What is a Kidney? The kidneys play key roles in body function, not only by filtering the blood and getting rid of waste products, but also by balancing levels of electrolyte levels in the body, controlling blood pressure, and stimulating the production of red blood cells.
The kidneys are located in the abdomen toward the back, normally one on each side of the spine. They get their blood supply through the renal arteries directly from the aorta and send blood back to the heart via the renal veins to the vena cava. (The term "renal" is derived from the Latin name for kidney.)
Types of Kidney Diseases:
The term "kidney disease" can refer to any type of condition that greatly reduces the functioning of the kidneys. Some forms of kidney disease are acute, which means that the damage is sudden and symptoms reveal themselves very quickly. Chronic kidney disease means that the decline in the kidney function is slow and progressive. There are several different types of kidney disease, some of which are worse than others-
Nephritis - kidney disease due to inflammation
Nephropathy - due to non-inflammatory causes
Hyperfiltration (Stage 1) - increased filtering without microalbuminuria
Mild microalbuminuria (Stage 2) - early stages of microalbuminuria
Clinical albuminuria (Stage 3) - microalbuminuria in larger amounts
Advanced clinical nephropathy (Stage 4)
Kidney failure (Stage 5)
Chronic renal insufficiency
Early kidney failure
Diabetic nephropathy
Kidney Cancer
Symptoms of Kidney Diseases:
Kidneys play a critical role in keeping the body healthy by cleaning and processing the blood. Working together, the 2 million nephrons filter and process 3-4 liters of blood approximately every 5 minutes, 24 hours a day, 7 days a week. It is important to be aware of any problems you may be having with your kidneys and get treatment quickly. Some common symptoms and signs of kidney problems are:
Swelling around the face, eyes, feet and ankles
Pain or a burning sensation during urination
Fever
Need to urinate more frequently
Problems controlling urination
Blood in the urine
Causes of Kidney Diseases:
Kidney disease can be caused by a number of conditions, though in many cases no cause can be determined. By getting an early diagnosis and learning how to manage your condition, you and your doctor might help delay or even prevent the onset of kidney disease.
Diabetes mellitus, which damages small blood vessels in your body and makes it difficult for the kidneys to function properly
High blood pressure (hypertension), if left untreated, can exert added force and cause damage or scarring to the glomeruli that filter waste from your blood
Glomerulonephritis, a type of inflammatory kidney disease that causes your kidneys to leak protein and/or red blood cells into your urine
Polycystic kidney disease (PCKD), a hereditary disorder caused by clusters of fluid-filled cysts that develop in your kidneys and other organs
Renovascular disease, which involves decreased blood flow to the kidneys due to fatty deposits in the arteries
Chronic pyelonephritis, a chronic kidney infection often caused by repeated episodes of urinary tract infections
Systemic Lupus erythematosus (SLE), systemic immune reaction where your body mistakenly attacks your own kidney tissue
Kidney stones, crystallized minerals and other substances that can form on the inner surface of the kidneys and over time become small, hard masses
Obstructive nephropathy, a blockage and backup of urine causing damage to the kidneys
Analgesic nephropathy and drugs, when some over-the-counter medications are taken in large quantities and cause kidney damage
Diagnostic Tests for Kidney Diseases:
When kidney function is decreased, substances such as urea, creatinine, and certain electrolytes begin to build up in the bloodstream. The following blood and urine tests measure changing levels of these substances in the bloodstream and can help estimate how well your kidneys are working.
Blood Tests: The simplest way to monitor kidney function is to obtain blood tests for BUN (blood urea nitrogen) and creatinine.
Urine Tests: One of the primary functions of the kidneys is to filter blood and remove waste products. Urine tests measure how well your kidney filters are working.
Measuring Kidney Function: The filtering function of the kidneys may be measured or estimated in several ways:
BUN and serum creatinine
GFR (glomerular filtration rate)
Creatinine clearance
eGFR (estimated GFR) determined by the MDRD equation
Imaging Tests: Various imaging tests can provide useful information about the kidneys with little or no discomfort and minimal risk to the patient. Various tests are;
Ultrasound
IVP
CAT scan (computed tomography)
MRI (magnetic resonance imaging)
Kidney Biopsy: The procedure of obtaining and examining a small tissue sample from the kidney is called a kidney, or renal biopsy.
