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chronic kidney diseases

Chronic Kidney Diseases – What They Are and How To Treat Them

Chronic kidney diseases, also known as chronic kidney failure (CRF), are kidney damage that cause progressive loss of kidney functions. It consists of decreased kidney function for more than three months and structural changes that can compromise the kidneys. These organs are responsible for maintaining the balance of the internal environment of our body, conserving substances that need to be preserved, eliminating unwanted substances and controlling excess or lack of water. If they are not treated, they can permanently compromise the functioning of the organ, leading to the paralysis of the kidneys, which are responsible for filtering the blood, eliminating harmful substances and nutrients in the body.

Causes and Risk Factors

When a disease or health condition is harmful to kidney function and causes organ damage, it can be the start of chronic kidney disease.

The diabetes, the hypertension and obesity constitute the main risk factors for the development of chronic kidney disease. According to Dr. Vinant Bhargava, nephrologist in Delhi, “kidney diseases can progress to CRF if left unattended, mainly associated with other metabolic problems”.

Smoking, being over 65, having heart disease and a history of kidney problems in the family also increase the risk of developing the problem. That’s why it’s so important to keep your appointments with kidney specialist in Delhi up to date.


According with the Dr. Bhargava, nephrologist in Gurgaon, in the early stages, CKD is usually asymptomatic. Loss of kidney function usually takes months to years to occur, and can be so slow that symptoms do not appear until the kidneys are very weak. The first signs of CKD include malaise, fatigue, shortness of breath, tiredness, headache, loss of weight and appetite, nausea, vomiting and itching. The main diseases that cause CKD are diabetes mellitus and high blood pressure. Other symptoms that may appear are impotence, decreased sexual interest and interruption of the menstrual cycle.

Diagnosis and Exams

An early diagnosis contributes to a more effective treatment. The disease can be detected through two tests: analysis of urine and blood, which identify the levels of albumin and creatinine respectively, proteins that can be affected by kidney dysfunction and be imbalanced in our body.

Prevention and Treatments

It is estimated that 10% of the world population has some degree of CKD. When the disease is already at an advanced stage, the kidneys enter a process of functional failure. Thus, treatment is carried out with medication and changes in eating habits. More severe cases in which the disease is at a more advanced stage, treatment involves replacing kidney function through three modalities: hemodialysis, peritoneal dialysis and kidney transplant in Delhi.

Ideally, the patient should receive prior follow-up with the best nephrologist in Delhi, be informed about these modalities and decide, together with his doctor, which is the most appropriate for his case. If he has a compatible living donor, he can be prepared soon for kidney transplantation, considered the best form of therapy, without the need to undergo dialysis. If he has no living donor, he can choose between hemodialysis and peritoneal dialysis. In the first, the blood passes through a dialyzer, which will make the necessary changes to ensure its survival with quality. In the other, a catheter is implanted between the intestinal loops. The “dialyzer”, then, will be the tissue that lines the intestinal loops and the belly internally, called the peritoneum.

The good news is that to prevent or control kidney problems, regular water intake, healthy eating, low in salt and rich in vegetables, fruits and vegetables, not taking medication without medical advice and having a periodic check-up can help you save from that problem.

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nephrologist in Delhi

Food Supplements & Other Problems That Can Affect The Kidneys

The human kidneys are dark red colored organs, measuring approximately 10 cm each and which perform vital functions, being known as the “filters” of the organism. Among the main functions, they participate in the internal chemical balance, elimination of toxins from the blood, control of blood pressure and regulate the amount of body fluids.

For the kidneys to function in the best possible way, it is extremely important to maintain a balanced diet and drink plenty of water daily. Several other conditions can cause kidney problems. If left untreated, they can lead to permanent damage and even kidney failure, warns nephrologist in Delhi.

How to notice kidney changes?

Some signs can be noticed when the kidneys are altered. Most of these signs are noticed in urination. It may be accompanied by pain, burning, the presence of blood, cloudy or whitish colors, as well as changes in its frequency, explains top nephrologist in Delhi.

However, there are also other signs that may indicate reductions in kidney functions: tiredness, lack of appetite, nausea and vomiting, accompanied by urinary changes. Below are some of the main problems affecting the kidneys:

Infections: Some infections in the urinary tract can also extend and affect the kidneys, such as cystitis or bladder infection. Some of the main signs are fever, pain in the back and lower abdomen, frequent urination followed by pain and burning during urination. When the urinary infection reaches the kidney tissue, it is called pyelonephritis and can cause other kidney problems.

Nephritis: it is characterized by a reaction of the immune system that ends up attacking the kidneys, initiating an inflammatory process of the renal glomeruli. It is a disease that, if elevated to a chronic level, can cause kidney damage.

Kidney stones: they are hardened formations of crystals in the urinary tract or kidneys. At first, they may go unnoticed, but they cause acute pain attacks that may be accompanied by nausea and vomiting. The main causes for the formation of these crystals are the excess of sodium (salt), calcium, phosphate and the lack of citrate. Controlling the consumption of these substances, especially salt and regular water consumption, are the best ways to prevent the formation of kidney stones.

