Renal Biopsy

Renal Biopsy/Kidney Biopsy Specialist in Delhi

Kidney Biopsy Specialist Delhi: A Renal Biopsy/kidney biopsy is a procedure in which small pieces of (6-8 mm) kidney tissue is taken out and subsequently, that kidney biopsy sample is processed to evaluate the microscopic picture, immunofluorescence, and electron microscopy is done. It is a simple bedside procedure done under local anesthesia. Ultrasound guidance is required for locating kidneys. It is done for diagnosing kidney disease, its prognosis, and any special treatment required. It is done on a prone position from the back for native kidney biopsy and from the front for transplanted kidney (graft) biopsy. The patient requires 24hrs of hospitalization for observation.

Why I should get a kidney biopsy

  • To know the type of kidney disease AKI, CKD, RPGN
  • To know the cause of kidney disease Nephrotic syndrome, SLE, IGA, ANCA, Anti-GBM, myeloma
  • To know the prognosis and outcome of kidney disease.
  • To know the cause of graft dysfunction
  • To know the graft status ( protocol biopsy)

Dr. Rajesh Goel is one of the best Nephrologists  In India with 18+ years of experience. He did his DNB Nephrology from Pushpawati Singhania Research Institute. He did  Fellowship in Kidney Transplant from Medanta The Medicity. He started serving as Senior Consultant Nephrology in P.S.R.I at Sheikh Sarai, Delhi, and as well as Senior Nephrologist in his clinic Kidney Care Centre.  

Online Consultation

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Phone consultation-Video consultation

Charges: 800 RUPEES/- For Two Times

Payment through any IMPS or NEFT or PAYTM

But it cannot replace consultation after doing the clinical examination.

# It is not applicable for medico medical-legal cases

Kidney Transplant in Delhi

Why is Kidney Transplant better than Dialysis?

A kidney is a bean-shaped fist-sized organ which is responsible for excreting the waste particles and other harmful substance out from the blood by producing urine. Kidney Transplant in Delhi has become quite common. A Kidney transplant might require for many reasons which mostly includes any chronic kidney disease or kidney failure. Kidney transplant helps in restoring the fatal condition of the kidney by surgery or replacing a kidney with a new one. A kidney transplant is a last-minute solution for all the patients suffering from chronic kidney disease.

What is a Kidney Transplant?

In simpler words, a kidney transplant in Delhi is a surgery or a surgical process that involves the replacement of an old and damaged kidney with a new one given by a donor. Thus, the normal functioning of the kidney is affected when it is negatively impacted by any chronic disease.

The need for a Kidney transplant : There are certain malfunctions of kidneys that can be treated by dialysis. Dialysis is a treatment procedure under which a machine undertakes the responsibility of the kidney when they become incapable of doing their duties. Dialysis can be troublesome whereas consulting kidney transplant doctors in Delhi could be a wise idea.

The proper functioning of the kidney is measured with the GFR or glomerular filtration rate. If the measurement resulted in 20ml/min or less, then it is considered to be a chronic kidney disease or the last stage of renal disease. Following are the reasons why one should prefer a kidney transplant over dialysis:

  •    A successful kidney transplant can give lifelong freedom from visiting the medical center on a regular basis and improve the quality of your life.
  •    Dialysis helps in improving the function of kidneys; however, the fatality might reoccur. Having a kidney transplant will eventually reduce the risk of uncertain death.
  •    Under Dialysis, the subject might need to maintain a strict diet that might not involve in case of a kidney transplant.
  •    Kidney transplant incurs onetime payment whereas Dialysis may incur regular expenses.

When will you not be eligible for a Kidney Transplant? : As discussed earlier, the benefits of having a kidney transplant are mentioned through the comparison with dialysis. However, there is a certain time when you might not be eligible for having a kidney transplant even after being diagnosed with chronic kidney diseases. Following are the condition where a kidney transplant hospital in Delhi considers before undertaking the transplant process:

  • The first thing that would be a matter is age, which is far more important than kidney transplant costs in Delhi.
  • A person above the age of 70-75 might be at a higher risk.
  • Any other underlying chronic diseases that might not get better even after having a transplant. This includes cancerous disease and infections that cannot be cured.
  • Any health condition caused due to high drug dosage or alcohol consumption is non-curable.

People who are at the last stage of renal disease can avail of extra years of life after a successful kidney transplant. However, it’s always better to take safety measures to stay away from the medical as well as fatal diseases.

Coronavirus

The Overview Of Coronavirus(COVID-19) And The Basic Patient Education 

 

2020 has brought a global crisis affecting the lives of billions. People are dealing with one of the deadliest viruses that have emerged on the Earth. The most common term on every lip today is COVID-19 that refers to the coronavirus. But, observing some precautions can save you from being the victim of this virus. Therefore, patient education is important. Please go through the article to get an overview of the do’s and don’ts in the scenario of the corona.

What is COVID-19? : COVID-19 is the medical term for coronavirus, which is a deadly infectious disease. The recent discovery of this brand-new virus has left the entire world into a pandemic situation. The actual name of this virus is SARS CoV-2. The virus generally spreads through saliva or nose discharge of an infected person as he/she sneezes or coughs. Hence, you have to take appropriate protection to save yourself from getting infected.

This virus came into existence in Wuhan, China during December 2019. There are a lot of controversies regarding its origin. But, nothing is conclusive. Eventually, it spread throughout the globe at lightning speed, engulfing lakhs of innocent lives. As per the recent reports till may 2020, more than 6 million people across 213 countries have been affected by the coronavirus. The death number is increasing day by day. However, more than 2.6 million people have already recovered from this deadly disease.

Symptoms of Coronavirus: If you want to have full protection, then you must be aware of the symptoms of coronavirus. The most common symptom is fever. But, older people or those who are having several health issues can get fever in the later stage of the disease. The other symptoms that tell that a person is being infected by Covid-19 are as follows;-

  • fatigue
  • shortness of breath
  • cough
  • pain in joints and muscles
  • nausea
  • vomiting
  • diarrhea
  • sputum production
  • Loss Of taste
  • Loss of Smell

The symptoms are not the same in every person. Some even have sneezing, running nose, etc. that seem to be quite normal in the beginning. But, after the test, they are found to be COVID positive. The initial cases also showed chest tightness as well as palpitations.

It has also been seen in around 89% cases, the patients are having fevers after being hospitalized. Even the infected persons also go through tastelessness and loss of smell. In medical terms, there is a time-gap known as the incubation period. This is between the time of getting infected and the time of development of the symptoms. The usual range of this period may be from 2 to 14 days. Hence, whenever you are observing any of the symptoms mentioned above, see a doctor immediately and get yourself tested. Some people can also have complications such as multi-organ failure, blood clots, heart inflammation, pneumonia, Acute Respiratory Distress Syndrome, and many others. It becomes quite challenging for doctors to treat such patients.

What are the preventive measures in Coronavirus?

No medicine has been discovered to prevent infectious disease. The only remedy is taking proper precautionary measures to reduce the chances of getting affected. If all of us join hands and do the needful, we will definitely succeed in defeating this dangerous virus. Let us see what the necessary steps are that you should take in order to fight Corona.

  • Wash your hands frequently with soap or alcohol-based hand sanitizer. This will kill the germs and will lessen the chances of spreading the virus.
  • Do not touch the face, mouth, or eyes. Hand-touch can transmit the disease quickly. It is more important when you are coming from outside as there are high chances of getting contaminated when you are outdoors. As a result, the germs can infect your body instantly.
  • Following social distancing is very important. Try to have at least 1 meter, that is, 3-feet distance when you are communicating with someone. This is because, when someone sneezes, coughs, or simply talks, the saliva droplets or other liquids can come on your face. So, if the person, by any chance, has got the infection, it will infect you too.
  • Avoid any crowded place in this terrible scenario. The reason is that there are more chances of getting in touch with an infected person amidst crowds.
  • You must ensure that you and all the people living in your house, apartment, or locality are maintaining complete hygiene. If you see any diversion, take necessary action immediately or try to make them understand the risk of a non-hygienic living. Always wear masks and gloves when you are going out or while talking with someone. Also, make sure the others are following the rules as well. Tell them about the instructions given by the government and to abide by them. You can avoid several diseases like flu, influenza, Covid-19, etc. if you follow good respiratory hygiene.
  • You should avoid traveling and remain in the homes. Home quarantine is the most effective way to break the chain of transmission of this deadly virus. In this way, you can protect yourselves as well as society at large. In case you have a cough and cold, then it is always better to go for self-isolation. If you can maintain these small points, you can easily get rid of the virus.
  • Whenever you are having fever, cough, and cold or trouble breathing, do not waste time. Immediate medical attention should be sought and follow all the instructions given by the physician. Calling in advance will allow you to get the correct treatment on time. The national and local authorities have all the information related to corona patients in a particular area. Therefore, through a small step, you can carry out the duty of protecting society from further spread of the virus.
  • You should always be updated about the current position and scenario from the reports as per trusted sources. Do not rely on any kind of rumors. WHO and the local authorities are the best source from where you can get the correct information. Follow the rules and regulations formed by the government in this respect. Thus, act as a responsible citizen of the nation.
  • Please wash your shoes and clothes regularly, after coming from outside. Also, don’t forget to wash or sanitize all tangible objects like money, bags, etc. This will wipe off all the germs that can contaminate your body.

