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Kidney Disease Treatment(Nephrology) in India

by Rishabh

What is Nephrology?

Nephrology is primarily concerned with the diagnosis and treatment of kidney diseases. Nephrology also includes hypertension, electrolyte disturbances and also those people who require renal placement therapy that also includes renal transplant patients.

Some of the kidney diseases are systemic disorders that are restricted only to the organ but can also require special treatment. Some of its examples also include acquired conditions like autoimmune diseases, vasculitides and genetic or congenital conditions like polycystic kidney disease.

Renal doctors or nephrologists treat those people who are suffering from kidney conditions and diseases associated with the functions of the kidney. They also care for those people who live on kidney transplant or dialysis. A lot of kidney diseases are treated with the help of medication. Transplant or dialysis is required when the chronic kidney disease has advanced to the fifth stage.

Conditions and Disorders Requiring Nephrologists

  • Acid or base imbalance and electrolyte disorders
  • Acute renal failure ( a sudden loss of renal function)
  • Recurrent or chronic urinary tract infections
  • Hematuria (blood in the urine)
  • Hypertension that has not responded to many forms of anti-hypertensive medication or is due to some other cause
  • Chronic kidney disease that results in declining renal function and is due to an inexorable rise in the creatinine
  • Proteinuria ( loss of protein especially albumin in the urine)

Nephrology Diseases

Acute Renal Failure: Renal failure represents a collection of diseases associated with reduced GFR and manifested by retention of creatinine and BUN. When there is decreasing urine output or increasing creatinine level over a period of days then this condition is termed as acute renal failure. Acute renal failure is due to the failure of kidneys as they are unable to perform their normal functions. Some of its causes include –

  • Renal : When there is problem with the kidney that prevented production of urine or proper filtration of blood.
  • Prerenal: When blood flow is affected before reaching to the kidneys.
  • Postrenal : When there are problems that affect the movement of urine out of the kidneys.

Nephrotic Syndrome: A type of clinical syndrome connected with proteinuria in the hyperlipidemia, nephritic range and edema is termed as nephritic syndrome. This syndrome is due to the direct action of the membrane attack that is a unit of complement on the glomerulus. Nephrotic syndrome is suspected in a person when protein is detected in the urine, generalized oedema and hypoalbuminemia.

Berger’s Disease: This disease is considered as the most common glomerulopathy across the world. Many cases of this syndrome are unknown. When there is abnormal deposition in the kidney causing an inflammatory response results in Berger’s disease. This syndrome is characterized by frequent attacks of gross hematuria.

Alport’s Syndrome: This syndrome is a type of genetic condition that is categorized by eye abnormalities, kidney disease and hearing loss. A person suffering from this syndrome experiences continuous loss of kidney function. It has also been seen that people suffering from this syndrome have blood in their urine indicating that there is abnormal functioning of the kidneys. This syndrome causes end-stage renal disease.

Chronic Renal Failure: When there is progressive and gradual loss of renal function then it results in chronic renal failure. Some of its causes include hypertension, lupus erythematosus, IgA nephropathy (Berger’s disease), diabetes mellitus, glomerulonephritis, amyloid and nephrotic syndrome. Renal transplant is the only treatment for chronic renal failure.

Anti-Glomerular Basement Membrane (GBM) Antibody Disease: In this autoimmune disease, autoantibodies are against type IV collagen. This disease is responsible for rapidly progressive renal failure which can be with pulmonary hemorrhage or without it.

Post-Streptococcal Glomerulonephritis (PSGN): This is basically a result of an uncommon complication of streptococcal skin infection or a strep throat. Inflammation of the kidney is also involved in post-streptococcal glomerulonephritis.

Diagnosis of Nephrology Diseases and Conditions

The diagnosis include at performing different laboratory tests that aim at electrolytes, urea, urinalysis and creatinine. Many specialized tests can also be performed for discovering some systemic diseases to kidney failure that include lupusserologies, hepatitis b or c and also other systemic diseases that causes kidney failure. A sample of urine is kept for 24 hours that provides information on the amount of protein loss in some forms of kidney disease and on the filtering ability of the kidney. Other tests include –

  • CT scanning is performed when many lesions are suspected and it also helps in suspecting nephrolithiasis.
  • Renal biopsy
  • Scintigraphy is done for accurate measurement of renal function
  • Ultrasound scanning of the urinary tract
  • MAG3 scans for diagnosing renal artery disease
  • Magnetic resonance imaging angiography is performed when the blood vessels are affected

Pediatric Nephrology

This is a specialized branch concerned with kidney problems in children. A large number of kidney problems in children results into immediate or acute problems such as acute kidney failure, nephrotic syndrome and urinary tract infection. The function of the kidney suffers in a long run when few conditions results in progressive kidney damage and it is also possible that there could be no or minimal symptoms at the acute stage. Some of the acute stage diseases include heavy protein in the urine, chronic irreversible kidney failure, kidney stones and renal dysplasia.

Diseases and Conditions of Pediatric Nephrology

  • Kidney stones
  • Vesicoureteral reflux
  • Acute renal failure
  • Glomerulonephritis
  • Kidney failure
  • Hypertension
  • Protein or blood in the urine
  • Renal dysplasia
  • Hemolytic uremic syndrome
  • Diabetic kidney disease
  • Recurrent urinary tract infections
  • Hydronephrosis
  • Renal tubular acidosis
  • Neurogenic syndrome
  • Systemic lupus erythematosus
  • Pediatric kidney transplants
  • Nephrotic syndrome
  • Polycystic kidney diseases

Diagnosis for Pediatric Nephrology Diseases and Conditions

The diseases of pediatric nephrology are diagnosed by performing a number of tests that include –

  • Urine analysis
  • Biopsy
  • CT imaging of the urinary system
  • Nuclear renal scan
  • Blood tests
  • Ultrasound
  • MR imaging of the urinary system

Treatment for Pediatric Nephrology Diseases and Conditions

Hypertension treatment for kids focuses on dietary and lifestyle changes. Lifestyle and diet changes include intake of healthy foods which are low in fat and salt, more intake of fresh vegetables and fruits, and proper stress management program. Medications can also be provided for managing blood pressure levels.

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