Category: Nephrology & Kidney Transplantation

Types of kidney stones:

There are several types of kidney stones, and each type is formed by a different combination of minerals or substances in the urine. The most common types of kidney stones are:

Calcium stones: These are the most common type of kidney stones, accounting for about 80% of cases. They are typically composed of calcium oxalate, although they can also be made of calcium phosphate.

Uric acid stones: These stones are formed when the urine is too acidic, causing uric acid to crystallize and form stones. They can be caused by a diet high in animal protein and certain medical conditions such as gout.

Struvite stones: These stones are less common and are usually the result of a urinary tract infection. They are composed of magnesium, ammonium, and phosphate.

Cystine stones: These stones are rare and are caused by a genetic disorder that causes the kidneys to excrete too much of certain amino acids, including cysteine.

Less common types of kidney stones include those composed of xanthine, indinavir, and other substances.

Identifying the type of kidney stone is important for determining the underlying cause and the most appropriate treatment approach. It can also help in developing strategies to reduce the risk of future kidney stones.

Here are some examples of how identifying the type of kidney stone can inform treatment and prevention:

Calcium stones: If a person has calcium stones, they may be advised to reduce their intake of foods high in oxalate, such as spinach, nuts, and chocolate. They may also be advised to increase their intake of fluids, especially water, to help prevent the concentration of minerals in the urine.

Uric acid stones: If a person has uric acid stones, they may be advised to reduce their intake of foods high in purines, such as red meat and shellfish, and to increase their intake of fluids to help dilute the urine.

Struvite stones: If a person has struvite stones, they may need antibiotics to clear up any urinary tract infections and prevent further stone formation.

Cystine stones: If a person has cystine stones, they may need to take medication to reduce the amount of cystine in their urine, and may be advised to increase their fluid intake to help prevent stone formation.

In addition to these specific treatments, all individuals who have had kidney stones are advised to increase their fluid intake and make dietary modifications as needed to reduce their risk of future stone formation. Regular follow-up with a healthcare provider may also be recommended to monitor kidney function and identify any changes in stone formation.

Who gets kidney stones? What are the risk factors?

Kidney stones can develop in anyone, but some people are at higher risk than others. Here are some factors that can increase a person’s risk of developing kidney stones:

Family history: If a person has a family history of kidney stones, they may be more likely to develop them themselves.

Age and gender: Men are more likely than women to develop kidney stones, and the risk increases with age.

Diet: A diet high in sodium, sugar, and animal protein can increase the risk of kidney stones, as can a diet low in calcium and water.

Medical conditions: Certain medical conditions, such as hyperparathyroidism, gout, and inflammatory bowel disease, can increase the risk of kidney stone formation.

Medications: Some medications, such as diuretics and antacids, can increase the risk of kidney stones.

Dehydration: Not drinking enough fluids can cause the urine to become concentrated, which can increase the risk of kidney stones.

Obesity: Being overweight or obese can increase the risk of kidney stone formation.

Previous kidney stones: People who have had kidney stones in the past are at higher risk of developing them again.

Geography: People who live in areas with hot and dry climates may be at higher risk of kidney stones due to dehydration.

It’s important to note that while these factors may increase the risk of kidney stones, they do not guarantee that someone will develop them. Conversely, someone without any of these risk factors may still develop kidney stones.

What are the symptoms of kidney stones?

The symptoms of kidney stones can vary depending on the size and location of the stone. Some people with kidney stones may not experience any symptoms, while others may experience severe pain. Here are some common symptoms of kidney stones:

Pain: The most common symptom of kidney stones is pain, which can be severe and sudden. The pain may come and go, and can be felt in the back, side, lower abdomen, or groin.

Nausea and vomiting: Some people with kidney stones may experience nausea and vomiting, especially if the pain is severe.

Changes in urine: The presence of kidney stones can cause changes in the urine, such as blood in the urine, cloudy urine, or a foul odor.

Urinary urgency: Some people with kidney stones may feel a strong urge to urinate frequently, or may have difficulty urinating.

Fever and chills: In some cases, kidney stones can cause a fever and chills, which may be a sign of an infection.

If you are experiencing any of these symptoms, especially severe pain, it’s important to seek medical attention right away. Your healthcare provider can diagnose kidney stones with imaging tests, such as X-rays or ultrasound, and can provide treatment to help manage the pain and prevent further complications

How are kidney stones diagnosed?

Kidney stones are typically diagnosed through a combination of medical history, physical examination, and imaging tests. Here are some common methods used to diagnose kidney stones:

Medical history: Your healthcare provider will ask you questions about your symptoms, including the location and severity of any pain, changes in urine, and any other related symptoms.