The Spread Of The Virus : Coronavirus can spread in various ways. The most common source is the droplets of saliva or fluid from the running nose of an infected person. There are two major ways through which a person can come in contact with these things;-

Direct Contact: A person has the maximum risk of getting the infection from a Corona positive person from coming into close contact if he is having the face uncovered or not maintaining the 1-meter distance.

Indirect Contact: The droplets containing the virus can remain as it is on the clothes or shoes for several days. So, you should not touch any of such articles or come across the ground having the virus. Otherwise, you have all the possibilities to get infected by the disease.

So, now the precautions and the way in which the disease transmits are clear to you. Therefore, you should avoid these activities that can increase the chance of infection. Rather, you should also take appropriate actions if the people near you are not following these rules. Remember, only our joint efforts can beat this tough circumstance. Hence, we should forget all the quarrels and other disturbances and focus on the betterment of our society.

People Facing The Highest Risk : We are going to mention over here the persons who are most likely to get affected by COVID-19.

The highest chances of infection lie with the family members or the persons coming in close contact with the COVID-19 patients. The older people, aged more than 60 years, should avoid going to crowded places or hospitals. They are more prone to the disease than the younger generation. Also, the same thing holds true for people suffering from high blood pressure, heart syndromes, respiratory problems like asthma, cancer, or diabetes.

It has observed that children and pets are less likely to get the disease. However, some recent reports also show that if the owner is COVID positive, then his/her pet can be infected. This holds good for the children as well. So, everyone should maintain hygiene in every step to fight against coronavirus.

What You Should Do After Getting The Symptoms: The symptoms of COVID-19 are quite similar to the usual cough and cold and respiratory issues that anybody can have due to the season change. It is true that every person showing such signs is not infected with Corona. But, verification of the same is essential. Without proper tests, you cannot be sanguine that the person is not a victim of the deadly disease. As a precaution, the suspected persons should follow these instructions. This is the measure of protection for themselves as well as society.

The most effective step for preventing the coronavirus from spreading is through home quarantine. The persons who must be at home for the 14 days are as follows;

  • Persons developing the symptoms
  • Those who have a traveling history in COVID affected places
  • People coming in close contact with the suspected or the infected COVID-19 persons

If these people see that these symptoms are prominent, they should immediately take medical help without any delay. Proper treatment and care are vital for curing the unfortunate victims.

Test For Corona: Although there is no vaccine yet for the coronavirus, the doctors have arranged for proper medical tests to detect the disease. If the doctor suspects that you have Corona, then you have to go through a series of tests. The first step involves taking a swab from the nose, and then the sample will be sent for the clinical lab. The doctors, as well as the nurses, should wear the requisite PPE kit while dealing with the COVID positive patients. Moreover, all the healthcare staff should abide by the necessary instructions for extra protection. However, all medical organizations are not conducting corona tests or admitting the patients. There are separate laboratories where these tests are being carried out. The people working in these labs should follow the testing instructions so that no one can get affected by the infected person. Let us take a look at the different kinds of tests that are applicable to the Corona suspected patients.

As mentioned earlier, the swab test is the first one to test the sample taken from the nose or throat. The primary residing place of coronavirus is the saliva. So, without conducting a swab test, nothing can be known with certainty.

The next step is the nasal aspirate. This test involves injecting a saline solution into the nose. After that, the sample will be taken with some amount of suction.

The tracheal aspirate is another technique of testing whether you are Corona positive or not. Here, the doctor will use a bronchoscope to reach the lungs by inserting it through the mouth. The doctors will collect the samples from the lungs only.

A thick mucus known as sputum comes in contact with the lungs and comes out as the person coughs. This process is called a sputum test, where the patient has to cough up the sputum. The fluid is collected in a special cup, or a swab test is taken for that.

Last but not least, a blood test is essential by taking a blood sample from the arm’s vein.

Apart from all these tests, another rapid test is also there. This is to test the different samples taken from the throat, nose, and lungs. Thus, this test is common in most of the CDC-approved clinics and hospitals that ensure a speedy recovery and accurate diagnosis of the disease.

Most importantly, while conducting all these tests, the health professional will instruct the patient to wear proper masks and follow other precautions too.

Instructions For Home Quarantine : Every country is going through a very tough time, both in terms of physical as well as financial conditions. The order of lockdown is prevailing in almost all countries. By now, people are well-acquainted about the positive and negative effects of lockdown. But, there was no other way to prevent the virus and its transmission. During your quarantined period at home, you should do the following activities and lead a hygienic life.

  • Staying in a separate room is highly needed. Please avoid a distance of more than 1 meter with others.
  • Ensure that there is only one caretaker
  • It is always advisable to wear a mask(preferably N-95). In the absence of the same, you can also use a cotton cloth and tie it around your neck. It is very important to cover your nose and mouth completely to prevent transmission of the virus.
  • The infected person must have separate towels, dishes, and similar other things. All the articles should be washed and cleaned very well.
  • The floors, cupboards, and other furniture should be cleaned at least once during the entire day.

Duties Of A Frontline Worker: Many people have come on the frontline to help the poor and distressed people. They want to help those who are going through a miserable condition due to this lockdown. However, they are very much exposed to the risk of getting the infection. Hence, these frontline workers should follow some simple steps and also guide others to prevent the spread of the virus.

As a responsible citizen, you should follow all the necessary instructions like maintaining social distancing, washing the hands frequently, carrying sanitizers or soap always with you, and similar others. If, as a frontline worker, you need to visit an affected person in any medical facility, you must cover your nose and mouth with a proper mask or cotton cloth. It will be difficult to maintain social distance in a crowded place or slum areas. However, you have to spread awareness about the transmission of the disease to the residents of those areas.

You must not conduct any community meetings or other outreach sessions involving more than 10-12 people. In this way, you can prevent social gatherings and play a vital role in the prevention of coronavirus.

You have to self-monitor for the probable signs of Corona. In case you observe anything similar, you must report to the medical officer without any delay. Also, give special attention to the marginalized. You should remember that older people have the highest risk. Hence, it is crucial to pay frequent visits to old-age homes and ensure that they are not out of the supply of any emergency medicines or food.

The Correct Way To Wear Masks: From the above discussion, you must have noticed that masks are inevitable in this dangerous pandemic situation. But, it is very unfortunate that most of the people do not know how to wear the masks properly. So, here we will give some instructions so that you can utilize these masks in the best possible way and stay protected.

  • Before wearing the masks, always keep your hands clean and sanitized.
  • Always ensure that the mask is not loose.
  • The mask should entirely cover the nose and mouth.
  • Avoid touching the masks from the front. Always use the sides to hold them.
  • It is better to change the masks every 6 to 8 hours. Even you should change it when it is moist.
  • Cotton masks should be cleaned daily.
  • In case of disposable masks, always use a separate bin to throw them. Avoid throwing them here and there as that can increase the chances of virus transmission.

Next Step For Corona Positive : The tests for Corona are carried out in separate steps. When your reports are positive, you should follow all the instructions given by the healthcare professional. These can give you some relief from the symptoms gradually. These steps include;-

  • Drinking a lot of water, juices, etc.
  • Take plenty of rest
  • Take over-the-counter medicines
  • Stay isolated in a separate room where no one can enter

If there are any signs of pneumonia, you should call for medical attention immediately. Along with the coronavirus, you can also have some other health complications. The only way to get cured is to listen actively to everything your doctor says without any questions.

If your reports are negative, then you should enquire whether any further tests are required. In order to prevent any further infection, please maintain hygiene and follow all the necessary precautions. Some people think that the transmission of coronavirus can occur through mosquitoes and flies. However, this is not at all true. The virus spread through clothes, shoes, bags, and their articles. So, try to sanitize everything to have maximum protection.

Precautions For Pregnant Women: The whole world is going through a tremendous critical situation due to the coronavirus pandemic. Pregnant women are in a very challenging situation where they have to take extra care of their health. We will discuss over here, some of the measures that you should definitely take during pregnancy. During this crucial period, a would-be mom is more susceptible to the infection of COVID-19. In fact, they can have a severe infection and other related complications in the delivery. Moreover, if they do not follow all the necessary steps, there are high chances that the child can take birth with the virus too. Hence, she should take all the provisions to protect herself as well as her unborn child.

  • Do not touch the eyes, nose, and mouth without washing the hands properly.
  • Do not come into close contact with any outsider.
  • There is no need to go to work.
  • You should avoid all kinds of non-essential travels

If the person follows all the rules, then it can surely reduce the risks of infection to a great extent.

 

The Deadly Disease Coronavirus (COVID-19)

The Deadly Disease Coronavirus (COVID-19): Few Questions And Answers

Deadly Disease Coronavirus: 2019, December marked the beginning of a black period in the history of mankind. A new name became the subject-matter of the headlines-Coronavirus (COVID-19). Wuhan of China became the first place of its attack. Gradually, the virus spread across the globe like wildfire. The eminent scientists of all countries are putting their heart and soul in the research of a vaccine that can prevent this deadly virus. However, no definite solution is found yet. The countries are going through continuous lockdown. Thus, this virus has adversely affected the health, business, and economic conditions. There is a scarcity of food, personal protection equipment, and people are out of money. Hundreds are facing unemployment issues. To help the public at large at this difficult stage, we will provide some questions and answers.

What is COVID-19 or Novel Coronavirus? How did it get the name?

Coronavirus Disease 2019(COVID-19) is absolutely a new type of virus that has emerged on the Earth’s surface. This is a disease that has no similarity with any of the previously identified diseases that circulate among humans. Hence, the procedure for diagnosis is also different. The diagnosis will not match the processes involved in coronavirus 229E, HKU1, and similar diseases. So, special types of care and treatment will have to be arranged for the COVID-19 affected people.

