Due to the changing lifestyle and bad eating habits of people today, many people have started getting kidney disease. Among these, kidney failure is a significant problem. The number of kidney patients in our country is increasing daily. Thousands of people die every year due to kidney disease. In case of complete failure of both kidneys, the patient is left with life-long dialysis or a kidney transplant. Based on a conversation Shanti Sharma had with Women's Health, DM Nephrology, Neuro Cardio and Multispecialty Hospital, Dr. Nishant Bhurtel, which one looks best considering both methods:
1. What is the function of the kidney?
The kidneys are an essential part of our body. Kidneys purify the body's blood and remove unnecessary things from the body. Kidneys filter toxic substances in the blood, balance water, produce hormones needed to make red blood cells, and manage glucose.
2. What is kidney failure?
When the kidneys can't do their job correctly, many problems appear in the body. When the kidneys stop functioning, kidney failure happens. Kidney failure is viewed in two ways: short-term and long-term. Short-term means any kidney problem that is less than three months old or the problem that appears for the first time and which can be cured is called a short-term problem. But if the problem is more than three months, creatinine is high, and kidney size is decreasing, it is a chronic problem.
3. Causes of kidney failure
There are many causes of kidney failure. In which the leading cause of kidney damage is diabetes (sugar).
- Diabetes,
- High blood pressure,
- Renal enteric disease
- In case of kidney infection,
- kidney stones,
- Randomly taking painkillers
- If there is a hereditary disease or kidney failure due to diabetes of the father and mother in the family, then the problem of kidney failure occurs in sons and daughters. Therefore, diabetes should be checked from time to time.
4. Symptoms of kidney disease
- Very tiring
- Having high blood pressure
- Too loud
- Breathing
- Aching bones
- Foamy and bloody urine
- Stopping urination
- Increase in anemia
Since the symptoms of kidney failure are not very severe, many people go to the hospital only after kidney failure. Therefore, if you see any of the above symptoms, go to the hospital immediately for examination to treat it as soon as possible.
In the case of chronic kidney problems, only two options are left.
dialysis
Kidney transplant
What is dialysis?
Dialysis is one of the treatment options for chronic kidney failure. When the kidney cannot perform its regular function, the method of artificial kidney function is called dialysis. Dialysis is done in two ways: hemodialysis and peritoneal dialysis.
Hemodialysis: Hemodialysis is usually done. This is also called blood dialysis. Hemodialysis is artificially purifying blood through a machine by going to the hospital 2/3 times a week.
Peritoneal Dialysis: It is a method of purifying blood that involves inserting a plastic tube (catheter) into the abdomen and administering water (dialysate) to it via surgery.
In what cases is dialysis necessary?
- Dialysis is necessary if the symptoms and reports are alarming despite the long-term kidney patients being treated with drugs. In this case, the patient needs dialysis.
- Dialysis should be started in an emergency if the blood pressure increases.
- Dialysis should be started if the patient hears too much or if the legs cannot bear it.
- If the amount of salt (potassium) in the body is too high, it can even kill, so even if potassium is increasing in the report, dialysis should be started.
- Dialysis should be started even when the amount of acid in the body is very high.
- If the amount of creatinine is increasing (above 10, 12, 14), the doctor uses the GFR formula to extract a value from which it is known how much the kidneys have worked. This value is 100 in normal people, but it decreases in kidney patients, and dialysis should be started even if it is less than 10 in this patient. This is known only when creatinine rises.
Things to keep in mind while doing dialysis:
- After kidney disease, first of all, it is necessary to pay attention to diet. Not only dialysis patients but kidney patients, diabetics, and high blood pressure patients should first increase their salt intake.
- Eat less salt
- Drinking regardless of the amount of urine (500 ml to 1 L only)
- Don't eat sour things (lemon, orange). It increases potassium
- Don't eat packet food
- Red meat
- Don't eat too many green vegetables
- Avoid infection
- Periodic blood tests
How long should dialysis be?
Dialysis is such a treatment method that, once started, life cannot be continued without dialysis. Kidneys do not return to normal after dialysis. Dialysis can only lead to a better and longer life. On average, a person who has undergone dialysis lives for 8 to 10 years. However, according to the doctor's advice, if he takes medicine, does dialysis, and pays attention to his diet, there is also a record of 40 years of life after dialysis. If you do dialysis properly, you can live, but during dialysis, other health problems will also occur, such as infections and heart problems, which will make the body heavy.
Treatment
The world's best treatment for chronic kidney disease is kidney transplantation. In case of failure of both kidneys, the only option left for the patient is to remain on dialysis for life or to undergo a kidney transplant. By all measures, a kidney transplant looks excellent. However, a kidney transplant only solves some of the patient's problems. However, since it is difficult to get a kidney for transplantation, it is better if dialysis is appropriately done.
Dialysis situation in Nepal?
The government of Nepal has done a commendable job by providing free dialysis. In a poor country like Nepal, it is an excellent job of the government to provide life-sustaining treatment like dialysis for free and to give an additional Rs 5,000 for medicines. Currently, the government is trying to increase dialysis facilities in 77 districts. However, as the number of kidney patients has increased recently, hundreds of patients are still waiting for dialysis.
Currently, the number of free dialysis machines in Nepal is around 500 to 1000, and 100 dialysis centers and approximately 5000 patients are taking the service. The government is still preparing to add more dialysis machines.
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