FAQ

General FAQ

  • What are the kidneys?
    Normally, there are two kidneys, located at upper and back side of the abdomen, one on either side of the spine under the lower ribs.They are a pair of bean shaped organs and in adults; each kidney is about the size of a closed fist. Additional information on Kidney and its Function, Page : 4
  • What are the symptoms of kidney diseases?
    The symptoms of kidney diseases are variable and depend on the type of underlying disease and its severity. The common symptoms include the swelling of face (most noticeable in the morning), loss of appetite, nausea, vomiting, hypertension at young age, weakness, pallor, reduced urine volume, burning sensation in urine, difficulty in ‘voiding’ and the presence of blood in urine. Additional information on Symptoms of Kidney Diseases, Page : 9

FAQ - Kidney Failure

  • What is the difference between acute kidney failure and chronic kidney failure?
    In acute kidney failure, the kidney function is reduced or lost within a short period (over hours, days or weeks) due to various reasons. This type of kidney failure is temporary, and usually reversible.
    While gradual progressive and irreversible loss of kidney functions over several months to years is called chronic kidney disease or chronic kidney failure. This is a non- curable disease where kidney function reduces slowly and continuously and after a long period it may reduce to a stage where the kidney stops working almost completely. This advanced and life threatening stage of disease is called end stage kidney disease. Additional information on What is Kidney Failure?, Page : 35

FAQ - Chronic Kidney Disease

  • What are the causes of chronic kidney disease?
    The two most important causes of chronic kidney disease are diabetes and high blood pressure. Other important causes are glomerulonephritis, polycystic kidney disease, ageing of the kidneys, renal artery stenosis, blockages to the flow of urine, drug-induced kidney damage, recurrent kidney infection in children and reflux nephropathy. Additional information on Chronic Kidney Disease: Causes, Page : 43
  • What are the symptoms of chronic kidney disease?
    Symptoms of chronic kidney disease vary as per the severity of the disease. During the early phase, there may be no warning symptoms. But early clues may be nocturia, elevated blood pressure, urine abnormalities and normal or slightly higher serum creatinine. Common early symptoms of kidney diseases are swelling, loss of appetite, nausea, weakness, severe or uncontrolled hypertension and pallor.
    Advanced stage or end stage kidney failure patients are usually symptomatic. Some patients may not have symptoms and the problem may go undetected until the kidneys are severely damaged. Common problems at this advanced stage are severe nausea, vomiting, weakness, breathlessness, pallor, confusion, altered sensorium and convulsion. Additional information on Chronic Kidney Disease: Symptoms and Diagnosis, Page : 44
  • Which measures can help you treat chronic kidney disease medically and preserve kidney function?
    Important measures in conservative treatment of chronic kidney disease are:
    Meticulous treatment of underlying primary conditions such as diabetes mellitus, hypertension, urinary tract infection or obstruction, glomerulonephritis etc.
    Strict blood pressure control (BP 130/80 mm of Hg).
    Early use of ACE inhibitor or angiotensin II receptor–blocker therapy to control BP and reduce proteinuria.
    Protein restriction to preserve kidney function.
    Supportive treatment of symptoms of kidney failure (i.e. use of diuretics to increase volume of urine and reduce swelling, treatment of nausea and vomiting etc).
    Lipid lowering therapy and correction of anemia.
    Avoid painkillers (such as non-steroidal anti-inflammatory drugs), avoid certain natural medicines contain heavy metals and toxic substances which can cause damage to the kidney, give up smoking and tobacco products and limit alcohol intake to protect kidneys. Additional information on Chronic Kidney Disease: Treatment, Page : 53
  • How is anemia in CKD treated?
    Supplementing iron and vitamins is the first step to treat anemia due to CKD. Severe anemia, or anemia not responding to drug therapy, needs injections of synthetic erythropoietin. Erythropoietin injection is safe, effective and the most preferred method of treating anemia due to CKD. Additional information on Chronic Kidney Disease: Treatment, Page : 58

FAQ - Diet in Chronic Kidney Disease

  • What dietary restrictions are advised to patient with CKD?
    To reduce the burden on the kidney with impaired function and to avoid disturbances in fluid and electrolytes balance, patients with chronic kidney disease should modify their diet as per the guidance of the doctor and the dietician. Dietary advices usually given are:
    Salt restriction in patients with high blood pressure and swelling.
    Limiting the intake of fluid and water in case of swelling.
    Restriction of potassium and phosphorous.
    Restriction of protein intake to 0.8 gm/kg of body weight/day. Supply adequate amount of carbohydrate, vitamins and trace elements. Additional information on Diet in Chronic Kidney Disease, Page : 195
  • Why must patients of CKD take precautions in fluid intake?
    As the kidney functions worsen in patients with CKD, the volume of urine usually decreases. Reduced urine output leads to water retention, causing puffiness of the face, swelling of the legs and high blood pressure. Accumulation of fluid in the lungs causes shortness of breath. Inadequately treated, severe breathlessness can be fatal. To avoid these problems, fluid restriction is advised in patients of CKD with swelling. Additional information on Diet in Chronic Kidney Disease, Page : 198
  • Why are CKD patients advised to restrict potassium in diet?
    Removal of excess potassium in the urine may be inadequate in patients with chronic kidney disease, which can lead to high level of potassium in the blood (hyperkalemia). High potassium levels can cause severe muscle weakness or an irregular heart rhythm which can be dangerous. When potassium is very high, the heart can stop beating unexpectedly and cause sudden death. To avoid serious consequences of high potassium, CKD patients are advised to restrict potassium in diet. Additional information on Diet in Chronic Kidney Disease, Page : 204

