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    3. Acute Dialysis Catheters

    Acute Dialysis Catheters

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    What is Dialysis?

    It is a treatment which is carried out when the kidney exhibits abnormal functioning. Two main types of dialysis processes are known - haemodialysis and peritoneal dialysis. 

    Haemodialysis diverts the blood towards a device where it’s purified before returning to the body, whereas, in peritoneal dialysis the dialysis fluid is pumped inside the abdomen to clean the blood vessels lining the interior of the abdomen.

    What are dialysis catheters?

    A dialysis catheter is a thin tube like device used during the haemodialysis procedure to exchange blood between the haemodialysis machine and the body. It consists of two openings, namely:

    • Arterial lumen - it carries blood from the patient to the dialysis machine
    • Venous lumen - returns blood from the machine to the patient.

    Although named differently both lumens reside in the vein. In the case of prolonged dialysis, a 3-8 cm long polyethylene terephthalate cuffed catheter is inserted beneath the skin. The cuff acts like a barrier for infections. 

    How is a dialysis catheter placed?

    The usual preferred site for the placement of this catheter is Internal Jugular Vein, in the neck (mostly on the right side). The device is inserted on the right side by making an incision in the skin, further advancing downward towards the chest.

    What are the common complications related to this procedure?

    • Clotting - there can be chances of clot formation either in the interior or exterior region of the catheter, which can block the opening and decline the blood flow. This can be overcome by checking the catheter at regular intervals.
    • Infection - infection may occur even at proper rate of blood flow, therefore, all the instructions must be followed properly. Symptoms of catheter infection can be - fever, weakness, redness at the catheter exit site, chills.

    How can these complications be avoided?

    The person undergoing the catheter placement must follow certain instructions to minimise these clotting and infection risks:

    • The end of the catheter should always be capped so as to avoid air entering into the catheter.
    • During the dialysis process, the patient and the doctor are advised to wear a mask to prevent infection causing microorganisms from entering the catheter.
    • The doctor must be informed about any discomfort at the catheter site.
    • It is advised to keep the catheter clean and dry at all times. While bathing, the catheter end should be tightly capped to block the water from entering into the catheter.

    What are the medications given to remove catheter blockage?

    Normally, heparin is injected into the catheter, before and after every treatment for the prevention of clots. Occasionally, urokinase commonly called “clot busting drug” can be given for dissolving the clots. The process can be repeated if the clot still persists. 

    The treatment can help to restore the blood flow and can increase the quality of life. 

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    Testimonials

    Doctors, hospitality and treatment at Sakra was amazing

    Words of Heart
     
    I live in Kala Pahar, Guwahati, Assam and have two grandchild. Their names are Bitumoni Kalita

    Read More

    Testimonial by Mr. Govindappa


    My father was suffering from frequent mild headaches and blurred vision due to tumour in the head. After surgery,

    Read More

    Thanks a lot Team for Giving Me a New Life

    Dr. Sushma Rani, Dr. Venu Reddy & Dialysis Team

    THANK YOU For being on the front lines of care, your kindness,

    Treatment: Kidney Transplant

    Name: Sanpreeth Singh

    Read More

    had i gone for regular checkups and properly managed my hypertension, I could have prevented this

    “in 2007 I was diagnosed with hypertension during a regular health checkup. I was prescribed hypertensive medicines but I did

    Treatment: Regular Health Checkup

    Location: Bangalore

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    Wish I had been more careful about my BP I could have prevented damage to my kidneys

    “It is going to be 2 years and 5 months now since I am on Dialysis. I have been a

    Treatment: Regular Health Checkup

    Location: Bangalore

    Read More
    ‹ ›

    Blogs related to

    • What You Need to Know About Kidney Transplant

      The kidneys are parts of your body whose function is to filter and remove excess waste, minerals and fluid and regulate blood pressure. However, there are situations when your kidney is unable to perform this

      Read More

    • Obesity and Kidney Diseases

      Kidney Disease is often thought to be a rare occurrence and one can really not see it coming as in most of the cases 90% of the kidney function is already lost by the time

      Read More

    • 8 Golden Rules To Keep Your Kidneys Healthy

      The kidneys are bean-shaped organs, each roughly the size of a fist. They are two in number and located one on each side of the backbone deep in the abdominal cavity, beneath the rib cage.