Food supplements and their effects on the kidneys

Food supplements have the main function of complementing a diet, either for nutritional replacement, or for specific purposes (such as gaining muscle mass), providing the necessary nutrients for the healthy functioning of the body, such as proteins, carbohydrates, vitamins or minerals. However, food supplements if consumed inappropriately, instead of nourishing, can harm the entire body, especially the kidneys and livers. They can trigger a series of mild and serious health problems, since their excess can cause an overload of these organs and / or the accumulation of substances, leading to residual formations, such as calculations. Below are the main kidney complications caused by excess dietary supplements, explained by best kidney specialist in Delhi:

  • Kidney stones: usually caused by the overuse of water-soluble supplements, such as minerals, especially calcium, phosphate and vitamin D.
  • Intoxications: many people take vitamin supplements excessively believing that the excess will be completely eliminated by the body. It is true that, unlike proteins and carbohydrates, vitamins are eliminated, but the excess of one vitamin can cause the need to consume another and this imbalance leads to renal intoxication. Intoxications inhibit the functioning of the kidneys and can cause kidney failure.
  • Renal failure: Caused mainly by excessive intake of protein supplements, which forces the kidneys to work harder, leading to partial and even total failure in the long run.

How to prevent kidney overload?

To prevent the kidneys from working overload, you should first have a diet with balanced nutrients, without excess and you should drink water in an adequate amount. Water consumption is even more important if the person uses food supplements and practices physical activity. The use of supplements is far beyond reading the label. In order to have a healthy consumption, the choice and dosage of the supplement must be adjusted to the physical condition of each person and, therefore, it must always be accompanied by a nutritionist and a kidney specialist in Delhi.

How to identify a renal complication?

Usually kidney complications are noticed in the act of urination and appearance of urine. If the urine is extremely acidic, reddish in color, with unusual odors, with foam or if the urination itself is accompanied by pain, it is possible that there is some complication in the functioning of the kidneys. For this, it is recommended to seek the best nephrologist in Delhi to investigate the changes.

Kidney Transplant


A kidney transplant is a surgical procedure to place a healthy kidney from a living or deceased donor in a person whose kidneys no longer function properly. Transplantation improves the hope and quality of life of patients with renal impairment.

Kidney transplants are performed under general anesthesia, so you are not awake during the procedure. The surgical team monitors your heart rate, blood pressure, and blood oxygen level during the procedure.

During surgery:

  • Your kidney transplant surgeon in Delhi makes an incision in your lower part on one side of your abdomen and puts your new kidney in. Unless the kidneys themselves are causing complications such as high blood pressure, kidney stones, pain, or infection, they are in place.
  • The blood vessels of the new kidney connect to the blood vessels in the lower abdomen, just above one of the legs.
  • The ureter of the new kidney (the tube that connects the kidney to the bladder) connects to the bladder.

After the procedure

After your kidney transplant in Delhi, you can expect:

  • Spend from a few days to a week in the hospitalNephrologist in Delhi and nurses monitor your condition in the hospital’s transplant recovery area for signs of complications. Your new kidney will produce urine like your own kidneys did when they were healthy. This often starts immediately. In other cases, it may take several days, and you may need temporary dialysis until your new kidneys start working properly. You may feel discomfort or pain around the incision site during healing. Most kidney transplant recipients can return to work and normal activities three to eight weeks after transplantation. You should not lift objects weighing more than 10 pounds (4.5 kg) or exercise (except walking) until the wound has healed (usually about six weeks after surgery).
  • Have frequent checkups while you are in recovery. After you are discharged from the hospital, you will need a thorough follow-up by kidney specialist in Delhi for a few weeks to check if the new kidney is working well and to make sure your body is not rejecting it. You may need blood tests several times a week and may need to adjust your medications in the weeks after your transplant. During this period, if you live in another city, you may need to arrange to stay near the transplant center.
  • Take medication for the rest of your life. You will need to take several medications after your kidney transplant. Medications called “immunosuppressants” (anti-rejection drugs) help prevent the immune system from attacking and rejecting the new kidney. Other medications help reduce the risk of other complications, such as infections, after transplantation.


To prevent your body from rejecting your donor kidney, you will need medications to suppress your immune system. Because these anti-rejection medications make your body more vulnerable to infection, your       doctor for kidney in Delhi may also prescribe antibiotics, antiviral medications, and antifungal medications.

It is important to take all your medications as prescribed by your best nephrologist in Delhi. Your body may reject the new kidney if you skip medications even for a short period. Contact your kidney transplant doctor in Delhi right away if you are having side effects that prevent you from taking your medications. After the transplant, it is strongly recommended that you get self-control and go to checkups with a dermatologist to check for any signs of skin cancer and track your other cancer.


Diet and nutrition

After your kidney transplant, you may need to adjust your diet to keep your kidney healthy and in good working order. You will have fewer dietary restrictions than you would have if you were getting dialysis therapy before your transplant, but you may still need to make some changes to your diet.

Your transplant team includes a nutrition specialist (dietitian) who can discuss your nutrition and diet needs and answer any questions you have after the transplant.

Some of your medications can increase your appetite and make weight gain easier. But reaching and maintaining a healthy weight through diet and exercise is just as important for transplant recipients as it is for everyone else to reduce the risk of heart disease, high blood pressure and diabetes.

You may need to keep track of how many calories you eat or limit foods high in sugar and fat.

Your dietitian will also recommend several healthy food options and ideas to implement in your nutrition plan. Your dietitian’s recommendations after a kidney transplant may include:

  • Eating at least five servings of fruits and vegetables a day
  • Avoid grapefruit and grapefruit juice due to its effect on a group of immunosuppressive medications (calcineurin inhibitors)
  • Include enough fiber in your daily diet
  • Drinking skim milk or consuming other skim dairy products, which is important for maintaining optimal calcium and phosphorus levels
  • Eating lean meats, poultry, and fish

Your dietitian may also recommend:

  • Follow a low-salt, low-fat diet
  • Follow food safety guidelines
  • Stay hydrated by drinking the right amount of water and other fluids every day


Once you recover from transplant surgery, you should regularly incorporate exercise and physical activity into your life to continue improving your overall physical and mental health.