FAQ - Dialysis

  • What is dialysis?
    When kidneys no longer function, dialysis is an artificial process by which waste products and unwanted water is removed from the body. It is a life saving kidney replacement therapy for patients with severe kidney failure. There are two main types of dialysis - hemodialysis and peritoneal dialysis. Additional information on Dialysis, Page : 59
  • When is dialysis needed in CKD?
    When kidney function reduces by 85 to 90 % (end stage kidney disease -ESKD), kidneys no longer remove enough wastes and fluid from the body and that leads to symptoms such as nausea, vomiting, fatigue, swelling and breathlessness. At this stage of CKD response to medical management is inadequate and the patient needs dialysis. A patient with CKD usually needs dialysis when blood test shows 8.0 mg/dl or more serum creatinine. Additional information on Dialysis, Page : 59
  • What is CAPD?
    Continuous Ambulatory Peritoneal Dialysis (CAPD) is a widely accepted and effective modality for the patients with end stage kidney disease. CAPD can be carried out by a person at home without the use of a machine. As CAPD provides convenience and independence it’s a popular dialysis modality in developed countries. Additional information on Dialysis, Page : 74
  • How is CAPD done?
    Continuous Ambulatory Peritoneal Dialysis (CAPD) is done at home, usually without a machine. In CAPD a soft tube called a catheter is inserted in the abdomen. Through the catheter, dialysis solution is infused into the abdominal cavity. Dialysis fluid (dialysate) remains in the peritoneal cavity for hours (dwell time), during which process of purification occurs. Subsequently, PD fluid with waste products and excess fluid is drained out through the catheter. Additional information on Dialysis, Page : 74

FAQ - Kidney Transplantation

  • Who can donate a kidney?
    Healthy persons with two kidneys can donate a kidney if the blood group and tissue types are compatible with the recipient. Generally, donors should be between the ages of 18 and 65 years. A kidney donated by a parent or sibling of the recipeint results in the most successful kidney transplantation. When living kidney donor is not available, the only option is a deceased or cadaver donor Additional information on Kidney Transplantation, Page : 83

FAQ - Deceased Kidney Transplantation

  • What is “Brain Death”?
    “Brain Death” is a complete cessation (stopping) of all brain functions which do not recover with any medical or surgical treatment. “Brain Death” is a diagnosis in hospitalized unconscious patients on ventilator support. In a patient with “Brain Death”, respiration and the beating of the heart will stop as soon as the ventilator is switched off. Additional information on Kidney Transplantation, Page : 94

FAQ - Diabetic Kidney Disease

  • Why is it important to know about diabetic kidney disease?
    Diabetic kidney disease (diabetic nephropathy) is the leading cause of chronic kidney disease. It is responsible for 40-45 % of newly diagnosed patients of end stage kidney disease (ESKD). Early diagnosis and treatment can prevent diabetic kidney disease. In diabetes with established chronic kidney disease, meticulous therapy can postpone the stage of dialysis and transplantation significantly. So awareness, prevention, early diagnosis and meticulous treatment of diabetic kidney disease are extremely essential. Additional information on Diabetic Kidney Disease, Page : 99
  • How is diabetic kidney disease diagnosed? Which test detects it at the earliest?
    There are no symptoms in the early stages of diabetic kidney disease and detection of the disease is possible only with laboratory tests. Two most important tests used to diagnose diabetic kidney disease are the urine test for protein and the blood test for creatinine (and eGFR).
    The ideal test to detect diabetic kidney disease at the earliest is a microalbuminuria test of urine. In Type 1 diabetes, this test should be done after 5 years of onset of diabetes and every year subsequently. In Type 2 diabetes, microalbuminuria test should be done at the time of diagnosis and every year subsequently.
    In absence of availability of microalbuminuria test, the next best diagnostic test is the urine test for albumin by standard urine dipstick test. Detection of macroalbuminuria by urine dipstick test is a simple and cheap method, which is available even in small centers of developing countries and therefore is an ideal and feasible option for the mass screening of diabetic kidney disease.
    Re Additional information on Diabetic Kidney Disease, Page : 102
  • How to prevent diabetic kidney disease?
    Important measures every diabetic should follow to prevent diabetic kidney disease are:
    1. Regular follow up with the doctor.
    2. Achieving the best control of diabetes. Keep HbA1C level less than 7.
    3. Keep blood pressure below 130/80 mmHg. Early use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) group of antihypertensive drugs.
    4. Restrict sugar and salt intake and eat diet low in protein, cholesterol and fat.
    5. Check kidney at least once a year by urine test for albumin and the blood test for creatinine (and eGFR).
    6. Other measures: Exercise regularly and maintain ideal weight. Avoid alcohol, smoking, tobacco products and indiscriminate use of painkillers. Additional information on Diabetic Kidney Disease, Page : 106
  • How to treat diabetic kidney disease?
    Important measures to treat diabetic kidney disease are proper control of diabetes and blood pressure, early use of angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are antihypertensive drugs, diuretic drugs to reduce swelling, other supportive medications and dietary restrictions. Additional information on Diabetic Kidney Disease, Page : 106

