitement. The hormone testosterone affects men and women in having (and getting) a sense of sex. In the case of kidney damage, testosterone decreases. The sense of sex can therefore decrease.

In addition, erection problems can arise.

Erection problems

With sexual excitement, more blood goes to the penis. This makes the penis stiff. Approximately 7 out of 10 men with chronic kidney damage or kidney failure get erection problems. This means that it is more difficult to stiffen the penis or keep it stiff.

  • Sometimes an erection is no longer possible at all.
  • Sometimes the sensitivity of the penis is reduced by neuropathy (nerve pain). To get excited then you need stronger sexual stimuli than you might have been used to.
  • If you do not have an erection, sexual intercourse is not possible, but enjoying sex and getting an orgasm is often possible. Due to the reduced feeling, the perception of orgasm can be different.

Sometimes there is orgasm but no ejaculation anymore. The sperm then ends up in the bladder. This is also called dry cumshot. It does not hurt: you just piss out the semen.

Causes of erection problems

There are several causes of erection problems:

  • high blood pressure
  • medicines
  • testosterone deficiency
  • overweight or an unhealthy lifestyle
  • fear of failure or other worrisome thoughts

Kidney damage often involves high blood pressure. That affects the blood vessels. As a result, there is insufficient blood in the penis during sexual excitement. The penis then only gets half stiff, or not at all. It is also possible that there is enough blood to go to the penis, but that it is drained too quickly. Then the penis will swell, but it will not stay stiff for long.

Medications can also prevent erection. Blood pressure-lowering drugs sometimes ensure that there is insufficient blood to the penis during excitement. This also applies to certain sedatives if you use them for a long time.

Sometimes medication for the treatment of kidney disease leads to a shortage of testosterone. Then your penis and your brain are less sensitive to sexual stimuli. Being overweight can worsen testosterone deficiency.

Fear of failure or other worrisome thoughts

In the case of erectile problems caused by kidney damage, emotional problems often arise from fear of failure or other worrisome thoughts. If one fails to get an erection, the man can be afraid in advance that it will not work again next time. If all the attention goes to the erection, there is no attention to the love game. The man is more of a spectator who looks critically at whether the penis stays stiff. As a result, he does not notice sexual stimuli and loses his erection.

In case of fear of failure, there is also a good chance that the man (unwittingly) tightens the muscles of the pelvic floor too much. These are the muscles with which you stop your pee. If the muscle tension in the pelvic floor is too high, the blood circulation of the penis does not start with sexual excitement. Then there is no erection.

If the erection problems persist, there may be guilt that your partner suffers from your problems.

Discuss your problems

Are you less easily sexually stimulated? Or do you have other erection problems? Talk about it with your nephrologist in Delhi. Or discuss it with your best sexologist in Delhi. It can also help you to discuss sexual problems if you find it difficult.

Your best nephrologist in Delhi will talk to you about your problems, or refer you to a urologist or sexologist. Check whether the amount of testosterone in your blood can be measured. In a conversation, you will discuss together what causes your sexual problems. In addition to physical obstacles, emotional matters usually also play a role. Think of anxiety, fatigue, shame or guilt.

Treatment options

There are different treatment options for men with sexual problems.

  • more and stronger stimulation of the penis. For example, with lubricant, hand or mouth
  • a penis ring
  • erection pills
  • injections with a substance into the erectile tissues of the penis
  • good nutrition and enough exercise
  • the lovemaking plan at times when you are not too tired

Erection pills ensure that the erection lasts longer with sexual stimulation. Such medicines are only available on prescription. Erection agents are also offered on the internet, but that is not recommended: these resources are not reliable.

Always consult your kidney specialist in Delhi if you want to use resources to solve your erection problems. Your doctor knows which are safe for you and how to use them.

Solutions for fear of failure and worrisome thoughts

You can prevent fear of failure by (seeing) learning sex as something you enjoy. And not as something for which you have to perform.

  • Relax your body and your pelvic floor muscles.
  • Focus on what feels pleasant in your body.
  • Do not put yourself under pressure, for example with the idea that you should be able to have a community.
  • You and your partner may have just as much pleasure with stimulation by mouth or hand.

Because of worrying thoughts about sex, it is often difficult to pay attention to what you find exciting. It is then more difficult for you and your partner to enjoy sex.

Do you already suffer from fear of failure or other worrying thoughts? And keep it on? Talk about it with your partner. Feel free to ask for help from a healthcare provider if the problems persist. For example your top nephrologist in Delhi, or a sexologist in Delhi.

Dialysis: An Artificial Kidney

Kidney Specialist, Nephrologist, ,

According to Dr. Vinant Bhargava, a Nephrologist in Delhi, perfectly working kidneys minimize excess water, waste material, and different harmful particles from gathering in your body. Kidneys also support regulating blood pressure levels and also control the amounts of toxins in the blood, such as sodium, salt, and potassium. Kidneys additionally trigger a type of vitamin D that boosts the ingestion of calcium.

Kidney Specialist in Delhi Dr. Vinant Bhargava further explains that whenever your kidneys are unable to execute these types of works as a result of disease or trauma, dialysis in Delhi can help in maintaining the body running as normal as possible. In the absence of dialysis, toxins and other waste products will gather in the blood and infect the body. Still, dialysis is not a permanent treatment for kidney disease or some other issues impacting the kidneys. Various treatments may possibly be recommended to handle those problems.

In general terms, Dialysis is a replica of kidney function which cleans your blood artificially. Dialysis is categorized into two types:

Hemodialysis

Hemodialysis is the most used form of dialysis. It utilizes a hemodialyzer, which is also called an artificial kidney, to eliminate waste material and toxins from your blood. A doctor will create an access point into your blood vessels to get the blood flow to the hemodialyzer. This access point enables a higher volume of blood to flow through your body during the course of hemodialysis treatment. This enables more blood to be filtered and refined.

dialysis in Delhi

Peritoneal Dialysis

Peritoneal dialysis consists of a surgical procedure to attach a catheter inside your stomach area. During the course of procedures, a specific liquid, referred to as dialysate, flows into your abdomen. As soon as the dialysate extracts waste product out of the blood, it is emptied from your stomach.