Diabetes- The soft and silent killer !

The minute most of us hear “Diabetes”, we think of Blood Sugar.

Blood sugar is elevated level of sugar or glucose in the blood which if unchecked overtime, leads to diabetes. Diabetes is a disease in which the body’s ability to produce or respond to insulin is impaired, resulting in abnormal metabolism of carbohydrates, inability of our body to convert sugar into glucose and subsequently elevated levels of glucose in the blood.

We all know about Type 1 Diabetes, Type 2 Diabetes but whats important is what happens in the body, when we have elevated levels of sugar in the body for long.

Common Effects and Risks associated with high sugar levels and diabetes are:

Diabetes
Diabetes complications affected organs. diabetes affects nerves, kidneys, eyes, vessels, heart, brain and skin

Risk of stroke: Diabetes or elevated sugar levels, increase our risk of stroke, about 4 times more than non diabetics

Risk of Heart Disease:  Diabetes increases risk of heart attack , heart disease. As the blood vessels get damaged, it puts the heart under pressure and an increased risk of heart attacks.  High glucose levels also lead to fatty deposits. Coupled with obesity, high blood pressure, it puts you at a severe risk and an angioplasty  or an open heart bypass surgery may even be required.

Risk of Cataract: Diabetics are at an increased risk of developing cataracts

Risk of Glaucoma: Glaucoma risk is significantly more for diabetics. If left untreated, Glaucoma can lead to blindness.

Risk of Pancreas Malfunction: A malfunction in pancreas leads to diabetes and higher blood sugar levels in turn continue to damage the pancreas.
Risk of Gastroparesis:   Increase in blood sugar levels also makes it hard for the  stomach to empty completely. This also in turn leads to an increase in blood sugar levels. Nausea, vomiting, bloating, and heartburn are common symptoms.
Risk of Kidney Damage:  Unchecked High sugar levels and diabetes, damages the kidneys, leads to diabetic neuropathy and eventually one may need a dialysis or even a kidney transplant.
Risk of Nerve Damage: Diabetics often  have tingling sensation in the foot and suffer from nerve damage. Lack of sensation or peripheral neuropathy is dangerous as due to lack of sensation, one may fail to notice injuries

.
Foot Problems:  Unchecked diabetes can lead to diabetic foot where the entire foot may even need to be amputated.
Ketoacidosis:   In absence of insulin,  the body uses alternate hormones to turn fat into energy, which creates a high level of toxic chemicals such as acids and  ketones, which may lead to a condition called diabetic ketoacidosis.  Diabetic ketoacidosis  often leads to loss of consciousness and other life threatening complications. A Fruity Breath or a sweet smelling breath is often an indicator of diabetes and calls for a check on blood sugar levels.
Visual Problems:  Diabetics often face visual problems, as high glucose levels often lead to swollen, leaky blood vessels in the eye, leading to a condition called diabetic retinopathy.  These vision problems,  may even lead to partial or total loss of vision Vision problems can be gradual hence routine eye checkups if you are diabetic or have pre diabetes are a must.

Risk of damage to blood vessels:  High blood sugar levels or high glucose levels,
restrict blood flow, damaging the blood vessels.

As unchecked diabetes, leads to a host of problems, it is important to make life style changes. Pre diabetes conditions can be reversed by exercise and dietary changes.  Type 2 diabetes can be controlled and even reversed if significant life style changes are made.

One of the most important life style change is to Quit smoking as diabetes and smoking leads to an enhanced risk of heart disease.

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High Uric Acid levels ! Is there something to worry about ?

Uric acid is produced naturally by the body as a result of metabolism. Our kidneys filter and throw out uric acid normally.

In some cases, the body produces more uric acid than it can excrete or the kidneys are not able to excrete uric acid being produced, it leads to a rise of uric acid levels and leads to a condition called hyperuricemia.

