FAQs

Yes. The treatment of renal failure depends on the disease-causing renal failure and its severity. In general most of the diseases causing acute renal failure are amenable to treatment and a cure is possible. Most of the diseases causing chronic renal failure can be treated to slow down the progression to end-stage renal disease but a complete cure is not possible. However, it is important to recognize that this is a broad generalisation and exceptions are there.

The most common cause of chronic renal failure in our country is diabetic kidney disease. India has the second-largest number of diabetic patients. One in five adults in an urban area has diabetes.

When does a chronic renal failure patient need dialysis or renal transplantation? Treatment for chronic renal failure depends on the severity of the renal failure and the disease-causing renal failure. In general medicines and diet modification can be used to treat chronic renal failure in its early stages. However renal replacement therapy (RRT) is needed in end-stage renal disease or CKD Stage 5.

When a patient with chronic kidney disease develops CKD stage 5 or end-stage renal disease (ESRD), medicines and diet modification alone are not enough. The patient needs renal replacement therapy (RRT) to substitute for the function of the failing kidneys. The modalities of RRT are

1. Peritoneal dialysis
2. Renal transplantation
3. Hemodialysis.

Dialysis is a blood purification procedure done for patients with end-stage renal disease (ESRD). It is done for removing waste products of metabolism like urea, for treating acid-base and electrolyte abnormalities, and for removing excess fluid in ESRD patients. It is of 2 types. Hemodialysis - The blood purification procedure is done by passing the patient's blood across a filter with the help of a Hemodialysis machine. It is done in the hospital by qualified technicians. Peritoneal dialysis - The patient’s peritoneal membrane (layer covering a cavity called peritoneum in the abdomen) acts as a filter for removing toxins. PD is done by infusing concentrated glucose solution into the peritoneal cavity. PD can be done at home by the patient or caregiver after proper training.

Among the 3 RRT options, available Renal transplantation gives the best results (in terms of patient survival and quality of life) for ESRD patients. It is a surgical procedure in which a Kidney harvested from a suitable donor is surgically placed in the ESRD patient’s abdomen by a urologist or transplant surgeon. After successful renal transplantation, the patient has to take immunosuppression medicines and follow the advice of a nephrologist life long.

Diabetes is the most common cause of chronic renal failure. Measures to prevent diabetics and prompt detection and appropriate treatment of diabetics in early stages can help to prevent CKD and detect CKD earlier in many patients. All individuals > 30 years should undergo screening for diabetics. Individuals with risk factors for diabetics like those with positive family history (Mother, Father, or a First degree relative with diabetes), Heart disease, stroke, PCOD (Polycystic Ovarian Disease), Obesity, and Hypertension should undergo screening earlier.

1. All diabetic patients should be screened periodically for kidney disease (at least once a year). Early detection of kidney disease helps in appropriate treatment.


2. Avoid smoking, Alcohol


3. Decreasing salt intake in diet to less than 5g/day helps to prevent hypertension and slow down the progression of kidney disease.


4. A healthy diet (including fresh fruits, and vegetables and avoiding junk foods, packed and processed foods).


5. Maintain a healthy weight appropriate for height.


6. Physical activity - at least 30 minutes of brisk physical activity per day is recommended as a lifestyle modification for non-pharmacological treatment for both diabetics and hypertension.


7. Avoid taking medicines without a doctor’s prescription.