Those with diabetes are at high risk for kidney disease. High blood sugar causes damage to the kidneys and impairs its functioning.

Q:Can I have kidney disease and not know it?


Dr:Yes. The kidneys are built in such a way that they continue to keep the body functioning normally even when they are damaged. You may not notice any symptoms until the disease has advanced. This makes it necessary for those at risk, to take extra care to eat healthy, drink enough water and take periodic kidney function tests upon consultation with the doctor.


Q:What is Glomerular Filtration?


Dr:It is the first step in the kidney’s filtration function. It is the process by which the kidney eliminates excess fluids and waste products from the blood. These products are filtered out of the blood and into small urine collecting tubes of the kidney. While checking the functioning of the kidneys, the rate at which Glomerular Filtration takes place is measured to assess the health of the kidneys. This is a blood test.


Q:Is there another test to determine how well the kidneys are functioning?


Dr:The Albumin to Creatinine ratio test is also an important one. Here a urine sample is evaluated for the presence of albumin, which is a type of protein. If the test comes back positive, it is indicative that the kidney might not be filtering the blood enough. The test must then be repeated twice, with a month’s gap between each. Three positive results are a sign of kidney disease. The condition in which albumin is detected in the urine is called albuminuria.


Q:Does diet have an impact on preventing kidney problems?


Dr:Most definitely. One must eat a lot of leafy greens, low fat dairy, whole grains, fresh fruits, and vegetables. Cut back on salt and sugar. Drinking lots of water helps the kidney eliminate waste and prevents formation of kidney stones.


Q:Who is at risk of developing kidney disease?


Dr:Those with diabetes are at considerable risk for kidney disease. High blood sugar causes damage to the kidneys and impairs its functioning. This leads to Diabetic Kidney Disease. A tell-tale sign for onset of diabetic kidney disease is traces of albumin in urine. Albumin is a protein in the blood and a healthy kidney will not allow albumin to pass into the urine. Another condition that can cause kidney disease is high blood pressure, which impedes proper kidney function leading to fluid build in the blood. Excess fluid in the blood increases BP even more. Those with a family history of kidney failure must also be wary.


Q:Does everyone with chronic kidney disease need dialysis?


Dr:Not necessary. If kidney damage is detected earlier on and the patient is following the advice of his doctor in terms of medication, diet and exercise, the condition will gradually cease to progress. Dialysis is only required by patients with kidney failure or end-stage renal disease.


Q:What is the difference between Peritoneal Dialysis and Haemodialysis?


Dr:In Peritoneal Dialysis, tiny blood vessels in the lining of the stomach use a special dialysis fluid to cleanse the blood of impurities. In Haemodialysis blood from the body is passed through the dialysis machine where the waste products are eliminated. The cleansed blood is then sent back into the body.


Q:Can children develop chronic kidney disease?


Dr:Birth defects, congenital abnormality, and hereditary conditions such as polycystic kidneys are the main cause for CKD in children. However, a strep infection caused by streptococcus bacteria and frequent urinary tract infections can also lead to kidney damage in children. A strep infection can inflame the filtering units of the kidney, impairing the glomerular filtration process, while some UTIs can scar the kidney and lead to poor kidney function if left untreated. Hence taking a complete antibiotic course with a follow Kidney Function Test (KFT) can help maintain kidney health.


Q:What medications lead to kidney damage?


Dr:Both prescription and OTC drugs are filtered by the kidney. We must make sure that the drugs we are taking are not harming the kidneys. Misuse/ overdose of over the counter (OTC) painkillers is harmful for the kidneys. Certain diabetes medications, antimicrobial drugs and OTC antacids also impair the functioning of the kidneys – more so if you have chronic kidney disease. If you have CKD, you must inform whichever doctor you consult to ensure they prescribe drugs that will not further harm your kidneys.


Q:Who is eligible for a Kidney Transplant?


Dr:People diagnosed with end stage renal disease or kidney failure, are evaluated for kidney transplant if dialysis also does not seem to be effective enough. A team of specialists will evaluate the patient via various tests to decide whether he/ she is viable for a transplant. A living donation is when a healthy kidney is taken from a living person and transplanted to a patient with kidney failure. Healthy kidneys from a recently deceased person can also be transplanted.


Q:What is Kidney Rejection after Kidney Transplant?


Dr:Kidney Rejection is one of the most common complications after a Kidney Transplant Surgery. The body detects the surgically implanted kidney and sees it as a foreign body. The natural immune system of the body begins to attack the new kidney, and this could lead to further complications. This condition is called Kidney Rejection. This condition can be averted by taking anti-rejection medication which suppresses the immune system and prevents the body from rejecting the new kidney. Taking anti-rejection meds diligently as prescribed by the doctor is one of the most important parts of post-transplant care.


Dr.BALAMURUGAN.B - CONSULTANT - NEPHROLOGIST at Dr.Kamakshi Memorial Hospitals
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