In order for the renal transplant to function and not be rejected by our body for the work of the immune system, we need to reduce or block the action of certain components of the immune response. We do this by administering drugs aimed at certain metabolic pathways as specific as possible that allow us to reduce the adaptive immune response without affecting the innate measure to a greater extent, but they entail another series of factors, entities or risks that we will detail in this post. The risk of infections Infections are the first cause of death after a kidney transplant in Delhi. Logically, by decreasing the body’s defenses the main risk is represented by infections. Both the usual and those called generated by the so-called opportunistic pathogens (those microorganisms that usually would not cause infection in a healthy patient, are able to infect and make an immunosuppressed patient sick). The greatest risk of infection occurs in the first 3 months after transplantation, since at the beginning higher doses of immunosuppressants are administered to avoid acute graft rejection, says nephrologist in Delhi. The most common infections are respiratory infections and urinary infections, secondly gastrointestinal infections; There is usually a history of an infected relative who may have been the cause of the infection, explains nephrologist in Noida. With respect to opportunistic pathogens, the most frequent are viruses starting with cytomegalovirus (CMV) and polyomaviruses (BK and JC viruses), hepatitis viruses, herpes, chickenpox, to name a few. Then we find bacteria such as Nocardia, listeria, pneumocystis, among others. In some cases, we can reduce the risk of infection by getting vaccinated. All transplanted patients should receive a series of vaccines to reduce the risk of infection by these microorganisms; however, it should be noted that vaccines with live or live-attenuated microorganisms should NOT be administered, only those with inactivated, dead microorganisms or bacterial/viral proteins should be administered, says doctor for kidney transplant in Delhi. Vaccination and prophylaxis Another way to reduce the risk of infection is through prophylaxis (that is, preventive treatment). Depending on the epidemiological environment of the center where the transplants are performed, more or less prophylactic medications are administered and usually maintained only during the first 3 to 6 months. However, if in spite of all this, a transplanted patient contracts an infectious disease, it is important that he notify his nearest health professional, and in the case of fever, go to the hospital emergency department as soon as possible, suggests kidney Specialist in Noida. Immunosuppressive toxicity Immunosuppressive medications can generate negative effects not only by their direct action, but also by indirect actions or adverse reactions of each family of medications. On the one hand, we have the anticalcineurinics (cyclosporine and tacrolimus) almost indispensable in most immunosuppression regimens in some patients can general gum growth, hair loss, neurological disorders, insomnia and even direct kidney damage (in very high concentrations). On the other, mycophenolate (purine nucleotide synthesis blocker) is characterized by generating gastrointestinal disturbances, commonly diarrhea. Another similar medication, azathioprine can cause anemia or leukopenia (decrease in white blood cells below adequate values). Finally, another group of medications known as mTOR inhibitors, sirolimus and everolimus can cause anemia, hypertension, slow healing or generate joint pain. As we can see, the effects that these drugs can generate are varied, but their usefulness and benefit outweigh these risks, so it is important that if you notice any alteration or change in normality related to the effects mentioned above, contact your kidney transplant doctor in Delhi.
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Muscle is one of the largest affected by chronic kidney disease (CKD), due to various factors associated with kidney degradation. To this are added factors that also contribute to this loss of muscle tissue, such as the patient’s age, comorbidities or a sedentary lifestyle. It is an inexorable process of difficult prevention that can be alleviated or counteracted through clinical nutrition and physical exercise. “There are multiple observational studies that relate the loss of muscle mass and strength in CKD with an increased risk of hospitalization, of having a heart attack or even of dying. This patient is so complex that in the clinic we tend to prioritize only short-term metabolic risks. It is also important to focus on nutritional aspects and physical exercise programs that can benefit the patient, ”says the best nephrologist in Delhi. This kidney specialist in Delhi explains that “patients with CKD are undergoing a process of progressive muscle loss due to many factors related to kidney degradation. These include an increase in muscle degradation mechanisms due to oxidative stress, metabolic acidosis and persistent inflammation; an impoverishment of muscle repair and synthesis mechanisms, such as resistance to the action of insulin, growth hormone or testosterone, and the catabolic process involved in the dialysis session itself, together with a small but continued loss of the amino acids of the diet in the blood filtrate during dialysis ”. It is estimated that between 30 and 50% of patients on dialysis have the “energy protein wasting syndrome”, and that it refers to the confluence in the patient with CKD of a malnutrition process (due to a loss of appetite and sometimes to the dietary restrictions that must be maintained) and a hypercatabolism process (propitiated by the mechanisms described). This syndrome is associated with an impoverishment of the quality of life, an increased risk of hospitalization, cardiovascular events, and mortality, says nephrologist in Delhi. “The way to avoid it is first, implementing identification and screening programs in the clinic,” says nephrologist in Noida and lists some examples such as “screening in patients looking for symptoms of malnutrition / muscle loss (every 6 months in patients not dialyzed in stages 4-5; every three months, in dialysis patients); in patients with symptoms, exploration of causes of malnutrition / muscle loss, and, thirdly, to implement a specific nutritional therapy, which may include various complementary strategies including the use of nutritional supplements, exercise programs (preferably resistance), use of anabolic agents and treatment of the triggering causes (such as inflammation and metabolic acidosis, among others)”. The group of elderly patients on dialysis is growing, a subgroup of patients who require specific measures in terms of nutrition and exercise. Nephrologist