Hyperuricemia is defined as an excess of uric acid in the bloodstream. If your uric acid is in excess of 7 mg/dL – you may have hyperuricemia.

Hyperuricemia has a few major health effects. They are as follows :

Gout
Gout

Gout : It is defined as a type of arthritis that causes inflammation in the smaller bones of the joints. Typically, chalky deposits of uric acid called “tophi” deposit as lumps under the skin causing severe pain and redness specially in the base of the big toe over a long period of time. This tophaceous gout compresses the nerves and is visible to the naked eye – making it disfiguring and making the pain worse. Gout, is characterised by episodes of intense pain. Sometimes uric acid crystals start to deposit in other joints such as elbow, knee, fingers, hand etc and may also damage surrounding cartilege.
Though extremely rare, sometimes, due to damage of the cartilage a joint replacement surgery such as total knee replacement may be required.

Doctors very rarely let patients come to this stage though and prescribe medication to take care of the pain and to shrink the uric acid crystals.

Incase Tophi or the uric acid crystals become too large or become infected, a surgery though rare, may be needed to remove crystals.

Large Tophi may also affect the range of movement of the joint such as hand or knee and a simple surgery may be required.

Kidney Stones : Kidney stones are defined as a hard mass formed in the kidneys due to insoluble calcium compounds. Initially, the kidney stones are small and pass out with the urine; however, over time the kidney stones become larger and block the urinary tract causing a difficulty in the passing of urine and urinary tract infections due to the buildup of bacteria in the tract. A high level of Uric acid is also a predictor and indicate’s renal dysfunction well in advance before the dialysis stage or the kidney transplant stage .
In patient’s with Rheumatoid arthritis or RA, high uric acid levels, call for a visit to the doctor.

Possible surgeries and procedure to take care of kidney stones are SWL(Shockwave lithotripsy), Ureteroscopy, PCNL(Percutaneous Nephrolithotomy ).

PCNL is best for treatment of medium to large stones , for complex stones or if there are too many stones in one kidney and needs a good, trained urologist.

Ureteroscopy is slightly more invasive than Shockwave lithotripsy but is good for stones which are very small and also way down in the urinary tract.

The best way to take care of gout related problems is to prevent hyperuricemia.

The following natural remedies are easy to implement and help prevent hyperuricemia :
Lemon Juice : Lemon is a natural antioxidant and contrary to popular belief, helps neutralise the uric acid in the body. A glass of lukewarm lemon juice water in the mornings before breakfast may go a long way in preventing uric acid buildup.
Apple Vinegar : Vinegar contains malic acid that helps to breakdown uric acid and make the solution alkaline. A glass of water with 2 tablespoons of apple vinegar has anti – inflammatory benefits.
Water : It is supposed to flush out toxins from the body and regulate kidney function. 8-10 glasses of water a day help dilute uric acid in the body and help excrete out the same from the body. Additionally, care should be taken to include water rich fruits such as watermelon and vegetables such as cucumber in ones diet.
Berries : Cherries and other purple or blue coloured berries contain anthocyanin that have anti- inflammatory and anti- oxidant properties and that help lower uric acid in the body. A bowl of cherries a day greatly reduces the risk of hyperuricemia.
These natural remedies are suggested to be followed post a doctor consultation and are by no means an alternative to prescription medication which is critical for treatment of gout.

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Stop that Kidney Damage !

The kidneys are two fist shaped organs and they are located on each side of the spine.
Kidneys play an important role in our body functioning. They act as filters, flush out toxins from the body and maintain the acid, alkaline balance in the body. Kidney trouble leads to water retention, swelling, oedema and affects quality of life.

Kidney Disease
Kidney Damage

It is very difficult to detect kidney damage till the last stage as kidneys can continue to function well even when they are 80% damaged, which leads to discovery when the patient has reached end stage kidney disease post which dialysis followed by kidney transplant is the only option

Are there any habits that damage the kidneys every day?

