KIDNEY DISORDERS
Kidneys are vital organs that play a critical role in filtering waste from the blood, while also regulating blood pressure, balancing electrolyte levels and producing hormones essential for red blood cell production and bone health.
Kidney illnesses are a major public health concern. Worldwide, 850 million people suffer from kidney problems. The 10th leading cause of mortality, it is expected to become the fifth principal cause of death by year 2040. Over 90 percent of people with chronic kidney disease are unaware of this condition in early stages.
Chronic kidney disease is a long-term condition characterized by a gradual loss of the bean-shaped organs’ function over time. It is often caused by diabetes mellitus, high blood pressure and other conditions that put strain on the kidneys. Other risk factors are congenital or genetic defects, autoimmune disorders, obesity, smoking, stones in the kidneys, blockage of urinary system, use of certain drugs or excessive use of pain medications and poor lifestyle.
Common symptoms of chronic kidney disease (CKD) are fatigue, swelling in the ankles, feet, or hands, changes in urination frequency and appearance, blood in the urine, persistent itching, shortness of breath, or nausea and vomiting.
Acute kidney injury, formerly known as acute renal failure, is a sudden loss of kidney function that occurs over a few hours or days. It can be caused by a variety of factors, including severe infections, dehydration, severe blood loss or toxic exposures. It is a serious condition that requires immediate medical attention.
Other common issues are kidney stones and infections of the urinary tract. Kidney stones are hard deposits of minerals and salts that form inside the bean-shaped organs. They can vary in size and cause severe pain when passing through the urinary tract. Factors contributing to the growth include dehydration, certain diets, obesity and genetic predisposition.
Urinary tract infections (UTI) while primarily affecting the bladder and urethra, infections can also reach the kidneys, causing a condition known as pyelonephritis. UTIs are more common in women due to a shorter urethra. Symptoms include frequent urination, pain during urination and abdominal ache.
It is important for everyone to have a routine physical examination with their primary care doctors. Very often, early diagnosis is made from routine blood and urine tests. Specific blood tests to measure levels of creatinine and urea and urine tests to detect protein, blood and other abnormalities are done. If there is an abnormality, additional tests are conducted with imaging tests such as ultrasound, CT scan and MRI.
It is critical to diagnose chronic kidney disease early on for treatment and followed closely before it becomes a life-threatening emergency. Physicians who specialise in managing kidney diseases are called as nephrologists.
Various medications can help manage kidney disorders, including blood pressure drugs, diuretics and medications to control blood sugar in diabetic patients. Lately, the group of drugs called GLP-1s are getting more attention for those with obesity and diabetes mellitus. Immunosuppressants may be prescribed for autoimmune-related kidney diseases. There are other newer treatments of use for CKD.
Lifestyle changes and management of underlying risk factors and contributory problems are equally important. Diet and lifestyle changes are crucial in managing kidney health. This includes reducing salt and sugar intake, maintaining a healthy weight, staying hydrated, and avoiding smoking and excessive alcohol consumption. A regimen with vegetables, whole grains, nuts and fruits as in Mediterranean diet are considered good, while reducing red meat, ultra processed food and saturated fats are beneficial.
For patients with advanced kidney disease, dialysis may be necessary. Haemodialysis and peritoneal dialysis help filter waste products and excess fluids from the blood when the bean-shaped organs can no longer perform this function. Many patients on dialysis for indefinite period of time get depressed. As a result, some elders voluntarily terminate the dialysis courting death.
In cases of this end-stage disease, a kidney transplant may be the best option. This involves surgically placing a healthy kidney from a living or deceased donor into the patient’s body. Post-transplant, patients will need to take immunosuppressant drugs to prevent rejection of the new kidney. With advances in medical science, kidney replacement has become a very well recognised procedure nowadays.
Prevention and early recognition are crucial instead of undergoing treatments. Regular visits to a healthcare provider can help detect kidney problems early, especially in individuals with risk factors such as diabetes, hypertension or a family history of kidney disease.
Adopting a healthy lifestyle can significantly reduce the risk of kidney disorders. This includes a balanced diet, regular exercise, avoiding overuse of painkillers, and keeping chronic conditions such as diabetes and high blood pressure under control.
Guest Coloumn
Thirty years of Living with a Kidney Transplant
How many of us get a chance to start a 'new life', a second life, after developing a serious disease like kidney failure? At the age of 47, the peak of my health and profession, I developed an incurable kidney disease called Ig A Nephropathy that would progress to kidney failure soon. My initial bewilderment and shock gave way to a whirlwind of emotions, including severe anxiety, depression and despair, not knowing what the future held for me.
That was when my sister stepped forward to donate one of her kidneys. Yes, I am that lucky recipient of a kidney transplant from my loving sister. Receiving a kidney from a living or cadaveric donor is truly life changing and I can vouch for this from my own experience, first as a patient with kidney failure and then a 30-year span of life as a successful kidney transplant recipient. And what is equally important is that I was able to continue my profession as a full-time cardiologist serving two hospitals and a large number of patients in my private practice, till I retired at 70 years of age.
Here is a brief chronology of what happened. When my creatinine climbed up to nearly 11 mg/dl (normal <1.3) which meant kidney function was down to just 10 percent, my nephrologist suggested, “Ravi, time has arrived for you to go on dialysis unless you can get a kidney transplant.” My sister in India agreed to willingly donate one of her kidneys but getting her to USA turned out to be a little complicated because the Madras American Consulate initially refused her visa initially but relented eventually. Then we decided to go to University of Minneapolis Medical Center for transplant surgery by Dr. John Najarian, considered to be one of the best kidney transplant surgeons in the world. And on that fateful day, Nov. 10, 1994, I received the precious kidney transplant from my loving sister Ratnam, truly a life-changing moment. Thank God, I am saved now, I thought.
