Understanding Kidney Failure: Causes, Symptoms, Diagnosis, and Transplant Options

The kidney maintains the balance of water in the body. Along with this, it performs important functions such as eliminating toxic substances like urea and creatinine produced in the body, balancing acidic substances, regulating blood pressure, and assisting in blood production.

Kidney failure occurs when the kidney is unable to perform its function for any reason. If alternative measures are not adopted in such a situation, there is a risk to life.

Causes of Kidney Failure

Diabetes, high blood pressure, kidney protein leakage disease, infection, and recurrent stones damage the kidneys. Furthermore, there is a risk of kidney failure due to genetic reasons. Especially, if one remains alert in time about diabetes, high blood pressure, infection, and stones, kidney disease can largely be prevented and avoided.

How to Know?

Symptoms may not appear even when the kidney is up to 90 percent damaged. Symptoms start appearing only when it exceeds that level. By the time people realize it, the kidney is completely damaged, which is why this disease is called a 'silent killer'.

Symptoms include feeling weak, getting tired quickly, loss of appetite, nausea, water retention in the body, swelling of the legs and face, gradual decrease in blood production leading to lower hemoglobin, difficulty breathing, rising blood pressure, shortness of breath making it difficult to live a normal life if water accumulates in the lungs, and irregular heartbeat. Moreover, when urea and creatinine increase, there is a possibility of becoming delirious and even unconscious. If treatment is not received in time, there is a risk to life.

Treatment

Since this is a disease where symptoms are known only after 90 percent failure, testing should be done regularly. Whether there is a problem with the kidney can be determined through blood and urine tests and X-ray. The level of creatinine in the blood and whether protein is leaking in the urine is checked. Similarly, an X-ray reveals if there is any change in the size of the kidney.

Once kidney failure is confirmed through testing, there are only two options for treatment—one is dialysis and the other is transplantation. Dialysis is a temporary option. Dialysis also carries the risk of infection and is financially expensive if required lifelong. If dialysis is not done, life can be at risk.

Therefore, the best option is transplantation. This allows the patient to live life as before, eat and drink, pursue profession/business like a healthy person, and contribute to the country and family. Dialysis can be done temporarily until preparations for transplantation are complete.

Transplant Service at Norvic

Kidney transplants are regularly performed at Norvic. Due to the high technology available here, all types of skilled manpower, and specialized services, the success rate of transplantation here is high. Furthermore, the Government of Nepal has set certain rules for organ donation. Norvic provides kidney transplant services in adherence to those rules.

Things to Note After Transplantation

Once kidney failure is identified, transplantation must be performed. Dialysis must be done until transplantation occurs. However, dialysis is not an alternative to transplantation.

Transplantation is the process of placing an organ from another person. The body tries to reject the foreign organ. Therefore, we administer medication lifelong that slightly weakens the body's immune system. This increases the risk of infection for the patient, so all possible measures must be taken to avoid infection. One should avoid contact with people suffering from communicable diseases. Even for a mild cold or diarrhea, medical advice should be sought so that the infection does not spread. Medications must be taken regularly, otherwise, there is a risk of rejection of the transplanted kidney. Regular testing is necessary to know if there are any side effects of the medication and what the drug level is. Diet can be managed like that of a healthy person.

How Can Organs Be Obtained?

The kidney to be transplanted in a patient can be obtained in three ways. First, a healthy person can donate. Relatives of the patient can donate organs. In Nepal, the law has been relaxed to allow organ donation from within 52 specified relatives of the patient. Secondly, mutual exchange (peer exchange) can be done. According to this, if an organ does not match within relatives, organs can be exchanged between non-relative families for transplantation. Transplantation can also be done by taking organs from a brain-dead person. Organs that would otherwise be wasted after brain death can be taken with the family's consent. Up to 8 organs can be taken from one person, including the kidney, heart, lungs, liver, pancreas, and small intestine.

If someone suffers a severe head injury and treatment is not possible, brain death can be declared according to certain criteria. Such individuals are legally and medically completely deceased. The other organs of such individuals can function for a few more hours with ventilator support. If organs are donated at that time, life can be given to other people. Therefore, raising public awareness about this is also necessary.

Dr. Pukar Chandra Shrestha works as a specialist in Kidney and Liver Transplantation at Norvic Hospital.