Even though we barely realise it, some of our daily habits contribute to kidney damage. Below is a list of some common habits, taking care of which can help us, prevent the damage to our kidneys.

Being a Pill Popper : Popping medicines without prescription or medicine abuse is dangerous for the kidney and can lead to a condition called rhabdomyolysis which is defined as a breakdown of muscle tissues that releases a damaging protein into the bloodstream – causing it to be transported to the kidneys and in turn, damaging the kidneys causing a need for dialysis.

Drinking too much Soda : 2 cans a day is too much ?According to a study presented in the kidney week in 2013, two cans of soda are enough to cause damage to your kidneys. Researchers from a leading university in Japan divided participants into three groups- one that drinks a can of soda a day, one that drinks two cans of soda a day, and one that does not drink soda. The results were startling – by the end of three years, more than 10% people from the second group developed a disease called proteinuria – a disease that may lead to End Stage Kidney disease.

Eating too much salt : Loading up on too much salt in our diet leads to excess of sodium in our body. Sodium is one of the most abundant elements on earth and is one of the main constituents of salt. However, in high amounts sodium causes kidney damage. This is because kidneys cannot eliminate excess fluid and sodium from the body. The built up sodium and fluid causes high blood pressure which in turn reduces kidney function.

Protein overload : Although protein intake is a must as proteins are the building blocks, a very high protein diet may cause a decline in kidney function in people especially with declining kidney function or kidney disease as the body may not be able to eliminate all the waste products of protein metabolism.

Not drinking enough water : Not drinking enough water also leads to kidney damage. Drinking enough water not only prevents kidney stones but also urinary tract infection because kidney stones are prevented from sticking to together in the presence of hydration while water helps dissolve the antibiotics used to treat UTI’s which makes it more effective in treatment. It also helps the kidneys flush out more toxins and infection causing bacteria by producing more urine.

Not exercising enough : Lack of exercise, promotes kidney damage while exercising increases mobility and circulation in the body causing more absorption and reabsorption by the kidneys; thus, increasing renal function.

Smoking : It promotes kidney damage because increases blood pressure, reduces blood flow to the kidneys, narrows the blood vessels in the kidneys by doubling the endothelium cells in the vessels, and accelerates loss of kidney function. According to statistics, smoking is a cause that can lead to end stage renal disease.

Lack of Magnesium in our diet: High magnesium levels in the body help prevent kidney stones, by preventing the formation of calcium oxalate. This is because kidney stones are formed by the binding of calcium onto oxalate; however, high levels of magnesium cause it to compete with calcium and bind to the oxalate instead – preventing the same.

Not getting enough sleep : Researchers from Brigham and the women’s hospital in Boston evaluated thousands of women and concluded that lack of sleep has a direct correlation with declining kidney function. It has also been suggested that less sleep changes the physiology of the kidney causing kidney damage.

Drinking too much Coffee : Caffeine is a stimulant which increases blood pressure causing more pressure on the kidneys. According to a study in 2002, long term caffeine consumption resulted in kidney failure in obese and diabetics – causing people to conclude that caffeine results in kidney damage.

Holding your pee for too long also affects the kidneys and leads to kidney damage.

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Holding up your Pee for long ?

What are the long term implications of holding your pee ?

Most of us often end up, holding going to the washroom off and on. But do we realise, the long term damage that happens in the process ?

Holding your pee can lead to enlarged prostate, problems with urinary bladder, even kidney disorder

When we feel the urge to urinate, the process involves coordination between muscles, organs and nerves.

When your bladder is half full, it activates the nerves in your bladder which then signal your brain to give you the urge to urinate. The brain then signals the bladder to hold on. Holding your pee for long involves consciously fighting the brain signal to urinate.

When we hold on to the pee for long, the urine can back flow into the ureter into the kidneys and lead to a urinary tract infection in the bladder or the urethra. The infection can then travel to the kidney and lead to kidney infection and even kidney disease.

