Kidney Transplant by Dr Ravi Bansal

 

 

Dr Ravi Bansal MD, DM Nephrology (AIIMS), FASN
Senior Consultant, Nephrologist and Kidney Transplant Physician
Pushpawati Singhania Research Institute
New Delhi

 

 

What is kidney failure? What are its causes? Is it hereditary? Can it occur in children too?

The inability of the kidney to remove waste products from the body and achieve water- and salt-balance is called kidney failure. Most common causes are diabetes, high blood pressure, use of over-the-counter painkillers and other medicines, and delay in treatment of kidney infections and stones. It may or may not be hereditary. It can occur in children also.

How is it diagnosed? How much do the diagnostic tests approximately cost?

Kidney failure can be diagnosed by presence of swelling of legs, high blood pressure and decrease in appetite. Patient can also have anemia (low hemoglobin) and breathlessness. Simple lab tests like serum creatinine and urine routine can detect kidney failure. Cost of these tests varies from Rs 100/- to Rs 200/- only.

What is the course of treatment when single or both the kidneys shut down?

Usually both kidneys are affected together by the same disease. Very rarely only one kidney will be affected like in kidney stone disease and vascular disease. The treatment has two parts. One is to help the patient survive in spite of kidney failure by substituting its work by dialysis and medicines; the other is to find out the cause of kidney failure and to treat it. Some kidney failures are recoverable and kidney starts working again.

What is dialysis and when should it be considered? How frequent does dialysis need to be done and can it be done at home? What is the cost involved? How long can one stay on dialysis?

Dialysis is removing the waste products from the blood by an artificial filter. Decision on starting dialysis has to be taken by the treating doctor on the basis of patient’s symptoms and lab reports. Dialysis frequency is dependent on the patient’s condition and generally, it is three sessions per week. Cost per dialysis varies from Rs 2500/- to 4500/- per session depending on various types of dialysis. It can be done at home also. There is no limit to how long one can stay on dialysis.

When should kidney transplant be considered?

If the kidney cannot recover and the patient is medically fit as ascertained by detailed examination and testing then the patient can be taken for kidney transplant.

Where in India can kidney transplant be done and what is the approximate cost of the whole procedure? How long does a transplanted kidney last?

Kidney transplant can be done at any of the govt. certified transplant centers in India. The cost of procedure varies from Rs 5 to 6 Lakh. Some special type of transplant where there is no blood group match or increased risk of rejection, cost can go up to Rs 10 – 12 Lakh. There is no limit to the life of new kidney.

Who is a suitable kidney donor? What are the options if there is no compatible donor in the family? Can an unrelated person donate kidney to the patient?

A blood group match 1^st degree family related donor is the best. If there is no such donor we can go for without blood group match transplant (ABO-Incompatible Transplant). Patient can also register for cadaveric kidney transplant. An unrelated person cannot donate kidney.

Are there any kidney donor registries in India? Can you suggest some of them?

Deceased donor kidney transplants can be done. Patients can register with NOTTO (National Organ and Tissue Transplant Organization) through the treating hospital. It is a recipient registry. There is NO donor registry.

Can you suggest some support groups (online or offline), NGOs or government agencies in your city/India that offer support to individuals requiring kidney transplant?

Financial support can be taken from Chief Minister Fund or Prime Minister Fund by application to the government agencies.

Can a person after the transplant, lead a normal life like any other person, e.g., study in school/college, do a full-time job, etc.?

Yes

Do you advise any dietary/lifestyle changes to the patients who have undergone kidney transplant?

Take less salt and have a regular check-up with a doctor. Diet may vary depending on the lab reports from time to time.

 

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