After transplantation, regular exercise helps increase energy levels and strength. It also helps you maintain a healthy weight, reduce stress, and avoid common complications after transplantation, such as high blood pressure and high cholesterol levels.

The best kidney specialist in Delhi will recommend a physical activity program tailored to your personal needs and goals.

Right after the transplant, you should walk as much as you can. Gradually, start incorporating more physical activity into your daily life, including doing at least 30 minutes of moderate exercise, five days a week.

Walking, biking, swimming, low-impact strength training, and other physical activities you enjoy can be part of a healthy and active lifestyle after a transplant. Be sure to contact your nephrologist in Gurgaon before starting or changing your exercise routine after the transplant.

Obstructive Nephropathy

Obstructive Nephropathy: Diagnosis and Treatment

What is it and what are the reasons?

Obstructive nephropathy is an abnormality in the structure and function of the kidneys, which is caused by obstruction of the outflow of urine due to partial or complete obstruction of the urinary tract (most commonly ureters or urethra), explains the best nephrologist in Delhi.

The most common causes are prostatic hyperplasia and cancer, tumors (uterus, ovary, large intestine), uterine prolapse, retroperitoneal fibrosis, narrowing of the ureter or its opening to the renal pelvis or bladder (may be acquired or congenital), posterior urethral valve (usually congenital in boys).

The cause of obstructive nephropathy may also be impaired urinary tract function, most often the bladder after a spinal cord injury or as a result of a malformation of the spinal cord (e.g. cerebrospinal hernia) or so-called neurogenic bladder (bladder neck spasm).

A variant of obstructive nephropathy is drainage nephropathy caused by long-term backward reflux (reflux) of urine from the bladder to the ureter and kidney.

How common is obstructive nephropathy?

Obstructive nephropathy is a fairly rare kidney injury in adults, while it is the most common cause of chronic renal failure in children (due to urinary congenital malformations), says the nephrologist in Delhi.

How is it revealed?

An obstacle to the outflow of urine from the kidney leads to the development of hydronephrosis, i.e. the widening of the pelvis and the renal calyces. If the urine outflow from the kidney suddenly almost completely closes, renal colic appears.

When hydronephrosis develops slowly, it may not have any symptoms, but if it reaches a large size, it manifests itself like a tumor in the abdomen – a large kidney can be felt by touch examination or press on other organs in the abdomen. Sometimes urinary tract obstruction is partial or changes over time, and then large (polyuria) and small (oliguria) urine volumes may alternate. Symptoms of a urinary outflow obstruction may be urinary tract infection or haematuria. When permanent, severe damage occurs to both kidneys, symptoms of chronic renal failure occur, says the nephrologist in Noida.

What to do if symptoms occur

Always seek medical attention if you experience symptoms suggestive of a urinary tract disease, i.e.

  • urination disorders
  • pain in the lumbar region or lower abdomen
  • haematuria
  • palpable tumor in the stomach
  • symptoms of urinary tract infection.

How does the doctor make a diagnosis?

Reported symptoms (as above) indicate a disease of the urinary tract which may lead to obstruction of urine outflow (and development of obstructive nephropathy). The most important are imaging of the urinary system, first of all USG, then usually urography or CT They show unilateral or bilateral hydronephrosis, and when the obstacle is located low – widening of one or both ureters or bladder distension. These tests also help to identify the cause, i.e. the type of obstacle to the proper outflow of urine, explains the nephrologist in Gurgaon.

What are the treatments?

The goal of treating obstructive nephropathy is to restore effective drainage of urine from the kidneys, which involves removing or bypassing an obstacle that obstructs urine outflow. Usually urological treatment is needed. If the obstacle cannot be removed and the urine outflow is restored, urological procedures are carried out by the urologist in Noida to avoid the obstacle. This can be the introduction of a catheter into the bladder, ureter or directly into the renal pelvis through body shells in the lumbar region (so-called transcutaneous nephrostomy). Usually these are urgent interventions that ensure urine outflow until the patient is ready for elective surgery for the final treatment of the obstacle (e.g. prostate surgery, bladder tumor or urinary reconstruction).

Is it possible to cure completely?

Complete cure for obstructive nephropathy is possible provided the obstruction has been permanently cured before irreversible kidney changes have occurred. Removing an obstacle if chronic kidney damage has already occurred does not lead to cure because chronic kidney disease is progressive, states the kidney specialist in Delhi.

What do you need to do after treatment?

In obstructive nephropathy, urological supervision and periodic monitoring of urinary tract function are usually necessary. When there is permanent kidney damage (chronic obstructive nephropathy), periodic nephrological monitoring is required, says the kidney specialist in Noida.

What to do to avoid getting sick?

To avoid obstructive nephropathy, obstacles to urine outflow should be detected and treated early. Particular attention should be paid to any urination disorders, suggests the nephrologist in Delhi.

Diabetic Kidney Disease

Diabetic Kidney Disease

Diabetes is the leading cause of kidney failure in the developed world, says the best nephrologist in Delhi.

The diabetes, characterized disease excess blood glucose can affect various organs of the body including the kidneys (diabetic nephropathy) or eyes (diabetic retinopathy). Good diabetes control is able to prevent, delay or decrease the appearance of these and other complications of the disease.

The constant maintenance of high levels of glucose (sugar) in the blood causes a disturbance in the wall of the arteries. As a consequence, the blood does not correctly reach the tissues and this leads to a disorder in the structure and function of different organs in the body, explains the nephrologist in Delhi.

