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Did You Know?

  • Chronic Kidney Diseases affect 10% of the world’s total population.
  • New patients diagnosed with End Stage Kidney Disease (ESKD) starting on dialysis or transplantation is over 100,000 per year.
  • In India many Kidney fatalities go undetected due to lack of awareness.
  • Often the disease itself turns chronic due to lack of awareness.
  • Chronic kidney disease affects approximately 10% of the world's population.
  • As per national registry roughly 2 lakhs people die of advanced kidney disease every year in India, but the original figure maybe even bigger.
  • Our research reveals that almost 1 out of 11 Indian suffers from chronic kidney disease.At present dialysis requiring patient in India is cumulatively 2.2 lakhs per year. In the coming year the burden of dialysis requirement will reach crores.
  • The Nephrologist to patient ratio in India at present is 1:72000.
  • No symptoms surface till almost 70 percent of the kidney functions are compromised. By then it is too late to take any course, other than transplant and dialysis.

Symptoms of kidney diseases can be many. They are as follows:

  • Tiredness
  • Nausea & Poor appetite
  • Swollen feet and ankle
  • Puffiness around eyes, especially in the morning
  • Frothing in urine
  • Anaemia
  • Uncontrolled blood pressure
  • Frequent urge to pass urine, especially during the night
  • Forgetfulness
  • Disturbed sleep
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KIdney Disease Awareness : True Story of Mr. Subir Pattanayak

Some medicine can be deadly for kidneys. Avoid this to stay safe.

  • Diclofenac
  • Nimesulide
  • Ibuprofen
  • Ketorolac Tromethamine
  • Aceclofenac
  • Aspirin ( High Dose)
  • Celecoxib/ Rofecoxib
  • Piroxicam
  • Ketoprofen

Beware of NSAIDs in combination with Paracetamol. This combination can be toxic.

  • Environmental toxins can enter our body orally, transdermal or through inhalation. All the toxic material generated in our body, or introduced in our body from the environment is handled by the kidney, and thus they are highly vulnerable to the effects of environmental toxins. Environmental toxic mediated Chronic Kidney Disease (CKD) is another emerging threat to the society.
  • Glycophosphate use in fertilizer can cause CKD. Recent research has also shown that pesticides containing beta-endosuplhan, aldrin, and alpha-HCH can cause kidney injury in healthy adults if these pesticide applied crops and vegetable are consumed.
  • Organochlorine pesticides such as DDT and endosulfan are banned in many countries but in India they are still being used.
  • Heavy metals such as cadmium (Cd), mercury (Hg), lead (Pb), chromium (Cr) and platinum (Pt) are a major environmental and occupational hazard. Exposure to heavy metals is potentially harmful because of its ability to reabsorb and accumulate divalent metals; the kidney is the first target organ of heavy metal toxicity. Heavy metal toxication may cause nephropathies, with various levels of severity, from tubular dysfunctions like acquired Fanconi syndrome to severe renal failure and occasionally may lead to even death.
  • We breathe air to sustain our lives but latest studies shows air contaminated with fine particulate consisting of strong particles obtained from combustion of coal, petrol and diesel matters have adverse effects on kidneys.
  • Melamine is an organic nitrogenous compound used in the production of plastics, dyes, fertilizers, and fabrics. A variety of toxic effects from melamine, including nephrolithiasis, chronic kidney inflammation and bladder carcinoma etc have been reported. Melamine dinnerware are often used in our daily life but it is better to avoid and melamine dishes and bowl should never be used in the microwave.
  • Formalin is a cadaverous chemical. In recent days, use of formalin has alarmingly increased specifically in fishes, fruits and many other food items, exposing the large majority of the population to severe health risks like renal failure, liver diseases, if they are consumed regularly.
  • Bisphenol A or BPA is the highest volume chemical produced in the whole world and is widely used in the production of polycarbonate plastics and epoxy resins. Polycarbonate plastics are used to make common household products as well as other consumer products. We often use plastic bottles for storing and drinking water, storing food products and with many more uncountable consumer products which may actually be hazardous to our health. We must know how to avoid BPA products for the sake of our own health.

Introduction: Failure of vital organs like kidney liver heart is very common and serious health problem nowadays. Though with improvement of supportive care patients with organ failure can live a compromised life for few more years but only intervention that can offer them near normal life is Organ Transplantation. Now organs cannot be manufactured someone need to donate. A living person can donate one of his two kidneys, part of liver but cannot donate heart cornea or other vital organs. Unfortunately there are scarcity of organ donors and gross mismatch between demand and availability. If we look at the statistics of our own country, in India roughly we need 1,75000 kidney transplantation per year, to save our kidney failure patients however due to scarcity of donors and other issues hardly we can perform 5000 kidney transplantation. Similarly with regards to liver failure where we need roughly 50,000 liver transplantation a year, as per our national need hardly we can perform 700liver transplantation a year. Same level of demand supply mismatch is there in regard to heart failure patients (50,000 vs 30, pancreas, and blind patients (100000 vs 25000). The only plausible solution to bridge the gap of huge demand supply mismatch is more and more cadaver organ donation and successful cadaver transplantation programme.

