Kidney Transplant

 

We at Alchemist Hospital, Panchkula provide the best comprehensive treatment for patients suffering from kidney failure. We are the best-known transplant Centre of the region and pioneer in the Swap or paired kidney exchange transplant program catering to the needs of patients from entire north India. When you suffer from kidney failure, you either need dialysis or a kidney transplant to live. Kidney transplant is considered the best treatment option for people suffering from kidney failure because it increases your chances of living a longer and a healthier life. And we at Alchemist Hospital are committed to provide you with best of medical care in experienced hands.

Many research studies prove that patients who had chosen kidney transplant lived much longer than patients on long-term dialysis. A patient after successful kidney transplant may lives upto 15 years longer than dialysis patients. Having a kidney transplant can be a life-changing opportunity. Earlier you get a kidney transplant better and longer life you get.

Benefits of kidney transplant

Kidney transplant surgery is considered safe, and is very successful. On average, living kidney donor transplants last 15-20 years, and deceased kidney donor transplants last 10-15 years. For people with kidney failure, a kidney transplant can increase your chances of living a longer, healthier life.  Because dialysis can only do part of what healthy kidneys do for your body, people who have a kidney transplant usually live longer than those on dialysis.  After successful transplant, your health may be almost as good as a person with healthy kidneys as long as you closely follow your doctor’s advice after the transplant surgery.
Also, when you get a kidney transplant, you may avoid some of the complications that people on dialysis often have, such as bone problems, anemia, stroke, heart disease and recurrent infections related to dialysis

A kidney transplant can improve your quality of life. After your kidney transplant, you have:

• More energy
• Fewer limits on what you can eat
• More free time from not having to go to dialysis
• More flexibility to travel
• Greater ability to work and hold a job

Risks with a kidney transplant are the same as with any major surgery. Risk does not mean these things will happen, it means they could happen in few of the patients. Some of the risks are infection, bleeding, or delayed recovery.

Types of Kidney Transplant

You can get a kidney from a person who is alive and willing to donate organ, or someone who has just died (i.e. brain dead or deceased).

1. Living Donor Transplant
A living donor kidney transplant is a surgery to give you a healthy kidney from someone who is alive.
This is possible because a healthy person only needs one healthy kidney to live. A person with two healthy kidneys can donate one kidney to a person with kidney failure. A living donor can be spouse, a family member, a member of the extended family or a close friend or distant relative as guided by the Transplantation of Human Organs Act (THOA).

Kidneys from living donors can sometimes last almost twice as long as kidneys from deceased donors. On average living kidney donor transplants last 15-20 years. How long your kidney will last depends on many factors including your health status before transplant, but the most important is how well you take care of it. To help your new kidney last as long as possible, you must take your medicine every day, as many times a day as your doctor tells you, and at the times your doctor tells you. Skipping your medicine can cause your new kidney to stop working.

2. Paired kidney exchange (Swap Kidney Transplant)

The kidney paired donation transplant enables two incompatible recipients to receive healthy, more compatible kidneys. All medically eligible donor/recipient pairs may participate in the paired kidney exchange program. This is explained in the following example:

Sunil wants to give a kidney to his wife Sunita, but they are not a good match either because of different blood groups or due cross reactivity of tissue matching. Similarly, Pooja wants to give a kidney to her brother Pankaj, but they’re also not a good match due to different blood groups. However, Sunil is a good match for Pankaj and Pooja is a good match for Sunita. So, Sunil donates his kidney to Pankaj, and Pooja donates her kidney to Sunita. That way, everyone who needs a kidney gets one and this is called as

‘Paired Kidney Exchange’.

Paired kidney donation (or paired exchange) is an option when you have a relative who is willing and able to be a kidney donor, but he or she is not a match for you. In a paired exchange, your relative gives a kidney to someone who needs it, and you receive a kidney from the donor/ relative of other patient. Look at the picture below to understand how this works.

3. Deceased donor transplant

Some of the people who have kidney transplants get their new kidney from a deceased donor. A deceased donor is someone who is brain-dead. This person or their family members decided to donate healthy organs at the time of death in order to benefit people who need transplants. No matter how the person died, his or her kidney will only be given to you if it is healthy and likely to work in your body. In our country, efforts are being made to raise awareness about organ donation after death, although this program is well established in most of the western countries.