The mechanism by which excess glucose affects the arteries is very complex. On the one hand, the wall of the arteries is made up of proteins. Glucose tends to bind to these proteins, and this phenomenon can ultimately deconstruct the arterial wall. On the other hand, the insulin deficiency characteristic of diabetes means that the transformation of glucose for energy is carried out through a specific type of metabolic pathway. As a consequence, the body accumulates a series of substances that can also cause alterations in the walls of the arteries, says the nephrologist in Noida.

The appearance of complications in a diabetic person also depends on their personal susceptibility to changes caused by high glucose levels.

Diabetes is the leading cause of kidney failure in the developed world, accounting for approximately 35-40% of new cases of kidney failure each year, says the nephrologist in Gurgaon. It should be known that:

The development of early stages of diabetic nephropathy is frequent

Throughout life, around 50% of people with type 1 diabetes develop microalbuminuria – presence of the albumin protein in the urine, which is an indicator of impaired kidney function.

Approximately 20% of people with type 1 diabetes develop kidney failure.

In Caucasian people with type 2 diabetes, between 5 and 10% go on to develop end-stage chronic kidney failure (CRFD), while among non-Caucasians the proportion is even higher.

Diabetic kidney failure is the most common cause of admission to kidney replacement programs, dialysis or transplantation, in most countries of the world, says the kidney transplant doctor in Delhi.

In India, around a third of people with end-stage chronic kidney disease have diabetes. This population is estimated to grow at an annual rate of 8%.

Up to 40% of new cases of IRCT can be attributed to diabetes.

The risk of CKD is 12 times higher in people with type 1 diabetes compared to those with type 2 diabetes, says the kidney specialist in Delhi.

There are two treatment options when the kidneys fail.

Dialysis – peritoneal dialysis or hemodialysis – and kidney transplant. The costs of both treatments are high. Diabetes is estimated to represent between 5 and 10% of the national health budget in western developed countries.

Diabetic kidney failure develops so slowly that it may not give symptoms for many years.

The best way to detect the problem is to test your urine for proteins, which should not normally be present, such as albumin. The Kidney Specialist in Noida recommends that every person with diabetes undergo a urine test for albuminuria each year.

Close control of the blood glucose level reduces the risk of microalbuminuria, and therefore of future chronic terminal renal failure, by up to 35%.

There is conclusive evidence that good blood glucose levels can significantly reduce the risk of developing complications and slowing their progression in all types of diabetes.

Control of high blood pressure and high levels of fats in the blood (hyperlipidemia) is also very important, says the nephrologist in Delhi.

Prevention and Early Diagnosis of Kidney Diseases

Most kidney diseases can behave like ” silent killers “: they work undisturbed, without symptoms, for years and, when their effects are revealed, it can be late to run for cover. Attention to them is dictated by the need to prevent chronic renal failure and to reduce cardiovascular risk, which increases significantly already in the presence of mild renal failure.

We cannot therefore think that our kidneys are indestructible, or worse that they do not deserve any consideration; we don’t even have to think that kidney disease is always a deadly trap.

If the diagnosis is early, the treatments can be very effective. A healing is common. In any case, the evolution of the disease can be significantly slowed down, says the nephrologist in Delhi.

So, what can you do to find out about kidney injuries in time?

First of all, be careful of the signs that may indicate their appearance.

Here are the main ones:

  • Emission of dark colored urine (up to a “coca cola” color) or blood red, or with bad smell. Even the formation of a lot of foam can have a meaning of abnormality;
  • Significant increase in urinary volume, especially at night, and persistent thirst;
  • Edemas, in the lower or diffuse limbs;
  • Increase in blood pressure values ​​beyond the maximum normal limits;
  • Pain in the lumbar area (up to real colic), sense of weight in the kidney not referable to lumbosciatalgia;
  • Unexplained anemia, fatigue, significant malaise for no apparent reason;
  • Burning urinating, fever (especially if with chills), need for frequent urination;

First of all, a fresh urine test must be performed (to avoid alterations caused by fermentation).

Most kidney diseases cause urinary changes, with the presence of:

  • blood, mostly not evident to the naked eye, but only on chemical (hemoglobin) and microscopic (micrometry) examination;
  • albumin (albuminuria) isolated, or associated with other blood proteins (proteinuria);
  • white blood cells, a sign of inflammation of the kidney or urinary tract, often, but not always, of infectious origin;
  • other elements, such as the so – called cylinders, which are “molds” of proteins, cells or cellular debris, precipitated in the lumen of the tubules and then mobilized by the flow of urine;

A separate case is that of cancer cells that can be highlighted by the so-called urinary cytological examination.

Abnormal amounts of albumin, blood and white blood cells can be easily searched for by immersing a test strip in the urine. It is this safe and rapid research method that is used in the screening of kidney disease. In case of abnormality, the examination will be supplemented by the microscopic one of the urinary sediments.

Very reliable and rapid automatic equipment is now spreading in the most modern laboratories, which allow to combine the chemical examination with that of the urinary sediment.

As always happens in medicine, there are exceptions to the kidney disease rule = urinary alterations. The most common exception is that of nephroangiosclerosis and some hereditary diseases, at least in the initial phase, such as polycystic kidneys, which can be present without there being obvious urinary changes.

It should also be borne in mind that, in the course of their progression towards an ever more serious renal failure, chronic kidney diseases often cause arterial hypertension.

In turn, kidney damage can be caused by an arterial hypertension that is not initially linked to nephropathy (by far the most common condition is that of the so-called essential arterial hypertension).