in Gurgaon indicates that “the high age of patients usually limits the amount and intensity of the exercise that can be prescribed. However, any improvement in physical activity, however small, does great good in this population. The first step would be to encourage them to walk, about 30 minutes a day 3-4 days a week. This mild exercise has been associated with a decrease in inflammatory activity, improved exercise capacity, and muscle functionality, and is associated with a reduction in the rate of hospital admissions. In the elderly dialysis patient (and in all dialysis patients, of course), it is important to ensure that you consume enough calories and protein in the diet to compensate for these losses/catabolisms. The clinical guidelines recommend a protein intake of 1.0 or 1.2 grams per kilo of weight per day, and a caloric intake of 30-35 kcal /Kg/day. In an elderly person of appetite and reduced mobility, these requirements are not likely to be met spontaneously and the dietitian, endocrinologist or nephrologist in Gurgaon can assess the need to prescribe some type of oral supplement.” How can I know if I have kidney disease? According to the best nephrologist in Delhi, In general, kidney disease in its initial stage has no symptoms. The only way to know how well your kidneys are working is to be tested. Have a kidney disease check if you suffer from:
Have a checkup to determine if you have kidney disease. Early treatment can help protect your kidneys. What tests do doctors use to diagnose and monitor kidney disease? To determine if you have kidney disease, doctors order:
GFR blood test Your nephrologist in Gurgaon will order a blood test to evaluate the function of your kidneys. The test results mean the following:
You cannot raise your GFR, but you can try to keep it from decreasing. Creatinine: Creatinine is a waste product of your body’s muscle metabolism. Your kidneys remove creatinine from your blood. Providers use the amount of creatinine in their blood to estimate their GFR. As the disease of the kidneys progresses, the creatinine level rises. Urine test to detect albumin If you are at risk of kidney disease, your doctor can evaluate your urine for albumin. Albumin is a protein found in the blood. A healthy kidney does not pass albumin from the blood into the urine. A damaged kidney lets some albumin pass into the urine. The less albumin you have in your urine, the better. The presence of albumin in the urine is called albuminuria. A healthy kidney does not let blood albumin pass into the urine. A damaged kidney lets some albumin pass into the urine. A kidney specialist in Gurgaon can detect albumin in your urine in two ways: Test strip for albumin. The provider uses a urine sample to detect albumin in your urine. You collect the urine sample in a container at the doctor’s office or in the laboratory. For the test, the provider places a chemically treated paper tape, called a test strip, into the urine. The test strip changes color if albumin is present in the urine. Albumin creatinine ratio in the urine (UACR). This test measures and compares the amount of albumin with the amount of creatinine in your urine sample. Providers use this ratio to estimate how much albumin passes into their urine in 24 hours. A urine albumin result of:
If you have kidney disease, measuring albumin in your urine helps your doctor know what is the best treatment for you. A level of albumin in the urine that stays the same or decreases may indicate that the treatment is working. How do I know if my kidney disease is progressing? You can keep a record of the results of your tests over time. You can say that your treatments are working if:
Nephrologist in Delhi warns of a growing number of cases of chronic kidney disease, a condition that undermines health and quality of life. In the last two decades, India has seen the number of people with chronic kidney disease triple. Today more than 1,200,000 citizens are on dialysis in the country and it is estimated that at least 40,000 of them die each year. The alarming Indian statistics do not differ from the rest of the world. An estimated 850 million people worldwide suffer from kidney disease - 2.4 million deaths a year, making kidney disease the 11th leading cause of death worldwide. In the face of this epidemic, the best nephrologist in Delhi has been trying to draw the attention of the population to this vital and often overlooked pair of organs. In addition to removing waste and extra fluids from the blood, the kidneys have the task of controlling the body's chemical balance, helping to balance blood pressure, maintaining healthy bones and producing the erythropoietin hormone necessary to maintain red blood cell levels and prevent anemia. The great challenge of kidney disease is that in its early stages it is asymptomatic. A person can lose 90% of the functions of these organs without feeling anything. Only at an advanced stage do some signs usually appear, such as swelling, fatigue, decreased appetite, hiccups, reduced urine volume, among others, says kidney specialist in Delhi. We talk about a problem that, strictly speaking, has no cure, which causes patients to need care for a lifetime. Although the quality of treatment has come a long way in recent years, quality, individualized dialysis is not yet accessible to those in need, just as not everyone can get a kidney transplant in Delhi. As the prevalence of kidney disease is drastically increasing, the cost of treating this growing epidemic carries a huge burden on healthcare systems around the world. In Indian, the amount spent on treating the condition already outweighs the cost of breast, lung, colon, and skin cancers combined. The best strategy for cost reduction and patient harm is prevention. The warning is for countries to invest more in this regard and make kidney disease screening primary health care, including access to blood (creatinine) and urine (EAS) tests. Early diagnosis and treatment can prevent or delay kidney disease from progressing to more severe stages requiring dialysis or transplantation. People with hypertension and diabetes should pay special attention, as these problems are the main causes of kidney disease today. Therefore, protecting yourself from them and maintaining a balanced diet and a healthy lifestyle is also a way of taking good care of the kidneys, says nephrologist in Gurgaon. |
AuthorA passion for helping others led me down the path of Medicine into a career that allows me to provide my patients with high quality healthcare. As a professional Nephrologist in Delhi since 2008, I bring a holistic approach to medicine in order to find comfortable and effective solutions for everyone. Read on to learn more about my medical background. Archives
March 2023
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