Dr Arivazhagan’s Nephrology clinic has been started with an aim to provide Nephrology Outpatient services with the guiding principles of
- Quality
- Ethics
- Scientific evidence-based and
- patient centric care with considerations for patient’s socio-economic circumstances.
“Prevention is always better than cure” - True in Nephrology too. Hence focus will be on correct diagnosis, classification of kidney diseases and treatment to cure or slow down the progression to more advanced stages. That will be easier when patients approach a Nephrologist at earlier stages
Importance of screening for early diagnosis in kidney diseases
Most of the advanced stage kidney failure patients (requiring dialysis/ transplant) pass through various stages
| eGFR (ml/min | Treatment | |
|---|---|---|
| Stage 1 | >90 | Diagnose the cause, treat to reverse or stop progression to advanced stages |
| Stage 2 | 60 to 90 | |
| Stage 3 | 30 to 60 | |
| Stage 4 | 15 to 30 | Slow progression, prepare for renal replacement therapy |
| Stage 5 | <15 | Transplant, Dialysis |
Many kidney disease patients can avoid progression to the stage of dialysis or transplant if diagnosed at earlier stages for better results. It is extremely important to pick up kidney diseases at earlier stages for interventions. Warning signs, to name a few, are
- Protein in urine
- Blood in urine
- Rise in serum creatinine
Remember when serum creatinine is 2.0, it means kidney function is already down by 25 to 50 percent from normal
To preserve or protect your kidneys, it is always better to consult a Nephrologist who has trained in General medicine for three years and in Nephrology for another three years.
50 to 70 percent of kidney disease are due to diabetes and Hypertension. All diabetes and hypertension patients have to undergo screening tests for kidney problems every six months to one year ideally.
Not all kidney diseases are due to diabetes/ hypertension (even in diabetes patients). These potentially curable kidney diseases need a structured evaluation (including kidney needle biopsy) and benefit from specific treatment based on correct diagnosis
Patients with advanced stage kidney diseases benefit from comprehensive care including
- Counselling (nature of disease, various treatment options)
- Individual Diet plan (balance between slowing disease progression and undernutrition)
- Access planning
- Allow patients to choose appropriate treatment – Hemodialysis, Home dialysis, Transplant (Live, Cadaver,ABOi,Swap kidney etc.)
Who should consult a Nephrologist?
- At risk groups for kidney disease include patients with
- Diabetes - Annual screening every year
- Hypertension - Annual screening every year
- Obesity/ Metabolic syndrome
- Family history of kidney diseases
- Heart and cardiovascular diseases
- Pregnancy related hypertension and diabetes
- Liver disease
- Lupus and other rheumatologic diseases
- Pain killer medicine abusers/ over-the-counter medicines without prescription
- Protein in urine, Blood in urine
- Urinary Tract Infections
- Kidney Stones