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Protecting kidneys during COVID Lockdown

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Dr Sudeep Singh Sachdev

While the COVID pandemic has restricted many to refrain from binging on junk and processed food, poor eating habits, sedentary lifestyle, physical inactivity are some recent lifestyle trends that significantly contribute to various health ailments.
High protein diets (without any exercise – as per recommendations) lead to high levels of protein (albumin) in the body. In addition to high cholesterol levels or too low levels of protein result in poor body functioning.
When such symptoms collectively persist, it affects the efficient functioning of the kidneys, which is referred to as Nephrotic Syndrome. While people across all age groups are equally vulnerable to the condition, certain studies has revealed that men are twice as likely to suffer from nephrotic syndrome than women. Other major co-morbidity that triggers this condition is diabetes in adults that not only restricts the kidney functions but gradually leads to its failure as well.
One can identify this condition if there is swelling in the legs, hands or both the limbs and sometimes in the face. Patients with this condition feel drowsy and tired throughout the day and may observe sudden weight gain along with loss of appetite.
There are main causes that include primary and secondary cause. Primary cause includes scars in the filters of the kidney that restricts its proper functioning. This condition of development of scars is termed as Focal segmental glomerulosclerosis (FSGS) which can be either congenital, hereditary or due to some infections.
While in most of the cases, secondary cause is responsible for this condition, diabetes. Kidney disease caused due to diabetes is one of the leading and serious conditions leading to end stage renal failure. Diabetic Nephropathy, or commonly known as diabetic kidney disease gradually affects the kidney functioning and can lead to accumulation of toxic waste and fluids in the body. According to a recent report, it is estimated that around 40% of the diabetics eventually develop renal problems over a period of time that leads to renal failure.
Kidney biopsy is usually performed to diagnose the condition along with blood and urine tests and treatment aims to restrict the amount of damage done in order to prevent or delay the onset of end-stage renal disease (ESRD) or commonly known as kidney failure.
There are a number of options available for the treatment which is dependent on the condition and at what stage the disease has been diagnosed. Most of the times patients are recommended with certain medications which will control the blood pressure, blood sugar, cholesterol level, and protein in the urine. The process will require follow-up testing to check the recovery and how your organs are responding to the medications.
There is a huge discrepancy between the demand and supply of organs in our country. Every year approx. 2 lakh new patients with chronic kidney failure are registered while only 5000 transplantation surgeries take place. Apart from non-availability of donors, lack of awareness among people about the advancements in treatment options is a major reason. Usually, people are sceptical about their own well-being when they are asked to donate one kidney.
Kidney transplantation is also unequally spread, mostly due to social, cultural and psychological aspects. In India the national figures show that 70 -80% of the patients are males whereas 70- 80% of the donors are females. Imagine the situation where the awareness about kidney cancer is low and how many life is at risk.
Surgery always evokes a feeling of fear and distress in the mind of all patients. Pain and disfigurement are a major fear-factor. Nephrologists have always been in the forefront of imbibing newer technologies to help their patients. Renal transplantation procedures have become less invasive, less painful, safer and cosmetically better, has ensured better and quicker recovery.
In the last few years, there have been many advances in renal replacement and organ support. More complex cases are being performed with great precision and minimal blood loss. Now, the upcoming promise is firefly and image interposition technology where CT/MRI images are superimposed on surgical area to guide operating surgeon in real time.
(The author is Clinical Lead &Senior Consultant Nephrology and Renal Transplantation Narayana Superspeciality Hospital, Gurugram)

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