Finding a Match

Before having a transplant, you will need tests to see if the donor kidney is a match for your body. For the kidney to be a good match, the new kidney will need to be very similar to the other organs and tissues in your body so that your immune system will not attack it.

The job of your immune system is to find anything that should not be inside your body, attack it, and then get rid of it to keep your body healthy. The immune system is meant to protect your body by fighting anything it senses can hurt you, such as bacteria from spoiled food or viruses like the flu. Because the donor kidney comes from another person’s body, your immune system will notice right away that your new kidney is different than the rest of your body, then start to attack the new kidney as if it were a disease. To lower the chances of this happening, your transplant team will make sure that the new kidney comes from someone whose blood type works with your blood type.

There are four basic groups of blood types that people have: type O, type A, type B, and type AB. If your blood type is very similar to that of the new kidney, there is a lower chance that your immune system will try to fight the new kidney.

If your blood type is:

• O, you can only get a kidney from someone with type O blood.
• A, you can get a kidney from someone with type A or type O blood.
• B, you can get a kidney from someone with type B or type O blood.
• AB, you can get a kidney from someone with type A, type B, type AB or type O blood

Causes and Risk factors for Kidney Failure/ Chronic Kidney Disease

Diabetes and high blood pressure are the two leading causes of kidney disease. They are also considered risk factors, because having either condition increases your risk of getting kidney disease in long-term (especially, if not well controlled).

Diabetes

Diabetes is the #1 cause of kidney disease. Diabetes is a disease that causes your body to have trouble making or using insulin. When your body doesn’t produce or use insulin the right way, too much sugar stays in your blood, which can lead to chronic kidney disease over time and ultimately may lead to End Stage Renal Failure (ESRD).

High Blood Pressure

High blood pressure is the #2 cause of kidney disease. High blood means your heart is working too hard to pump your blood. When blood flows too forcefully through the tiny blood vessels in your kidneys, this can hurt these tiny vessels. Over time, this can lead to chronic kidney disease.

Family History of kidney disease

If you are related to someone who has kidney disease, you are at greater risk, because there are certain genes that can increase your chances of getting kidney disease. Diabetes and high blood pressure also run in families, and can increase your risk of getting kidney disease.

Kidney Stones

Kidney stones are other leading cause of kidney failure in developing countries like India. Especially neglected or improperly treated stones put your kidneys at a higher risk of kidney failure.

Obesity

Being obese puts you at greater risk for the two biggest cause of kidney disease: diabetes and high blood pressure.  This means that being obese puts you at greater risk for kidney disease too.

Smoking

Smoking can cause high blood pressure, which is the second biggest cause of kidney disease. Smoking also causes blockages in your body’s blood vessels. When a blood vessel is blocked, your kidneys cannot get the blood flow they need, and this can cause damage, which can lead to chronic kidney disease.

Past history of acute kidney injury (AKI)

Acute kidney injury is when your kidneys stop working suddenly or temporarily, over a short period of time. People who have had acute kidney injury before are more at risk for chronic kidney disease than people who have never had acute kidney injury.

Heart disease

Heart disease is when your heart isn’t working as well as it should. This makes it harder for the kidneys do to their job. If your kidneys are working too hard, they may become damaged.

• Recurrent Kidney infections
• Glomerulonephritis
• Polycystic kidney disease (PKD)
• IgA nephropathy
• Other rare conditions like: ⦁ Lupus nephritis, ⦁ Focal segmental ⦁ glomerulosclerosis⦁ (FSGS), Amyloidosis

