CME INDIA Presentation by Admin.

Activating patients’ knowledge, skills, and confidence in self-managing kidney disease improves care and quality of life.

On the eve of World Kidney Day 2021 – Know the 20 clinical Pearls in Nephrology to manage your patients (by Dr Harsh Vardhan, Associate Professor of Nephrology, IGIMS, Patna, Bihar) and share the Scientific Awareness tips (by Dr Sanjay Pandya, Eminent Nephrologist from Rajkot, Gujrat).

Message of World Kidney Days is Illuminating

  • 10% of the population worldwide is affected by Chronic kidney disease (CKD) with over 2 million people worldwide receiving treatment with dialysis or a kidney transplant.
  • We want to stress that with timely identification and appropriate treatment, patients with kidney disease can lead a healthy and successful life and maintain their role and social functioning in line with their priorities, values and goals. It is everyone’s responsibility to improve patients’ understanding of their role, and provide a facilitating environment that improves their skills and allows them to get the most out of the healthcare system” – Dr Vivekanand Jha, president of the International Society of Nephrology (ISN) and Siu-Fai Lui, President of the International Federation of Kidney.
  • The current disease-centric approach does not fully reflect the patients’ priorities and values regarding living well with the disease. Effective strategies can help minimize the burden of CKD related symptoms to improve patient satisfaction, quality of life, and ultimately life participation.

World Kidney Day

20 pearls while dealing important kidney disorders

(By Dr Harsh Vardhan, Associate Professor of Nephrology, IGIMS, Patna)

1. World Kidney Day is a global campaign that aims to raise awareness of the importance of our Kidneys to our overall health and to reduce the frequency and impact of Kidney disease and its associated health problems worldwide.

2. WKD is celebrated every second Thursday in March.

3. Calculate eGFR to know the degree of renal dysfunction. (CKD EPI Equation)

4. ”Normal” serum creatinine level does not rule out kidney disease.

5. Urine examination is the mirror of kidney (liquid biopsy).

6. Spot urine albumin creatinine ratio for screening in patients with negative dipstick test.

7. Always quantify proteinuria.

8. Red Flags in urine are Proteinuria and RBC (Glomerular hematuria)-Active sediments in non-catheterized urine samples).

9. Always use syndromic approach for diagnosis of kidney diseases.

10. Major renal syndromes are Acute Kidney Injury/Chronic kidney disease/Rapidly progressive renal failure/Nephrotic syndrome/Nephritic syndrome etc.

11. Avoid NSAIDs or NEPHROTOXIC Drugs – Avoid AMINOGLYCOSIDES as much as you can.

12. Avoid dehydration.

13. Avoid iodinated contrast in high-risk patients.

14. Identify the risk factors for kidney disease. (DM HTN Age Family history of Kidney disease etc.)

15. Adequate control of DM and Hypertension.

16. Optimal use of ACE inhibitors and ARB especially in DM and Proteinuric patients.

17. Use of SGLT2 inhibitors for renoprotection.

18. Smoking cessation.

19. Plant based protein diet better.

20. Acute kidney injury is a risk factor for Chronic kidney disease.

World Kidney Day

CME INDIA Public Forum

Share the Scientific Information to Your Patients

(By Dr Sanjay Pandya, Senior nephrologist practicing at Rajkot, Consulting Nephrologist at Gokul Super speciality Hospital, Founder, Kidney Education Foundation.)

On World Kidney Day – Learn and Live Well with Kidney Disease – for patients to live well with kidney disease, it is vital to know about its symptoms, take medications regularly and meticulously follow restrictions in food and water (Fluids).

1. Know your disease

  • Proper education and awareness of both symptom management support and encourages patients to live well with kidney disease. There is no cure for chronic kidney disease (CKD).
  • Treatment is aimed to preserve kidney function, provide relief from symptom, improve well-being and quality of life, and delay the need for dialysis or transplant.
  • Adequate symptom management of CKD may lead to improved clinical results, including patient survival. Early CKD has no signs or symptoms. But management at this stage is most rewarding, so it is essential not to neglect treatment this stage.

2. Regular check up with your doctor’s and understand your blood work.

  • To allow the doctor to plan proper treatment to protect your kidneys and to reduce symptoms due to kidney disease, regular follow up is important. When you plan to visit your doctor, make a list of questions you wish to ask. This will help doctor to provide you all necessary instructions and guide you in better way. Such a questionnaire will help the doctor provide you with all the necessary instructions and guide you better.
  • Every kidney patient should know the value of important blood test parameters such as blood sugar, creatinine and potassium. Blood sugar tells you about the control of diabetes. The value of creatinine level in a blood test is very important because it is the main indicator of kidney function. Its high value indicates that kidneys aren’t functioning properly. So always look at the creatinine level. Reduction in its value suggests improvement, and its increasing value reflects the worsening of kidney function.
  • Every kidney patient should know about their potassium level because kidney disease is a common cause of a high potassium level which can cause heart problems. The doctor advises a change in diet to keep the value of potassium in the safe range.

3. Follow your doctor’s orders properly.

  • Take medicines regularly as prescribed even if you are completely well because it helps to protect your kidneys and prevent serious problems.

4. Follow a healthy and prescribed diet plan.

  • It has a key role in controlling your diseases and avoid complications. Advise usually given to kidney patients are restriction of salt to control high blood pressure and swelling, avoid potassium rich diet (fruit, fruit juice, coconut water, dry fruits, etc), optimum intake of fluid in patients with swelling and avoid high protein diet.

5. Look after yourself by home monitoring.

  • Common advice usually given to kidney patients is regular blood pressure and blood glucose measurement, maintaining its chart, and maintaining daily weight chart in patients with swelling. Notice new symptoms and sick help of doctor early.

6. Regular exercise, stay active and aim for a healthy weight.

  • Physical activity for 30 minutes or more on most days should be part of routine for kidney patients. Regular exercise as per the doctor’s advice, helps to improve general health, reduce stress, control blood pressure as well as diabetes, achieve your weight goals, and reduce the risk of problems such as heart disease.

7. Stop smoking and tobacco chewing.

8. Get vaccinated against hepatitis B, Pneumococcal pneumonia and other diseases as per doctors advise.

9. Plan ahead.

  • When kidney function worsens, the doctor will advise you to prepare AV fistula and the need for kidney transplantation or dialysis.

(For authentic information about the prevention and care of kidney diseases and to get the book “Save Your Kidney” in 37 languages Free Visit: World Record Award Winner Website prepared by a Global Team of 100+ Nephrologists)

CME INDIA Tail Piece

World Kidney Day

Overview of the preventive measures in chronic kidney disease (CKD) to highlight the similarities and distinctions pertaining to primary, secondary, and tertiary preventive measures and their intended goals. AKI, acute kidney injury; BP, blood pressure; GFR, glomerular filtration rate; RAASi, reninangiotensin-aldosterone system inhibitors; SGLT2i, sodium-glucose cotransporter-2 inhibitors. Courtsey: Kidney International (2020) 97, 226–232

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