 The novel coronavirus was first identified in Wuhan, China. In the earlier stage, there was no proper name for the disease. After that, when the disease started spreading in other countries also, the World Health Organization (WHO) announced an official name for the same on 11th February 2020. Previously, the experts used to refer to the disease as “2019 novel coronavirus” or “2019-nCoV” as it emerged in December 2019. However, the new name of the disease is Coronavirus Disease 2019, the abbreviation of which is COVID-19. There are various coronaviruses that cause mild respiratory problems. However, as the virus causing COVID-19 is new for humankind, the word novel is attached to the same.

How is the virus transmitted from one person to another?

The rapid transmission of COVID-19 mainly occurs from the infected persons to the others. The carrier of the virus is the respiratory droplets from the coughs and sneezes of the infected person. If you are taking appropriate protection, these droplets can fall on the nose or mouth or can enter the lungs also during inhalation. The chances of transmission are more when the person comes in close contact with the affected person, say within the distance of six feet. At present, the world is witnessing a ‘community spread’ in several corners as this virus is transmitting at a random speed. The term ‘community spread’ means people of a particular geographical area are getting affected by the disease. Among them, some are not sure how they got the infection.

As the infected persons can spread the disease quickly among a hundred more, it has been recommended that the patients developing the symptoms for the disease should stay in isolation. So, as a responsible citizen, everybody should stay at home quarantine and break the chain of infection. Quarantine means separating a person with a contagious disease with the rest of the world. For COVID-19, the minimum isolation period is 14 days. Therefore, somebody leading a quarantined life is not a risk for society.

Why are we observing a rise in the cases?

The cases of coronavirus are increasing rapidly, mainly due to the carelessness of the locals. Besides, sometimes the government also does not generate accurate records on a timely basis. Laboratory testing requires a lot of time. As a result, the day count varies depending on the scenario. So, in the absence of the correct reports showing the exact number of people affected, an increase in the number of cases is quite evident. Even some people who did not show any symptoms also got positive reports for COVID-19. For how long a person should be kept in the hospital varies on different factors as per the facts and circumstances of each case. Also, the doctors take the decision after consulting with the state and local health officials.

What are the precautionary measures to prevent coronavirus? 

The precautionary measures that everybody should take to prevent the spread of coronavirus are as follows;-

  • Wash Your Hands: After coming from a public place, or sneezing or blowing your nose, you must wash your hands thoroughly with soap for at least 20 seconds. In case of unavailability of soap and water, you can use an alcohol-based hand sanitizer. Please avoid touching your mouth, nose, and eyes with unwashed hands.
  • Avoid Close Contact: Please do not come in close contact with any person suffering from any kind of disease. Sick people have the highest risk of being infected. Hence, maintain a safe distance, even at home. Always try to maintain a minimum distance of six feet with others. Avoid any kind of gatherings or crowded places like the mall, cinema halls, etc.
  • Cover The Mouth: It is very important that you wear proper masks to cover your nose and mouth whenever going out or communicating with others. In case you do not have a mask, you can use a cotton cloth and tie it around your face. But, you must keep in mind that wearing masks is mandatory to protect yourself and the others from the infection. However, you cannot avoid social distancing even if you are using a mask.
  • Protection during Coughs and Sneezes: Even if you are in a private place, never cough or sneeze in the open air. You must cover the face with a tissue or hanky and throw the same in the bin. After that, you must wash your hands thoroughly or use a hand sanitizer.

Maintain Hygiene and Cleanliness: Clean all the touchable objects, floors, or other surfaces daily that you come across frequently, such as tables, doorknobs, toilets, desks, and others. You can disinfect the non-washable goods like phones, laptops, etc.

What are the symptoms of coronavirus?

People who are having coronavirus can develop different types of symptoms. Sometimes, these are even seen much after the reports are generated, showing positive corona results. The most common symptoms include high fever, dry cough, and troubled breathing. Besides, there are a few less common signs, too, that indicate that you might have been infected by the virus. These are sore throat, diarrhea, aches and pains, headache, skin rashes, and many more. However, you will understand that the health condition is taking a serious turn when you are suffering from acute chest pain, shortness of breath, or loss of speech or unsteady movements. So, if you have any of these, an immediate call for medical help. Always remember that you cannot compromise with your health as well as that of your family. Hence, without any delay, take the initiative to go through the tests. Once you are assured of the reports, whether you are having COVID-19 or not, you can think of the next steps.

What should you do after developing any of the symptoms?

Coronavirus has already taken millions of lives across the globe. The way it is spreading, getting paranoid is very natural. However, if you are always afraid about what is going to happen in the next moment, it will not do any good. The proper solution will be to take appropriate precautions and to follow all the instructions of the government in this regard. By taking some small steps, we can protect ourselves as well as the whole society.

If you or any of your family members are showing any kind of symptoms of the corona, it is essential that you maintain home quarantine strictly and do not move out of the house except for extreme emergencies. Before going to any medical facility, it is better to explain all your symptoms to your doctor over the phone. In case the symptoms are mild, the doctor will only advise you to drink a lot of liquids, stay at home, take sufficient rest, and keep a watch on the symptoms. If you observe any betterment, you should communicate that too. However, in case of the development of some more symptoms, do not hesitate to share that with your physician. Your health is very crucial. So, always wear a mask and avoid crowded places or public transport.

Who has the highest chances of getting affected by the virus?

The virus causing COVID-19 can infect anyone irrespective of their age. However, medical history suggests that majorly two groups of people have the highest risk of getting affected by the disease. One section includes the older people who are aged 60 years or above; the other group consists of sick people. Sick means those who are suffering from some acute health problems like cancer, cardiovascular disease, diabetes, or any other chronic disease. The risk will start increasing for the people above 40 years of age. Hence, adults should behave in a more responsible way to protect themselves as well as others from the harmful hands of this virus. Special circulars and advice are there from the WHO for these two groups of people. These are steps to ensure that they get full protection from the infection of COVID-19. Such people who are not staying in isolation are exposed to vulnerabilities for getting the infection. Hence, there should be a special arrangement of treatment and social care for these people.

What are the different types of tests associated with coronavirus?

There are different kinds of tests associated with coronavirus to identify whether a person is having COVID-19 or not. These are as under;

Swab test: This is the first and primary test where the samples of fluid are taken from the throat or nose. It is quite painful for the patient while the samples are collected.

Sputum test: Sputum is a kind of thick mucus. This is collected when you cough and kept in a separate cup.

Blood test: A blood sample is also taken to check whether your blood contains the virus.

Rapid test: This is the most popular test that involves the collection of fluid samples from the lungs, nose, or throat. It is prevalent in most of the CDC-approved health organizations and ensures an accurate diagnosis more quickly.

There are many other tests, but during all the tests, you can feel a bit uncomfortable. However, these effects are temporary in nature. After the test is over, the respective places will heal slowly.

 

When should a person get admitted to the hospital?

When a person severely develops any of the symptoms, he or she should go to the medical help immediately. The hospital authorities can decide to admit a suspected patient immediately and put the person in an isolation ward. There are no separate hospitals as per the WHO recommendations for COVID-19 patients. However, some countries can choose to build separate cells to keep the affected persons separate from the general crowd. Moreover, every patient should abide by the WHO infection prevention suggestions so that they can protect the other patients, medical staff, and visitors.

 

Does any protected immunity develop after treating the corona infection? Is there any chance of recurrence of the disease?

There is no conclusive evidence until now that persons recovering from the coronavirus infection have developed any antibodies. Hence, you cannot say with certainty there can be no chances of recurrence of this deadly disease. Immunity develops a pathogen through natural infection. It is a multi-step process, and so it is not easy to develop the protected resistance power to prevent the further occurrence of COVID-19. Some think that antibiotics have the potential to treat or prevent the disease. However, this is not true.

What is the recommended PPE for healthcare professionals dealing with corona patients?

 

 

All healthcare professionals dealing with corona patients should take extra protection for themselves. Personal protection equipment or PPE is a must for people working in healthcare units. FFP2 and FFP3 respirators are the best to provide respiratory protection. Besides, the ideal PPE kit should also contain goggles or face shields to protect eyes, long-sleeved water-resistant gown, and medicated gloves for hand protection.

 

Covid-19-Hemodialysis

Covid-19-Hemodialysis-Unit-Preparedness-Checklist

 

This checklist contains the guidelines given by the government. This is specifically for various dialysis units across the place. If patients arrive at hospitals with Cocid-19 symptoms, this needs to be followed.

Before The Arrival Of The Patient                                                                Done(Y/N)  Remarks

Things to Assess:

The dialysis staff needs to be educated about:

  • Epidemiology, Testing and Triage of Covi-19.
  • Wearing the PPEs.
  • Etiquettes to be observed while coughing and sneezing.
  • Hand wash and sanitization.

Details related to Stocks:

  • Dialysate, dialysers, tubes, catheters, fistula, needles and heparin.
  • Disinfectants and medication.
  • Stick of PPEs and sanitization materials.

Details related to staff rosters and shifts:

  • Presence of adequate staff members.
  • Detection of Exposure rate of staff members.

