Planning for kidney transplant

Planning for kidney transplant

Kidney transplant is the surgical process of replacing the diseased kidney with the healthy one. The need for kidney transplant arises when your kidney is not able to function normally. This is the end stage of the renal disease when it is necessary to replace the kidney. If both kidney’s are not function properly then you just need to replace only one kidney. A person can live normally on his one kidney and live his life normally.

Evaluation before kidney transplant

Before going for kidney transplant, you must have to get full health evaluation by taking proper tests and examinations. It will help you in decision making for the kidney transplant. After deciding for the kidney transplant you have to go through the following steps.

  • Find out the best match with your kidney. The donor can be a family member or an outsider whose blood group is matching with yours.
  • The evaluation will take one day or the several days. On the day of evaluation, you and your family will meet the transplantation team.
  • Several health tests and examinations will take place at the transplantation centre and decide that you have need surgery or not.
  • Tests you need to do are: blood and tissue type tests, HIV and hepatitis test, prostate exam for men, mammogram and pap smear for women, heart and lung examination, kidney and liver test, colon exam etc.
  • You have to ready yourself for the kidney transplant physically as well as mentally. If you are not ready for the surgery then it make your transplantation process dangerous.
  • Before surgery, you have to follow the instructions by the doctors about caring yourself as well as your kidney.
  • Clear all the doubts about your surgery, by asking the questions about financial support system, insurance policy that will help you to plan and prepare the best care of yourself.

After the evaluation, if you are ready for the transplantation then you need a kidney donor. If you do not have living donor then the team of transplantation will added your name in the waiting list of kidney donor. If living donor is available then your transplantation process can be start earlier.

Post kidney transplantation planning

Once your transplantation process has done then you have to stay in the hospital till doctor’s measure your good health condition.  Your stay in the hospital will be depend on some factors like type of transplant procedure, body acceptance of new organ and your overall health condition. Doctors and nurses will take care of you until you will feel comfortable and confident to go home. You need to follow some instruction before going home that is given below.

  • Without any assistance you have to follow your medicine schedule correctly.
  • Keep thermometer and blood pressure cuff with you to take care of your temperature and blood pressure.
  • If any medication problem arise then report immediately to transplant coordinator.
  • Keep a record of fluid intake and urine output regularly.
  • Regularly follow appointments with transplantation team and tell them your health condition. So that they can give you proper medication.
  • After going home keep a record of your weight, blood pressure and temperature daily.
  • You need to avoid being around infected people (with colds and flu) at least three months because in this case the danger of infection is more.

After following the above instructions you will recover from the surgery successfully. It will also help the doctors to identify that your body is accepting the new kidney or not. If not then the prescribed medication treatment by doctors will help you to control the rejection.

About Chronic Kidney Disease

About CKD

What is chronic kidney disease?

What are 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).
Nausea, vomiting, hiccoughs.
Breathlessness on exertion or physical activity.
Low sugar levels (hypoglycaemia) in case of diabetic related kidney failure.
Generalized weakness, easy fatigability.

Life threatening presentation

a. Convulsions
b. Abnormal heart rate (due to high potassium)
c. Chest pain (pericarditis)
d. Altered sensorium (uremic encephalopathy)
e. 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?

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:-
A. Diabetic patients
B. Hypertensive patients
C. Coronary heart diseases patient
D. Cerebrovascular disease patient
E. Over weight and Obese patient
F. Persons who are on long term kidney harmful medicines like painkillers (NSAIDS, lithium), some anti-biotic, some indigenous medication.
G. Smokers and chronic tobacco users.
H. Patients having recurrent urine infections.
I. Patients having multiple kidney stones
J. Persons in whom family member is suffering from kidney disease
K. Some genetic related kidney disease.
L. Urine outflow obstructive diseases.
M. Hyperuricemia and gout.
N. Connective tissue diseases like sjogrens, rheumatoid, sarcoidosis and others.
O. 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.

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.

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.