KIDNEY
Kidney Disease Symptoms
When you know the symptoms of chronic kidney disease (CKD), you can get treatment and feel your best. CKD symptoms can be subtle. Some people don’t have any symptoms — or don’t think they do. If you have one or more of the 15 symptoms below, or worry about kidney problems, see a doctor for blood and urine tests. Many of the symptoms on this list can be caused by other health problems. The only way to know the cause of YOUR symptoms is to see your doctor.
NOTE: Low back pain is not a sign of kidney disease. Your kidneys are above your waist in the back of your body. If you have pain there, tell your doctor.
Fill out the symptom-chart at the end of this section and print it to share with your health care team.
15 Symptoms of Kidney Disease
1. Fatigue – being tired all of the time
Why this happens:
Healthy kidneys make a hormone called erythropoietin (a-rith’- ro-po’- uh-tin), or EPO, that tells your body to make oxygen-carrying red blood cells. As the kidneys fail, they make less EPO. With fewer red blood cells to carry oxygen, your muscles and brain tire very quickly. This is anemia, and it can be treated.
What patients said:
I was constantly exhausted and didn’t have any pep or anything.
I would sleep a lot. I’d come home from work and get right in that bed.
2. Feeling cold – when others are warm
Why this happens:
Anemia can make you feel cold all the time, even in a warm room.
What patients said:
I notice sometimes I get really cold, I get chills. Sometimes I get really, really cold. It could be hot, and I’d be cold.
3. Shortness of breath – after very little effort
Why this happens:
Being short of breath can be related to the kidneys in two ways. First, extra fluid in the body can build up in the lungs. And second, anemia (a shortage of oxygen-carrying red blood cells) can leave your body oxygen-starved and short of breath.
What patients said:
At the times when I get the shortness of breath, it’s alarming to me. It just fears me. I think maybe I might fall or something so I usually go sit down for awhile.
I couldn’t sleep at night. I couldn’t catch my breath, like I was drowning or something. And, the bloating, can’t breathe, can’t walk anywhere. It was bad.
4. Feeling faint, dizzy, or weak
Why this happens:
Anemia related to kidney failure means that your brain is not getting enough oxygen. This can lead to feeling faint, dizzy, or weak.
What patients said:
I was always tired and dizzy.
It got to the point, like, I used to be at work, and all of the sudden I’d start getting dizzy. So I was thinking maybe it was my blood pressure or else diabetes was going bad. That’s what was on my mind.
5. Trouble thinking clearly
Why this happens:
Anemia related to kidney failure means that your brain is not getting enough oxygen. This can lead to memory problems or trouble with concentration.
What patients said:
I know I mentioned to my wife that my memory—I couldn’t remember what I did last week, or maybe what I had 2 days ago. I couldn’t really concentrate, because I like to work crossword puzzles and read a lot.
I would get up to do something and by the time I got there I couldn’t remember what I was going to do.
6. Feeling very itchy
Why this happens:
Kidneys remove wastes from the bloodstream. When the kidneys fail, the build-up of wastes in your blood can cause severe itching.
What patients said:
It’s not really a skin itch or anything, it’s just right down to the bone. I had to get a brush and dig. My back was just bloody from scratching it so much.
My skin had broke out, I was itching and scratching a lot.
7. Swelling in hands or feet
Why this happens:
Failing kidneys don’t remove extra fluid, which builds up in your body causing swelling in the legs, ankles, feet, and/or hands.
What patients said:
I remember a lot of swelling in my ankles. My ankles were so big I couldn’t get my shoes on.
Going to work one morning, my left ankle was swollen, real swollen, and I was very exhausted just walking to the bus stop. And I knew then that I had to see a doctor.
8. Swollen or puffy face
Why this happens:
Failing kidneys don’t remove extra fluid, which builds up in your body causing swelling in the face.
What patients said:
My sister, her hair started to fall out, she was losing weight, but her face was really puffy, you know, and everything like that, before she found out what was going on with her. My checks were always puffy and tight. Sometimes they would even hurt.
9. Food tastes like metal
Why this happens:
A build-up of wastes in the blood (called uremia) can make food taste different and cause bad breath. You may also notice that you stop liking to eat meat, or that you are losing weight because you just don’t feel like eating.
What patients said:
Foul taste in your mouth. Almost like you’re drinking iron. I don’t have the appetite I had before I started dialysis, I must have lost about 10 pounds.
10. Ammonia breath
Why this happens:
A build-up of wastes in the blood (called uremia) can cause bad breath.