Signboards in all languages in the Dialysis unit

Signage asking patients and relatives to report Covid-19 symptoms

Instructions related to reporting of SAR Covid 19 before embarking into the Dialysis area

The Screening Area

Things to Assess:

Presence of an entry and exit for staff members and patients

Presence of a specific area for screening patients before dialysis begins

Adequate space for social distancing in the wards

Availability of Masks

Screening Guidelines in the Screening area:

  • Covid -19 symptoms
  • Thermal screening
  • Contact History
  • Recent Travel History Outside India

 

Presence of adequate and relevant signage on Covid -19.

Sanitizing norms in the wards – hand wash with at least 60% alcohol for hand

wash with liquids disinfectant soaps for 20 seconds

Signing of consent documents with respect to Covid-19

 

The Dialysis Area

Elements To be Assessed

Teaching of Cough Etiquettes to patients

Maintenance of Eating guidelines

Presence of alcohol-based hand sanitizer

Presence of Trash cans

Presence and usage of 3-layer surgical masks

Following of hand hygiene rules

Presence of Questionnaire on Respiratory symptoms of dialysis staff

Social distancing norms maintenance in the unit

Availability and Usage of:

  • Stethoscopes
  • Thermometers
  • Oxygen saturation probes
  • BP cuffs

 

Guidelines for Suspected Patients

Dialysis arrangements for Covid -19 patients:

Needs isolation

Staff division between positive and negative patients

 

Dialysis norms of patients detected for Covid -19 in the last few hours.

Distance of 2 meters maintained between two patients

Usage of PPE for staff caring for Covid-19 infected patients

  • Shoe covers
  • Gown
  • Googles
  • Cap
  • Mask N95 or Triple layer
  • Surgical gloves

Maintenance of usage guidelines of PPEs and disposal

Notification about Covid-19 positive patients to District medical teams

 

Cleaning and Disinfection Process

Cleaning details of dialysis machines and trash cans after each shift

Change of upholstery and bed linen after each shift

Maintenance of gowns and kits and disinfection with 2% hypochlorite solution

Disinfection of furniture – beds, tables, trays, counters, toilets, faucets, taps, bathroom WC.

Presence of dedicated cleaners for wheelchairs and weighing machine

Usage and maintenance of 2 % hypochlorite, 60 % alcohol and other disinfectants

Proper usage and disposal of gloves

RO disinfection procedure maintenance

Kidney Transplant & COVID-19

Kidney Transplant & COVID-19

Kidney Transplant & COVID-19 Patients Guidelines

You must know a few facts about kidney transplant recipients, then only you can understand the implications. These patients are continuously required to take immunosuppressive drugs. Therefore, they have a higher risk of infection from corona virus or any other simple virus, such as cold or flu. To lower the chances of getting the coronavirus, kidney transplant patients should follow the CDC’s guidelines. They know how to avoid catching or spreading viruses. Moreover, they can contact their doctors, if they develop symptoms of COVID-19.

Are post-transplant patients at higher risk from contracting the disease?

Yes, this is a relevant question. If you have just undergone kidney transplant and staying with family members. You should be cautious of members who have contracted the disease. There might be additional sanitization norms for such patients.

How can I get emergency kidney treatment? 

You should keep your dialysis center number handy. In case, you face a situation where you need dialysis, call them up. They will schedule you, if it is urgent or else they will recommend you to the nearest center.

Moreover, during this time, you should have food with low sodium and potassium. It increases the risk all the more.

Do the transplant kidney patients and donors get affected by the virus?

As already told, kidney transplant patients are at a higher risk of contracting Covid -19. However, the risk comes after the surgery. You cannot get the virus from donors. Donors are properly screened. Moreover, living donors are asked to stay in 14 days’ isolation to avoid the contamination themselves.

However, if things go awry then the below symptoms do crop up.

Cold symptoms

Sore Throat

Fever

Less urine generation

Weight imbalance

Pain over transplant area

 

What should I know about medicines and treatments?

As reported worldwide, there is no miracle cure. No patients can be cured overnight. It depends on the patient’s immune system in totality. In fact, research on vaccinations are underway. There has been no concrete success on the same.

 

What are the Prevention tips Kidney Transplant & COVID-19

It is very important, that you take proper care of yourself. You can undergo routine tests. Moreover, you can also get your urine samples checked. If there is no option for home testing, you need to go to the lab to give your samples. All healthcare areas are sanitizing their equipment and machinery before staring tests. So, you can be privy to that. Moreover, they are using PPEs while interacting with customers and patients. You yourself can wear a mask. Also, come back home and wash properly. Use hand sanitizers, wherever possible.  Moreover, you have to be well prepared.

You should buy extra supplies, that includes masks and disposable gloves.  This is to enable you to fight the virus, should you come into contact with someone at a medical center or someone in your locality. Also remember to disinfect touched surfaces such as doorknobs and countertops.

Will there be any drugs supply delays in future?

There is no report on drug supply delays yet. However, if people like you start hoarding drugs and medicines, there might be. The government is aiming at maintain a steady supply of all necessary medicines. Moreover, the Food and Drug Administration is keeping a close watch on drug supply and management. So, you need not worry. Just, buy what has been prescribed to you. Do not change the medicines without speaking to your doctor.

Are you feeling stressed out and depressed?

It is natural for those, who have been diagnosed with chronic kidney diseases to feel scared. Moreover, there are other patients as well, like those on dialysis, kidney transplants patients and donors to feel depressed. The most that you can do in such cases is to maintain the sanitization norms that the government has advised.  WHO has some great ways for helping you to manage your stress and anxiety. They have even started helplines to assist you.

 

Do any of the kidney medications increase the risk from COVID-19?

Yes, it is true. Those who have co-morbidities are at a higher risk of the infection. Cancer patients and those on this drug are at a higher risk. These medicines and drugs reduce the body’s immune system. The immune system becomes powerless. Oral steroids taken as a part of the treatment also reduce the bodies normal immune power. Moreover, if you are taking it for a longer time, it becomes all the more evident.

 

Are other medical conditions responsible for aggravation?

The Covid -19 virus aggravates the satiation even more. The virus that causes the disease infects people of all ages. They are the older people over sixty years old.  Then people with medical conditions such as heart diseases, diabetes, asthma, other respiratory disease, and cancer. The risk of severe disease gradually increases with age starting from midlife. It is important that adults in this group save themselves from the virus. WHO is advising older people to meet people, if necessary without touching. Ask everyone to wash hands for 20 seconds. They should clean their clothes and body regularly with disinfectant soap.

What are various modes of distancing like?

They are self-isolation, quarantine and distancing. The self-isolation refers to separate and stay away in a room or a far off place. You should not talk or interact with anyone. They may be infected.

Quarantine means restricting all your activities. These are people with exposure to Covid conditions. They may not be infected yet but taking precaution. They may carry symptoms.

Physical distancing means distancing norms for normal people. You should follow these norms when visiting markets and other public places.

Can children catch the disease?

Children and teens are also at a higher risk just like older adults and kidney patients. So, you must ensure to keep them well-protected. These groups should follow the same guidelines as followed by other members of the community. Do not allow children to play with other children from the community. This is a prerequisite. So, take care to follow it without fail.

Urinary Tract Infections

Patient education: Urinary tract infections in adults (The Basics)

What is the urinary tract?

The urinary tract is the gathering of organs in the body that handle urine. The urinary tract incorporates the:

  • Bladder, a balloon-formed organ that stores urine
  • Kidneys, 2 bean-formed organs that use to filter the blood for making urine
  • Urethra, the tube that use to carry urine from the bladder towards the outer surface of the body
  • Ureters, 2 tubes which use to carry urine from your kidneys towards the bladder

What are urinary tract infections? 

Urinary tract infections, also named “UTIs,” happen to be infections that change either the kidneys or the bladder:

  • Kidney infections happen when the bacteria travel considerably higher, affecting kidneys. The medical phrase for kidney infections known as “pyelonephritis.”

The symptoms of:

  • Loin pain
  • Fever
  • Hematuria
  • Vomitings
  • Bladder infections are more typical than infections in the kidney. They occur when bacteria enter the urethra and go up into the bladder known as “cystitis”.

Both bladder and kidney infections are more typical in women rather than men.

What are the symptoms of a bladder infection? 

The symptoms include: 

  • A burning feeling or pain when you urinate
  • The need to urinate abruptly or in a rush
  • The need to urinate frequently
  • Blood in the urination

Symptoms of kidney infections

The symptoms of kidney infections acute pyelonephritis can include the symptoms of a bladder infection, yet kidney infections can also cause: 

  • Fever
  • Vomiting or Nausea
  • Back pain or loin pain

How to evaluate if i have a urinary tract infection? 

Consult a kidney specialist. Person can tell in the event that you have a urinary tract infection just by explaining about your complaints.

Your nephrologist may do a straightforward urine routine test. Further urine culture and leukocyte count tests will be done.

How to treat urinary tract infections? 

Most of the urinary tract infections happen to be treated with the help of antibiotics. For bladder infection (cystitis) antibiotics for 3 to 7 days. For kidney infection or acute pyelonephritis antibiotics oral or intravenous for 7 to 21 days. Also may require hospital admission.

Proper antibiotics course to be taken. In recurrent episodes prophylaxis antibiotics therapy is an important planned by a kidney doctor.

For severe bladder pain, bladder analgesics will be given. These drugs ease the pain caused by urinary tract infections. It also reduces the frequency of urination.

What in the event that I get severe bladder infections? 

In the first place, verify with a nephrology doctor to ensure bladder infections. Bladder infection symptoms can be sourced by different things.

