Facts On Kidney Care

The world kidney day (WKD) this year is on 14 March 2019, and the theme for this year is Kidney Health for Everyone Everywhere. The global burden of kidney related problems is very huge and nearly 850 million people worldwide are now estimated to have kidney diseases from various causes.

 There are so many misconceptions related to kidney problems amongst the ordinary people. Therefore we will take this occasion to uncover a few misconceptions related to kidney diseases
 and clarify with factual information for the ordinary people, says Dr.Sukant Kishore Das.
Dialysis once performed, will always be required subsequently.

Actually it depends on the underlying cause of kidney failure. Acute kidney failure is of short duration and and mostly a reversible type of kidney failure.Most of the patients of acute kidney failure who need dialysis for a short period rarely require dialysis in the long run. Their kidney functions returns to normal after treatment of the cause behind the acute kidney failure. Delay in dialysis because of fear of permanent dialysis can be life threatening in such cases.Only Chronic kidney disease causes a progressive and irreversible type of kidneyfailure and in chronic kidney disease stage 5 (End Stage Kidney Disease) lifelong dialysis support is required.

Dialysis can cure kidney failure.

No, dialysis does not cure kidney failure. Dialysis is an appropriate
and life saving treatment in kidney failure. It carries out the function that kidney is no longer capable of doing, such as removal of waste toxic products, excess water and corrects electrolytes as well as acid base disturbances. Dialysis keeps patient asymptomatic, fit and healthy in spite of severe kidney failure.

Once a kidney disease occurs it cannot be cured .

Actually all kidney diseases are not incurable.Many kidney diseases can be curedwith early diagnosisand treatment. Treatment started early often slows orhalts the progression of kidney diseases.
Kidney failure can occur even if one kidney fails.

Fortunately people do not have any problem if one kidney fails completely, and in such cases, value of blood urea and serum creatinine in blood tests are usually normal.But when both kidneys fail, toxic  products accumulate in thebody and the raised level of blood urea and serum creatinine in bloodtest suggests kidney failure. Actually kidney failure occurs only when both kidneys fail.

Presence of oedema (swelling of body) suggests kidney failure.

No, oedema can occur due to many diseases, such as heart ,liver ,thyroid and kidney diseases etc.Sometimes in certain kidney diseases oedema is present, but kidneyfunction is totally normal (e.g. nephrotic syndrome).

If there is no oedema (swelling of body, there is no kidney failure.

Oedema may be present in majority of patients with kidney failure, but not in all. A few patients do not have oedema even in advance stage of kidney failure. So the absence of oedema does not rule out kidney failure.

All patients with kidney failure have a reduced amount of urination.

Some times in early stages of kidney failure the urine output quantity may be still normal, but the serum creatinine may be higher than normal values. Only in advanced stages of kidney failure,urination decreases.

Drinking  a large amount ofwater prevents against kidney failure ?

 Actually requirement of water varies from person to person ,and people should drink water according to their thirst and according to seasonal requirements and avoid excessive dehydration . Only patients suffering from stone disease and urinary tract infection withnormal renal function are advised to drink a large amount of water. Those with reduced urine output due kidney failure are advised for water restriction.

Since there are no symptoms there is no kidney problem underlying?
Unfortunately in early stages, only clue to detecting underlying problem is getting urea and creatinine tests in blood, as most patients otherwise may have no clear symptoms.

Kidneys are normal if serum creatinine level is slightly above normal?

In early stages, chronic kidney disease is usually asymptomatic, and increased value of serum creatinine may be the only clue of underlying kidney disease. Serum creatinine level of 2 mg/dl means over 50% of kidney function is already lost, which is significant.Treatment under the care of a nephrologist at this stage ofchronic kidney disease helps to preserve kidney function for a verylong time.When serum creatinine level is 4.0 mg/dl, it means 45% of kidney function is lost. This value suggests seriously impaired kidney function.Proper treatment at this stage is beneficial to delaydisease progression .When serum creatinine level is 8 mg/dl, it means nearly 85% of kidneyfunction is lost and this value suggests end stage kidney disease. Most of the patients need dialysis or transplant at this stage.

A woman can not get pregnant and give childbirth after having transplantation?

A woman who has had a kidney transplant usually has more regular periods and better general health. Therefore, it is easier for her to get pregnant and have a child. However, pregnancy is not recommended for at least one year after the transplant, even with stable kidney function. In some cases, pregnancy is not recommended because of risk to the mother's life or possible loss of the transplant.

Women after kidney donation can not give child birth and men lose their sexual function?

Kidney donation is very safe and there is no effect on health and sexual function. Kidney donors live a normal life including marital life and childbirth
Dr Sukant Kishore Das ,DM
Senior Consultant Nephrologist and Kidney transplant physician
AMRI Hospitals Bhubaneswar.

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