What patients said:
My husband always tells me I have fish breath. Sometimes my breath smells like urine and I need to brush my teeth more often.
11. Upset stomach, nausea, vomiting
Why this happens:
A severe build-up of wastes in the blood (uremia) can also cause nausea and vomiting. Loss of appetite can lead to weight loss.
What patients said:
I had a lot of itching, and I was nauseated, throwing up all the time. I couldn’t keep anything down in my stomach. When I got the nausea, I couldn’t eat and I had a hard time taking my blood pressure pills.
12. Getting up during the night to make urine
Why this happens:
Kidneys make urine, so when the kidneys are failing, the urine may change. How?
- You may urinate more often, or in greater amounts than usual, with pale urine.
- You may feel pressure or have difficulty urinating.
What patients said:
My urine is what I had started noticing. Then I was frequently going to the bathroom, and when I got there, nothing’s happening. You think, ‘Hey, I’ve got to go to the john,’ and you get there, 2 or 3 drops. I would get up two or three times at night and had lots of pressure each time.
13. Foamy or bubbly urine
Why this happens:
Kidneys make urine, so when the kidneys are failing, the urine may change. How?
- Urine may be foamy or bubbly.
- This can lead to an above-normal amount of protein in the urine.
What patients said:
The bowl would be filled with bubbles. Sometimes I would notice my urine being very foamy, so I made an appointment with the doctor.
14. Brown, red, or purple urine
Why this happens:
Kidneys make urine, so when the kidneys are failing, the urine may change. How?
- You may urinate less often, or in smaller amounts than usual, with dark-colored urine.
- Your urine may contain blood.
What patients said:
I was passing blood in my urine. It was so dark it looked like grape Kool-Aid. And when I went to the hospital they thought I was lying about what color it was. I thought I had a urinary infection when I first saw blood in my urine.
15. Pressure when you make urine
Why this happens:
Kidneys make urine, so when the kidneys are failing, the urine may change. How?
- You may feel pressure or have difficulty urinating.
What patients said:
When you go to use the restroom, you couldn’t get it all out. And it would still feel just like tightness down there, there was so much pressure.
The pressure was so great, yet it would come out so slow. Like 2-3 minutes slow. I thougth what is going on here.
Which is The Best Hospital in India for Kidney Transplant
A Kidney transplant is recommended to patients having kidney complete kidney failure. The function of the kidneys is to filter the waste substances from the blood and excrete it out of the body through urination. The kidneys also help maintain the fluid and electrolyte balance in the body.
When is a kidney transplant recommended?
In most of the cases, a kidney transplant is recommended to the patients with end-stage renal disease (ESRD). When all other forms of treatment including medications and the dialysis fail to cure the disease, the ultimate option is the kidney transplant.
What are the main causes of kidney failure?
Raised blood pressure – The increased blood pressure in the micro blood vessels present in the kidneys may cause long-term irreversible damage to the kidneys.
Glomerulonephritis – This condition involves inflammation of blood vessels and some other parts of nephrons. This is common in immunocompromised patients such as those having lupus erythematosus.
Diabetes – A rise in blood sugar over several years gradually hampers the filtration process in the kidneys, which causes diabetic nephropathy progressing further to end-stage kidney failure.
Click here to read in detail about Diabetic Nephropathy.
Interstitial nephritis – This is caused by an allergic reaction of inflammation to the kidneys caused by certain medications or herbal products.
Polycystic Kidney Disease – This is a genetic disorder as part of which several large-sized cysts are created in the kidney that interferes with the kidney function.
Why India is a preferred destination for a kidney transplant
India has been one of the most famous nations when it comes to medical tourism. This is because of several factors, the most common one being the cost factor. India provides efficient forms of medical treatment with cutting-edge technology and highly skilled doctors at the most affordable possible prices as compared to that in the developed countries.
There is hardly any language barrier for international medical tourists. The hospital staff is educated and well-versed in English. There is a special provision for language interpretation in hospitals. The recovery phase is well-taken care by a team of physiotherapists, and other medical specialists. Some of the best kidney transplant hospitals in India are listed below:
Medanta’s Hospital, Gurgaon
Founded in 2009 by a renowned cardiovascular and cardiothoracic surgeon, Dr. Naresh Trehan, the hospital is both NABH and NABL accredited.
It is the first hospital to offer robotic surgery in urology.
Awarded the VC Circle Healthcare Awards for Single Specialty Healthcare Entity category in 2013.
This is one of the prime centers which uses, minimally invasive surgical techniques including the latest-edge technology of da Vinci robotic surgery for any type of kidney problems.