In any case, if you are really dealing with recurrent urine infections, there are things you can do to prevent getting more infections. These include: 

  • Drinking more fluid – This can help avert bladder infections.
  • Avoiding spermicides (sperm-murdering creams) – Spermicide is a form of birth control. It appears to increase the danger of bladder infections in certain women, especially when utilized with a diaphragm. If you use spermicide and get a ton of bladder infections, you should have a go at changing to an alternate form of birth control.
  • Urinating directly after sex – Some doctors think this aides, because it assists flush with excursion germs that may get into the bladder during sex. There is no confirmation it works, however it also cannot hurt.
  • Antibiotics – If you get a ton of bladder infections, and the above strategies have not helped, your doctor may give you antibiotics to help avoid infection. Nevertheless, taking antibiotics has downsides, so doctors usually recommend attempting different things first.
  • Vaginal estrogen – In the event that you happen to be a woman already experienced in menopause, your doctor may propose this. Vaginal estrogen arrives in a cream or an adaptable ring that you put into your vagina. It can help counteract bladder infections.

Can cranberry juice or other cranberry products anticipate bladder infections? 

The researchers proposing that cranberry products anticipate bladder infections are not excellent. Different investigations propose that cranberry products don’t avoid bladder infections. In any case, if you want to attempt cranberry products for this reason, there is probably very little harm in doing as such.

Chronic kidney disease

Patient education: Chronic kidney disease (The Basics)

What is chronic kidney disease?

Chronic kidney disease (CKD) is the point at which the kidneys completely quit working just as they should. At the point when they are working normally, the kidneys filter the blood and expel waste and water and overabundance salt.

In individuals with CKD, the kidneys gradually lose the capacity to filter the blood. In time, the kidneys can quit working totally. That is the reason it is so important to prevent CKD from deteriorating.

What are the symptoms of CKD? 

From the start, CKD causes no symptoms. As the disease deteriorates, it can: 

  • Make your ankles, feet, or legs swell (doctors call this “edema”)
  • Give you hypertension
  • Make you tired
  • Damage your bones

Is there anything that can be done preventing your kidneys from deteriorating if I have CKD?

Truly, you can secure your kidneys by: 

  • Taking blood pressure medicines each day.
  • Keeping your blood sugar in a solid range, in the event that you have diabetes
  • Changing your eating routine, if your doctor or nurse says you ought to
  • Quitting smoking, in the event that you smoke
  • Losing weight, in the event that you are overweight
  • Avoiding medicines known as “no steroidal anti-inflammatory drugs,” or NSAIDs. These medicines incorporate ibuprofen (test brand names: Motrin, Advil) and naproxen (test brand name: Aleve). Check with your nurse, doctor, or kidney authority before beginning any new medicines – significantly over-the-counter ones.

What are the treatments for CKD? 

Individuals in the beginning times of CKD can take medicines to prevent the disease from deteriorating. For instance, numerous individuals with CKD should take medicines known as “ACE inhibitors” or “angiotensin receptor blockers.” If your nurse or doctor prescribes these medicines, it is important that you take them consistently as coordinated. If they cause reactions or cost excessively, address your nurse or doctor about it. The person may have answers to offer.

What occurs if my kidneys quit working totally? 

In the event that your kidneys quit working totally, you can pick between 3 unique treatments to assume control over the activity of your kidneys. Your decisions are portrayed beneath.

  • You can have kidney transplant surgery. That way, the new kidney can carry out the responsibility of your own kidneys. If you have a kidney transplant, you should take medicines for a mind-blowing reminder to prevent your body from responding seriously to the new kidney.
  • You can figure out how to utilize an extraordinary liquid that must be channeled all through your belly each day. This treatment is designated “peritoneal dialysis.” If you pick this sort of dialysis, you will require surgery to have a peritoneal dialysis catheter embedded in your belly.
  • You will be able to have your blood cleaned by a machine. This kind of treatment is designated “hemodialysis,” yet numerous individuals call it just “dialysis.” If you pick this methodology, you should be snared to the machine, in any event, each week 3 times. Before you start, you will likewise need to have surgery to set up a blood vessel for connection to the machine.

How would I pick between the distinctive treatments alternatives? 

You and the doctor must work jointly for discovering a treatment that is directly for you. Kidney transplant surgery is generally the best alternative for a great many people. Nevertheless, regularly there are no kidneys accessible for transplant.

Solicit your doctor to clarify all of your alternatives and how they may work for you. At that point talk straightforwardly with the person in question about how you feel pretty much the entirety of the alternatives.

What is COVID-19?

What is COVID-19 all about?

COVID-19 is a type of coronavirus strain. It is a new virus or disease that is contagious. Those who become infected with this virus, will experience mild to severe symptoms. The symptoms are more of the respiratory types. The virus affects aged people more than anyone else. Those who have a history of heart ailments, asthmatic symptoms and diabetes should be more vigilant.

The disease which is caused by this virus Covid-19, has several implications. The Coronavirus disease was first detected in 2019 in Wuhan, China. Therefore, the strain has been named Covid-19, according to the year.  COVID-19 is also known as the “Novel Coronavirus,” which means, it is a new type of coronavirus not previously discovered or identified.

Corona Viruses are a large group of viruses, which have been known to cause illness in humans and animals. It leads to respiratory infections which range from common cold to severe diseases. The various diseases are MERS or Middle East Respiratory Syndrome or SARS, whose full form is Severe Acute Respiratory Syndrome.

What are the various different kinds of symptoms of COVID-19?

The most commonly found symptoms of the coronavirus disease are:

  • Fever
  • Dry Cough and sore throat
  • Shortness of Breath
  • Nasal Congestion
  • Diarrhoea
  • Aches and Pains

If you have the above symptoms, then you should immediately call your healthcare provider. You can acquire information related to the virus and its symptoms from the Ministry of Health & Family Welfare Government of India website.

Why is the entire world so worried about COVID-19 or the Corona Virus disease? 

Till date, we had only heard of pandemics and epidemics. However, the current generation is facing this for the first time. The world has witnessed the small pox epidemic and cholera epidemic. However, this is very new. The world does not even have a vaccine and that is bothering most.

The reasons everyone is so worried about Corona Virus disease are:

  • It is a new virus.
  • There are numerous facts, we don’t know about it.
  • There are no vaccines or medication available as of now.
  • It spreads like fire.

How does COVID-19 spread?

The disease mainly spreads through droplets from coughing and sneezing. You can either get infected through direct contact or through indirect contact. Direct contact means, that you are in close contact with someone, who is suffering from the disease. Indirect contact refers to contamination through cough and sneeze droplets, that survive on the surface for fourteen hours. If someone touches any such surface and touches his or her mouth, contamination can happen.

When is someone with the Novel Virus or COVID-19 contagious?

It can be contagious when someone has or does not have the symptoms. Moreover, it may also spread from people who are already infected, but do not display symptoms. Such people have a strong immune system, however they are at a greater risk of infecting others.

According to the CDC, Corona virus spreads mainly through close contact with infected persons. And through the cough and sneeze droplets from someone who is infected. also it spreads from fomites. People who are infected often have no symptoms or signs of illness. Some people without symptoms may spread the virus, as others are not aware that the incumbent has the disease.

Who is at a risk of contracting the COVID-19?

Covid-19 is a new disease that can affect some people more severely than the others. Older adults and people who have underlying conditions like asthma, cardiac diseases, diabetes, are at a higher risk than normal and younger people.

Do kidney ailments put me at a higher risk of infection?

Yes, people with a chronic kidney disease are at higher risk for more severe illness.

There are people, who are on dialysis. They have weak immune system. Therefore, making it hard for their bodies to fight infections. However, it is important for all to know that such kidney patients need to continue with their treatments and should take precautions as advised by their doctors.

There are people who had a kidney transplant very recently. Such people have not recovered fully and need to take anti-rejection medicines or immunosuppressive medicines. These medicines make the immune system weak, which can make it hard to fight viruses. However, it is still necessary to keep taking these medicines. It is also useful to wash both the hands, maintain good sanitary norms and follow the guidelines from their respective doctors.

Why do you need to wash both your hands and avoid touching the face?

Public health officials are encouraging washing the hands for 20 seconds. The virus lives on various surfaces for a long period of time. Therefore, you have to keep washing hands and eyes. You never know, where the contamination is. Most people have a habit of scratching their faces, biting nails, rubbing their eyes and noses. So, washing hands is really important. The infectious virus enters through the body’s opening.

How do I keep my hands sanitized and clean?

You can keep your hands clean by washing them frequently. It can prevent the virus from entering the body through the orifices in the body. You should wash hands before and after making food, before and after eating, before and after treating wounds, and also on handling various objects. If you have pets at home, you should increase the number of times, you wash the hands. It is advisable to clean hands with any soap, liquid hand wash and a sanitizer containing at least 60% alcohol.

What are the cleaning agents that work against the virus?

The Council recommends that busy and over-used surfaces should be cleaned daily. Apart from cleaning the surfaces with disinfectants, you can clean hands with soap and water. Sodium hypochlorite is a bleach and you can use it as well. The other option is to wash hands with surgical solution. You can use ethanol that is diluted. Or else, you can also use doctor’s spirit. Moreover, you can also use surface wipes and hand sanitizers.

What do you mean by Flattening of – Curve 

Flattening the curve means the aim of slowing the spread of an infectious disease, like Covid -19 in an effort to keep the disease under control.

Certain diseases like COVID-19, can be contagious and can spread from one person to the other person. However, maintain such things as social distancing, which are used to help slow down the spread of the disease and also prevent a rush at hospitals.