Measuring blood pressure is therefore another important step to discover nephropathy in time and, often, to prevent it.

A simple urine test and a blood pressure check therefore allow you to suspect the existence of a kidney disease, but unfortunately the normal results are not enough to rule it out categorically.

For this reason, it is necessary to identify people at risk of developing nephropathy in order to subject them to more detailed investigations.

Detecting the presence of a condition at risk of developing nephropathy, and not rarely if more than one is associated with it, is however very important if you want to prevent the onset of kidney damage.

To prevent kidney disease, the most important risk conditions for their appearance must be taken into account and, if possible, prevented and corrected, suggests the nephrologist in Noida.

Here are the main risk conditions for the development of a kidney:

  • aging (over 60 years)
  • hypertension
  • diabetes
  • prolonged use of medications without medical supervision, especially non-steroidal anti-inflammatory drugs
  • severe hypercholesterolaemia
  • important obesity
  • kidney stones
  • recurrent urinary tract infections
  • lower urinary tract obstruction (e.g. high prostate hypertrophy)
  • previous kidney disease
  • ongoing immunological diseases (lupus, rheumatoid arthritis etc.)
  • presence of kidney disease in family members

Taking these conditions into account, nephrologist in Delhi suggests some good rules for defending our kidneys.

  1. Prevention means first of all treating diseases that can induce kidney damage: first of all arterial hypertension, arteriosclerosis and diabetes. Naturally, first of all, the conditions that can favor their appearance must be corrected, such as obesity, the so – called dysmetabolic syndrome, too sedentary life, varying, if necessary, the lifestyle.
  2. In keeping with the previous rule, avoid diets very rich in calories, sugar, sweets, animal fats and salt, and smoking.

The traps are many. Canned and preserved foods are generally rich in salt; even the bread of some regions is quite rich: in case of need, consuming bread without salt can be useful. It is always good to drink water with a certain abundance: a liter and a half or two a day is a safe dose. The smoke can also be harmful to the health of the kidneys, warns the nephrologist in Gurgaon.

  1. Do not resign yourself to living with high cholesterol and excess body weight, which can promote arteriosclerosis, high blood pressure and diabetes.
  2. Regularly check the blood pressure, knowing that it is considered an optimum pressure equal to or less than 130 of 80 mm of mercury, and that values above 140/90 are defined as pathological, at any age (although in diabetics is suggested keep the pressure at values ​​lower than 130/80), suggests the kidney specialist in Delhi.
  3. If you are hypertensive, have diabetes or signs of arteriosclerosis, also take care to protect the kidneys, by implementing all the measures recommended by the doctor for kidney in Delhi. However, it is not enough to be content with following treatments: it is also necessary to check that the results are really what you want. For example, in the case of high blood pressure, the treatment can be considered effective only if blood pressure values ​​lower than the classic “140 out of 90” are obtained. Today there are many drugs to control arterial hypertension and it is often obtained by combining several medicaments in small doses, with reduction of negative side effects and enhancement of the positive effect. It is also important to know that some of these drugs, such as ACE inhibitors and so-called receptor antagonists, in addition to the antihypertensive effect, also have a specific renoprotective action.
  4. In the case of diabetes, make sure to obtain well-controlled glycemic levels, with values ​​of the so-called glycated hemoglobin as close as possible to the norm, and also in this case check blood pressure very well and resolve any overweight conditions, says the kidney specialist in Noida.
  5. Maintaining a proper diet and careful control of body weight, which is always important: taking medications does not authorize you to neglect dietary rules.
  6. Do not resign yourself to living with urinary tract infections, kidney stones or chronic obstruction of the urinary tract, for example from prostatic hypertrophy.
  7. Avoid prolonged use of potentially nephrotoxic drugs, such as analgesics or anti-inflammatory drugs, especially if taken without medical supervision; this does not mean that those who need it should give it up, but it is advisable, if you use them frequently, to remember to check the kidney situation periodically, advices the kidney specialist in Gurgaon.
  8. Carry out, even if it feels good, a simple urinalysis during other laboratory tests, or in any case with a two-year deadline, and do not neglect any minor anomalies revealed by the urinalysis, such as blood or proteins in very large quantities modest. On the other hand, it should not be forgotten that in some situations, such as in the presence of kidney damage due to high blood pressure or arteriosclerosis, the urine test is often normal for a long time.
  9. Perform, under all risk conditions, a check on renal function with the determination of creatininemia, possibly repeating it at regular intervals, for example annual, or every six months if the risk is high. Creatinine is a muscle mass product which is eliminated by the kidney and accumulates in the blood when kidney function decreases. Blood values ​​above 1.2 mg / dl in women and 1.4 mg / dl in men may indicate functional kidney damage and warrant further investigation. Using simple mathematical formulas and commonly used calculators it is easy to deduce the value of renal filtration from creatininemia. This control, which has supplanted the traditional one of blood urea nitrogen, can constitute a first alarm bell, particularly important when the urine test is normal, for an evolutionary nephropathy.
  10. Be careful of minor and nonspecific signs of kidney disease, such as edema of the lower limbs, hypertension, even if not constant, chronic or relapsing urinary tract infections, the emission of urine of a different color or odor than usual.

All these signs do not always indicate the presence of kidney disease or urinary tract, but it is best to make sure that they are truly harmless, suggests the nephrologist in Delhi.


The therapeutic objectives of referral to a nephrologist in Delhi are aimed at reducing and treating the associated complications of CKD, and preparing adequately and sufficiently in advance, the replacement treatment for renal function. Early detection and appropriate referral to Nephrology of patients with CKD reduces complications and improves long-term survival, since it allows early identification of reversible causes, decrease the rate of progression, decrease associated cardiovascular morbidity and mortality, and prepare the patient adequately for dialysis if necessary.

