Patients

1. What function(s) do kidneys do?
The kidneys are bean-shaped organs that serve several essential functions in humans. They remove waste products of metabolism from our bodies.They also help maintain the internal environment around the cells with the regulation of electrolytes, maintain acid-base balance, regulate blood pressure (via maintaining salt and water balance), and secrete different hormones including active vitamin D, erythropoietin ( that kick starts bone marrow to produce red blood cells) and renin ( that help maintain blood pressure).

2. What are kidneys made up of?
Each kidney is made up of about one million nephrons (filter and tube). The filter is considered very inefficient; apart from big molecules and cells, almost all things are filtered out and the tubes are the most efficient ever built that absorb all of what is required and necessary for our body. The rest is what makes urine. Some toxins are also secreted into the urine by the tube cells.

3. What causes kidney diseases?
There are multiple factors that can cause kidney disease. Some are birth defects in the structure of the kidney including genetic defects. Others are infections, allergic reactions,autoimmune diseases, toxins, some medicines that are cleaned by the kidneys, stones and even cancer. There are some chronic diseases that can cause kidney damage. In the United States the two leading causes of kidney failure are diabetes and high blood pressure. When these two diseases are controlled by treatment, the associated kidney disease can often be prevented or slowed down. Healthy lifestyle changes, such as sufficient water intake, eating a healthy diet, losing weight and regular exercise, often help to control high blood pressure and diabetes and its related kidney disease. When diabetics have associated high blood pressure, special drugs called angiotensin converting enzyme (ACE) inhibitors may help to protect their kidney function.

4.Is kidney disease preventable?
Some forms of kidney diseases are preventable. There are some basic general things you can do to protect your kidneys and prevent damage.

• • Drink sufficient amounts of fluids. Ask your doctor about how much water to drink. This can vary depending on your overall health, your heart and kidney condition, but generally about 6–8 regular sized glasses in a day is recommended.
  • Having an active life style which includes regular exercise is very important. It regulates your body’s metabolism and helps you lose weight and control other chronic diseases including High Blood Pressure and diabetes.
  • Avoid taking Over the counter painkillers especially if you have already have early kidney disease and especially without good water intake. Keeping yourself hydrated is very important when taking one of these medications.
  • Follow up with your physicians on a regular basis so that they can monitor kidney function and advise on timely remedies for your kidneys’ health.

5. What is dialysis?
Dialysis is a way of replacing kidney function with a machine when a person’s own kidneys fail. The machine cleans blood through special solution and a filter that helps remove blood waste products and acids from the body and return back healthier, cleaner blood. Dialysis itself is a painless process. There are different forms of dialysis and each has its own set of merits and disadvantages. Depending on the modality, you will need creation of access in the body for exchange of body fluids. Your doctor will explain the process in details when needed.

6. When is dialysis needed?
Dialysis is generally required when 85–90% of the kidney function has been lost and the ability for the body to function properly is hampered by the high levels of toxins and fluids in the blood and in the cells that are not expelled or neutralized by the kidney. Some people experience nausea, vomiting, mental confusion and sometimes even seizures from these high toxin levels.

7.What are the types of dialysis?
There are two major forms of dialysis.- hemodialysis and peritoneal dialysis.

A. Hemodialysis
In hemodialysis, an artificial kidney (hemodialyzer) is used to remove waste and extra chemicals and fluid from your blood. To get your blood into the artificial kidney, the doctor needs to make an access (entrance) into your blood vessels. This is done by minor surgery to your arm or leg.

Sometimes, an access is made by joining an artery to a vein under your skin to make a bigger blood vessel called a fistula.
However, if your blood vessels are not adequate for a fistula, the doctor may use a soft plastic tube to join an artery and a vein under your skin. This is called a graft.

Occasionally, an access is made by means of a narrow plastic tube, called a catheter, which is inserted into a large vein in your neck. This type of access may be temporary, but is sometimes used for long-term treatment.
Hemodialysis can be done in a center (usually the case) or even at home ( in motivated patients who want to do it at home).

B. Peritoneal dialysis
In this type of dialysis, your blood is cleaned inside your body using your belly membrane as the filter. No blood vessels are punctured and blood handling is not involved. The doctor will do surgery to place a plastic tube called a catheter into your abdomen (belly) to make an access. After the surgery area heals, the catheter can be used for dialysis. During the treatment, your abdomen is slowly filled with dialysate through the catheter. The blood stays in the arteries and veins that line your peritoneal cavity. Extra fluid and waste products are drawn out of your blood and into the dialysate. Usually peritoneal dialysis is done at home so there is somewhat more responsibility on your part and your family’s part to learn how to do it at home.

8. How can I avoid dialysis?
You can avoid dialysis by keeping your body and the kidneys in good health and by protecting them from further harm by following the advice of your physician. Kidney disease is usually silent i.e. without much symptoms until it gets into advanced stages, so it is very important that you have your kidney health checked out by your primary care doctor and have followup with him on a regular basis. If there is evidence of kidney damage, seeing a kidney specialist early on, identifying the cause of damage and charting out a plan of preventing further damage can help protect your kidneys from further damage. There is a lot of reserve kidney function that God gave us. Usually there are no need to do dialysis, unless kidney function drops to below 90 percent.

9. Do you treat kidney stone?
Kidney stones can form due to a variety of reasons. Infections and genetic problems rank highest. Once kidney stones are formed your primary care doctor can refer you to a kidney specialist like us who can work with your urologist to help identify dietary changes that are needed to prevent further episodes of kidney stone formation. Remember that some kidney stones are preventable by drinking plenty of fluids up to two liters daily and keeping yourself well hydrated especially in those hot summer days.

10. Can you see us in a short notice?
Yes, we are all about helping our patients feel a personal connection, the sense that their health is a top priority and they can reach us anytime in need. Call our office (513-841-0222) if you have been told that you have kidney disease and one of our six highly trained and experienced physicians can accommodate you as quickly as possible.

11. Difference between nephrologist and urologist .
Urologists and nephrologists both treat kidney problems. Urologists are surgical specialists who focus on anatomical or structural disorders of the kidneys and urinary tract. They treat problems such as kidney stones, kidney blockages, and kidney cancer, which may require surgical intervention.

Nephrologists are medical specialists who focus on disorders that affect the way the kidneys work. Nephrologists prescribe nonsurgical medical treatments for these disorders.

12. More information about renal failure?
Here are some educational resources for more information.

• • Kidney disease prevention
  • Kidney stone prevention
  • Transplant Living
  • Nutrition in Kidney disease stage 1-4
  • Nutrition for patient’s on dialysis
  • General information on Chronic Kidney disease from Mayo Clinic
  • National Kidney foundation (The National Kidney Foundation is the leading organization in the U.S. dedicated to the awareness, prevention and treatment of kidney disease for hundreds of thousands of healthcare professionals, millions of patients and their families, and tens of millions of Americans at risk. )