Dr Vikas Jain, clinical lead & senior consultant and Dr Suman Lata Nayak, senior consultant, Nephrology & Renal Transplant at Dharamshila Narayana Hospital talk to Priyanka Joshi about the rising cases of kidney failure due to high blood pressure, diabetes or a family history

What is the reason for the sudden rise in kidney diseases among Indians?

Dr Vikas Jain (VJ): First, environment, second, lifestyle diseases brought on by diabetes and hypertension. Third, the genetic make-up of the body. For example, if your parents are suffering from kidney disease diabetes or hypertension, you are at a higher predisposition of developing a condition. So get a regular check-up done for early diagnosis and treatment.

What causes kidney stones?

VJ: Kidney stones are formed because of the decrease in water intake. We all forget to drink enough water. I advise everybody to consume 2.5 to 3 litres water per day in a city like Delhi. In summer, increase the water intake as we lose a lot through sweat. More women develop kidney stones than men not just because of less water intake but Indian women don’t take nutritious food like green leafy vegetables. Also, some genetic makeup are more predisposed because of underlying genetic issues.

lAhead of World Kidney Day which is on March 8, what are the plans to mark this day?

VJ: We will be launching a health check-up camp where patients will be screened for kidney diseases, counselled and create awareness programmes and activities.

What are the risks involved with pregnant women having a kidney problem?

Dr Suman Lata Nayak (SLK): Women's health is the most neglected in our country. It starts from puberty and pregnancy stage and imagine the impact on the national health index considering 80% of our population lives in villages. Sepsis and infection during pregnancy and delivery lead to kidney problems. Sometimes the kidney just shuts down because of infection. If there is an infection in the blood, it affects the kidney too as it circulates through that vital organ. Sometimes the damage can be so massive that the kidney does not recover on its own. The patient is then put on dialysis. Thus, we have to take preventive steps during pregnancy and even after delivery.

The second worrisome factor is that women take a lot of painkillers over the counter. Everybody is carrying a strip of tablets of the Voveran group, which leads to kidney problems. Even one tablet of Brufen and Combiflam can cause a kidney problem. Women shouldn’t use painkillers without a prescription and don’t make their usage a habit. Similarly, avoid antibiotics for a normal fever. Let the fever run its course with normal drugs.

VJ: Third, avoid obesity. It is the root cause of Diabetes. Women should take care of their health, weight and lifestyle to ensure smooth metabolism.

What is the latest technology?

The most important technology in kidney transplant is the Laparoscopic Donor Nephrectomy. We take out the donor's kidney in a laparoscopic manner or through a keyhole. Since we remove the kidney through a very small incision, the donor goes home on the third or fourth day. This is a major improvement and the donor acceptability has increased after this. Ten years ago, we had trouble finding donors, even family ones. Now they know they can get back to work on the third or fourth day and will be living as normal a life as before transplantation.

What are the criteria for undergoing kidney transplant?

VJ: Transplantation is indicated in a patient who has an end stage renal disease or when the kidney function has come down to less than 15%. There are various stages of kidney diseases. We call it Chronic Kidney Disease (CKD) of levels 1, 2, 3, 4 and 5. Once the patient reaches CKD-5, which we also call end stage renal disease, he needs a transplant. At CKD-5 or ESRD there are two options, undergo a dialysis or transplant. A transplant is better because it improves the patient's quality of life and longevity. Dialysis is not a permanent and viable option.