The graph from the Centers For Disease Control shows the idea of what a flattening the curve is. The taller the curve, the more severe the outbreak is, with no intervention. The flatter the curve, it shows a possible outbreak with interventions. Flattening the curve can help reduce the pressure on hospitals and other parts of the health system. It gives a chance to respond without becoming pressurized with uncertainties.

Why COVID-19 does not have a medicine or vaccine yet?

COVID-19 is a new form of coronavirus. Therefore, there is no vaccine. Moreover, past research work may speed up the search for Covid-19, however approval process may take 18 months to 2 years.

The potential treatments need to go through a three-phase clinical trial. Then only, the government can release it in the market.

How can we teach social distancing and the importance of social distancing?

There are various reports of people celebrating marriages and birthdays, without fear. In the process, they are contaminating others. There are a lot of young nurses and healthcare professionals working in close contact, are contracting the disease. During these trying times, everybody has to understand, that maintaining distances is the only way to stop the spread of the disease.

People of all age groups who need to be educated, on what this virus can do to them and the people in the family. A few older people are getting bored at home and are venturing outside.

There are researchers who are working day and night to develop a vaccine. The process of research and development are taking new turns and can take many years. When a vaccine is out, it also needs to be examined and checked to make sure it’s working and effective. Moreover, the elderly is over confident. They think, they know more.

Misinformation and stubbornness are the main reasons. Therefore, they have to be explained about the vulnerabilities in details.

How can we find COVID-19 facts from myths?

There are various myths associated with Covid-19. There are myths that high temperature can destroy the virus. However, this not true. Another myth is that, if you expose yourself to the sun, you can kill the virus. Another myth is that steaming, gargling, and bathing in very hot water can protect you against COVID-19. It is not true. Too much of steaming can damage your respiratory channel.

Trustworthy sources

Ministry of Health & Family Welfare Government of India, WHO or the World Health Organization is one of the trustworthy sources for Covid-19 information.

You should only believe in information from reliable sources. You should not pay much heed to news generated by social media. Most of the news bulletins are fake. Use your good judgement, to differentiate between the right and wrong. You should not trust all the sources in the market.

Social media: use caution

Everybody is representing the government today. Therefore, is commenting and distributing facts and figures. The posts on social media can be very misleading. They turn myths into facts under most circumstances and should be given a miss. The best way is to avoid reading them.

You can be part of the solution

You should take care to collect and disseminate proper information. Always make sure to follow the directives from Ministry of Health & Family Welfare Government of India. Moreover, you should also encourage others to follow the directives. If you see that someone is not listening, you can make arrangements to make them follow the government instructions.

How can I make a mask at home?

You can make a mask very easily. The common people do not need three-ply masks or N95. You can make a cloth mask easily at home. Just take a square piece of cloth and attach elastic bands on both ends.

Can COVID-19 cause kidney failure?

There have been reports of kidney failure for patients suffering from Covid-19. However, it is not entirely true, that the virus has caused it. The patient may be having other silent symptoms.

Know the  several kidney ailments

There are two forms of kidney diseases. These are two conditions. They are called acute kidney injury and the other one is called chronic kidney disease, which will lead to chronic kidney failure. The detection of the proteins and blood in urine swabs is an easy way of detecting kidney malfunction in people.

You are a high risk individual, if you are in any of these categories. If you had a kidney transplant, if you are on dialysis, if you are above 70 years and have been taking immune-suppressants. Moreover, if you are suffering from autoimmune conditions, you are in the high risk category.  If you are undergoing dialysis. These people must isolate themselves. Covid-19 is known to aggravate these symptoms, so you have to be careful.

Kidney Disease

Kidney Disease

Kidneys are an essential part of our body. There is a pair of fist sized organs located at the bottom of the rib cage. There is one kidney on each side of the spine.

Kidneys are basically responsible for filtering waste products, excess water and impurities out of the blood. They stored toxins in the bladder and then removed them through urination. They also regulate PH, salt and potassium level in the body. Kidney produces hormones which control blood pressure and control the production of red blood cells. They also activate a form of Vitamin D which helps the body to absorb calcium.

Kidney disease occurs when kidneys get damaged and can’t perform their function. This disease may leave kidneys unable to remove wastes. It can be damaged by diabetes, high blood pressure and various other chronic conditions. Kidney disease can cause other health problems such as weak bones, nerve damage and malnutrition.

If your kidneys get damaged then waste products and fluid can make up in your body. It can cause swelling in your ankles, nausea, weakness, poor sleep and shortness of breath.

If the kidney disease gets worse with the period of time then it may stop working completely. It means that dialysis is required to perform the function of the kidneys. Dialysis is a treatment for kidney disease which filters and purifies the blood using a machine. Dialysis can’t cure the disease but it can prolong your life.

What are the types of kidney disease?

Chronic disease is one of the most common kidney diseases. It is a long-term kidney condition which doesn’t improve within the period of time. It is mainly caused by high blood pressure. High BP is risky for kidney disease because it can enhance the pressure on the glomeruli. Glomeruli are the very small blood vessels in the kidneys where blood is cleaned. With the passage of time, the increased blood pressure damages these vessels and kidney function starts to decline. Diabetes also leads to chronic kidney disease. Diabetes is a bunch of diseases which can cause high blood pressure. The increased level of sugar in the blood deteriorates the blood vessels in the kidneys over time. It means the kidneys can’t do the function properly. It may result in kidney failure when your body becomes overloaded with toxins. Other causes are chronic glomerulonephritis, chronic pyelonephritis, kidney stones, polycystic diseases, reflux nephropathy and others.

Kidney stone is another type of kidney problem. It occurs when minerals and other substances in the blood crystallize in the kidneys, forming solid stones. Kidney stones evenly come out of the body during urination. Passing kidney stones can be very painful but they rarely lead to significant problems.

  • Glomerulonephritis

Glomerulonephritis is the inflammation of the glomeruli. Glomeruli are very small structures inside the kidneys which filter the blood. It can be caused by infections, drugs and congenital abnormalities. It generally gets better on its own.

  • Polycystic kidney disease

This disease is a genetic disorder which causes the number of cysts to grow in the kidneys. These cysts can interfere with kidney function and result in kidney failure.

  • Urinary tract infections

UTI are bacterial infections of any part of the urinary systems. Infections in the bladder and urethra are the most common. They are easily treatable and infrequently result in more health problems. Though, these infections can spread to the kidneys and result in kidney failure.

What are the main symptoms of kidney disease?

Kidney disease is a condition which can easily go unnoticed till the symptoms become worse. The below symptoms are early warning signs which might be developing kidney diseases:-

  • Fatigue
  • Trouble in sleeping
  • Poor appetite
  • Dry and scratchy skin
  • Frequent urination
  • Difficulty in concentration

Symptoms which show that your kidney disease is developing into kidney failure:-

  • Nausea
  • Vomiting
  • Loss of appetite
  • Changes in urine output
  • Anemia
  • Sudden rise in potassium levels
  • High blood pressure
  • Breathlessness
  • Swelling over body

How is kidney disease diagnosed?

  • Glomerular filtration rate (GFR): the test will analyze how well your kidneys are performing and determine the stage of kidney disease.
  • Ultrasound scan: it creates clear images of your kidneys and urinary tract. The image allows your doctor to see if your kidneys are very small or large. They can also show any tumors that may be present.
  • Kidney biopsy: during a kidney biopsy, your doctor will eliminate a small piece of tissue from your kidney while you are composed. The tissue sample can help your doctor analyze the type of kidney disease you have and how much damage has occurred.
  • Urine test: your doctor may suggest you urine test for albumin. Albumin is a protein which can be passed into your urine when your kidneys are damaged.
  • Blood creatinine test: creatinine is a waste product. It is recused into the blood when creatinine is broken down. The levels of creatine in your body will enhance if your kidneys are not working properly.

How is kidney disease treated?

Treatment of kidney disease mainly emphasizes controlling the underlying cause of the disease. It means that your doctor can help you better manage your blood pressure, blood sugar and cholesterol levels. They may use one of the following methods:-

  • Drugs and medication
  • Dietary and lifestyle changes

How can kidney diseases be prevented?

Some risk factors of kidney disease such as age, race and family history are not possible to control. Although, there are some measures you can take to help prevent kidney diseases:-

  • Drink lot of water
  • Decrease intake of salt
  • Control sugar if you are diabetes patient
  • Control blood pressure
  • Stop smoking, no tobacco intake

Who is nephrologist?

Who is nephrologist?

Nephrologists are Doctors who are physicians full treat all form of kidney diseases.  Nephrologist the world comes from nephron which means a basic filter in the kidney. The nephron is a basic part of the kidney which filter blood and fond urine so many nephrons (one millions approximately) from one kidney.

Nephrons removed toxins waste excess sub senses from the blood and form urine. Doctor who special gist is creating kidney disease knowness nephrologist.

So after doing post-graduation internal medicine doctor who do superspecilization in kidney diseases are known as nephrologist of kidney specialist or kidney doctor.

Nephrologist Degree can be D.M.or D.N.B.

There is significant scarcity of the number of nephrologist an India. Nephrologists are superspecialist and most of the superspecialist. They are practice in metropolitans or major cities in India. Out of all metropolitan Delhi NCR has maximum number of nephrologists. There is many part or cities of the country where nephrologist, medical facilities related to kidney disease, dialysis centre or kidney transplant facility are available.

Introduction to Dr. Rajesh Goel

Dr.Rajesh Goel is a Senior Consultant Nephrologist and Kidney Transplant Physician practicing in Delhi, South Delhi, NCR, Panipat, Narela and Faridabad.

