Chronic Kidney Disease is a serious condition, affecting 37 million people, often overlooked until symptoms appear. CKD is progressive and can put you at high risk for serious health complications, including kidney failure. To help counter the lack of awareness we at Medicircle are conducting a world kidney day awareness series, featuring eminent nephrologists and neurologists from different healthcare organizations to get their views on maintaining good kidney health.

Dr. Avinash Ignatius is a Senior Consultant Nephrologist and Transplant Physician. He did his DM from AIIMS, New Delhi. He has established and now heads the Department of nephrology at Noble Hospital and also consults at Ruby Hall Clinic Pune. He has been a consultant Nephrologist at Fortis Hospital New Delhi, and Holy Family Hospital New Delhi. Dr. Avinash is a principal investigator in several national and international multicentric clinical research trials. He has been awarded the Pune healthcare Leadership Award 2018 and Icon of Health 2018 by The Times of India.

Early Screening Means Symptoms-Free Life

Dr. Avinash says, “Kidney diseases turning into an epidemic now, but in the initial stages of kidney disease, rarely anyone have any symptoms. Study shows that 1 in 10 adults is having some form of early kidney disease. And 90% of these people are not aware that they have kidney disease. Just as we are aging, kidney gradually ages, kidneys lose about 1% of its function every year. If someone has diabetes or hypertension, the rate of decrease may go up from 1% to 5%. If we're able to identify these diseases, we treat them by diet, medications, lifestyle changes, this rate of decline, which is probably 5 or 6%, gets down to 1 or 2%, the person's kidney can survive much longer. This simply means 15-20 years of symptom-free life. Swelling in the legs or puffiness in the eyes, difficulty in passing urine if not being explained, then we need to diagnose it,” adds Dr. Avinash.

Early Detection is a Lifesaving Step

Dr. Avinash suggests, “Sometimes even people with kidney stones don’t have pain. After performing a kidney test, a person gets to know. A person more than forty having diabetes, Blood Pressure, or a family history of kidney disorder should get their Annual health check-up done especially on your birthdays. This way diagnosing or screening is done at least once a year. Early screening and detection help a lot in preventing many of the deadly diseases and can be a lifesaving step.”

Dietary Suggestion and Lifestyle Changes

Dr. Avinash emphasizes, “Diabetes, BP, obesity, mental stress, lack of exercise, improper diet, having more of non-veg foods, dehydration, high salt intake are some of the factors which can be responsible for lifestyle diseases. 70-80% of a kidney disorder is owing to diabetes, BP and stone. If we do these things in moderation, there will be fewer chances of getting diabetes, BP, or stones which ultimately helps in avoiding kidney disorder.

Not only the medicine but with some dietary suggestions and lifestyle changes can make a huge difference in living a disease-free life. Incorporating changes in lifestyle like avoiding fast food, high sugar, and salt intake and oily things, regular exercise, keeping our weight control helps to sustain a healthy life.”

Water Content and Kidney Disorder

Dr. Avinash explains, “A healthy person generally drinks 7 to 8 glasses of water in a day. Depending on the work environment, we should drink an average of approx. 1.5 to 2.0 liter. For example, those people who go to a regular gym or the person doing physical labor generally sweats a lot, so they need to increase their quantity of fluid intake by 1 to 1.5 liter.

Binge drinking - One should avoid drinking water on a whole, they should divide intake of fluid throughout the day so that our urine remains diluted. Especially people having stones, they should divide their fluid intake in such a way, that the body remains hydrated full day. Even before going to bed, they can drink a handsome amount of water and if they feel to urinate, they should pass the urine and can have water again.” 

Dr. Avinash adds, “Patients with kidney disorder and not having any symptoms, not having problem in micturating, no swelling, they can carry on with their regular fluid intake. But if a person having some symptoms like swelling in the legs, face, breathlessness, decrease in water retention capacity, then they should restrict the fluid intake. Here fluid intake refers to the liquid you are taking throughout your day be it be tea, juice, water, soup, etc. Salt in food is directly proportional to the urge of drinking water. Kidney patients with decrease water retention capacity can’t hold an excess fluid intake. Thus, we should avoid it.”

Dr. Avinash stresses, “Excess of anything is bad for our health, and it applies to everything. For example, the first thing after getting up most of the people do is drink 3 – 4 glasses of water, thinking it will detox the body. They need to understand that requirement of fluid in the body is necessary throughout the day, not only in the morning. This way people end up drinking too much water in a day, which is also not good for the body.”

Kidney Symptoms are Non-Specific

Dr. Avinash clarifies, “The disease doesn’t show any prominent symptoms by looking at which one can decide the body is having any disorder. Lower hemoglobin, restlessness, dark patches on facial skin are some of the symptoms which are associated with the patient of kidney disorder having diabetes. Diabetic patients should get themselves check regularly and if not regularly at least once a year. If their GFR (Glomerular Filtration Rate) is less than 60, then it is a sign to alert and get assessed.”

Dr. Avinash suggests, “Checking urine for protein and creatinine are two simple markers and inexpensive for kidney disease. Urine is being tested for leakage of proteins i.e. Albumin & Creatinine. If the concentration of protein is found higher than the normal values, it signifies the early stage kidney disorder. This is the time when a patient needs to consult the specialist and go for further diagnosis. Kidney takes care of everything and doesn’t say anything. We should take care of our kidney by diagnosing it frequently because it is so quiet yet so dangerous.”

(Edited by - Renu Gupta)