The improvement of the care and the prognosis of CKD must be made through early detection plans in the population at risk, which implies close coordination and collaboration between Primary Care and Nephrology, says the nephrologist in Noida.

According to the nephrologist in Delhi, the treatment of Chronic Kidney Disease aims to avoid or reduce risk factors for disease progression, prevent the onset of symptoms and minimize complications.

The low protein diet delays the appearance of excess urea symptoms (pruritus, insomnia, neurological, neuromuscular, gastrointestinal and other disorders), by reducing its generation. Although controversial, it is suggested that protein restriction slows the progression of CKD. This concept is not applicable to patients with polycystic kidney disease, but protein restriction is especially beneficial in diabetic nephropathy, says the nephrologist in Gurgaon.

Before prescribing the diet, the patient must undergo a nutritional evaluation. Also, the diet must include an adequate energy supply. There is a favourable circumstance that phosphorus restriction is proportional to protein restriction, so both guidelines are consistent.

In addition, the low protein diet prevents part of metabolic acidosis, by reducing the generation of acids in the body. A low protein diet is especially useful in patients with CKD grade 4 and 5, although it is less important if the patient has very well controlled blood pressure. The low protein diet can cause malnutrition, so it should be provided between 0.6 and 0.8 g / kg / person / day, in those with moderate-severe or severe kidney failure, and some parameters should be evaluated periodically corporal like the index of corporal mass, the triceps fold or the circumference of the arm, and biochemicals (in the analytical ones) like albumin and serum cholesterol, or lymphocyte levels. On the other hand, the diet must contain 35-40 kilocalories per kilogram of weight per day, suggests the kidney specialist in Delhi.

With a low protein diet, acid production is reduced, but despite this, in an advanced CKD situation, the kidney is not capable of producing the bicarbonate necessary to replace what is lost, and it is necessary to replace it as a supplement (3 -4 grams daily in the form of oral stamps or bicarbonated water). This amount depends on kidney function and the animal protein content of the diet, explains the kidney specialist in Noida.

The water intake depends on the diuresis that is conserved. Diet salt is often limited to control excess fluids and high blood pressure. However, the loss of the ability to dilute urine associated with CRF implies that a minimum intake of salt is necessary to guarantee that the patient can eliminate, for example, 2 liters of water; otherwise water is retained, and sodium in the blood drops too low (hyponatremia). This process is frequent during hospitalization, in which very restrictive diets can be indicated in salt and liquids are provided in the form of glucose serum.

Salt restriction reduces the sodium load reaching the end places of the nephron where sodium is exchanged for potassium (the tubule reabsorbs sodium and expels potassium), thus favouring the dangerous increase in potassium in the blood (hyperkalemia), says the kidney specialist in Gurgaon.

The different alterations in bone-mineral metabolism (hyperphosphoremia, hypocalcaemia, hyperparathyroidism, osteoporosis, etc.) are secondary to the progressive loss of mass and kidney function. As glomerular filtration decreases, a discrete but significant decrease in calcitriol can be seen secondary to the loss of renal mass, and to phosphate retention, which in turn decreases the renal synthesis of calcitriol. Furthermore, with this deficit of calcitriol synthesis, intestinal calcium absorption decreases, producing hypocalcemia. The positive balance of phosphorus, the deficit of calcitriol and the hypocalcemia, lead to an increase in PTH and trigger a situation of secondary hyperparathyroidism. Control of the phosphocalcium balance is essential to prevent it, and its values ​​must be kept in range according to the degree of renal failure of the patient. The basic treatment is with phosphorus chelating drugs, which manage to “catch” it from the diet and eliminate it with the faeces. A normal diet provides about 1,200 mg of phosphorus a day; When urinary phosphorous excretion is less than 700 mg / day, hyperphosphoremia and stimulation of PTH secretion begin to occur. At this time, emphasis should be placed on restricting foods rich in phosphorus, and if necessary, combining chelators and vitamin D, suggests the doctor for kidney in Delhi.

People with Chronic Kidney Disease have a much higher cardiovascular risk than the general population, and it is essential to fight all the factors that increase that risk. It is as important to try to slow down the progression of CKD as to combat factors such as high blood pressure, excess cholesterol, obesity, which multiply the complications in these vulnerable patients. Most patients with CRF have anemia, due to the relative deficit of renal synthesis of erythropoietin. Specific treatment improves survival, decreases morbidity, and increases quality of life in both dialysis and pre-dialysis patients, says the nephrologist in Delhi.

Tobacco use is the most common cause of preventable cardiovascular mortality worldwide. The immediate deleterious effects of smoking are related to activation of the sympathetic nervous system, which increases myocardial oxygen consumption through an increase in blood pressure, heart rate, and myocardial contractility.

Furthermore, smoking induces a progressive increase in arterial stiffness and is a major risk factor for cardiovascular disease, coronary heart disease and cerebrovascular disease. Furthermore, tobacco induces and accelerates the progression of CKD. In patients with advanced CKD, smoking is a cardiovascular risk factor and is associated with an increased risk of developing heart attacks, peripheral vascular disease, heart failure, and mortality. Quitting smoking is an essential therapeutic goal in CKD patients.


There are two types of kidney failure, acute kidney failure (which occurs suddenly) and chronic kidney failure (which occurs over time).