Types of Kidney Treatment
Acute Kidney Diseases Treatment: Treatment of acute renal failure depends partly on the cause and extent of the failure. The patient should be referred to a kidney specialist (nephrologists) for care. The first goal is to pinpoint the exact cause of the kidney failure, as that will partly dictate the treatment. Secondly, the degree to which accumulating wastes and water are affecting the body will impact treatment decisions about medications and the need for dialysis.
Chronic Kidney Diseases Treatment: The goal of treatment for chronic kidney disease is to prevent or slow additional damage to your kidneys. One of the most important parts of treatment for chronic kidney disease is to control the disease that is causing it. If you have diabetes or high blood pressure, you and your doctor will create a plan to aggressively treat and manage your condition to help slow additional damage to your kidneys. Your doctor will also check you for other conditions or diseases that may cause kidney damage, including a blockage (obstruction) in the urinary tract or long-term use of medicines that can damage the kidneys, such as some antibiotics or pain relievers (such as NSAIDs).
What is Kidney Dialysis?
In medicine, dialysis (from Greek "dialusis", meaning dissolution, "dia", meaning through, and "lysis", meaning loosening) is primarily used to provide an artificial replacement for lost kidney function in people with renal failure.
Dialysis is the artificial process of getting rid of waste (diffusion) and unwanted water (ultrafiltration) from the blood. This process is naturally done by our kidneys. Some people, however, may have failed or damaged kidneys which cannot carry out the function properly - they may need dialysis. In other words, dialysis is the artificial replacement for lost kidney function (renal replacement therapy). Dialysis may be used for people who have become ill and have acute kidney failure (temporary loss of kidney function), or for fairly stable patients who have permanently lost kidney function.
Types of Kidney Dialysis:
There are two basic types of dialysis:
Hemodialysis: Hemodialysis is the process of pumping blood through a machine which takes blood from the patient via a catheter, filtering the blood through a semi-permeable membrane and returning the filtered blood through another catheter back into the patient. Most often the treatment is performed three times a week for 3 to 5 hours each time. Twice a week sessions are limited to patients who have some residual kidney function.
Peritoneal Dialysis: In peritoneal dialysis, the patient's peritoneum, or lining of the abdomen, acts as a blood filter. A catheter is surgically inserted into the patient's abdomen. During treatment, the catheter is used to fill the abdominal cavity with dialysate. Waste products and excess fluids move from the patient's bloodstream into the dialysate solution. After a waiting period of six to 24 hours, depending on the treatment method used, the waste-filled dialysate is drained from the abdomen and replaced with clean dialysate.
What are Kidney Stones?
A kidney stone is a hard mass developed from crystals that separate from the urine within the urinary tract. Normally, urine contains chemicals that prevent or inhibit the crystals from forming. These inhibitors do not seem to work for everyone, however, so some people form stones. If the crystals remain tiny enough, they will travel through the urinary tract and pass out of the body in the urine without being noticed.
Kidney stones may contain various combinations of chemicals. The most common type of stone contains calcium in combination with either oxalate or phosphate. These chemicals are part of a person’s normal diet and make up important parts of the body, such as bones and muscles. A less common type of stone is caused by infection in the urinary tract. This type of stone is called a struvite or infection stone. Another type of stone, uric acid stones, are a bit less common, and cystine stones are rare.
4 Types of Kidney Stone Treatment:
Kidney stones are one of the most painful and common disorders of the urinary tract. Depending on where they are located, kidney stones are known as urinary calculi, urinary tract stone disease, renal calculi, nephrolithiasis, ureterolithiasis and urolithiasis.