Complications of Kidney failure and Long-term Dialysis

Dialysis helps to replace some of the work that your kidneys used to do, but it is not the same as having working kidneys. This means that you need to take extra steps to stay healthy. It also means that you may be at risk for complications of kidney failure. Some of the most common complications of kidney failure include anemia, bone disease, heart disease, high potassium and fluid buildup.
Anemia
Your kidneys help your body, make red blood cells (RBCs) of your blood that impart red color to the blood. As RBC maturation (called as Erythropoiesis) is one of the main function of healthy kidneys, your body is not able to make enough red blood cells when your kidneys are not working properly. This condition is called anemia.
Bone disease and high phosphorus (hyperphosphatemia)
We need adequate amount of functional vitamin D and calcium for good bone health. Vitamin-D formation and Calcium metabolism are another important functions of kidneys. Therefore, healthy kidneys help keep your bones healthy. If you have CKD, your kidneys may not be able to do this important job leading to poor bone health and bone resorption.
Heart disease
Heart disease can cause kidney disease, but kidney disease can also cause heart disease. Heart disease is the most common cause of death among people on dialysis. Patients on dialysis have more than double the risk of dying of heart disease, as compared to patient who has undergone a kidney transplant.
Stroke and Brain attacks
Kidney failure patients on regular dialysis are 10 times more prone to develop brain stroke than general population. This can lead to paralysis and is one of the reasons of death among kidney patients.
High potassium (hyperkalemia) and other electrolyte disturbances
Healthy kidneys filter extra potassium (a mineral found in many foods) from the blood. If you have CKD, you need to limit your potassium because your kidneys may not be able to filter it. High potassium levels in blood can lead to disastrous consequences including cardiac arrest and death if not treated in a timely manner.
Fluid overload and chest complications
Healthy kidneys take out extra fluid (liquid) from your blood. When your kidneys are not working properly, they cannot take out enough fluid. This can cause the extra fluid in your blood to build up in your body.
Having too much fluid in your body can cause problems with your heart and lungs. The extra fluid may accumulate in lungs causing difficulty in breathing and can even lead to lung infections and pneumonia. It can also cause high blood pressure, which can further worsen the underlying problems. Controlling your fluid intake can help prevent these problems and lower your risk for further kidney damage.

Advanced Laparoscopic Surgeries

 

Laparoscopic surgery is a technique of performing surgeries with the most modern specialized surgical instruments in which the surgeon puts in a camera in the patient’s abdomen and operates upon the different organs situated inside. Laparoscopic operations are performed through very small incisions hardly 5mm to 10mm, which result in minimal scarring and are extremely comfortable to the patient. In this technique placing a small high definition camera through a small incision, which is barely visible after six months, does the entire operation. The advantage of using this high definition camera is that it gives an immensely crystal clear view inside the body so the operations are done with extreme precision and can also reach areas, which are difficult to reach during open surgical operations.

 

 

What is the advantage of laparoscopic surgery?

The laparoscopic surgery evolved in the nineties, with the gall bladder and appendix being the earliest operations being done by this technique. There was an era when most of the gall bladder operations were done by traditional open surgery by a long incision over the front of the abdomen, but now most of the patients would want their gall bladders to be removed Laparoscopically. The greatest advantage of Laparoscopic surgery is that it requires a very small incision for very complex high end surgeries. It is specially important in urological operations. A traditional open surgical incision in the kidney requires cutting of the strong muscles of the back as well as the stomach on the front. Since the incision stretches from the back up to the front so the length of the traditional incision is usually between 20-30cms. It requires muscles being cut so is more painful for the patient. It also requires cutting of the 12th rib for exposure of the kidney so all the way is much more painful. In laparoscopic urological surgery all these problems are avoided since the incision is usually 2-3 cms in most of the kidney and ureter operations.

After laparoscopic surgery the patients can go home early, require less amount of painkillers an the incision heals very nicely. Since the incision is small it never leads to development of hernia in future. Another advantage to the patient is that the patient starts eating up early after the operation and there is less bleeding so usually blood transfusion is not required. After the surgery the patient usually goes back home in two days and can resume his daily routine work or can join office after a week. In open surgery since the incision is long and takes more time to heal, so usually they are discharges after 4-5 days and can not resume work by even two weeks. In fact the actual healing of the incision takes around 6 weeks to six months. The main advantage to the surgeon is that with the help of the high definition camera the vision is very clear and the field of vision is also extensive. Since in the open surgical operations the vision gets limited in the peripheral areas, this form of surgery is better in that aspect. In today’s date almost all leading specialist centers have started such kinds of operations for the kidney.

Laparoscopic pyeloplasty is a surgery to perform reconstruction of a narrowing or scarring where the ureter (the tube that drains urine from the kidney to the bladder) attaches to the kidney. It is performed using minimally invasive surgery where few small keyholes in abdomen are used for surgery.

This operation is used to correct a blockage or narrowing of the ureter where it leaves the kidney. This abnormality is called a ureteropelvic junction (UPJ) obstruction which results in poor and sluggish drainage of urine from the kidney. UPJ obstruction can potentially cause abdominal and flank pain, stones, infection, high blood pressure and deterioration of kidney function.

When compared to the conventional open surgical technique, laparoscopic pyeloplasty has resulted in significantly less post-operative pain, a shorter hospital stay, earlier return to work and daily activities, a more favorable cosmetic result and outcomes identical to that of the open procedure.