When treated in time, simple antibiotics can cure UTI’s.
Untreated bladder infections may lead to more severe problems such as bacterial blood stream infections which may cause sepsis, also kidney disorders and subsequent damage which over time may lead to dialysis followed by kidney transplant.

Holding pee for long also weakens the bladder muscles and leads to urinary retention, where the bladder doesn’t get emptied and one has to urinate very often.

Other problems include enlarged prostate, weak pelvic muscles, inflammation of the bladder walls, pain in lower abdomen which does not go away, incontinence and kidney failure.

 

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Kidney Transplant vs Dialysis ! Which is a better option ?

Kidney Transplant vs Dialysis, Kidney Transplant In IndiaIt is often assumed that kidney transplantation is the last resort for CKD patients or patients suffering from Chronic Kidney Disease.

However research shows that patients with kidney transplant often live 10-15 years longer than those on hemodialysis or peritoneal dialysis

If you are suffering from chronic kidney disease and are on dialysis or  if your doctor is considering dialysis, considering a preemptive or early kidney transplant , depending upon your individual situation could offer many benefits and drastically improve quality of life with a more active lifestyle.

Most patients on dialysis think they can live forever. Most patients on dialysis live upto 5 years however patients who receive a kidney transplant typically live longer than those who stay on dialysis.  The transplanted kidney usually functions immediately and functions effectively for 12-20 years from a living donor.

A deceased donor kidney functions from 8 to 12 years.

Kidney Transplant survival rates are 90% at 5 years from a deceased donors and at 96% at 5 years.

Many Kidney Transplant patients live between 15-20 years post transplant from a living donor.

On the other hand, Dialysis works only upto 10% the efficiency of a living kidney and hence can cause serious complications. 

  • Anemia
  • High Blood Pressure
  • Heart Disease
  • Nerve Damage
  • Infection

Patients on dialysis have restricted lifestyles, suffer from fatigue and unpredictable ups and downs and as a result, the average life expectancy for a patient on dialysis is generally five years.

On the other hand,  kidney transplant patients live much longer.

Patients who get a kidney transplant before dialysis starts live an average of 10 to 15 years longer than if they stayed on dialysis. 

 The younger the patient, the more is the benefit from a transplant. However, even adults as old as 75  are able to extend lifespan by  an average of four- five  more years post  transplant than if they had stayed on dialysis.

New kidneys  work much longer in patients transplanted before they start dialysis. Spending a long time on dialysis before transplantation may also compromise the life of the new kidney graft once transplant occurs.

Patients who have been on dialysis for 6 months or so  do much better than those on dialysis for 2 or more years. Patients who receive their  new kidney when their health is generally good,  have better kidney function and hence better health and increased life expectancy.

However, getting a transplant is still a better option even if the patient has been ondialysis waiting for a donor kidney due to health complications arising due todialysis.

Even though kidney transplant is major surgery, in comparison to dialysis,  it offers an opportunity for a increased life expectancy and a healthier, active, less restricted life style.

Kidney transplant in India is offered by some of the best hospitals at reasonable costs compared to the west and even Africa and middle east.

General cost estimates vary from US$ 14000 to US$ 16000 depending upon whether the  transplant is  a robotic surgery or otherwise.

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Kidney Transplant, High Blood Pressure and Kidneys

Kidney Transplant cost in India,Kidney transplantOur kidneys are responsible for filtering excess fluid and waste from the body and this depend upon healthy blood vessels.