Physical examination: Your healthcare provider may perform a physical examination to check for signs of pain, tenderness, or swelling in the abdomen, back, or side.

Imaging tests: Imaging tests can help identify the presence of kidney stones and determine their size and location. Common imaging tests include:

X-rays: X-rays can help detect most types of kidney stones, but they may not be able to detect smaller stones or stones that are made of certain materials, such as uric acid.

CT scan: A CT scan is a more detailed imaging test that can detect even small kidney stones and determine their location and size.

Ultrasound: An ultrasound uses sound waves to create images of the kidneys and can help detect kidney stones, especially in people who are pregnant or have allergies to contrast dye used in other imaging tests.

Urine tests: Your healthcare provider may also collect a urine sample to check for signs of infection or other conditions that may be contributing to the formation of kidney stones.

If you are experiencing symptoms of kidney stones, it’s important to seek medical attention. Your healthcare provider can diagnose the condition and recommend appropriate treatment to manage your symptoms and prevent further complications

What are the treatment options for kidney stones?

The treatment for kidney stones depends on the size, location, and type of the stone, as well as the severity of the symptoms. In many cases, small kidney stones may pass on their own with plenty of fluids and pain management, while larger stones or stones that cause severe symptoms may require medical intervention. Here are some common treatment options for kidney stones:

Drinking plenty of fluids: Drinking water and other fluids can help flush out kidney stones and prevent them from forming in the first place. Your healthcare provider may recommend drinking at least 2-3 liters of fluids per day.

Pain management: Over-the-counter pain medications such as ibuprofen or acetaminophen can help manage pain associated with kidney stones.

Medical therapy: Some medications can help dissolve certain types of kidney stones or prevent them from forming in the first place. For example, alpha-blockers can help relax the muscles in the ureter and make it easier for small stones to pass.

Other medications include oral alkalinization used to increase urine pH for uric stones and hypercalciuria for calcium stones.

Extracorporeal shock wave lithotripsy (ESWL): ESWL uses shock waves to break up kidney stones into smaller pieces, which can then be passed more easily. This procedure is non-invasive and does not require surgery.

Ureteroscopy: Ureteroscopy involves using a small, flexible scope to visualize and remove kidney stones that are located in the ureter or bladder.

Percutaneous nephrolithotomy (PCNL): PCNL is a surgical procedure that involves making a small incision in the back and using a scope to remove larger kidney stones.

If you have kidney stones, it’s important to talk to your healthcare provider about the best treatment options for your specific case. In addition to medical treatment, lifestyle changes such as a healthy diet and regular exercise can also help reduce the risk of kidney stone formation.

At AINU’s Stone Treatment Center – providing services at our BANJARA HILLS, DILSUKH NAGAR, HI-TEC CITY, and VIKRAMPURI (SECUNDERABAD) – we offer state-of-the-art and minimally invasive care for kidney stones.

As kidney stones have a rate of recurrence of up to 50% at 5 years, surveillance with imaging modalities is necessary to ensure treatment success or to guide further changes to the treatment plan.

AINU’s Stone Treatment Center has state-of-the-art operating rooms that are equipped with the latest technology including ultra-thin flexible and rigid ureteroscopes, high-end digital imaging, and a variety of lasers including HOLMIUM LASER, THULIUM FIBRE LASER. AINU’s urologists are fellowship trained and perform high-volume weekly caseloads.

As a result, AINU has a reputation for the successful management of difficult stones, and many of our patients are able to go home within a day or two after surgery.

Kidney Stone Prevention

Are there prevention programs for kidney stones?

AINU’s Stone Treatment Center concentrates not only on the treatment of kidney stones but also on prevention once the initial stone is removed.

At AINU we have a commitment to 24-hour urines and metabolic work-up to prevent future recurrences.

We also provide dietary counseling for appropriate diet and nutrition planning to prevent a recurrence of kidney stones.

One of the best preventative measures against kidney stones is proper fluid intake.

It is recommended that you drink at least 8 glasses or 3 liters of water each day in order to pass about 2.6 quarts (2.5 liters) of urine daily. Other general diet and prevention recommendations include:

Around 10% of the adult population has some form of kidney disease.

90% of the people who are diagnosed with severe kidney disease die because they are unable to afford the treatment.

Also, patients with kidney disease are at a higher risk of cardiovascular disease.

