MANAGE CHRONIC CONDITIONS, DIALYSIS AND SELF-MONITOR HEALTH

New Delhi: In view of the ongoing pandemic and lockdown, leading nephrologists of India have advised people with chronic kidney diseases to control diabetes and anemia, and not to miss scheduled dialysis and self-monitor to seek medical advice.
 
“Usually, there are two kinds of kidney diseases such as chronic and acute kidney diseases, but they can overlap as well. Chronic kidney disease has slow, insidious progress and is caused by diabetes, hypertension, periodic urinary tract infections, and painkillers, among others. Therefore, people should make sure that diabetes and hypertension are controlled,” said Dr (Prof.) A.K. Bhalla, Senior Consultant, & Chairman, Department of Nephrology, Sir Ganga Ram Hospital, New Delhi.
 
Discussing the management of chronic diseases is key to manage kidney problems, Dr Sampath Kumar, Senior Consultant & HOD, Nephrology, Meenakshi Mission Hospital and Research Centre, Madurai said, “Anemia is a major factor that affects the quality of life which needs to be managed – the hemoglobin levels should always remain in double digits. One can do that by reducing dialysis, if possible. If the type of anemia highlights lack of iron, make sure it is replenished if needed through tablets or injection.”
 
“There are three indications that tell whether a person needs to seek medical advice – if one is urinating too much or too frequently, experiencing swelling in the legs and a change in the urine color or blood in the urine, they should seek medical advice. However, one should also, keep in mind that the color of the urine may become deeper due to less water intake,” Dr. Kumar added.
 
The virtual summit on kidney health care during the coronavirus pandemic, organized by the Integrated Health and Wellbeing (IHW) Council was attended by Dr Raka Kaushal, Director- Nephrology and Kidney Transplant, Ivy Hospital, Mohali, Dr. Sishir Gang, Chairman, Department of Nephrology, Muljibhai Patel Urological Hospital, Dr. Tarun Jeloka, Director- Nephrology, Aditya Birla Memorial Hospital, Pune, and Dr. Ram Mohan Bhat, Consultant Nephrologist, Mazumdar Shaw Medical Center, Narayana Health City, Bangalore.
 
Other panelists included Dr. Santosh Varughese, Professor & Head of Department Of Nephrology, Christian Medical College, Vellore, Dr. Lalit K Agarwal, Senior Nephrologist, Woodlands Multispeciality Hospital, Dr. Pankaj Hans, Head of Department Nephrology, Ruban Memorial Hospital & Associate Professor, PMCH, Patna, Dr. Nisith Kumar Mohanty, Senior Consultant & Head Nephrology, Apollo Hospital, Bhubaneswar, and Dr. Tarun Kumar Saha, Senior Consultant Nephrology, Apollo Hospitals, Secunderabad.
 
The web-based session was the fifth in the series of virtual summits being held by the IHW Council, a premier think tank that advocates for a healthy world through multilateral stakeholder engagement.
 
Mr. Kamal Narayan, CEO, IHW Council said, “There are a lot of kidney patients who are facing disrupted care due to the ongoing COVID-19 crisis. Over the past 26 days, we have brought various sessions involving specialists for guidance and tips on managing chronic diseases, mental health, and maternal health. More than 120,000 kidney patients in India undergo dialysis in a hospital set up. This staggering number makes it critical to ensure that they do not miss out on the special health support they need due to lockdown. Today’s webinar was watched by more than 3000 people and we hope to reach out to more people in our upcoming sessions on PCOS on 23rd and rheumatoid arthritis on 24th April.”
 
Highlighting that even children may develop kidney problems Dr. Mehul A. Shah, Consultant, Pediatric Nephrologist, Apollo Health City Hospital, Hyderabad said, “30-40 percent of kidney problems in children are due to developmental issues or genetic reason. Children as young as 4-5 years can develop serious kidney problems. Parents must watch out for some indications, such as frequency of urination as usually, these children urinate more than their siblings and therefore, are more thirsty; unexpected and repeated high fever; and delayed physical milestones. In older children, headaches and recurrent vomiting may indicate some problem with the kidney.”
 
More than 14,000 people have in India so far tested COVID-19 positive and over 550 people died since the first case was reported in January. The pandemic triggered a slew of measures to contain the spread of the virus into the country including a nation-wide lockdown.
 
The doctors said that the pandemic may alter positively the way kidney patients are treated, including conducting transplant surgeries. “We can conduct the RTPCR and IGG tests on those who are selected for surgery. If they are RTPCR negative and IGG positive, they are eligible for any surgery without the risk of spreading infection,” said Dr. Narayan Prasad, Professor, Department of Nephrology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow.
 
“With the hygiene practices in place, we can hope that occurrence of other dialysis-related infections is likely to come down. Telemedicine is also likely to get more popular – at our hospital, we are attending about 10 patients daily. Certain practices at hospitals are also likely to change such as the introduction of more robust queue management and less use of central air-conditioning; instead, we may start focusing more on open windows and cross ventilation,” said Dr (Prof.) Bhalla.