When a person has acute kidney failure, the kidneys cannot filter waste from the blood and remove it through the urine, this causes it to rise in the blood (in hours and days) and begin to cause discomfort or symptoms. Acute kidney failure can be reversible (as opposed to chronic) if it is detected and treated early, explains the nephrologist in Delhi.

When a person has chronic kidney failure, we mean that the kidneys have not been able to perform their functions properly for months or even years, and unlike acute kidney damage, the kidney damage is not reversed, states the nephrologist in Noida.

What are the causes of acute kidney failure?

When we speak of acute kidney failure, we mean damage to kidney function that occurs suddenly and can occur from a few hours to even days (not more than a month). It can be caused by various causes.

According to the nephrologist in Gurgaon, the causes of acute kidney failure are further divided into three categories, depending on where the damage occurs:

  • Prerenal: It is the most frequent cause of acute kidney failure, occurring in up to 70% of cases. It can be caused by diarrhoea, vomiting, bleeding, heart disease, liver cirrhosis, and taking some medications.
  • Intrinsic or parenchymal: It occurs in up to 20% of patients. It is due to injuries within the kidneys due to toxins (internal or external), because the kidneys do not receive enough blood, due to increased uric acid, for abusing some medications, including many in common use such as naproxen, diclofenac, ibuprofen, meloxicam, among others.
  • Postrenal or obstructive: It occurs in approximately 10% of patients. The urinary tract is obstructed. It most often affects men, because the most common cause is prostate growth, but it can also affect women.

Remember that acute kidney failure can be reversible if treated appropriately and in a timely manner , so if you or any of your family members suspect that you may have acute kidney failure, do not hesitate to immediately contact the best kidney specialist in Delhi.

What are the causes of chronic kidney failure?

When a person is found to have chronic kidney failure, it means that the kidneys have been damaged for at least three months or years and are not doing their job properly.

In many patients with chronic kidney failure, the kidneys still have a little function, however, the disease progresses slowly and as time goes by, so if some medications and lifestyle changes are detected in time, they can slow down chronic kidney failure, says the kidney specialist in Delhi.

In order to talk about the types of chronic kidney failure, we must first know that it is the Glomerular Filtration Rate (GFR), which means the amount of fluid in the body that the kidneys filter at a certain time , this amount is calculated by doctors with a special formula and must be equal to or greater than 90 ml / min / 1.73m2. Once we know this definition, we can know what the types of chronic kidney failure are, which are divided as follows:

  • Stage 1: In this stage there is some damage to the kidneys, however GFR is normal or even increased (equal to or greater than 90 ml / min / 1.73m2).
  • Stage 2: In this stage there is a slight reduction in GFR (60 – 89 ml / min / 1.73m2).
  • Stage 3a: In this stage there is already a moderate reduction in GFR (45 – 59 ml / min / 1.73m2) and the damage to the kidneys at this point is no longer reversible.
  • Stage 3b: As we observed in the previous stage, the damage can no longer be reversed, it is still considered as a moderate reduction in GFR (30 – 44 ml / min / 1.73m2).
  • Stage 4: In this stage there is already a severe and significant reduction in TGF (15 – 29 ml / min / 1.73m2) and the symptoms are becoming more evident.
  • Stage 5: In this stage the reduction of GFR is very severe (less than 15 ml / min / 1.73m2) and the kidneys no longer fulfil their functions of filtering and eliminating waste from the blood through urine, even patients stop urinating and already require dialysis.

Unlike acute kidney failure, chronic kidney failure cannot be reversed, especially when patients are in stage 3a, as explained above.

Having explained the types of kidney failure and what causes it, it is important to be able to identify them in time and immediately seek medical attention and contact the best nephrologist in Delhi. Remember that the timelier the care you receive, the better the quality of life that you and your family can lead.

How You Can Prevent Chronic Kidney Disease

Chronic kidney disease or chronic kidney failure refers to the progressive and irreversible degradation of renal function, in which prevention and early diagnosis are essential for survival.

Local medical statistics show that approximately ten million Indians suffer from chronic kidney disease and that, annually, the number of cases increases by up to 10%. Specialized medical care and timely intervention prevent the need for dialysis and kidney transplant in Delhi.

Causes and risk factors

The kidneys perform the important function of filtering excess residues and fluids from the blood, which are then excreted through the urine. When renal function becomes deficient, large amounts of fluids, electrolytes, and waste accumulate in the body.

In the early stages of chronic kidney disease, the signs and symptoms are indistinguishable. Renal failure presents clinical manifestations when renal function is almost lost, in about 90% of cases, says nephrologist in Delhi.

Among the diseases and medical conditions that can cause chronic kidney disease are:

– type 1 and 2 diabetes;

– high blood pressure;

– glomerulonephritis;

– interstitial nephritis;

– polycystic kidney disease;

– prolonged obstruction of the urinary tract (caused by an enlarged prostate, kidney stones or some types of cancer);

– bladder-urethral reflux;

– pyelonephritis (recurrent kidney infections).

The risk factors that increase the susceptibility to chronic kidney failure are

– diabetes;

– high blood pressure;

– heart disease;

– smoking;

– obesity;

– high cholesterol level;

– heredity;

– age over 65 years.

Prevention of renal failure

The key to preventing or stopping the evolution of chronic kidney disease is early detection of renal dysfunction and aggressive intervention by nephrologist in Delhi, so as to slow the progression of the disease.

Because diabetes and high blood pressure are responsible for two-thirds of the cases of chronic kidney failure, following proper treatment to control these conditions also means a diminished risk of renal function. Even if you have not been diagnosed so far, ask for the following urinalysis.

– Uroculture. Check the level of protein, glucose, and blood in the urine.

