The prevalence of Chronic Kidney Disease (CKD) in India has doubled over the last decade, and over 5 lakh individuals in the country have been diagnosed with the disease. Out of these, only few are able to undergo a Kidney Transplant. It is important to prevent, identify and subsequently treat CKD in time.  At present, 80% of Renal Replacement Therapy (RRT) is provided by the private healthcare system. The crude and age-adjusted incidence rates of End-Stage Renal Disease (ESRD) are estimated to be 151 and 232 per million populations respectively, in India.  Even today, over 90% of patients requiring RRT in India die within months of diagnosis because of inability to afford treatment, and even in those who do start RRT, 60% stop treatment for financial reasons.

WHAT IS CHRONIC KIDNEY DISEASE?

Chronic Kidney Disease (CKD) also referred to as Chronic Renal Failure (CRF) is described as the gradual loss of Kidney function. This occurs when the Kidneys are damaged and are unable to filter body’s metabolic wastes. During the initial stages of CKD, individuals may have very few signs or symptoms, the disease may not be obvious until the Kidneys are significantly damaged. When the disease reaches an advanced stage, the levels of fluid, waste and electrolytes are at a seemingly dangerous level and can affect the body tremendously. CKD can develop rapidly and subsequently lead to end stage Kidney failure, which could be fatal without dialysis or a Kidney transplant.

RISKS AND PREVENTION:

To prevent Chronic Kidney Disease, it is important to ascertain risk factors which will ultimately help to cease the progression of the disease, and reduce complications.

• People with Diabetes and high Blood Pressure are highly susceptible of developing Kidney problems
• Blood Sugar and Blood Pressure control are an important means in preventing the onset of Kidney failure by medicines; some particular medicines help in reducing the protein leak in the urine (Proteinuria) being a major risk factor
• It is essential for Diabetics to manage their medicines to control blood glucose levels, which affect the Kidneys
• For hypertensive patients, there is added stress which affects the Kidney’s ability to filter blood
• It is recommended that these patients should modify their lifestyles and seek doctor’s consultation to manage medication

MANAGING CHRONIC KIDNEY DISEASE:

Management of CKD depends upon at what stage the patient approached the doctor. Treatment includes measures to slow down the progression of disease, reduce complications associated with the disease to curb any problem which may lead to end stage Kidney failure. End Stage Kidney Failure is the stage when the body cannot keep up with clearance of waste and fluids on its own, and at this point renal replacement therapy in the form of dialysis or Kidney transplant is required.

Dialysis: This involves artificial removal of waste and fluids from the blood, when the Kidney is unable to do so. There are two types; ‘Hemodialysis’ consists of a machine filtering the excess fluids from the blood and ‘Peritoneal Dialysis’ which consists of a catheter (thin tube) inserted into the abdomen that fills the abdominal cavity with a dialysis solution acting as a sponge for the fluid. Depending on the method advised by an expert, dialysis is carried out two to three times a week.

Kidney Transplant: Kidney transplant is the best modality of treatment for end stage Kidney failure. This is a surgical operation in which a donor Kidney is transplanted in the recipient. The source of the Kidney is either from living or deceased donors. Lifetime medication is required in order to sustain the transplanted organ and to stop the recipient’s body from rejecting it. Dialysis is not required once a Kidney is transplanted into a recipient. Kidney transplant is far more superior to dialysis, in terms of cost of treatment and outcomes.

WHO IS SUITABLE TO DONATE THEIR KIDNEYS?

Kidney transplants are carried out through living donations and cadaver donations (upon brain death). When it comes to living donor donations, one can donate their Kidneys only if there is no evidence of Kidney disease or a medical condition that may lead to development of the kidney disease in the future. The criteria for Kidney donation include:

• Above 18yrs and below 65yrs of age
• Good physical health
• No indication of chronic illnesses like Diabetes, Cancer or Heart Disease
• Even hypertensives can donate their Kidney provided;
  • Not on more than one antihypertensive medicine
  • No protein leak in urine
  • No left Ventricular Hypertrophy in ECG
  • No Retinopathy in eye

Dr. Suresh K. Bhagat, Urologist & Transplant Surgeon, SL. Raheja Hospital Mahim- A Fortis Associate