He practices in Kidney Care Centre which is located in Faridabad and Delhi(Saket, South Delhi), and Pushpwati Singhania Research Institute (PSRI) Hospital Kidney Care Centre is founder by Dr. Rajesh Goel with his wife Dr. Sonia Goel in 2013. In Kidney Care Centre manages all forms of outpatient department services related to kidney diseases.  PSRI Hospital is one of the best Multi Speciality Hospital in Delhi. In PSRI hospital Nephrology department deals with all forms of kidney disease. In this hospital lots of research programs and DNG Nephrologist training in nephrology is conducted. PSRI Hospital was established in 1996. In this hospital till now   successful kidney transplant have been conducted.

Who is best Nephrologist in Delhi

Dr. Rajesh Goel is very sincere and helpful to his patients. He is a doctor who listens patiently, nonjudgmentally, empathically, and who shows that he understands his patient’s problems. He skillfully manages patient problems.

He also gives proper time to his patients. He is very helpful for poor patients.

Many patients come to him from far away for a second opinion.  He not only promotes health as well as manages kidney diseases. He gives unbiased advice to his patients. He also properly communicates and prognosticates about kidney failure treatment. He respects his patients, juniors, seniors, nurses, and mentors.

He is sincere, experienced and well trained in managing all forms of kidney diseases. He has a vast experience of kidney transplant. He has manage a number of kidney failure patients, chronic kidney diseases, nephrotic syndrome(protein leaking throw urine), temporary dialysis catheter(Jugular, subclavian, femoral), kidney biopsy SLE (Lupus) Nephritis, Hemodialysis, Peritoneal dialysis(Continuous ambulatory peritoneal dialysis, automated peritoneal dialysis-APD), permacath, cystic disease,  autosomal dominant polycystic kidney(ADPKD), Vesico ureteral reflux(VUR, reflux nephropathy), renal tubular acidosis, acute kidney injury (AKI) or acute renal failure (ARF),unexplained renal failure, diabetes, related kidney disease, hypertension  related kidney disease, kidney stone, pyelonephritis, and many other kidney  diseases.

Best Kidney Hospital in Delhi

PSRI Hospital has very coordinated care, team-based care, transparent pricing and is helpful for poor patients kidney care centre.

Best Kidney Transplant Hospital in Delhi

PSRI Hospital provides one of the best kidney transplant program in north India.

They have the best transplant surgeons and nephrologist team. Dr. Rajesh Goel has conducted a number of successful kidney transplant patients.

Best Kidney Specialist in Delhi

Kidney Specialist is a Doctor who manages all types of kidney diseases. They are also known as nephrologists, kidney doctor or kidney transplant doctor.

Chronic kidney disease (CKD)

What is chronic kidney disease?

The kidneys filter waste and excess fluid from the blood. As kidneys fail, waste builds up.
Symptoms develop slowly and are not specific to the disease. Some people haven’t any symptoms in the least and are diagnosed by a lab test.
Medication helps manage symptoms. In later stages, filtering the blood with a machine (dialysis) or a transplant could also be required.

What causes chronic kidney disease (CKD)?

  • Diabetes
  • High blood pressure (hypertension)
  • Heart disease
  • Having a family member with kidney disease
  • Being African-American, Hispanic, Native American or Asian
  • Being over 60 years old

What are the symptoms of kidney failure?

There are less or no symptoms in mild to moderate kidney failure. Thus, early or even late kidney failure is usually detected on a preventive health check-up.

Swelling over body sometimes it is first noticed over feet (around ankles) or over face (around eyes).

  • Itching
  • Muscle cramps
  • Nausea and vomiting
  • Not feeling hungry
  • Swelling in your feet and ankles
  • Too much urine (pee) or not enough urine
  • Trouble catching your breath
  • Trouble sleeping

If your kidneys stop working suddenly (acute kidney failure), you may notice one or more of the following symptoms:

  • Abdominal (belly) pain
  • Back pain
  • Diarrhea
  • Fever
  • Nosebleeds
  • Rash
  • Vomiting
Life threatening presentation
  1. Convulsions
  2. Abnormal heart rate (due to high potassium)
  3.  Chest pain (pericarditis)
  4. Altered sensorium (uremic encephalopathy)
  5. Severe metabolic acidosis

How to delay chronic kidney disease progression?

Detection of kidney disease at an early stage.

Control of blood pressure (less than 135/85 mmHg, less than 130/80 mmHg in proteinuria cases)

Control of blood sugar (HbA1c less than 7%)

Avoid nephrotoxic agents (common painkillers, some antibiotics and indigenous agents) and many others

Proper treatment of infections.

Proper treatment of urine outflow obstruction.

Avoid tobacco consumption and smoking

Healthy lifestyle

Very high protein intake

Proper treatment of stones

Some kidney harmful or nephrotoxic medications

Diabetic kidney disease

Kidney disease is very common in diabetic patients. In present scenario life style related diseases like obesity, diabetes, and coronary heart disease related kidney disease are very common. Swelling over feet or face is generally a common symptom in diabetic kidney disease.

Blood sugar level should be:
  • Between 70 and 130 before eating ;
  • Less than 183 about  2 hours After eating ;
  • Between 90 and 150 at bedtime.
How to monitor kidney related complications in a diabetic patients?
  • Following to be monitored at least 3 to 6 monthly.
  • Urine for proteinuria-urine for micro albuminuria, urine for albumin(dipstick)
  • Serum creatinine level.

Whether my both kidneys are affected?

Even a single kidney is enough to perform all functions of kidney (remove all toxins, and other functions) from our body. If serum creatinine level is high then either both kidneys (if both kidneys are working) are affected or if there is a single functioning kidney and that only is affected.

Kidney disease run in family

There are few kidney diseases common in family members. Following kidney diseases are:

  1. Diabetes related kidney disease.
  2. Polycystic kidney disease (PKD) – autosomal dominant PKD or ADPKD is passed from parent to child by an autosomal dominant type of inheritance. Thus if one parent has the disease, each child has a 50-50 chance of developing the disease.
  3. Fabry disease- it involves major organs.
  4. Kidney stones
  5. High Blood Pressure
  6. Alport Syndrome- leading to CKD (hereditary nephritis), deafness and eye abnormalities.
  7. Unknown family related kidney disease.

How to manage chronic kidney disease?

  1. Control your blood sugar if you have diabetes.
  2. Keep a healthy blood pressure.
  3. Follow a low-salt, low-fat diet.
  4. Exercise at least 30 minutes on most days of the week.
  5. Keep a healthy weight.
  6. Do not smoke or use tobacco.
  7. Limit alcohol.

How to know how much my kidneys are working?

Glomerular-filtration Rate: It is a rate at which blood is filtered through glomeruli in a minute. It tells us that how much the kidneys are functioning. It can be measured or estimated. There are various formulas for measuring GFR:

  1. Cockcroft gault formula (CGF)
  2. The Modification of Diet in Renal Disease  (MDRD) equation
  3. Creatinine clearance (Urine)
  4. Others

How to estimate GFR:

  1. Inulin
  2. DTPA

Most commonly used are CGF and DTPA

Using this GFR we can differentiate chronic kidney disease (CKD) into different stages

Stage 1 Stage 2 Stage 3 Stage 4 Stage 5 Stage 5 ND (not on dialysis) Stage 5 D (on dialysis) Stage 5 T (post-transplant) Patient can himself calculate GFR easily by computed formulas which are easily available on mobile applications and internet.

How to prevent kidney diseases?

Kidney diseases are common in:-

  1. Diabetic patients
  2. Hypertensive patients
  3. Coronary heart diseases patient
  4. Cerebrovascular disease patient
  5. Over weight and Obese patient
  6. Persons who are on long term kidney harmful medicines like painkillers (NSAIDS, lithium), some anti-biotic, some indigenous medication.
  7. Smokers and chronic tobacco users.
  8. Patients having recurrent urine infections.
  9. Patients having multiple kidney stones
  10. Persons in whom family member is suffering from kidney disease
  11. Some genetic related kidney disease.
  12. Urine outflow obstructive diseases.
  13. Hyperuricemia and gout.
  14. Connective tissue diseases like sjogrens, rheumatoid, sarcoidosis and others.
  15. Others

If there are above risk factors than routinely kidney function test (creatinine) and urine routine examination to be done.

If any modifiable risk factor is present than we need to modify them.

Medicines for chronic kidney disease (CKD)

In managing CKD there are lots of medicines are required. There is a major issue of pill burden (number of pills per day). Following medicines are used in treating CKD.

  • Hypertension-anti-hypertension medicines.
  • Anemia-oral or intravenous iron, injection erythropoietin, darbepoetin, mircera.
  • Antacids, proton pump inhibitors
  • Calcium Supplements.
  • Phosphate binders
  • Vitamin-D active or Cholecalciferol.
  • Vaccination- To prevent hepatitis B, Pneumonia, flu.
  • Multivitamins.
  • To control acidosis.
  • Medicine related to primary disease.
  • And others.