It has some of the finest and highly skilled experts in the field of urology and nephrology.
Leading doctor:
Dr. Naramada Prasad Gupta is the chairman of Kidney urology department in India. He has performed nearly 25,000 surgeries in urology in last 40 years.
He is one of the pioneers of robotic surgeries.
BLK Super Speciality Hospital, New Delhi
Eminent Obstetrician and Gynaecologist, Dr. B.L. Kapur had established the BLK Super Specialty Hospital in 1959. It was inaugurated by the then Prime Minister of India, Pandit Jawahar Lal Nehru.
The super-specialty hospital is both NABH and NABL accredited.
It has 17 modern well equipped modular operation theatres and houses 650 beds.
BLK Super Specialty Hospital is the first of its kind in the NCR region to install and start the use of automatic pneumatic chute system that enhances health care.
It has one of the largest critical care programs in the region with 125 beds in different intensive care units in Medical, Surgical, Cardiac, Paediatrics, Neonatology, Neurosciences, and Organ Transplant departments.
Leading Doctors –
Dr. Sunil Prakash is the director of the Nephrology department in the hospital, having an experience 30 years.
He has distinct expertise in kidney transplantation and dialysis with an experience of more than three decades.
Indraprastha Apollo Hospital, New Delhi
Established in 1996, Indraprastha Apollo Hospital is NABH, NABL and JCI accredited.
Apollo Group offers 10,000 beds across 64 hospitals, more than 2,200 pharmacies, over 100 primary care & diagnostic clinics and 115 telemedicine units across 9 countries.
Indraprastha Apollo Hospital has 52 specialties under one roof.
The hospital ranked first in Renal Sciences in The Times Of India Healthcare Survey 2016.
Awarded a Special Commendation for the Golden Peacock Environment Management Award by a jury chaired by Justice P. N. Bhagwati and Former Chief Justice of India for the hospital’s environmental practices.
Leading Doctor:
Dr. Sandeep Gulleria is currently working as a senior kidney transplant surgeon at the hospital.
He led the team that performed the first two kidney transplants in India.
Artemis Hospital, Gurgaon
Established in 2007, Artemis Hospital is a super-specialty hospital in Gurgaon, Delhi.
With an area spread across 9 acres, the hospital houses 380 beds.
It is the first JCI and NABH accredited hospital in Gurgaon.
In 2011 it received the ‘Asia Pacific Hand Hygiene Excellence Award’ by WHO.
Along with state-of-the-art infrastructure, the hospital excels in the fields of Nephrology and emergency care.
Artemis Hospital has 300 full-time doctors, 11 centers of excellence and 40 specialties.
It possesses the latest medical equipment such as 3 Tesla MRI, 64 Slice Cardiac CT Scan & 16 slice PET CT from Philips Medical System.
When will Dialysis or Kidney Transplantation be needed?
Dialysis or Kidney Transplantation is carried out in case of chronic kidney failure which is also called kidney/renal failure. Coming on to dialysis part, there are two types of dialysis: hemodialysis and peritoneal dialysis.
Dialysis or Kidney Transplantation – which one is required?
When the pair of kidneys stop working effectively, waste products and other fluidal plaque start building up in the blood. In such cases, dialysis is the treatment to be done before kidneys move forward towards the point where severe complications may occur. Dialysis is a procedure which uses a mixture of pure water and other chemicals to eliminate wastes, salt or extra water from the blood without removing other essential substances. This procedure controls blood pressure by balancing the body’s electrolytes such as sodium, potassium and bicarbonate in the blood.
If the kidney disease is in the advanced stage, then the specialist may recommend going for dialysis, while the patient is still in good condition and may only show up with mild symptoms of kidney failure. Such symptoms are nausea, vomiting, difficulty concentrating, etc.
Kidney transplantation is recommended in case of severe kidney failure to offer better quality of life in people as compared to the ones treated with dialysis. A kidney can be transplanted from a relative, unrelated person such as a spouse or a friend, or from the deceased ones. However, organs transplanted from the living ones work better rather than from the deceased ones. The donor has to undergo several tests before getting ready for transplantation to ensure that he should be healthy, fit and active.
What are the causes of End-stage Kidney disease?
Some of the common causes are:
- High Blood Pressure (Hypertension): The increase in blood pressure directly affects the kidneys leading to chronic damage.
Glomerulonephritis: Inflamed blood vessels and nephrons results in slow damage and scarring. It mostly happens in patients with autoimmune diseases like lupus and ANCA vasculitis in which the immune system considers the kidney as a foreign body and attacks it.
Renal Artery Stenosis: It means clogged arteries that bring blood to the kidneys over time.
