Dr. Vijay Kher is the Chairman of the Kidney and Urology Institute at Medanta – The Medicity, Gurgaon. He is one of the best nephrologists in the country and has treated many patients throughout his medical career. He shared his views with us on common kidney disorder. Let us have a look.
Interview Questions on Common Kidney Disorder
Here are some answers by Dr Vijay Kher, Chairman of Kidney & Urology Institute at Medanta Hospital, Gurgaon on common kidney disorder.
Question 1: The consumption of sugary beverages is on the rise in India. They are specifically popular among children. How do these drinks affect a person’s kidney health?
Answer: We need to understand that diabetes is the most common reason for kidney failure. 40 – 50% of kidney failure is related to diabetes. The reason behind this is obesity caused by sugary drinks and unhealthy food. There are many studies which show that obesity is increasing in school children because of their diet and an inactive lifestyle. Because of an increase in obesity, the blood pressure will increase, which may have long term effects.
Fortunately, the disease like hypertension and diabetes takes around 15-20 years to affect the kidney functions. So we have time to cure these disorders by following a good diet and a healthy, active lifestyle.
Question 2: How can a person keep their kidneys healthy and clean in their everyday lifestyle?
Answer: The only thing that can keep your kidney healthy and clean is a healthy lifestyle. People should have healthy food, a reasonable amount of fruits and vegetables. This doesn’t mean that non-vegetarian food should be avoided but try to keep it in a moderate amount. Do some physical activity or exercise every day.
Also, drink a good amount of water to keep your body hydrated. Generally, a person should drink 2-2.5 litres of water every day. Make sure you avoid sugary drinks. All these key points are beneficial for heart, diabetes and also for kidney disease.
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Question 3: High Blood Pressure is the second cause of kidney diseases. But hypertension is generally linked with cardiac health only. How does high bp affect kidneys?
Answer: People have a misconception that high blood pressure is only linked with heart. Well, there is no heart disease which can be caused by high blood pressure, alone. Every kind of blood pressure is linked with kidney functions.
High blood pressure can lead to kidney disorders. We can say that uncontrolled blood pressure damages your kidney functions.
Question 4: What are the particulars about kidney transplant, that a patient should know?
Answer: Kidney transplant is needed only when the kidney is irreversibly damaged. The doctors should try to preserve the kidney function as much as they can. If the reason for the kidney disease is blood pressure or diabetes, then the doctors will try to control these factors first.
If all things fail to preserve the kidney functions, they suggest kidney transplant. The transplantation is kept as the last option for the treatment of kidney disease.
The second most important thing for patients to know is that they have to continue the medicines for the rest of their life to avoid any kind of difficulty. The patient should never avoid the medicines, even for a single day. This could increase the chances of rejection. Sometimes, this rejection becomes very difficult to manage.
Apart from that, the patient needs to keep a check on their diet. They should come for a regular follow-up and try to be in touch with their doctor in case of any complication.
After 2-3 months of transplant, the patient can get back to his regular life. They should follow the doctor’s advice and take regular medication as per the direction.
Question 5: Is transplantation the only treatment for an End-stage renal disease? What alternatives does one have?
Answer: Without any doubt, transplant is the best treatment for end-stage kidney disease. The way to define kidney failure is that kidney function has irreversibly deteriorated to less than 10%. That’s what we called end-stage kidney disease. There is no reversible factor and no medicines which can help at this stage. But this doesn’t mean it’s the end of life.
In such conditions, we have two alternatives. First is a kidney transplant, and the second option is dialysis. Dialysis is of two types – Hemodialysis and Peritoneal dialysis.
Hemodialysis means purification of blood by using a machine and a filter to remove the water and waste product from the blood. This process takes four hours and needs to be done three times a week.
Peritoneal dialysis includes a small surgery to implant a peritoneal dialysis (PD) catheter into the abdomen of the patient. This will help filter the blood through the peritoneum. During this process, a fluid called dialysate flows into the peritoneum which absorbs the waste products from a patient’s body. Once the waste is drawn out of the bloodstream, it is drained from the abdomen. This process can be performed at home after specific training. It takes around 2 hours and needs to be done 3-4 times per day.
Both types of dialysis are equal in terms of outcomes. Only the complications are different in each case. In hemodialysis, the patient has to visit specific dialysis units which may lead to various complications such as infections, hepatitis A, B, or some kind of bacterial infections. Similarly, the risk involved in Peritoneal dialysis is peritonitis.
Both types of dialysis are equally good. But transplant is the best treatment option. The only major complication for a kidney transplant is to find a right and potential donor.
About The Doctor
Dr Vijay Kher is the Chairman of the Department of Kidney and Urology Institute at Medanta -The Medicity, Gurgaon. With more than 40 year of experience, doctor Kher is among the best nephrologist in India.
He has completed his MBBS from Glancy Medical College, Amritsar in 1973, MD from PGIMER, Chandigarh in 1977, DM in nephrology from PGIMER, Chandigarh in 1979, Research Fellowship Hypertension from Henry Ford Hospital, Detroit, USA in 1981 and Clinical Fellowship Nephrology from University of Cincinnati, Medical Centre, USA in 1983 and FRCS from The Royal College of Surgeons (RCS), the United Kingdom in 1987.
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