These statistics are alarming but true. The only way out is to be aware of the types of kidney disease and the best kidney hospitals in India so that you can seek immediate help if the need arises

A brief about the kidneys

The renal system is a complicated organ system that mainly consists of 2 fist-sized kidneys. They are present on either side of the spine. The kidneys have a network of nephrons that have multiple responsibilities such as:

Common types of kidney disease

There are many types of kidney disease that attack these nephrons and disrupt the normal functioning of the kidneys. We shall discuss a few of the common ones so that you stay on guard and take measures to avoid them.

Chronic kidney disease (CKD)

CKD is prevalent across India. When kidneys lose their ability to filter the blood and remove all the waste products, it leads to CKC. This can be very harmful because the waste builds up and leads to multiple complications.

This can get worse and lead to kidney failure. Deaths in India due to kidney failure have seen a sharp rise of 38% from 2001-03 to 2010-13. While damage to the kidneys cannot be reversed, when detected early, doctors can slow it down so that it does not worsen as fast. A kidney-friendly diet, exercise, and medication are advised.

People with diabetes (Diabetic Kidney Disease), heart disease, and blood pressure are at a higher risk of getting CKD.

Polycystic kidney disease (PKD)

PKD is genetic. It is a condition where cysts are formed on the kidneys. These cysts hinder the kidneys’ functionality and over time, cause kidney failure.

Sadly, there is no cure for PKD. Medication can help slow the cysts’ growth and avoid other related health problems.

Glomerulonephritis

The kidneys have small filters named glomeruli, which clean the blood. Glomerulonephritis occurs when these filters are damaged and are unable to perform their duties anymore.

Also known as Glomerular Disease, it usually occurs when the immune system gets overactive due to an infection or other causes. There are 2 types of Glomerulonephritis:

• Acute: Usually due to a viral infection
• Chronic: Due to high blood pressure or other chronic diseases

IgA Nephropathy

The immune system makes multiple proteins. When these proteins settle in the kidneys, it leads to IgA Nephropathy. It damages the glomeruli and ultimately leads to Chronic Kidney Disease. IgA Nephropathy often goes undetected until it gets severe and it has no cure. Medication can only slow the spread of the damage down.

There are many other rare kidney diseases that hurt the kidneys and lead to kidney failure. A healthy diet and an active lifestyle can go a long way in preventing these diseases.

Conclusion

Chronic Kidney Disease is the most common type of kidney disease. There’s no cure for it and it will lead to kidney failure and death sooner or later. This is why speaking to top kidney specialists in India regularly and getting health check-ups done is crucial. When detected early, doctors can take measures to minimize the damage

At AINU, we have some of the best kidney specialists in vizag who are experts in all forms of kidney disease. If you have any questions or would like to book a consultation, please get in touch with us.

World kidney day is a global campaign to raise awareness of the importance of our kidneys to overall health and to reduce the frequency and impact of kidney disease and associated health problems worldwide.

Approximately 1 in 10 people worldwide (an estimated 850 million people) have chronic kidney disease (CKD). Its associated symptoms, and treatment, can disrupt and constrain daily living and impair the overall quality of life of patients and their family members. The current treatment strategy is to preserve, substitute and restore kidneys function and provide relief from kidney failure. This status quo approach reduces the meaningful involvement of patients’ in the management and treatment of their disease. Because of this approach, patients frequently perceive treatments as imposed, punitive and out of control and does not satisfactorily reflect on patients.

The theme of the 2021 World Kidney Day campaign is “Living Well with Kidney Disease”. The focus of this year’s campaign is to raise awareness on patient-centred wellness. At the International Society of Nephrology’s Community Film Event at the 2020 World Congress of Nephrology, there was a quote in the film from a patient: “Tell me, I will forget; show me, I will remember; involve me, I will understand.” The World Kidney Day 2021 steering committee calls for an increase in education and awareness on essential goals of patient-centred wellness and to highlight the importance of the following strategies to achieve it.

Symptom management and life participation

More practical and holistic symptom management beyond traditional kidney therapies should be encouraged. Patients and their care partners should adopt effective strategies to identify and manage symptoms such as pain, sleep issues, depression, stress and others to alleviate these symptoms to have a better health-related quality of life. Life participation, which is the ability of patients to engage in meaningful life activities, should be the key focus in caring for patients with CKD. Caretakers, as well as family members and friends involved in the care of the patients with CKD, should also follow these principles of life participation equally.

Patient education, engagement and empowerment

Patients with CKD and their family members or care partners should be empowered to gain greater control over their decisions and actions affecting their health. Patients should understand their role and have the ability to engage with clinicians in shared decision-making and support for self-management. Strength-based approaches which encompass strategies to support patient resilience, harness social connections, build awareness and knowledge, facilitate access to support and establish confidence and control in self-management should be given greater emphasis.