– Blood pressure control.

– Blood glucose test.

– Test for creatinine in the blood. It measures the amount of residues resulting from muscle activity. When the kidneys are not functioning properly, the creatinine level increases.

A study published in the specialty journal The American Journal of Kidney Diseases in April 2013 showed that unhealthy eating choices, obesity, and smoking are associated with a significantly increased risk of kidney disease installation.

The researchers mentioned that, unlike genetic predisposition, diet, vices, and overweight are risk factors that can be controlled to prevent the degeneration of renal function. In this regard, best nephrologist in Delhi recommends you

– Reduce your daily sodium intake.

– Avoid eating red meat frequently (diets high in animal protein can be harmful to the kidneys).

– Do not consume sour juices. Many of these beverages contain phosphorus additives, which affect the health of the kidneys.

– Discard processed foods. Potato chips, biscuits, cheese creams, semi-preparations, and sausages are examples of foods rich in phosphorus and salt additives, potentially destructive to kidney function.

– Reduce your sugar intake. The abuse of sweets increases the risk of diabetes and obesity, both associated with kidney disease.

– Consume alcohol in moderation. Excessive consumption of alcoholic beverages has important negative effects on the health of the kidneys and their role in maintaining the optimum level of fluids, electrolytes, and acid-base balance.

– Carefully analyze the side effects of medicines. Aspirin, ibuprofen or acetaminophen can cause renal dysfunction when administered incorrectly or without the recommendation of a kidney specialist in Delhi.

– Keep your weight under control. Move at least 30 minutes every day and get rid of excess weight, if any.

– Quit smoking.

Prevention of chronic kidney disease in diabetes

One possible and very dangerous complication of diabetes is chronic kidney failure. Since the kidneys are the ones that filter out the blood residues, and diabetes is manifested by too much glucose in the blood, the kidney function is overstimulated. Eventually, the kidneys will no longer be able to fulfill their essential role for survival. Capillary vessels become more porous and begin to escape from residues and proteins that should not be filtered normally reach the urine, says nephrologist in Noida.

High blood pressure affects blood vessels throughout the body, including those that feed the kidneys. Thus, treating elevated blood pressure, which involves quitting smoking, following a dietary diet and regular movement, is essential for the maintenance of renal function, suggests nephrologist in Gurgaon.

Patients with diabetes should undergo at least 3 endocrinological checks per year to monitor urine (microalbuminuria) and creatinine levels in the blood (excess creatinine indicates difficulties with renal function in filtering blood).

Just follow the recommendations of the best kidney specialist in Delhi regarding keeping the glycemic index under control through diet, sports or the administration of insulin or other medicines. Check your blood sugar level regularly!

Call your doctor for kidney in Delhi immediately for the first sign of kidney or bladder infection, such as burning or pain in urine, turbid or redness urine, lower back pain or body tremor.

Five Things You Need to Know to Care for Your Kidneys

Water intake and carbohydrate moderation preserve kidney function

World Kidney Day was created to make the population aware of the necessary care to take care of kidney health. They are responsible for maintaining the balance of the internal environment and vital functions, that is, the composition of the liquid that surrounds the cells. For this to happen, it filters 1,700 liters of blood per day and eliminates several unwanted substances. Thus, the malfunction of the kidneys impacts on all health.

According to the Nephrologist in Delhi, human genetic inheritance was not made for sedentary lifestyle and poor diet, which makes the current lifestyle the most impacting risk factor in life expectancy. The five habits to take better care of your kidney and body health are:

  1. Drink water

Consuming at least two liters of water a day not only hydrates the body but also promotes generalized care to the body, including kidney function.

“When there’s a scarcity of water within the body, the kidneys cannot work properly and their filtering operate is weakened, which may accumulate unwanted toxins within the body”, explains the nephrologist in Noida.

In order to know more precisely the amount of water to be ingested daily, it is advisable to see a kidney specialist in Noida, who will make a general assessment of the organism.

  1. Avoid excess body fat

The more fat the patient has stored in the body, the more danger it poses to both the kidneys and other organs, such as the heart and liver. The area to be irrigated by the blood also increases, making the kidneys need to work harder than normal to supply the body’s new needs.

According to the nephrologist in Gurgaon, it is recommended that the patient who is overweight look for a nutrologist or nutritionist to assess his Body Mass Index (BMI) and make the necessary changes if necessary.

  1. Decrease the amount of salt and sugar

Excess salt and sugar in the diet can bring many problems to the patient’s health, such as high blood pressure (hypertension), diabetes and overweight. It is advisable to add as few of these components as possible on a daily basis and to avoid processed, frozen and processed foods as much as possible, which contain very large amounts of salt and sugar. Monitoring health through an annual check-up is also recommended by the kidney specialist in Delhi.

  1. Avoid self-medication

Self-medication, especially with anti-inflammatory drugs, is a habit that many people have, but few really understand what it can cause. The more unnecessary drugs the body receives, the more substances the kidney and liver will need to filter to avoid excess toxins, which, consequently, overloads kidney function.

“As harmless as a painkiller for routine use may seem, it should be taken only in the dosage indicated by the doctor and during the period he stipulated”, explains the doctor for kidney in Delhi.

  1. Practice physical exercises

Sedentary lifestyle is a great evil that can directly harm the body. Practicing physical exercises at least three times a week is a great way to fight obesity and prevent many diseases, such as those that affect the heart, liver and kidneys.

However, according to the nephrologist in Delhi, before starting to run or enter the gym, it is advisable to look for a doctor to assess if there are any impediment factors that restrict the practice of exercises.