Guidelines for Dialysis with reference to COVID-19 Infection

General Guidance for Dialysis Unit

  1. A sign board to report any fever, coughing or breathing problem in dialysis unit and waiting area.
  2. All staff should strictly follow hand hygiene. Avoid touching your eyes, nose, and mouth with unwashed hands
  3. Protocol to be made and inform to concerned authorities if our old patient comes covid 19 positive.
  4. The dialysis unit staff should be trained for donning and doffing of Personal Protective Equipment (PPE) to be used for dialysis of COVID-19 positive patients.
  5. All patients on dialysis, suspected of COVID – 19 should be tested with RT – PCR test as per Government of India protocol.
  6. Protocol to be made and inform to concerned authorities if our old patient is suspected for covid 19.
  7. Educate nephrologists, nurses, technicians, other staff and all patients undergoing MHD along with their care givers about COVID 19

I. For Patients 

A. Before Arrival to Dialysis Unit
  1. All units should instruct their patients to recognize early symptoms of COVID-19 (recent onset fever, Sore throat, Cough, recent Shortness of breath/dyspnea, without major interdialytic weight gain, rhinorrhea, myalgia/bodyache, fatigue and Diarrhea)and contact dialysis staff before coming to dialysis center. The unit needs to make necessary arrangement for their arrival in the screening area. 2. Patients, who are stable on MHD may be encouraged to come to the unit alone without any attendant
B. Screening Area
  1. Should have a designated screening area, where patients can be screened for COVID-19 before allowing them to enter inside dialysis area. Where this is not possible, patients may wait away from the dialysis unit until they receive specific instructions from the unit staff.
  2. The screening area should have adequate space.
    In screening area, every patient should be asked about:
  • Symptoms suspected of COVID-19 as above.
  • History of contact with a diagnosed case of COVID 19
  • History of contact with person who has had recent travel to foreign country or from high COVID-19 prevalence area
  1. Every patient and accompanying person should put on a facemask and to make their wash hands with soap and water before entering to hospital.
C. Inside Dialysis Unit
  1. Suspected or positive COVID-19 patients should properly wear disposable three-layer surgical mask throughout dialysis duration.
  2. To use hand sanitizer before entering to dialysis unit.

II. For Dialysis Staff 

To make list of all patients with addresses and correlate with hot spots areas for covid 19 infection During Dialysis

  1. All staff to wear a three-layer surgical facemask while they are inside dialysis unit.
  2. Suspected or positive COVID-19 be dialyzed in isolation. If not be possible use of a separate shift, preferably the last of the day for dialyzing all such patients or to physically separate areas for proven positive and suspected cases.
  3. Dialysis staff should use of all personal protective equipment (PPE) for proven or strongly suspected patients of COVID-19.
  4. Separating equipments like stethoscopes, thermometers, Oxygen saturation probes and blood pressure cuffs between patients with appropriate cleaning and disinfection should be done in between shifts.
  5. Stethoscope diaphragms and tubing should be cleaned with an alcohol-based disinfectant including hand rubs in between patients. As most NIBP sphygmomanometer cuffs are now made of rexine they should also be cleaned by alcohol or preferably hypochloritebased (1% Sodium Hypochlorite) solutions
  6. Staff using PPE should be careful of the following issues:

While using PPE, they will not be able to use wash room so prepare accordingly

If dialysis is to be done bed-side in the hospital, portable RO should be properly disinfected with hypochlorite (1% Sodium Hypochlorite) solution between use of two patients

DISINFECTION AND DISPOSAL PRACTICES IN DIALYSIS UNIT 

Cloth gowns should be soaked in a 1% hypochlorite solution for 20 minutes before sluicing and then be transported for laundering after each use.

Inside dialysis unit, clean and disinfect frequently touched surfaces at least thrice daily and after every shift.

PERSONAL PROTECTIVE EQUIPMENTS (PPE) Personal protective equipment must be used while dialyzing COVID-19 positive patients. These include:

Shoe covers

Gown

Surgical cap or hood

Goggles or eye shields

Mask: Ideally all masks should be N95 respirators with filters.

kidney stones

Kidney Stones

Stones can be in kidneys, ureter, urinary bladder or urethra. It is very common in Haryana and Punjab areas because of weather conditions and genetic susceptibility. Sometimes the kidney stone formers (metabolic stone former), usually run in family.

What are kidney stones?

As we all know that kidneys perform a crucial role in our body. The kidney removes all the waste and fluid from your blood to make urine and helps to maintain its functions properly. But sometimes when you have too much wasted with not enough fluid in your blood, it develops and sticks in your kidney and make it functions unwell, these wastes are known as kidney stone.

Kidney stones are similar petite stones that develop inside the kidneys because of few wastes. They made when salts, as well as minerals that are frequently in the urine, develop up plus made it harden.

Kidney stones can be painful when passing through the urinary. If that happens, the stones can cause:

  • Pain in the side of the lower section of the belly
  • colors change of Blood in the urine
  • Nausea or vomiting
  • Pain when you urinate
  • The need to urinate in a hurry
  • Cloudy or smelly urine
  • fever and chills
  • Pain in back, burning during urination

How do I know if I have kidney stones?

Kidney stones are like a petite piece of pebble that can develop on both sides of the kidney. Kidney stones seldom generate lasting damage. Kidney stones vary not only in size but also in shape and create pain in your back.

Usually, Kidney stones normally have yellow or brown. Kidney stones can block the natural flow of urine including severe pain as well as little bleeding.

If you see the symptoms like pain in your back and bleeding then you must consult with the doctor immediately without wasting your time and prevents yourself from all these problems such as Urinary Tract infection UTI.

If you have stones in your kidney then the symptoms of this can be a severe pain in your back, pain while you move into your lower belly, plenty of urinating, pain while you peeing, cloudy, red-pink or brown urine, nausea with stomach ache, fever and chills.

Do you know the scientific name of kidney stones? 

The scientifically the kidney stone identified by is renal calculus or nephrolith. You might listen to health care professionals call this condition nephrolithiasis, urolithiasis, or urinary stones which present on the kidney.

There are probably 4 types of kidney stones, which depend on the size, location and the material they are made up of kidney stone specialist doctor near me.

How are kidney stones treated?

Each person’s treatment is different according to the kidney stones. The right treatment for you will depend on: The size, type, and location of your stone, how much pain you have, how much you are vomiting, etc. You must take some treatments like:

  1. Water: 

Drinking 8 to 12 glasses of water each day helps you to melt the stone out through urine.

  1. Lemon juice: 

You must drink squeeze lemon juice because it contains citric acid which helps you to prevent kidney stones and helps to function the kidney properly. Lemon juice has also numerous health benefits.

  1. Basil juice: 

Basil contains acetic acid which assists to break down kidney stones and decrease pain. It contains full of nutrients with the presence of antioxidants and it helps maintain kidney health.

  1.  Apple cider vinegar:

It contains acetic acid which helps to dissolve kidney stones. It also helps you to prevent pain caused by stones in the kidney.

If the stone is large or produces severe indications, you might require visiting in the hospital. If the stone is inadequate as well as causes only mild signs, you might be ready to stay home plus wait for it to pass in the urine.

You will probably necessitate taking a bunch of fluids. Plus, you might necessitate using pain medicines or drugs that perform it more accessible to pass the stone.

Stones that do not move on then it can be treated with:

  • A device that utilizes sound waves to split up stones into scantier pieces, it identified as “shock wave lithotripsy.” This mode does not require surgery, but it can be notably painful.
  • A specific variety of surgery, that composes very petite holes in the skin. while this surgery, the doctor passes diminutive machines via the holes plus inside the kidney. Then they eliminate the stone. This is denoted as “percutaneous nephrolithotomy.”
  • A piping tube that goes inside the body the equivalent method urine comes out. Doctors use devices at the close of the tube to split up or eliminate stones. It is identified as “ureteroscopy.”

What people can do to prevent from getting kidney stones again?

One manageable thing you can perform is to take excess of water. You might also necessitate changing what you have, depending on what the kidney stones were created of best kidney doctor near me for kidney stone in delhi.

WHEN IS SURGERY REQUIRED?

Surgery for stones is usually required when the size of the stones is big, it is obstructing urine flow, severe symptoms (pain, infection, blood in urine, increasing serum creatinine) and in special occupations (pilots, sailors).

Kidney Transplant Vs Dialysis

Dialysis vs kidney transplant – which is right for me?

Dialysis and kidney transplantation are the treatment for advanced stage of kidney failure. Kidney transplantation is for end stage renal disease and should have a family donor for replacement. Dialysis is the process of taking care of your failure kidney and removes the fluid and waste products. Patients have multiple restrictions when on regular dialysis sessions. After transplantation of the kidney most patients feel active and resume doing the routine work.

You can take the kidney transplantation before initiation of dialysis which is called preemptive transplantation process. Dialysis has the negative consequences on health so it can be avoided through the early transplant. If you are going for the surgery after the dialysis than you need to have the donor. The transplantation process will be start by getting the full information about the donor if you do not have the living donor then deceased person kidney can be replaced.

Advantages of kidney transplant

  • Kidney transplant help you to improve the quality of your life and reduce the risk of your dying.
  • After kidney transplant you do not need to undergo for the dialysis treatment for life till functioning of transplanted kidney.
  • You can even go for the surgery before starting any dialysis treatment by getting the living donor.
  • Long term it is cost effective as initial cost is high but subsequently monthly expenses are less.
  • Less dietary restrictions.
  • Significant improvement in functioning of other organs like heart, brain, nervous system, and others.

Disadvantages of kidney transplant

  • There will be major surgical problems like infection, bleeding, damage to surrounding organs arise during and after the transplantation.
  • If you have infection and cancer or any severe illness (not fit for surgery) then kidney transplant is not the best treatment.

Kidney transplantation has the various less chances of rejection of new kidney. You must take care of your health after the surgery. If rejection occurs then medication treatment will help you to treat the rejection.
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