Chronic kidney disease(CKD) has a prevalence of around 17% in India and the graph doesn’t seem to show a dip. While diabetes and hypertension tops the list for being the risk factors for developing CKD, it can be genetic as well and therefore the disease may go unnoticed. And this very thing can delay the diagnosis and an early intervention to halt the disease. So what should a patient be aware of as to when consult a nephrologist?
1.If someone has diabetes or hypertension,one should be stringent in their control of diabetes and hypertension and follow the advice of the physician and stay in close touch,not resort to any indigeneous medications or pain killers;get their kidney function tests done atleast once in 6 months and depending on the levels one can opt for a shorter duration as well.
2.If you have swelling of your feet/decreased urine output/reddish coloured urine,contact a nephrologist at the earliest.
3.If you do not have diabetes/hypertension but you are passing urine more than 4 times at night,feeling lethargic or having diminished appetite,do consult a nephrologist as these may point towards a chronic renal failure.
One confusion that is quite prevalent and needs clarification is the diet. While you should restrict protein intake once you are labelled as having CKD, you should not cut down everything. A regular Indian diet usually lacks in protein and the recommended intake of protein is 0.8 gm/kg/day in CKD which falls short even in a regular diet.So there is no need to routinely curb down pulses from their diet and plant based proteins should be preferred over animal proteins.
So once we diagnose CKD,what’s the way ahead of us?Is it the end of life when dialysis is initiated or is it possible to get a normal life back?A life which wont be having those dietary and fluid restrictions and a thrice weekly dialysis schedule?
The answer is yes. Once you are having an advanced renal failure,there are two options. One to opt for dialysis-which can be hemodialysis or peritoneal dialysis and the second option is renal transplantation. Once you opt for renal transplant you are out of these dietary and fluid restrictions,out of undergoing dialysis three times a week and can lead a normal lifestyle with certain precautionary measures and have to take certain immunosuppressive medications lifelong to keep your kidneys working.
So who can donate you the kidneys?
It can be a live related transplant when someone from your family agrees to donate or it can be a cadaveric transplant when someone from the affected family comes ahead for organ donation after their patient is declared brain dead. With recent medical advancements unmatched blood grouping does not hold a barrier anymore for live related donation. While for cadaveric transplant it is a long way to go for our state in terms of awareness of organ donation. While a loss is a loss to the family members, one can save many lives even after death after organ donation.