Increase awareness of preventive measures

Early detection with a prolonged course of wellness despite kidney disease, after an effective secondary prevention program should be promoted. Prevention of CKD progression can be attempted by lifestyle and diet modifications and through effective drugs therapies. There should be increased awareness of the importance of preventive measures across populations, professionals, and policymakers, applicable to developed and developing countries.

Patient empowerment, partnership and improved communications, combined with a paradigm shift towards a strengths-based approach to care, can inspire confidence and hope that patients can live well with CKD. Hence, We must move beyond the status quo and advance patient-centeredness in research, practice and policy.

Asian Institute of Nephrology and Urology, an exclusive Kidney specialty hospital comes forward to achieve the goals set out by the World Kidney Day steering committee with an attempt to raise awareness among the healthcare providers, patients and caretakers on this crucial aspect “Living Well with Kidney Disease”. We are organising a five-kilometre run on 14th of March 2021 at 6:00 am at Necklace road, Hyderabad.

Conclusion

Asian Institute of Nephrology and Urology is the best Kidney hospital in hyderabad that comes forward to achieve the goals set out

Who requires Kidney Transplantation?

Kidney Transplantation is a procedure where one kidney is removed from a person and implanted into another person with permanent Kidney Failure. The person who donates a Kidney is known as a Donor and the one who receives the kidneys is known as the recipient.

Do all patients with Kidney Failure require Kidney Transplantation?

The answer is No. All patients of kidney failure don’t require kidney transplantation.
There are two primary types of kidney failure.
First category of kidney failure is Temporary Kidney Failure. This is technically known as Acute Kidney Injury (AKI), where in Kidney failure occurs because of a temporary insult and is potentially recoverable if that insult is eliminated within a particular time frame. These patients with Temporary Kidney failure don’t require Kidney Transplantation as Kidney failure is temporary.
The Second category of Kidney Failure is End stage Kidney Disease (ESRD). The other term for this entity is CKD/Stage 5-D (Chronic Kidney Disease/ Stage 5 requiring Dialysis). These are the patients whose both the kidneys have failed permanently and completely. These are the patients who are left with only 5-10% of net kidney function and this is deemed irreversible. These are the patients who mandate either Kidney Transplantation or lifelong Dialysis to move forward.

Who can be a Kidney Donor?

Fundamentally there are two categories of Kidney Donors.
The first Category being Living Kidney Donors and the Other Category being Deceased Kidney Donors. Living kidney donors are usually the individuals who are either biologically or emotionally related to the patient. The classical example of Biologically related individuals are parents and siblings. The most appropriate example of an emotionally related Living donor is Spouse.

The second category of Donors are Known as Deceased Donors. They are the donors whose brain is completely and irreversibly damaged but whose heart is still beating. Such a condition is medically termed as “Brain Death”. That is though they are biologically alive; due to the irreversible damage to the Brain they are technically dead as organs in the body cannot function when the Brain is irreversibly damaged. If the grieving family members are willing to donate the Kidney of their loved ones who are in a state of Brain death, Kidneys along with Liver, Heart and lungs are retrieved after following a stringent legal procedure as mandated by the law.

What are the fundamental requirements to donate a Kidney?

The fundamental requirement for kidney donation is the matching of Blood groups. The person who donates the kidney should have the same blood group like the patient or the donor should belong to the “O” Blood group. The Person with O Blood Group is regarded as a universal donor as such a person can donate a kidney to a person of any blood group.
The other prerequisites being the biological relation or undisputed emotional relationship as defined by the law. The tests such as HLA matching will decide the extent of biological matching between the donor and the recipient.

Is Kidney Donation Safe?

Kidney donation is a safe and well established procedure due to the adoption of stringent measures to evaluate the donor’s health prior to the donation. Every donor will undergo critical analysis of all the organ systems prior to donation. They will be evaluated in depth to assess their kidney functions and would be methodically analysed if the person can sustain kidney donation. If the entire evaluation reveals normal results, then only donation will be permitted. If this stringent process is followed, Donation is usually an acceptably safe procedure subject to subtle biological variations.

To conclude, Kidney Transplantation is indicated in patients with Permanent Kidney failure whose net kidney functions have dropped below 5-10%. Kidney donors can be biologically or emotionally related individuals or Brain dead individuals. Kidney donation from living donors is usually a safe and established procedure subject to the stringent evaluation of donor’s health status.