Dr Sumit Gahlawat, MBBS, MS, DNB, Mch-Urology (Gold Medallist), Urologist, Robotic & Renal Transplant Surgeon, Director & Senior Consultant, Narayana Hospital, Gurugram, is highly experienced and proficient in the operative and medical management of urological conditions including andrology. Known to provide exceptional care and treatment to patients, on the World Kidney Day, he emphasises on the importance of kidney care to lead a healthy life with dignity.
For the understanding of the common man, what is the significance of maintaining kidney function for overall well -being?
Kidney functions like the purifier of the body by filtering harmful toxins and waste from the blood. It also regulates the fluid balance, controls the blood pressure, maintains the body’s acid balance and produces erythropoietin hormone which regulates haemoglobin in the body. This is the reason that people who have kidney problem are anaemic. If these functions are impeded, toxin levels rise in the blood, impacting the overall functioning of rest of the organs, making them diseased.
What are the symptoms of kidney disease, and how can people evaluate their kidney health?
The early symptoms of kidney disease are swelling in the feet & face, nausea, loss of appetite and lethargy. When the symptoms progress patients feel breathlessness, fluid accumulates in the lungs and the heart is also under stress hampering its proper functioning. And if there is a delay in reporting to the hospital the patient becomes unconscious, rest of the organs stop functioning, leading to multiple organ failure which is fatal.
The kidney health can be evaluated based on 5 categories of patients:
1. People aged above 50 years should undergo overall check-up for all organs as they also age.
2. Diabetic and hypertensive patients are prone to develop kidney complications, so they should get their kidneys evaluated for early detection and treatment.
3. People with family history should start their kidneys evaluation by 35-40 years of age.
4. People with kidney stone is another risk group of which some cases are asymptomatic. Even if the stones are tiny with ridged edges they can stick to the inner wall of the kidney rendering the organ non-functional.
5. Patients on medications and health supplements are also at high risk as the kidney disease.
How can formation of kidney stones be prevented and the treatment options available?
Kidney stones are as small as 2mm in size, which can be flushed out through the renal passage. But if they are of large size they obstruct the passage and have to be operated. Those with family history tend to develop stones in the kidney repeatedly. Kidney stones are more common in people of north India e.g., Gujarat, Rajasthan, Uttar Pradesh, Haryana and even Uttarakhand, notoriously known as the ‘stone belt’. This has to do with the extreme climatic conditions and hard water.
Few reasons of stone formation are listed below:
Urinary tract infections can also lead to a variety of stone formations, including infectious stones. Some stones are caused due to one’s dietary habits, including high salt (sodium) intake. High intake of tea and coffee also increases the chances of stone formation.
A notion that Fruits and vegetables with seeds cause stone formation is a myth and no study substantiates this
Remember that water intake should be in accordance with one’s thirst. If the colour of the urine is light yellow, it means that you are drinking sufficient water. People doing rigorous physical activity require more hydration as compared to those in sedentary jobs, sitting in air-conditioned environments with limited urge to drink water. For them, 1.50 litres of water would suffice in a day.
Medication for kidney stone is given in accordance to stone’s size, shape and hardness. There are tablets that can help the tiny stones pass out of the body without any obstruction. Stones can be removed by fragmentation of it using lasers, for eg., surgeries like URSL and RIRS
When does a patient need kidney transplantation and what are the latest advancement in this procedure?
Patients on dialysis need kidney transplantation as their quality of life and longevity is poor. One should know that life expectancy of a patient on hemodialysis is usually less than 10 years because the heart and lungs get affected with passage of time, whereas, after transplant the life can be extended by 20-25 years or even more.
Dialysis has increased chances of infection and a typical session lasts around 4 hours and usually done thrice a week. It is a burden, both physically & financially and requires time. If such patients undergo kidney transplantation, 95% chances are that the donor or cadaver kidney will be successful and they can lead quality life. Lifelong medications and care is, however, mandatory. If a person undergoes pre-emptive transplantation i.e., without having undergone dialysis, the results are much better in terms of operative success and quality of life.
Robotic renal transplant is now available since more than a decade.Its main benefit is less associated morbidity with no inferiority in primary outcomes of graft and patient survival. But the challenge is finding a donor. The apprehension, that the health of a donor will be affected, is not true. There are many patients who live their entire life on one kidney.
On World Kidney Day what is your word of caution to the readers of The Week?
The theme of World Kidney Day 2025, “Are Your Kidneys OK? Detect Early, Protect Kidney Health”, highlights the importance of recognising kidney disease risk factors and accessing timely testing to improve early detection, intervention and outcomes.