SAVE YOUR KIDNEYS

The twin bean-like organ located on either side of the spine is better known as the biochemist of the body. The kidneys filter about 200 litres of fluid every 24 hours and return it to the blood stream. Approximately 1.5-2 litres is eliminated from the body in the form of urine, and the rest is retained. The production of urine involves highly complex steps of excretion and re-absorption, which is necessary to maintain a stable balance of body chemicals.

Kidneys perform crucial functions, which affect all parts of the body. But the kidneys are also vulnerable to a range of problems from a minor urinary tract infection to progressive kidney failure. Advances over the past three decades have improved the ability to diagnose and treat those who suffer from kidney disorders.

Kidney diseases usually affect both kidneys. If the kidney’s ability to remove and regulate water and chemicals is seriously damaged, waste products and excess fluids build-up, causing severe swelling and symptoms of kidney failure.
Different kinds

The different types of kidney diseases are characterised as Hereditary, which can be transmitted to both males and females and generally produce clinical symptoms from teenage years to adulthood; Congenital, which usually involves some malformation of the genitourinary tract leading to obstruction; Acquired, also known as nephritis or inflammation. The most common is "glomerulonephritis".

Kidney failures are not always permanent. Some get better after treatment. With acute kidney failure, dialysis may be needed until the kidneys get better. In Chronic or End Stage Kidney Failure, there is no improvement and dialysis is a must for the rest of the patient’s life. If the patient is in a fit condition, kidney transplant can be one treatment option.

Unfortunately, many kidney diseases are still of unknown cause. Some can be successfully treated while others progress to advanced kidney failure, or End Stage Renal Diseases (E.S.R.D) requiring dialysis and/or transplantation.

Dialysis is performed routinely on persons who suffer from acute or chronic renal failure, or who have ESRD. It involves removing waste substances and fluid from the blood that are normally eliminated by the kidneys. Dialysis may also be used for individuals who have been exposed to or ingested toxic substances to prevent renal failure.
Treatment

Haemodialysis removes waste products from the blood by passing it out of the body, through a filtering system (dialyser) and returning it, cleaned, to the body. While in the filtering system, the blood flows through tubes made of membranes that allows the waste products (which are much smaller than the blood cells) to pass out. The waste products pass through the membrane into a dialysis solution (dialysate), then out of the machine. The clean blood is returned safely to the body. This cycle is repeated throughout the dialysis session. It takes about four hours to complete a session and it needs to be done thrice a week.

In Peritoneal Dialysis, instead of being cleaned by an artificial membrane outside the body, the blood is cleaned inside the body, through the Peritoneum (a thin membrane that surrounds the outside of the organs in the abdomen).The peritoneum allows waste products to pass through it and is very rich in small blood vessels. By running a dialysis fluid into the peritoneal cavity through a tube called Catheter, and then out again, waste can be filtered from the blood.
Two types

There are two types of peritoneal dialysis: Continuous Ambulatory Peritoneal Dialysis or CAPD is done without machines. The patient can do it himself, usually four or five times a day at home or at work, while continuing with regular life. Automated Peritoneal Dialysis or APD is a more refined version. In this the dialysate solution is changed by a machine, at night, while the patient is asleep.

In both cases, the patient can travel, as the bags can be delivered to the visiting areas. In APD the small size of the machine makes it easy to travel.

Kidney transplant or renal transplantation is the organ transplant of a kidney in a patient with end-stage renal disease. There are two sources of kidney donors: Living and Deceased. But before opting for transplant one should thoroughly consult his doctor and get a physical examination done.

The writer is a Consultant Nephrologist based in New Delhi.
Warning signs

Burning or difficulty during urination

An increase in frequency of urination, nocturnal

Passage of bloody urine

Puffiness around eyes

Swelling of hands and feet

Pain in back just below ribs

High blood pressure