“Not so quickly,” somebody seemed to say. My recovery was stalled with one complication after another. So many fiery ordeals, you wouldn’t believe. A second surgery to remove clots from the femoral and renal vein and later another clot in the leg followed by pulmonary embolism (clot in the lung). Then came a heart attack that needed an emergency angioplasty. Later, a surgery for a ruptured Achilles tendon in the right leg. I survived all those and continued with a happy life till my retirement. We took a trip to Europe and then several trips to India and everything was going well. Then came further setbacks.
It was early 2020. Covid-19 was spreading fast all over the world and already many had lost their lives. I happened to be vacationing in India when I developed a bout of angina that needed another angioplasty. And we had to get a quick flight from Kochi, India to Orlando before the airports closed. For the next five months, I was okay but then needed a coronary bypass surgery and a year later a permanent pacemaker implant too.
In the final analysis, there is no doubt that a 'pre-emptive' kidney transplant was the best treatment for my renal failure, a cure for the disease. I didn’t have to go through the process of hemodialysis and the many related complications. Also, transplant patients enjoy double the life expectancy compared to dialysis patients. However, just because you receive a matching kidney, don’t think everything is going to be hunky-dory from here onward. Many complications like heart problems, rejection issues, infections, etc., can occur, so you have to be quite vigilant throughout your life. The good thing is that all these are treatable but early diagnosis is the key. And my donor, my sister, aged 85 years, is also doing well with her one kidney, very heartening indeed.
As I celebrate the 30th anniversary – kidneyversary – of my transplant, I want everybody to know that kidney transplant is the best treatment for kidney failure and even if you encounter complications after surgery, with proper management you can recover and go on to lead a normal life. At present, nearly 100,000 people are on the waiting list for a deceased-donor kidney in the U.S. and many more in India, with an average waiting time of 3-5 years. Obtaining a kidney from a living donor eliminates that wait. Since we have two kidneys and we need only one kidney to live healthy, donating one kidney is quite safe for the living donor. What is more noble than that?
(For further details of my kidney transplant journey, read my book, “Second Chance -A Sister’s Act of Love.” www.amazon.com or www.bn.com)
Dr. M. P. Ravindra Nathan is a retired cardiologist, a writer, and his articles have appeared in “Medical Economics,” “Cortlandt Forum,” “Florida Journal of Medicine,” “India Abroad,” “Tampa Bay Times,” “Tampa Tribune,” “Hernando Today” and “Hernando Sun.” He is the author of two books, “Stories from My Heart, A Cardiologist's Reflections on the Gift of Life” and “Second Chance – A Sister’s Act of Love.”
EYE CARE
Protect Your Vision This Summer
By Dr. ARUN GULANI
We all look forward to June as the month brings bright days and warm weather. It’s the season to step outside, enjoy the sun and make memories. But while we’re out there living life, it’s important not to forget that our eyes need protection too. The summer sun’s rays can be stronger than we think, and the heat, allergens and activities we enjoy can take a toll on our vision if we’re not careful.
Ultraviolet rays, or UV rays, are invisible but harmful. They can damage the eyes over time and increase the risk of conditions like cataracts and macular degeneration. Even a short time without protection can cause discomfort or more serious issues like photokeratitis — essentially sunburn to the eye. So, wearing sunglasses that block 100 percent of UVA and UVB rays is not just a fashion choice — it’s a necessity. I always recommend wrap around styles because they help keep harmful rays from sneaking in at the edges.
Summer also brings dry air, whether from the heat or a/c, which can cause your eyes to feel irritated or gritty. Drinking plenty of water and using preservative-free lubricating drops can help keep eyes comfortable. And if allergies bother you, especially with the pollen that peaks around this time, avoid rubbing your eyes — even though it’s tempting. Rubbing only makes things worse. Instead, rinsing your eyes with clean water or using allergy drops can bring relief.
Swimming pools, lakes and oceans are wonderful for cooling off but can introduce irritants or bacteria to eyes. Goggles aren’t just for competitive swimmers — they’re a smart choice for anyone spending time in the water. And if you’re playing sports or working outside, protective eyewear can prevent injuries that sometimes happen too quickly to react to.
Kids, especially, need our help with eye protection. Their eyes are more sensitive to UV rays, and besides children tend to spend hours outside. Make sure they wear good sunglasses, hats with wide brims, and understand why it’s important not to rub their eyes or swim with contact lenses. Regular eye checkups are equally important, especially if kids are active or have a family history of eye issues.
Nutrition also plays a big role in eye health. Vitamins like A, C and E, omega-3 fatty acids and antioxidants such as lutein and zeaxanthin, support vision and help protect eyes from damage. Eating colorful fruits and vegetables is one of the simplest, most effective ways to keep eyes healthy for the long term.
Today’s eye care has advanced tremendously. Treatments like next-generation dry eye therapy (MOIST®) and new surgical techniques can restore vision even in cases once thought untreatable. If you or someone you know struggles with dry eyes, irritation, or vision problems, don’t settle for the idea that nothing can be done. There are often real, effective solutions available that can improve comfort and clarity — often without invasive surgery or long recovery times.
If you notice sudden changes in vision, persistent redness, pain or discharge, seek professional care promptly. And don’t skip your annual eye exam — many eye conditions show no symptoms until they’ve progressed.