      Kidneys

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    View more blogs

    Words of Heart
     
    I live in Kala Pahar, Guwahati, Assam and have two grandchild. Their names are Bitumoni Kalita & Sunny Kalita. It was in the month of December /2017. When we came to know about that Bitumoni had Renal Kidney Disease after consulting a local doctor. She was on Dialysis, since Jan/2018. First session of Dialysis was done in Guwahati. Then after few months of Dialysis, we went to Chennai for better treatment. There also we got no improvement then we came to know Sakra World Hospital in the month of October. Suddenly, her health got improved within a few weeks. The hospitality we got here is so amazing. Dr. Sushma Rani Raju treatment in a month. The management and staff of hospital Mr. Sudhakar is so good.
     
    Thank you Sakra World Hospital
     
    From,
    Arun CH Das
    Guwahati
    Assam
     
    Karat CH Deka
    Kala Pahar Bimlanayura
    Guwahati, Assam


    My father was suffering from frequent mild headaches and blurred vision due to tumour in the head. After surgery, he is feeling well and recovering fast. I appreciate the efforts of Dr. Satish Rudrappa for this surgery. This is the second time doing surgery with Dr. Satish. I thank Dr. Satish. He was very kind to explain the surgery and boost the confidence of the patient. Overall it was a good and professional experience during our stay at Sakra. 

    Dr. Sushma Rani, Dr. Venu Reddy & Dialysis Team

    THANK YOU For being on the front lines of care, your kindness, dedication & healing touch. You always putting your patients first no matter how gruelling your day. You also providing an empathetic ear & compassionate hand when a life-changing diagnosis I delivered. I appreciate you for being A rock when water get rough & we wre fighting for our Lives. I can’t tell you how much I appreciate you all.

    Thanks a lot team for giving me a new life.

    “in 2007 I was diagnosed with hypertension during a regular health checkup. I was prescribed hypertensive medicines but I did not monitor my blood pressure very regularly. I continued taking the same medicine for 2 years without checking if my blood pressure was under control. Then one day in 2009, I suddenly started feeling nauseous, developed swelling in my legs and I was feeling very uncomfortable. When I consulted the doctors I was told that I was already at Chronic Kidney Disease Stage 5, where there was no going back and I my only choice was to start with dialysis immediately. So the primary symptoms that the doctors suspected was most likely uncontrolled hypertension which damaged the kidneys to the level of CKD stage 5 and no recovery was possible. The doctors told me that if I had gone for regular checkups and properly managed my hypertension, I could have prevented this or at least delayed it significantly for a few more years. I have been on dialysis for almost 8 years now. I had no family history of diabetes or hypertension and I still do not have diabetes but hypertension continues even today. I wish I was more aware and careful and would advise everyone to know their risks and to take care of any conditions like hypertension or diabetes and keep it under control. Often people don’t get to know when they develop these problems due to their busy and stressful lives, but once you have it detected please ensure that you take proper medication, regular checkups and adopt a lifestyle to keep these conditions under control to prevent any damage to the internal organs especially the kidneys which can get severely impacted by diabetes and hypertension.”

    “It is going to be 2 years and 5 months now since I am on Dialysis. I have been a diabetic for around 18 years now. Around years back I started developing sleeplessness and headaches, which I felt and discovered later was because of my hypertension. Then one day, I was sitting and watching TV at home I suddenly noticed some swelling in my feet. Immediately I consulted some doctors and was put on medication. They also suggested me prolonged dialysis and to get arteriovenous fistula done. The treatment continued but my swelling didn’t go and BP was still very high. After that, I suddenly developed breathlessness while I was on a tour in Kerala, where I consulted another doctor there who started my dialysis. So now I have been on continuous dialysis since then and come here 3 times a week. Once you are a patient on dialysis, you need to monitor yourself regularly and routine blood investigations are very essential. The only message I would like to give out is that if you are in the high-risk category - diabetic and hypertensive, or have a family history of any of these – you must monitor your blood pressure and blood sugar levels regularly. My diabetes was always under control and is in good limits even now, but my hypertension which I ignored was the one that damaged my kidneys. I have a family history of diabetes and hypertension and my mother passed away due to a cerebral hemorrhage caused by hypertension. Sometimes I feel if only I had been more careful about my blood pressure I could have prevented the severe damage to my kidneys.”