Fortunately, most stones can be treated without surgery. About 90 percent of all kidney stones can pass through the urinary system spontaneously with the help of plenty of water (two to three quarts a day) to help the stone move along. In addition to extra water consumption, the doctor may prescribe antibiotics to fight infection. For bigger stones, or stones that have more problems getting out of the kidneys, there are small tools a doctor can use to take them out or surgery may be required. Following are the various types of kidney stone treatment available;
Extracorporeal shock wave Lithotrispy (ESWL): Extracorporeal shock wave Lithotrispy (ESWL) uses highly focused electromagnetic waves projected from outside the body to crush kidney stones anywhere in the urinary system. The stones turn out to be sand-like and are passed. For removal of this procedure, patient acre located in a tub of warm, purified water or onto water cushion machine that operates as a means for passing on these non-electrical shockwaves.
Percutaneous Nephrostolithotomy (PCNL): Percutaneous Nephrostolithotomy is a minimal invasive procedure. Percutaneous (i.e., through the skin) removal of kidney stones (lithotomy) is accomplished through the most direct route. A telescope along with mechanical lithotriptor in inserted to break stone into fine particles to achieve stone-free status in large and complicated stones.
Ureteroscopic Lithotrispy with Holmium Laser: This procedure is performed to treat stones located in the middle and lower ureter. A small, fiberoptic instrument (ureteroscope) is passed into the ureter. Large stones are fragmented using 100-Watts Coherent Holmium Laser. The laser fragments stone into sand like particles, which are then flushed out through the natural urinary passage.
Open (incision) Surgery: This last removal method for kidney stone includes opening the affected area and removing the stone(s). In this procedure, run in an operating room after a person has been given anesthesia, the surgeon creates an incision in the skin and unlocks the pelvis of the kidney or the ureter in order that the stone can be manually removed. Since open surgery is a principal operation, healing may need four to six weeks.
What is Kidney Transplant? Kidney transplantation is a surgical operation in which the surgeon places a healthy kidney from another person into your body. The donated kidney does the work that your two failed kidneys used to do.
The surgeon places the new kidney inside your lower abdomen and connects the artery and vein of the new kidney to your artery and vein. Your blood flows through the donated kidney, which makes urine, just like your own kidneys did when they were healthy. The new kidney may start working right away or may take up to a few weeks to make urine.
Types of Kidney Transplant:
A nephrectomy is the surgical term for the removal of a kidney. A healthy kidney intended for donation is normally removed by one of two procedures.
Laparoscopic Nephrectomy: This technique is more commonly used today in kidney donor procedures. It involves making several incisions of a couple of inches long in the abdomen. These incisions, called "ports,” allow the insertion of the laparoscope (camera) and other surgical instruments into the abdomen. The camera and instruments used in a laparoscopic nephrectomy are used to cut the kidney away from surrounding tissue after clamping off the blood vessels and ureter. The kidney is then removed through an incision below the belly button.
Open Nephrectomy: This procedure opens the abdomen and involves making an incision up to 10 inches long along the bottom of the lower rib to the midriff. A different option for the open nephrectomy starts with an incision further on the back along the side to the front. However, a portion of the rib may have to be removed.
What is Kidney Cancer?
Kidney cancer is usually defined as any cancer that is determined to have arisen from the kidney. It usually does not include metastatic cancer of the kidney, i.e. cancer that arose outside of the kidney and has spread to it. The two most common types of kidney cancer, reflecting their location within the kidney, are renal cell carcinoma (RCC) and urothelial cell carcinoma (UCC) of the renal pelvis.
Kidney cancer affects men about twice as often as women. Most people who contract this disease are over the age of 50. The exact causes of kidney cancer are not well understood. Kidney cancer is not contagious; no one can "catch" any type of cancer from another person.
Types of Kidney Cancer Surgery:
Kidney surgery is the main avenue of treatment for patients with cancer confined to the kidney. The general goal of treatment of kidney cancer is to bring about a complete remission of the disease, in which there is no longer any sign of cancer in the kidneys or other areas of the body. Kidney cancer is generally treated by surgical removal of the whole kidney or only the part of the kidney that contains the cancerous tumor and surrounding tissue. This is called a nephrectomy. In some cases the adrenal gland that sits on top of the kidney, lymph nodes, and fatty tissue around the affected kidney are also removed. Options for kidney cancer surgery include:
Laparoscopic Partial or Radical Nephrectomy for Kidney Cancer: Laparoscopic partial and radical nephrectomies are technically challenging kidney surgeries. In a laparoscopic partial nephrectomy surgeons operate through three or four small incisions. They remove the tumor and a small margin of normal tissue around it, then repair or reconstruct the area of the kidney where the cancer was removed. Laparoscopic partial nephrectomy is a very effective procedure for treating small kidney tumors (less than 4 cm) that are not located at the center of the kidney. Patients with larger tumors (greater than 7cm) may need to have the entire kidney removed (a radical nephrectomy).