FAQ - Polycystic Kidney Disease

  • How is the kidney affected in PKD?
    In PKD, multiple clusters of cysts (fluid-filled sacs) of variable size (diameter ranging from a pinhead to as large 10 cm. or more) are seen in both kidneys. With time the size of cysts increases, which slowly compress and damage healthy kidney tissue. Such damage in long term leads to hypertension and reduction of kidney function, causing chronic kidney failure. Additional information on Polycystic Kidney Disease, Page : 109

FAQ - Living with a Single Kidney

FAQ - Stone Disease

  • What are the characteristics of abdominal pain due to urinary stone?
    The severity and the location of the pain due to urinary stone vary from person to person depending upon the type, the size and the position of the stone within the urinary tract. Stone pain can vary from a vague flank pain to the sudden onset of severe unbearable pain. Pain is aggravated by change of posture and vehicular jerks. The pain may last for minutes to hours followed by relief. Waxing and waning is the characteristic of the pain caused by a urinary stone. Additional information on Stone Disease, Page : 130
  • Can kidney stones damage the kidney?
    Yes. Stones in the kidney or ureter can block or obstruct the flow of urine within the urinary tract. Such obstruction can cause dilatation of kidney. Persistent severe dilatation due to blockage can cause kidney damage. Additional information on Stone Disease, Page : 131
  • How to treat urinary stones?
    The treatment of urinary stones depends on the degree of symptoms observed, size, position and cause of the stone, and the presence or absence of urinary infection and obstruction. Two major treatment options are conservative treatment and surgical treatment. Most frequently used surgical methods are extra-corporeal shock wave lithotripsy (ESWL), percutaneous nephrolithotripsy (PCNL), ureteroscopy and in rare cases open surgery. Additional information on Stone Disease, Page : 137

FAQ - Benign Prostatic Hyperplasia (BPH)

FAQ - Kidney and Drugs

FAQ - Nephrotic Syndrome

  • What is nephrotic syndrome?
    Kidney works as a sieve (filter) in our body which removes waste products and extra water from blood into urine. In nephrotic syndrome the holes of these filters become large, so protein leaks into the urine. Because of the loss of protein in urine, the level of protein in blood falls. Reduction of protein level in blood causes swelling. Depending on the amount of protein lost in the urine and reduction in protein level of blood, the severity of swelling varies. The kidney function, per se, is normal in most patients of nephrotic syndrome.
    Additional information on Nephrotic Syndrome, Page : 162

FAQ -Urinary Tract Infection in Children

  • What is Voiding Cystourethrogram test used in children with urine tract infection?
    Voiding cystourethrogram - VCUG (previously known as Micturating cystourethrogram - MCU) test is most often needed in the evaluation of urinary tract infection in children. In this special X ray test, the bladder is filled with contrast medium through catheter under sterile precautions. After the bladder is filled, catheter is removed and the patient is asked to pass urine. X rays taken at intervals during urination show outline of the bladder and urethra. This test is helpful to diagnose backflow of urine into the ureters and kidneys (known as vesicoureteral reflux) and the structural abnormalities of urinary bladder and urethra. Additional information on Urinary Tract Infection in Children, Page : 179
  • How is vesicoureteral reflux treated?
    The management of vesicoureteral reflux (VUR) depends on the grade of reflux, age of children and symptoms. Children with mild VUR are treated with appropriate antibiotic to control sepsis followed by long term antibiotic prophylaxis to prevent UTI. Surgery and endoscopic treatment are reserved for severe VUR or for those cases where antibiotics have been ineffective. Additional information on Urinary Tract Infection in Children, Page : 186

FAQ - Bedwetting

  • Is bedwetting a serious problem in children?
    No. Bedwetting is very common especially under the age of 6 years. But/However investigations and treatment are necessary if bedwetting continues after the age of seven or eight years, if bedwetting occurs during the day time or if the child has fever, pain, burning and frequent urination. Additional information on Bedwetting in Children, Page : 193