    What You Need to Know About Kidney Transplant

    The kidneys are parts of your body whose function is to filter and remove excess waste, minerals and fluid and regulate blood pressure. However, there are situations when your kidney is unable to perform this filtering ability and that is considered a kidney failure. When the kidneys fail to perform their functions, it needs prompt treatment and potentially transplantation. There are 2 options – dialysis or a kidney transplant. Dialysis is a procedure that uses an artificial kidney to remove waste and excess fluids from the body when your own kidney fails to do so.

    A kidney transplant, on the other hand, is a surgical procedure performed to treat kidney failure. Many opt for this procedure as it offers more freedom and a better quality of life. A kidney transplant is done by placing a healthy kidney into your body to perform its functions when your own kidney doesn’t function normally anymore.

    Who Needs A Kidney Transplant?

    Kidney transplants are usually considered when a person has End-Stage Renal Disease (ESRD). This is a permanent condition suggesting kidney failure. People who get transplants tend to live longer compared to those undergoing dialysis treatment. Along with this, a better quality of life, fewer restrictions on diet, fewer long-term health issues and a guaranteed more energetic body are some of the reasons people prefer a kidney transplant over dialysis.

    The kidney transplant could happen from a living donor or a deceased donor. The main reason as to why living donor transplantations are preferred more over deceased donors is because the former transplant has a lower risk of complications and lower time on a waiting list for a patient.

    What Are The Risks Of Kidney Transplants?

    Like any other surgery, there are some risks associated with this procedure. These include:

    1. Kidney rejection – Sometimes the body rejects the new kidney placed into the body of the patient. However, with healthcare development now, there are new medicines to help the patient to cope with such situations.

    2. General surgical procedure risks - Just like most surgeries have risks that come with it, some complications like bleeding and infections could occur.

    3. Side effects from anti-rejection medicines – After the procedure, a patient takes medicines in order to help the body accept the new kidney. These medicines could bring about side effects like acne, diabetes, weight gain, excessive hair growth or loss, high blood pressure or cholesterol.

    Eligibility

    A kidney transplant is a serious medical procedure and the first thing that the patient needs to do is to choose the right transplant centre or hospital for the procedure. A person with heart conditions, infections that can’t be treated, cancer, and other serious conditions that cannot be rectified will not be eligible for a kidney transplant. The centre will consider the following factors in the patient before adding them to the donor waiting list.

    1. Mental health evaluation – The patient’s mental state plays a major role in deciding their situation for a kidney transplant. Factors like stress, financial situation and family support are evaluated before deeming the patient fit for a transplant.

    2. Blood tests – One of the major steps before finalizing a transplant is to find a matching donor and ensure that the kidney will not be rejected. For this purpose, few blood tests are conducted on the patient.

    3. Other tests – Basic physical tests to check your kidneys, X-rays and other body scans will be conducted to have an overall health evaluation for the patient.

    Post - Surgery & Recovery.

    There are certain things you need to expect before and after the procedure. All the above factors based on the patient and their donor’s mental and physical health evaluation will be done. Post the surgical procedure, the patient will be taken to the recovery room for close monitoring until their body functionalities like heart rate, blood pressure and breathing become stable. The patient will spend a day or two in the ICU as well under observation during this period.

    Ideally, the recovery period requires the patient to spend a few days or a week at the hospital depending on their recovery speed. Blood samples will be taken often from the patient in order to check the status of the new kidney. Urine content will also be checked to test the kidney functionality in the new body. Anti-rejection medicines will be provided to the patient in order to help the body accept the new kidney. The patient will move slowly from liquid food to more solid food. Specialists will guide the patient on post-surgery care that needs to be followed at the hospital as well as on returning back home. Once the patient becomes stable, they will be discharged.

