General Information on Kidney Functions, Care & Kidney Ailments

What kidneys do?

a) Eliminate waste products.
b) Ensure water, mineral & electrolyte balance.
c) Regulate blood pressure.
d) Stimulate synthesis of red blood cells.

When to suspect kidney disease?

a) Hypertension
b) Anemia
c) Anorexia, nausea, vomiting & fatigue
d) Bone pain, increased urination at night
e) Leaking of blood / protein in urine
f) Swelling of blood, feet etc
g) Respiratory distress, coma. Fits
h) Marked reduction of urine volume

How can you keep your kidneys fit?

a) Do not neglect stone/prostate related problems
b) Inform your doctor about any existing kidney problem before he/she gives you any treatment.
c) Avoid painkiller and antibiotics without medical supervision.
d) Control hypertension and diabetes aggressively and at all time.
e) Avoid dehydration specially during diarrhea vomiting and extreme heat.
f) Treat malaria, snakebite etc. early & effectively.
g) Avoid exposure to industrial & environmental toxins.

Can there be hereditary kidney problem?

Yes, there are. Some of them can not be prevented while for some counseling prior marriage and conception is extremely rewarding. Even kidney problems of diabetes, hypertension, and stone diseases may have hereditary correlation.

How costly is treatment of renal failure?

Prior onset of dialysis, progression of kidney disease must be retarded by appropriate drug and diet. Ketoanalogues may cost you $100 (INR 4,000/-), erythropoietin can cost $150 (INR 6,000/-), Hemodialysis will cost you $300 (INR 12,000/-), and peritoneal dialysis $400 (INR 18,000/-) every months. Kidney transplantation costs $10,000 (Rs 4,50,000/-) initially followed by $100-200 (INR 4,000-8,000) every months thereafter. However this projected expenditure may increase by upto 30% in special situations. In India, the relative costs of hemodialysis is declining.

Responsibility of family members towards a kidney patient?

Treat him/her the same way before he/she fell ill and keep watch on diet and cleanliness. The expenses of treatment may be discussed as this may induce more discipline and compliance to diet and treatment. Drug and dialysis timings should be adhered to. Depression remains a problem and may need medical and psychological help.

Changing treating physicians:-

Kidney patients need not change physician frequently as this may be associated with unnecessary repetition of test and alteration of drugs. Sometimes this causes confusion in diet and treatment protocols. If you are being treated by a competent Nephrologists, going to another city for treatment does not materially change the treatment outcome in vast majority of the patients. Apart from a rise in treatment cost, patients family has to face problems accommodation, transport and language. You must appreciate that doctors at your place has similar degree and clinical experience as any other doctors in the world. Moreover your local doctors know more about you, your family, your living condition, dietary habits, and local availability of tests, drugs and infrastructure.

Mediclaims and Reimbursement:-

Kidney diseases are included in Mediclaim benefits. However you need not go for it after a disease is diagnosed. Hiding facts to access such benefits is easily detected and this remains the commonest causes of heart break when patients has to pay through his nose. Many kidney diseases are chronic and will need treatment for even decades. Even in an upper middle class family spending the entire lifetime saving / mediclaim benefit in a single admission in a prestige enhancing hospital may prove a foolish decision from second year onward. Your money must be spent for the best total outcome.

Job loss and quality of life:-

Patients with chronic kidney disease must enjoy a certain quality of life which may vary as par socioeconomic expectation. Job loss and ongoing expenditure for treatment may destroy a family both financially and emotionally. Hence therapeutic options needs to be individualized after consultation with close family members. Reducing fringe expenditure and tackling patient's core problems with rational investigation and minimizing hospitalization still remains the best offer that can satisfy most family.