We are talking about cadaver transplant but what is a Cadaver?

In a critically sick patient when there is permanent loss of brainstem function ie patient cannot take breath on his own and is fully dependent on ventilator, not sensing light sound or pain, a patient can be certified as dead even his heart is beating. It is approved all over the world even in our country brainstem death is legally accepted as death. After the brain stem death gradually over time the heart stops and cardiac death happens. The interface between certification of brainstem death to occurrence of cardiac death a patient is called cadaver. After brain stem death there is no scope of survival, but if timely intervention is done some of his organs like kidney liver heart can be transplanted to respective organ failure patient who need those organs. However after cardiac death as circulation stops, all the organs start decaying and they are of no use.

If after Brain stem death a person is otherwise dead why do common people hesitate to donate organ?

The reason is just lack of awareness. We need to understand life starts with breath not by heartbeat. Similarly life ends with cessation of capacity to take breath. As breathing and heart beating is inter connected once someone fails to take breath automatically his hearts stops and conventionally we call someone as dead. But with advancement of medical science it is possible when some ones breathe stops permanently with ventilator and other critical care support to keep his heart beating for few hours to days. All over the world people accept brain stem death as death and hence they don’t hesitate to donate organ. But in our country though government has legalized brain death certification till awareness regarding this area is gleam and people still believes cardiac death as death and hesitate to take decision for organ donation and hence huge number of healthy organs which otherwise could be transplanted are wasted.

My near and dear one is dying and doctors are telling about organ donation how should I accept that?

We need to understand one hard reality of life that death is inevitable. Everyone who has born, enjoyed life has to die one day. Question of organ donation comes when someone is brainstem dead but still some of his organ has not yet decayed and can be transplanted. We need to understand clearly brainstem death is medically and legally accepted death all over the world. There is no scope of survival after brain stem death. If we don’t accept this hard reality ultimately cardiac death happens and the organs which otherwise could be transplanted to save some one’s life will be decayed and they need to be either burned or buried. In all civilized society people accept this reality and come forward for donation. In my view donation of organ after brainstem death makes a person partially alive in some one’s body after his / her death. In Spain every 32 death one donation happens where as in India the rate of donation is 0.6 in per 10,000 deaths.

Can a person who dies at home donate his organs?

We need to understand once heart stops, blood circulation stops and major internal organs like kidney, liver, heart, pancreas starts decaying and hence they cannot be transplanted. In majority of the household death we don’t gets the opportunity to harvest healthy organs and hence their utilization as circulation stops permanently. However cornea, skin, bone, heart valves can be harvested and transplanted if collected in proper time.

What are the common organs a brain stem dead person can donate?

Two kidney to two renal failure patient, one liver to one liver failure patient (sometime in part can be donated to two recipient), heart to one heart failure patient, two lungs to two respiratory failure patients, two cornea to two blind patient. Other organ or tissue, which also can be of use, is pancreas, intestine, skin, bone, heart valves. In other word a brainstem death person can save life of so many organ failure patients, he can remain alive in so many persons life.

Whom to contact for Organ Donation?

If you take decision of organ donation of your near and dear relatives who is critically sick please express your concern to treating physician or hospital management or ROTTO office immediately the necessary steps would be taken.

Is there any re-imbursement if someone donates organ to their family?

The organ donation means organs which otherwise could be burned or buried are utilized for noble cause of saving some one’s life. There cannot be any financial benefit in this regards and law does not permits any such activities. However once brain stem death declared since then to till transplant of the organs all expense should be beard by hospital, legally hospital cannot charge to patient’s relative.

Is cadaveric transplantation is happening in India?

Yes in recent time there is significant improvement in general people’s awareness about cadaveric organ donation and transplantation. In Chennai, west India like Mumbai, Gujarat, north India like Delhi, Indore cadaveric transplant is regular happening. Slowly Bengal is also gearing up. In 2016, since June to December 6 cadaveric organ donation took place in the city of Kolkata, this year a week ago another cadaveric organ donation took place in SSKM hospital. More and more public awareness in needed in this regard and mass media and all stakeholders needs to selflessly involve in this noble cause.