    Obesity and Kidney Diseases

    Kidney Disease is often thought to be a rare occurrence and one can really not see it coming as in most of the cases 90% of the kidney function is already lost by the time any significant symptoms appear. It is also assumed that kidney disease manifests primarily in old age. It is important to know that these are serious myths about kidney disease that need to be addressed. Especially when one has a pre-existing condition that increases the risk of developing kidney disease. Some of the major risk factor to look out for include:

    1.     Diabetes

    2.     Hypertension

    3.     Obesity and overweight

    4.     Family history of kidney diseases

    5.     Habits like cigarette smoking

    6.     Other kidney problems like – recurrent urinary tract infections, stones and tumors, etc.

    Overweight/Obesity & Kidney Disease

    • 600 million people worldwide are affected by obesity

    • Individuals affected by obesity have 83% higher risk of developing kidney disease.

    • 24.9% of CKD in women is associated with obesity and overweight.

    • 13.8% of CKD in men is associated with obesity and overweight.

    CLEARLY, obesity contributes to be one of the major risk factors in the occurrence of kidney disease. Obesity itself can directly lead to CKD because in obese people the BMI being high, the kidneys have to work harder to meet the higher metabolic demands of the body by filtering beyond the normal values – hyperfilteration. Indirectly obesity contributes to the development of diabetes, hypertension and dyslipidemia that is altered lipid metabolism which in turn lead to kidney diseases.

    Obesity and Overweight

    Both Obesity and overweight can be defined as an excessive or abnormal accumulation of fat that affects the overall health of the body.
    Body mass index (BMI) is an index of weight-for-height that is used to classify overweight and obesity in adults. It is defined as a person's weight in kilograms divided by the square of his height in meters (kg/m2).
    In Adults

    1. BMI greater than or equal to 25 is categorized as Overweight and

    2. BMI greater than or equal to 30 as Obesity

    What causes obesity and overweight?

    One of the fundamental causes of obesity and overweight is an energy imbalance between calories consumed and calories expended which are often due to some the following factors:

    1. An increased intake of energy-dense foods that are high in fat

    2. An increase in physical inactivity due to the increasingly sedentary nature of   many forms of work, changing modes of transportation and increasing urbanization

    3. Genetic and endocrine conditions

    4.  Sometimes medication

    Why is CKD awareness important for a person who is overweight or obese?

    Obesity or excess weight are both preventable with a few lifestyle changes and weight reduction. These changes not only provide prevention and reduce the risks, but also in some cases cure chronic diseases like diabetes, high blood pressure, cardiovascular disease and CKD. Therefore, all individuals with obesity especially those with diabetes and high blood pressure should regularly monitor their – blood sugar, blood pressure, serum creatinine levels and urine tests for protein leak.

    How can obesity and overweight be managed to prevent or reduce the risk of CKD?

    The integration of a healthy diet, physical activity and refreshing sleep is the focus of management of obese and overweight people.

    Healthy Diet

    1. Rather than opting for extreme diets opt for small portion meals

    2. Substitute water or fresh fruit juices for sugary aerated drinks

    3. Limit energy intake from total fats and sugars;

    4. Limit protein and sodium intake

    5. Salt consumption should be limited especially in people with high blood pressure

    6. Increase consumption of fruit and vegetables, as well as legumes, whole grains and nuts

    Physical activity

    Physical activity is crucial to successful healthy weight reduction. Exercise increases energy expenditure, promotes weight-loss and helps sustain a healthy weight.

    1. Inactivity is unhealthy and should be avoided

    2. Engage in regular physical activity (60 minutes a day for children and 150 minutes spread through the week for adults)

    Sleep

    Adequate sleep promotes the maintenance of a healthy weight.