Polycystic Kidney Disease: When the large cysts or hollow spaces occur within the kidneys making them dysfunctional.
Diabetes: Diabetes is a slow death which contributes to kidney failure in people across different parts of the world. High blood sugar for long slowly damages the filters in the kidneys. It results in chronic kidney disease, called diabetic nephropathy that progresses over time leading to end-stage kidney failure.
Congenital Problems: The birth defects present since birth and before one gets to know about it, the kidneys already lose over 90% of their functional ability.
What are the advantages of kidney transplantation?
Kidney transplantation is performed when the patient is at end-stage kidney disease. It improves the quality of life and reduces the chances of dying. It also frees patients from regular dialysis treatment. Also, if you plan for transplantation in India, then it is the better medical destination as the kidney transplant cost in India is comparatively low and between USD 10,000 to USD 14,000. The pricing includes a total stay in India, medical tests, accommodation, etc.
Diabetic Nephropathy – Is it reversible?
Diabetic Nephropathy
Diabetic nephropathy is a kidney-related disorder that occurs as a complication to Diabetes Mellitus. This is one of the major causes of kidney failure. The condition is even worse it is associated with diabetes as diabetic people are more prone to chronic conditions such as high cholesterol, atherosclerosis, etc. They are also more likely to have other renal problems like bladder nerve damage or infection in the bladder.
The condition gradually reduces the ability of the kidneys to perform their regular function of removing the waste products and fluids from the body. If the condition continues for a long time, the filtration system is entirely damaged. Early treatment can prevent complications.
Diabetic kidney disease occurring as a result of type 1 diabetes and type 2 diabetes are slightly different. In the former, the symptoms start in the first 10 years after diagnosis of diabetes while in the later, the patients have kidney damage even before they get diagnosed.
Signs and symptoms
Swelling of the hands, feet, and face
Difficulty sleeping
Fatigue
Itching
Uncontrolled blood pressure
Urinary frequency
Inability to concentrate
Poor appetite
Muscle twitching
Drowsiness
Protein in the urine
Metallic taste
Change in the color of urine
How diabetes mellitus cause damage to the kidneys?
The kidney comprises of several minutes blood vessels that help in the filtration of waste products. Any damage to these blood vessels can be diabetic nephropathy or kidney failure. In people where there are high blood sugar levels associated with untreated diabetes, there is increased blood pressure causing severe damage to the kidneys by elevating the pressure in the filtration system.
Stages of diabetic nephropathy
The stages of diabetic nephropathy depend on the glomerular filtration rate and damage to the kidneys. Glomerular Filtration Rate is a measure to check kidney function. A low GFR indicates kidney issues. Depending upon the amount of kidney damage, diabetic nephropathy is of following types:
Stage 1 – Minor kidney damage but kidney function is normal. GFR is above 90.
Stage 2 – Significant kidney damage with some loss of kidney function. GFR is between 60 and 89.
Stage 3 – Mild to severe loss of kidney function with GFR between 30 and 59.
Stage 4 – Severe loss of kidney function with GFR between 15 to 29.
Stage 5 – Kidney failure with GFR less than 15.
How is it diagnosed?
After you notice the above-mentioned signs and symptoms, you must visit a nephrologist. The nephrologist will take a detailed case history in which you must inform the doctor about any past illnesses or any family history that you may have. This is followed by clinical examination and then, following tests are suggested:
Blood sample tests – This is done to analyze the condition of kidney function.
Urine tests – These tests are done to know the amount of protein present in the urine. High levels of a protein known microalbumin indicate severe damage to the kidney function.
Radio-imaging – Radiology tests such as x-ray and ultrasound are done to examine the size, shape and internal structure. The doctor may also recommend a CT scan or MRI scan to check the blood circulation in the kidneys.
Renal function test – This test is done to see the filtration capacity of the kidneys using renal analysis testing.
Kidney biopsy – The final test is a kidney biopsy in which a small portion of kidney tissue is removed after giving local anesthesia. After this, a thin needle is used to extract the cells to be later examined under the microscope.
Treatment –
Following approaches are followed to treat the condition depending upon the extent of kidney damage.
Medication
ACE Inhibitors – Angiotensin-Converting enzyme Inhibitors such as benazepril, captopril, and enalapril are used sometimes to control blood pressure. However, these have several side-effects, for example, they reduce GFR and cause kidney damage.
Medications to reduce blood sugar levels – Treating the increased blood sugar levels is the primary step to treat diabetic nephropathy. Efforts are done to achieve an average Hb A1C level of below 7.