  • Kidneys are bean-shaped excretory organs located near the middle of the back, just below the rib cage, one on each side of the spine.
  • The kidneys remove toxins out of the body. In a simple way the kidneys can be compared with a sieve.
  • When kidneys become sick, they cannot perform the filtration process and a number of metabolic waste products accumulate in the blood.
  • Measuring level of some of these chemicals in the blood can give us an idea about the functional status of our kidney. Most commonly used markers are Urea and Creatinine.
  • Kidney diseases are classified as Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD).
  • When Kidney damage takes place due to sudden biochemical or hemodynamic insult to the kidney tissue resulting the malfunction of the organ then it is called AKI.
  • Common example of AKI is renal failure after severe diarrhoea/ or massive blood loss due to some accident.
  • In majority of cases if treated properly, AKI has high chances of complete recovery. But sometimes AKI may lead to permanent loss of kidney function, if not intervened in time, or if the injury is severe and beyond the point of recovery.
  • When kidney disease starts silently and kidney function detoriorates gradually then it is called chronic kidney disease or CKD.
  • Most of the chronic kidney diseases lead to permanent loss of renal function.
  • A person may have “silent” kidney disease for years without any symptoms.
  • CKD gradually leads to ESRD or end stage renal disease where kidneys are almost inactive.
  • Many patients are detected with CKD when they have already lost most of the kidney function.
  • The only way to detect CKD is to check Serum Urea, serum Creatinine and loss of protein through urine. These are the markers for renal function.

Permanent loss of total or nearly total kidney function is called end-stage renal disease (ESRD). People with ESRD cannot live without renal replacement therapy.

When both the kidneys stop working, we require some mechanism to supplement the work of the kidneys in order to sustain life. The three commonly practiced interventions are Hemodialysis/Peritoneal dialysis/and Renal Transplantation. Altogether, these modalities of treatment are referred to as “Renal Replacement Therapy”.

  • Dialysis or Hemodialysis is advised to patients with end stage renal failure as the most common modality of renal replacement therapy.
  • Blood is passed through a special filter/dialyzer, which cleans/ purifies blood and is then returned to the body.
  • Depending on the clinical condition of the patient, it is given 1-3 times per week or more and takes 4-5 hours for each session.
  • For dialysis, a permanent access is required to pull the blood out of the body and after filtration to return it back to the body.
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There are lots of misconceptions regarding dialysis. The word dialysis itself creates fear. M. But the practical scenario is very different. With the support of proper diet, lifestyle changes and application of right medications a dialysis patient can have a good and long life.

This is the best possible solution for a renal failure patient but getting organ is a complicated procedure. Until an altruistic donor donate kidney or deceased person’s organ is available renal transplant is not possible. Renal transplant is done by a team of doctors. At first the health of donor and donor’s kidney function is checked. If donor is found healthy compatibility with recipient is checked. After thorough check up team of doctors approves a renal transplant. After a successful kidney transplant a renal patient gets back normal renal function but they must follow the prescribed medication dietary advice and suggested lifestyle modification.

  • Kidney disease is a silent killer.
  • This disease progress gradually and until major kidney function is compromised no symptoms are observed.
  • If CKD is diagnosed in critical stages then nothing much can be done for the patients. Then dialysis or transplant are the only modalities to follow.
  • Both dialysis and transplant are expensive and complicated procedures so it is always better to prevent renal disease than to treat it.
  • Hypertension and diabetes are two major causes for renal dysfunction.
  • NSAID group of pain killers and many antibiotics are bad for kidney and may cause renal dysfunction.
  • Everyone should check serum urea, serum creatinine and protein leakage in urine to detect renal dysfunction in early stages.
  • Awareness about renal dysfunction can save lives of many people.
  • Those who have high blood pressure, diabetes or have any sort of family history of renal disease must check renal health regularly.
  • The Kidney Care Society suggests that everyone should check renal function on their birthday. It is more meaningful than celebrating birthday with a birthday cake.
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  • GFR or the Glomerular Filtration Rate is the best way to check the renal health.
  • Normal GFR ranges between 90ml/min to 120ml/min.
  • For a rough estimation of the GFR, we simply need the blood creatinine value and the patient’s body weight age, sex and race.
  • From these data, GFR can be calculated by MDRD or CG formula. Depending on the GFR the stages of kidney disease are determined.
  • Dialysis can help a renal failure patient to survive but it cannot be efficient like the natural kidney.
  • Renal transplant is the best way out for the renal failure patient. But for that an altruistic donor or availability of a deceased person’s organ is required.
  • A person can maintain good health with one kidney so one kidney can be donated to save a life.
  • Organs can be transplanted from a brain dead person. After death we destroy the natural organs which can save other lives so everyone should come forward to increase the number of deceased organ donation. (Please see the deceased person’s organ donation FAQs) .

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Kidney Facts

Symptoms of kidney diseases can be many. They are as follows:

  • Tiredness
  • Nausea & Poor appetite
  • Swollen feet and ankle
  • Puffiness around eyes, especially in the morning
  • Frothing in urine
  • Anaemia
  • Uncontrolled blood pressure
  • Frequent urge to pass urine, especially during the night
  • Forgetfulness
  • Disturbed sleep