    1. Most individuals require about seven hours of sleep each night

    2. Prevent irregular sleep patterns

    3. Avoid eating before going to sleep

    Dr. Sushma Rani Raju
    Consultant - Nephrology
    MD (Internal Medicine), DM (Nephrology)
    Institute of Renal Sciences

    8 Golden Rules To Keep Your Kidneys Healthy

    The kidneys are bean-shaped organs, each roughly the size of a fist. They are two in number and located one on each side of the backbone deep in the abdominal cavity, beneath the rib cage.

    Kidneys do many functions to keep us healthy. 

    Their main job is to remove toxins and excess water from the blood. They also help to control the blood pressure, to produce red blood cells and to keep the bones healthy.

    Kidneys also control blood levels of many minerals and salts including sodium and potassium, and help to control blood acidity. Every day they carefully control salt and water level in the body so that the blood pressure remains in the normal range.

    How do we keep our kidneys healthy?

    Kidney diseases are silent killers, which will largely affect the quality of life. There are however several easy ways to reduce the risk of developing kidney disease.

    1. Keep fit and active

    Keeping fit helps to reduce blood pressure and therefore reduces the risk of Chronic Kidney Disease.

    2. Keeping the blood sugars under good control

    About half of people who have diabetes develop kidney damage, so it is important for people with diabetes to have regular tests to check their kidney functions. Blood test Serum creatinine and eGFR (estimated Glomerular filtration rate) will tell us about the total kidney function. The presence of excess protein or albumin in the urine is also a marker of kidney damage.

    Kidney damage from diabetes can be reduced or prevented if detected early. It is important to keep the blood sugars under control with the help of doctors, with regular medicine intake, good dietary practices and regular exercises.

    3. Regular monitoring of blood pressure

    Although many people may be aware that high blood pressure can lead to a stroke or heart attack, few know that it is also the most common cause of kidney damage.

    The normal blood pressure level is less than 140/80 mmHg. One should adopt lifestyle and dietary changes at 140/90 and above. They should discuss the risks with the doctor and monitor the blood pressure level regularly. High blood pressure is especially likely to cause kidney damage when associated with other factors like diabetes, high cholesterol and heart diseases.

    4. Eat healthy and maintain optimal weight 

    This can help prevent diabetes, heart disease and other conditions associated with Chronic Kidney Disease.

    Reduce the salt intake. The recommended sodium intake is 5-6 grams of salt per day (around a teaspoon). In order to reduce salt intake, try and limit the amount of processed and restaurant food and do not add extra salt to the food.

    5. Maintain a sufficient fluid intake

    Drinking 2 liters of water per day should be sufficient to maintain good health.

    Consuming adequate fluids will help the kidneys clear sodium, urea and toxins from the body which, in turn, results in a “significantly lower risk” of developing chronic kidney disease. However  “aggressive fluid loading”, which can cause side effects, is not recommended. It’s important to keep in mind that the right level of fluid intake for any individual depends on many factors including gender, exercise, climate, health conditions, pregnancy and breastfeeding. In addition, people who have already had a kidney stone are advised to drink 2 to 3 liters of water daily to lessen the risk of forming a new stone.

    6. Do not smoke

    Smoking accelerates the process of atherosclerosis, which is the hardening of the blood vessels and thereby slows the blood flow to the kidneys. When less blood reaches the kidneys, it impairs their ability to function properly. Smoking also increases the risk of kidney cancer by about 50 percent.

    7. Do not take over-the-counter pills/ pain killers on a regular basis

    Common pain killer medicines also called non-steroidal anti-inflammatory drugs like brufen, combiflam and voveran are known to cause kidney damage if taken regularly.

    Such medications probably do not pose significant danger if the kidneys are relatively healthy and when one uses them only during emergencies. However in situations of chronic pain like, arthritis or backache, one has to consult a doctor to find a way to control the pain without putting ones kidneys at risk.

    8. People with ‘high risk’-Get your kidney function checked 

    1. Those Who have Diabetes

    2. Those Who have hypertension or high blood pressure

    3. Those who are obese

    4. If one of the parents or other family members are suffering from kidney disease

    5. Those who are of Asian, African or Aboriginal origin

     

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