Common Kidney Problems: When to Seek Help

 

Introduction

Kidneys are vital organs that play a crucial role in filtering waste products from the blood, regulating blood pressure, balancing fluids, and producing hormones necessary for the body’s functioning. However, like any other organ, the kidneys are susceptible to various problems that can impact their performance.

Understanding the common kidney problems, their symptoms, and when to seek medical help is essential to maintain overall health. For those experiencing kidney issues, consulting the Best Kidney Doctor is imperative to receive the right diagnosis and treatment.

In this article, we will explore common kidney problems and guide you on when it’s necessary to seek help from a professional, such as Dr. Neeraj, a renowned kidney specialist.

Understanding the Role of the Kidneys

Before diving into common kidney problems, it’s important to understand the role of the kidneys in the body. The kidneys are two bean-shaped organs located on either side of the spine, just below the rib cage. They perform several vital functions, including:

• Filtering Waste: The kidneys filter out waste products and excess substances from the blood, excreting them through urine.
• Regulating Blood Pressure: They help regulate blood pressure by balancing salt and water levels in the body.
• Electrolyte Balance: The kidneys maintain the balance of electrolytes like sodium, potassium, and calcium, which are essential for nerve and muscle function.
• Producing Hormones: They produce hormones such as erythropoietin, which stimulates red blood cell production, and renin, which helps regulate blood pressure.

When the kidneys are compromised, these functions can be disrupted, leading to serious health issues. Recognizing the signs of kidney problems early and consulting the Best Kidney Doctor, such as Dr. Neeraj, can prevent further complications.

Common Kidney Problems

Several kidney problems can affect the kidneys’ ability to function properly. Some of the most common include:

Chronic Kidney Disease (CKD)

Chronic Kidney Disease is a long-term condition where the kidneys gradually lose function over time. CKD is often a result of other underlying health conditions like diabetes or high blood pressure. Early stages of CKD may not present noticeable symptoms, but as the disease progresses, symptoms may include:

• Fatigue and weakness
• Swelling in the legs, ankles, and feet due to fluid retention
• Shortness of breath
• Difficulty concentrating
• Persistent itching
• Changes in urine output or color

When to Seek Help: If you have risk factors like diabetes, high blood pressure, or a family history of kidney disease, it’s crucial to regularly monitor your kidney function. Consult the Best Kidney Doctor, such as Dr. Neeraj, if you notice any of the above symptoms or if you’re diagnosed with early-stage CKD.

Acute Kidney Injury (AKI)

Acute Kidney Injury is a sudden loss of kidney function, often occurring due to severe dehydration, infection, or the use of certain medications. AKI can be life-threatening if not treated promptly, but it is often reversible with timely intervention. Symptoms of AKI include:

• Decreased urine output
• Swelling in the legs, ankles, or around the eyes
• Fatigue
• Confusion or difficulty concentrating
• Shortness of breath
• Nausea and vomiting

When to Seek Help: AKI is a medical emergency. If you experience a sudden drop in urine output or any of the other symptoms mentioned, seek immediate medical attention. Early diagnosis and treatment by the Best Kidney Doctor, like Dr. Neeraj, can prevent permanent kidney damage.

Kidney Stones

Kidney stones are hard deposits of minerals and salts that form in the kidneys. They can vary in size and may cause intense pain when passing through the urinary tract. Common symptoms of kidney stones include:

• Severe pain in the back, side, or lower abdomen
• Pain during urination
• Blood in the urine
• Frequent urge to urinate
• Nausea and vomiting

When to Seek Help: If you suspect you have a kidney stone, it’s important to seek medical attention. Small stones may pass on their own with increased fluid intake, but larger stones may require medical intervention, such as lithotripsy or surgery. Consulting the Best Kidney Doctor, such as Dr. Neeraj, can help you determine the best course of treatment.

Urinary Tract Infections (UTIs)

Urinary Tract Infections are common, particularly in women, and occur when bacteria enter the urinary tract. If left untreated, a UTI can spread to the kidneys, leading to a more serious condition known as pyelonephritis. Symptoms of a kidney infection include:

• Fever and chills
• Back or side pain
• Frequent and painful urination
• Cloudy or foul-smelling urine
• Nausea and vomiting

When to Seek Help: While mild UTIs can often be treated with antibiotics, a kidney infection requires prompt medical attention. If you experience symptoms of a UTI along with fever and back pain, seek help from the Best Kidney Doctor, such as Dr. Neeraj, to prevent complications.

