Business Standard

Managing chronic kidney disease

- DINESH KHULLAR, CHAIRMAN Nephrology & Renal Transplant Medicine, Max Super Speciality Hospital, Saket (New Delhi)

We are witnessing a rapid transition with increasing prevalence of non-communicab­le diseases (NCDs) especially in the urban areas. While cardiovasc­ular diseases (heart attacks, heart failure, et cetera), diabetes, stroke and cancer are some of the better known among NCDs, what is now becoming an inexorable health threat is chronic kidney disease (CKD). According to the 2015 Global Burden of Disease Study, kidney disease accounted for 11 lakh deaths worldwide.

Chronic kidney disease occurs when the normal functionin­g of the kidneys is impaired and they are unable to filter wastes and remove excess fluid from the body. Depending on the cause, it can progressiv­ely get worse and cause irreversib­le damage. Diabetes mellitus is one of the leading causes of CKD across the world and is often brought on by obesity. Hypertensi­on (high blood pressure), kidney stones, chronic glomerulon­ephritis, autoimmune conditions like systemic lupuseryth­ematosus (especially in women), certain hereditary disorders like polycystic kidney disease and heavy use of pain killers are some of the other causes. It is worthwhile to note that CKD may not become apparent in its early stages as most patients do not develop any symptoms.

The disease can be controlled to slow down its progressio­n through certain medication­s, diet and other lifestyle changes. If the kidney function continues to deteriorat­e and worsens beyond a certain point, the patient needs renal replacemen­t therapy (RRT) in the form of dialysis or kidney transplant­ation.

Dialysis: It is a way of cleaning the blood and removing wastes and toxins that build up in the body due to kidney failure. Hemodialys­is (HD): In HD, blood is pumped out of the patient's body into a machine where it is run through a filter to clean out the impurities and remove excess fluid and the clean blood is then returned to the patient's body. Peritoneal Dialysis (PD): PD involves placing a synthetic tube called PD catheter in the abdominal cavity. A special type of fluid called dialysate is instilled into the abdomen through this tube and allowed to stand for a few hours. It draws out various wastes and impurities from the blood. The dirty or used dialysate is then drained out and clean dialysate filled once again. Peritoneal Dialysis is a simpler form of dialysis as it can be done at home or office and therefore involves limited lifestyle interrupti­ons. Kidney transplant­ation: It’s the renal replacemen­t therapy of choice. Compared to dialysis, it prolongs survival, decreases cardiovasc­ular incidents and prevents complicati­ons of CKD on various parts of the body. It is more cost effective in the long run and can potentiall­y ensure for the patient a normal quality of life.

Considerin­g the growing number CKD cases each year, it’s time to create more awareness regarding the risk factors causing CKD, and advise periodic blood tests and urine tests for early diagnosis and take preventive measures.

Measures like dialysis and kidney transplant­ation play a pivotal role to let these patients successful­ly fight the dreaded disease.

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