Statins – Cholesterol-lowering medications called statins are also used in people having high cholesterol levels and also reduce protein in the urine.
Foster bone health – This is given to Improve bone health.
Dialysis
This is a treatment done to remove waste excreta and fluids from the blood. There is two types of dialysis – hemodialysis and peritoneal dialysis. The former is more common and needs the patient to visit the center to get attached to an artificial kidney machine. This is done 3 times a week. Each visit is about 3-5 hours. The later can also be performed at home.
Kidney transplant
In extreme cases, a kidney transplant is the only option left. Sometimes it can also be associated with a pancreas transplant. However, before conducting the treatment, the patient is evaluated to check if he/she is eligible for the transplant.
To know the best nephrologists in India,
Liver transplant: Purpose, Risks, Treatment
A liver transplant is a procedure involving the removal of a damaged part of the liver and replacing it with a healthy donor liver. The donor liver may be received from a living or deceased donor. The liver is one of the most vital organs as it is responsible for the filtration of the blood and removal of toxins from the body. The liver transplant surgery is the last choice of treatment for chronic liver diseases when all other treatment options have failed.
What is the most common reason for a liver transplant?
The most common diseases that ultimately lead to the requirement of having a liver transplant are listed below:
- Chronic viral hepatitis (B, C, and D) which causes inflammation and chronic damage to the liver.
- Acute liver failure
- Auto-immune hepatitis – involves a compromised immune system and destruction of liver tissue
- Alcoholic liver disease
- Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis
- Primary biliary cirrhosis
- Hepatic or liver tumors
- Metabolic and genetic disorders
Other than the aforementioned reasons, a few signs and symptoms in children can also insinuate the need for a liver transplant in children:
- Portal hypertension along with variceal bleeding
- Failure of liver functions such as decreased albumin, raise clotting time, etc.
- Progressive jaundice
- Malnutrition
- Recurrent cholangitis
- Encephalopathy
- Severe hypersplenism associated with liver dysfunction.
Can you live a normal life after a liver transplant?
Even though, there is a very high success rate of approximately 70-80% with a smooth recovery. However, there are always some chances of having associated risks and complications, some of which are mentioned below:
- Internal bleeding
- Clotting of blood
- Liver transplant failure
- Infection
- Rejection of donated liver
- Mental confusion
- Seizures
These anti-rejection medications can cause a variety of side effects, including:
- Diabetes
- Headache
- High cholesterol
- Diarrhea
- High blood pressure
- Bone thinning
The living-donor liver transplant also holds some of the risks, which are listed below:
Leakage of bile substances – The bile juices start leaking sometimes outside the liver. This is usually rectified on itself and sometimes can be treated by doctors by inserting a tube in the liver.
Infection – the spread of infection is another common infection at the site of the surgery.
Organ damage – The liver can sometimes get damaged by living-liver donation.
What happens during a liver transplant?
The liver transplant is broadly categorized into two types:
Deceased-donor liver transplant
Living-donor liver transplant
Deceased-donor liver transplant is performed under general anesthesia. A long incision is made across the abdomen to get access to the liver. The blood supply and bile ducts disconnected and removed from the damaged liver. After placing the new liver in the body, the blood vessels and bile ducts are reattached. This type of surgery takes about 12 hours.
In a living-donor liver transplant, the surgeons transplant a portion of the donor’s liver in the body. The first procedure is done on the donor for the removal of the required liver part. This is followed by placement of the donated liver part into the patient’s body, then connecting the blood vessels and bile ducts to the new liver.
What to expect after the liver transplant?
You will need to stay in the intensive care unit of the hospital for a few days where you will be monitored for any signs of complications.
Once your condition is stable, you will be shifted to the transplant recovery area for recovery.
After 5 -10 days of hospital stay, you will be discharged and asked for frequent checkups with the doctor. The doctor might recommend a few blood tests a few times every week and then less frequently.
You will then need to take medications for the rest of your life. Medicines such as immunosuppressants help the immune system from attacking your liver. Other drugs are advised to prevent complications from a liver transplant.
How much does a liver transplant cost?
It has been calculated that the overall liver transplant cost in India is 50% less than that in other western countries. This is the reason why most of the international patient across the globe prefer to visit India for their treatment. Moreover, the nation is widely known for its excellent infrastructure and skilled surgeons. For instance,
The approximate cost of liver transplant in India revolves around 38,000 USD. However, the exact cost depends upon several factors such as,
Fees of the liver transplant surgeon
Cost of medications
Type of accommodation
The city and the hospital
The Complexity of the case.