Cryotherapy for Kidney Cancer: Cryotherapy treatment (also called cryoablation) is a promising new minimally invasive technique in which surgeons use very low temperatures to kill kidney cancer cells. Cryotherapy treatment is appropriate for small kidney tumors (less than 4 cm). During cryotherapy treatment surgeons insert several needles into the kidney tumor. Argon and helium gas circulate through the needles, lowering the temperature to -40°C for several minutes. Surgeons can control the extent of freezing and evaluate the kidney and needle placement with ultrasound imaging during the procedure. Depending upon the location of the tumor, doctors perform cryotherapy either through a laparoscopic or CT guided approach (which is done without incisions).
Open Partial or Radical Nephrectomy for Kidney Cancer: Patients with large and/or deep tumors, and who already have limited kidney function, are candidates for open partial or radical nephrectomy, in which the surgeons operate to remove part or the entire kidney through a single, long omit long incision in the flank. During partial nephrectomy, it is necessary to temporarily interrupt the blood supply to the kidney. Open surgery allows the kidney to be placed in ice and gives the surgeon more time to operate on the kidney since the ice reduces the oxygen consumption of the kidney. For this reason, complicated partial nephrectomies are preferentially performed by an open approach.
Measures to Prevent Kidney Damage:
Stop smoking or don't start smoking
Have urine infections treated immediately
Control blood cholesterol and triglyceride levels with diet and medication if necessary
Drink alcohol in moderation only-switch over to red wine preferably
Aim to achieve and maintain your weight within the correct range for your height and age
Exercise regularly
Have your urine, blood and blood pressure checked regularly by your doctor
Ask your doctor to inform you of new developments in the treatment of diabetes
Cost of Kidney Treatment in India:
The cost of Kidney treatment in India is less when it is compared with the other western countries; it is relatively cheap because Indian surgeons, and doctors charge less as compared to other countries. A cost comparison of various medical treatments can give you the exact idea about the difference:
Medical Treatment
Procedure Cost (US$) (Approximately)
United States
India
Kidney Dialysis
44,000
25,000
Kidney Stone
12,000
5,000
Kidney Cancer
2,00,000
1,60,000
Kidney Transplant
150,000
1,00,000
Best Kidney Surgeons in India:
To be recognized as a good kidney surgeon in India, one should have Qualifications as mentioned:
MS in General Surgery
MCH in Nephrology Surgery
DNB/FRCS/MRCS from International Colleges and Hospitals
International Fellowship and Training Programs
Publications and Paper Presentations in Reputed Scientific and Medical Journals
Wide Clinical Experience
All of our associate doctors / surgeons have trained or worked in some of the best medical institutions in United States, United Kingdom, Europe and other countries across the globe.
Top Kidney Hospitals in India: Choosing the correct hospital can have a significant impact on the amount of recovery following your Kidney Transplantation. Following are the reasons why one should consider Kidney Hospitals in India for their kidney transplantation;
India offers excellent kidney care and language is not a barrier. You will be able to find foreign-trained kidney surgeons, as well as English-speaking Indian surgeons, without any difficulty.
In India, healthcare centers are of global standards and are well equipped with computerized dialysis instruments, operating rooms, intensive care units, and all other necessary equipments.
These Kidney Hospitals in India are considered among the best in the world to have the most advanced laparoscopic and robotic facilities to conduct precision driven kidney transplantation. The highlights of some of the facilities available at these Kidney Hospitals are:
World class Hospital Infrastructure
Dedicated Anesthesia Team
Diagnostics and Dialysis
Operating Rooms
The Intensive Care Unit
Specialized Equipments etc
Major hospitals in India have special departments for Nephrology and kidney transplant. Indian Cities where top and world renowned kidney hospitals situated are;