 Having high blood pressure can damage the blood vessels leading to and out of the kidneys.
Diabetes along with hypertension worsens the damage.
Very often Hypertension leads to Nephropathy or  several types of kidney disease.
Kidney  Failure
Hypertension over a period of time, can damage both the large arteries leading to kidneys and the smaller blood vessels too. As a result your kidneys cannot filter by products leading to accumulation of toxins , damage and subsequent failure.
 As a result you may need dialysis followed by Kidney Transplantation.
Kidney Scarring
Scarring of the kidneys is caused by damage to small clusters of blood vessels which help filter blood from the kidneys.
Scarring once it starts is irreversible.
The kidneys shrink and finally the patient  may need dialysis followed by a kidney transplant.
Aneurysm of the kidney artery
A bulge in the wall of the artery is called aneurysm. An aneurysm in the kidney artery is called renal artery aneurysm.
Atherosclerosis can weaken and damage the arterial wall. Over a period of time, high blood pressure can lead to a bulge or aneurysm which can leak leading to internal bleeding which can be life threatening.
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Kidney transplant,cost in India, Why is India emerging as a destination of choice

Kidney transplant cost in India:

Kidney transplant cost in India:

Having a kidney transplant is often the last resort to save the life of an individual whose kidneys have failed and no longer process waste products in the body. It is important to arm yourself with kidney transplant information before undergoing any procedure.

You should learn how the kidneys work and why they may fail. The system will make more sense when you have this knowledge.

Here are few things doctors explain about kidney transplant in India. The kidneys have multiple functions. They follow a critical regulatory role, and they have a big part in the urinary system and ridding the body of toxins.

Additionally, they work to keep everything in the body in the balance. This includes maintaining the balance of acids and bases and regulating blood pressure, fluids in the vessels and the circulating electrolytes.

Your kidneys are your body’s natural filters. They filter out wastes from your bloodstream. In turn, this produces urine, which moves into the bladder where it is stored for future removal when you relieve yourself.

When your kidneys produce urine, wastes like urea and ammonium are excreted. Kidneys also are in charge of reabsorbing important things like water, amino acids, and glucose that your body needs to function properly.

The kidney can survive on ice for several hours before transplant so that technically, a person can be dead and still donate their kidneys. The kidney is then kept in a cold solution before donation. The best organs for kidney transplant come from the brain dead donors.

Cost of kidney transplant in India

The average cost of a kidney transplant in India is around 14,000 US dollars which are less than a third of the cost of kidney transplant surgery in US, UK or any other Western country.

Kidney transplant in India is done at best kidney transplant hospitals with the best kidney transplant surgeons.

What is included in the cost of renal transplant?

The standard price includes:

  • Initial work up–tests and investigations for the donor and the recipient
  • Surgery charges for both donor and recipient
  • Airport transfers
  • Stay within the hospital for a stipulated number of days and food for the patient and one attendant.
  • Costs beyond what is quoted often includes accommodation and food  cost before the surgery and after the surgery outside the hospital, cost of transportation etc.

It is better to know about and prepared with these extra costs as they may form a bit  of the cost that you would spend for getting kidney transplant operation in India.

Important Guidelines for kidney transplant in India:

The patient needs to bring a donor, who is a blood relative of the patient. Organ transplant act in India does not approve unrelated donors unless approved by the transplant committee.

Patient should bring all necessary documents with him

Once the Transplant Committee of the hospital approves the procedure, it can be undertaken at any of the best kidney transplant hospitals in India.

How to get kidney transplant surgery in India?

Send the latest medical reports of the patient and the donor to get a detailed medical opinion by the Kidney Transplant Team.

Details primarily viral markers (HIV mainly of donor and recipient) and blood group of both donor and recipient is needed, which can be done locally or a country close to you. If HIV is negative and a related donor is blood group, the patient can go for the transplant. Kidney transplants can also be carried out for non blood group compatible transplants but the rate of rejection is much higher.

The patient and the donor would be advised to come to India where then  get evaluated, have dialysis and be worked up for transplant

After the organ transplant committee of the hospital approves of the transplant, the surgery is done.

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Patients are not only able to search ,discover best hospitals in for kidney transplant India and take a free 2nd opinion and estimated cost of  kidney transplant from some of the best doctors, best nephrologists in India but also save on cost of surgeries as well.

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