Glomerulonephritis

Glomerulonephritis is a condition where the tiny filters in the kidneys, known as glomeruli, become inflamed. This inflammation can lead to kidney damage and affect the kidneys’ ability to filter waste. Symptoms may include:

• Blood or protein in the urine
• High blood pressure
• Swelling in the face, hands, feet, and abdomen
• Fatigue
• Reduced urine output

When to Seek Help: If you notice blood in your urine or experience unexplained swelling, it’s essential to seek medical advice. Early diagnosis and treatment by the Best Kidney Doctor, like Dr. Neeraj, can prevent the condition from progressing to more severe kidney damage.

Polycystic Kidney Disease (PKD)

Polycystic Kidney Disease is a genetic disorder characterized by the growth of numerous cysts in the kidneys. These cysts can lead to enlarged kidneys and impair their function over time. Symptoms of PKD include:

• High blood pressure
• Pain or tenderness in the abdomen
• Blood in the urine
• Frequent urination
• Kidney stones
• Urinary tract infections

When to Seek Help: PKD can lead to chronic kidney disease and other complications if not managed properly. If you have a family history of PKD or experience any of the symptoms listed, consult the Best Kidney Doctor, such as Dr. Neeraj, for a thorough evaluation and appropriate treatment plan.

Nephrotic Syndrome

Nephrotic Syndrome is a kidney disorder that causes the body to excrete too much protein in the urine. It can result from damage to the glomeruli and is associated with other conditions like diabetes or lupus. Symptoms include:

• Severe swelling, especially in the legs and around the eyes
• Foamy urine due to high protein levels
• Weight gain from fluid retention
• Fatigue
• Loss of appetite

When to Seek Help: If you notice significant swelling or changes in your urine, it’s important to consult a healthcare provider. Nephrotic Syndrome requires specialized care, and seeing the Best Kidney Doctor, like Dr. Neeraj, can help manage the condition and prevent further complications.

When Should You Seek Help?

Knowing when to seek help for kidney problems can make a significant difference in the outcome. Here are some general guidelines:

1. Persistent Symptoms: If you experience persistent symptoms such as swelling, changes in urine, or unexplained fatigue, it’s important to seek medical advice.
2. Sudden Onset of Symptoms: A sudden decrease in urine output, severe pain, or symptoms of infection require immediate medical attention.
3. Family History: If you have a family history of kidney disease or conditions like PKD, regular check-ups with the Best Kidney Doctor are essential for early detection and management.
4. High-Risk Factors: Individuals with diabetes, high blood pressure, or autoimmune disorders should be particularly vigilant about their kidney health and consult a specialist if they notice any changes.
5. Routine Check-ups: Even in the absence of symptoms, routine check-ups with a kidney specialist, such as Dr. Neeraj, can help monitor your kidney function and catch any potential issues early.

Preventing Kidney Problems

While some kidney problems are unavoidable, others can be prevented through lifestyle changes and proactive health management. Here are some tips for maintaining healthy kidneys:

• Stay Hydrated: Drinking plenty of water helps the kidneys filter waste and prevents kidney stones.
• Control Blood Sugar: If you have diabetes, keeping your blood sugar levels in check can prevent kidney damage.
• Monitor Blood Pressure: High blood pressure is a leading cause of kidney disease, so it’s important to manage it through diet, exercise, and medication if necessary.
• Limit Salt Intake: Excess salt can lead to high blood pressure and strain the kidneys.
• Avoid Overuse of Painkillers: Over-the-counter pain medications can cause kidney damage if used excessively. Always follow the recommended dosage and consult a doctor if you need long-term pain management.
• Maintain a Healthy Diet: A balanced diet rich in fruits, vegetables, and whole grains can support kidney health and prevent obesity, a risk factor for kidney disease.
• Avoid Smoking and Excessive Alcohol Consumption: Both smoking and excessive alcohol intake can damage the kidneys over time.

Conclusion

Kidney problems can have a profound impact on your overall health and quality of life. By understanding the common kidney issues and knowing when to seek help, you can take proactive steps to protect your kidney function. Regular check-ups, especially if you have risk factors like diabetes or high blood pressure, are crucial for early detection and management of kidney problems