kidneycare

“Everybody’s going to have some degree of health problems, as we get older. I think we’ve gotta maintain.” — Tom Hanks A Real-World Reminder   It was 6 p.m. and I was ready to leave the hospital when I received a call from the emergency department. “Sir, we have an elderly gentleman who hasn’t passed urine since morning. He’s in severe lower abdominal pain.” I rushed to the ER. A man in his seventies lay on the bed, visibly distressed. A quick examination confirmed what I suspected — his bladder was overdistended. We inserted a catheter, and nearly 1.5 litres of urine drained out. His relief was immediate. He was accompanied by his son, and as we spoke, I learned the patient had been struggling with urinary symptoms for three months — but had said nothing. This is not uncommon. Many older adults quietly adjust to declining urinary health, often mistaking it for normal ageing. Why Kidney and Urinary Issues Rise With Age   As we age, multiple changes affect the kidneys and urinary system: Renal function declines naturally with age Chronic illnesses like diabetes and hypertension accelerate kidney damage In men, prostate enlargement can lead to urinary blockage Urinary incontinence becomes more common due to nerve dysfunction and weakened bladder muscles 👉 Without proactive care, these issues can suddenly escalate into emergencies — especially when the elderly are living alone. Prostate Enlargement: The Silent Disruptor in Men   One of the most common age-related urinary issues in men is benign prostate enlargement.The prostate, a walnut-sized gland, encircles the urethra and tends to grow with age. More than 50% of men over 60 may have some degree of prostate enlargement. 🚨 Common Symptoms   Weak urinary stream Frequent urination, especially at night Incomplete bladder emptying Dribbling of urine Delay in starting urination 👉 Many men ignore these symptoms or assume it’s just “getting old.” Don’t let your loved ones fall into that trap. ✅ Simple Remedies & Tips   Avoid excess fluids before bedtime Cut down on caffeine, alcohol, and spicy foods Try double voiding: wait and try urinating again a few minutes after the first attempt When Is Treatment Needed?   If symptoms worsen or don’t improve with lifestyle changes Evidence of urinary stasis (stagnation), infections, or kidney issues Medications can shrink or relax the prostate In some cases, surgery may be needed ⚠️ Important: Prostate enlargement is not the same as prostate cancer, but regular PSA tests after age 40 help screen for cancer early. Other Kidney and Urinary Issues in the Elderly   1. Urinary Incontinence   Unintentional leakage of urine or urgency can arise due to aging nerves and bladder dysfunction. Though common, it shouldn’t be dismissed. Management: Avoid liquids 2–3 hours before bedtime Limit triggers like caffeine, alcohol, acidic foods Manage diabetes and blood sugar Medications and, rarely, surgery can help If You’re Living Away From Your Parents   Here’s how you can still keep a close watch on your parents’ kidney and urinary health: 1. Create a Health Checklist Schedule annual check-ups with blood and urine tests Include serum creatinine, urinalysis, PSA (for men) Ensure they do renal ultrasounds if urinary symptoms appear 2. Be Medication Aware Many elderly patients are on multiple drugs Some painkillers, antibiotics, or BP medications can affect kidney function more significantly in older adults 3. Have Health Conversations Often Gently ask about urinary issues, swelling, fatigue, or changes in urination Encourage openness about symptoms they may feel shy to disclose 📞 4. Involve Local Support Connect with a local doctor or a trusted caregiver Use telehealth services for follow-ups Final Reminder   Caring for ageing parents from a far can feel overwhelming. But with proactive monitoring, regular testing, and open conversations, you can prevent many emergencies — like the one I faced that evening in the ER. “Always remember: elders are more prone to kidney insult. Early intervention is better.”  

“If human numbers increase, the rate of infection also increases.” — William H. McNeill, Plagues and People 👩‍⚕️ A Night at the ICU: A Real Case A week ago, an elderly woman was rushed into our emergency ward from a nearby town. She was gasping for breath, cold and clammy, with no recordable blood pressure. Her family reported she had fever and back pain for a week — and her diabetes was uncontrolled. We intubated her immediately and started life support. Her CT scan confirmed a severe kidney infection. The infection had now spread into her bloodstream, leading to sepsis — a life-threatening condition. Her kidneys were failing. We quickly started broad-spectrum antibiotics to fight the infection. She was on the brink of needing dialysis. This is not a rare scenario today. Especially in people with poor immunity, uncontrolled diabetes, or delayed diagnosis, even a simple urinary infection can rapidly escalate into irreversible kidney failure. ❗ Why This Is Worrying Twenty years ago, such infections were usually curable with antibiotics. But now, due to drug resistance, bacteria have become stronger and smarter. They no longer respond to common antibiotics. 👉 If not caught early, the damage can be severe — sometimes permanent. The key message:Early diagnosis and treatment of urinary infections can prevent kidney damage, save lives, and reduce hospital costs. 🚨 Symptoms of a Urinary Tract Infection (UTI) UTIs can present with one or more of the following: 🔥 Burning or irritation while urinating 🌡️ Fever with chills 💥 Pain in the lower abdomen or back 🚽 Frequent urge to urinate 💉 Blood in urine 🤢 Nausea or vomiting 🌊 Frothy or cloudy urine ⚠️ Who’s at Greater Risk? (Complicated UTI) Some individuals are at higher risk for complications: Pregnancy Kidney stones Diabetes Catheter use Immunocompromised (HIV, cancer, organ transplant) Kidney transplant patients Urinary tract abnormalities 👉 These patients often require hospital admission and longer treatment. 🔥 Pyelonephritis – When Infection Reaches the Kidneys Pyelonephritis is a serious form of UTI that affects the kidney tissues directly. It can: Affect one or both kidneys Cause acute kidney failure Spread to the bloodstream (sepsis) Require urgent and aggressive treatment 🔬 How Is It Diagnosed? Your doctor may recommend: Urine tests – For pus cells and culture Blood tests – To assess kidney function and infection Ultrasound – To check for obstruction or swelling CT scan – In complex or recurrent cases 💊 How Long Is the Treatment? For simple infections: 5–7 days of oral antibiotics For complex infections: Up to 4 weeks of treatment, possibly intravenous Patients with repeated infections may need low-dose long-term antibiotics 🛡️ Tips to Prevent UTIs ✅ Drink at least 3–4 liters of water per day✅ Avoid holding urine for long periods✅ Always urinate after sexual intercourse✅ Wear breathable cotton underwear✅ Complete the full course of antibiotics✅ Consult a gynecologist if you have frequent UTIs✅ Diabetics should keep blood sugar under control “Urinary tract infection will most often have an underlying trigger. Identify it early and act.” 👩 A Final Note UTIs are common but not always harmless. In people with diabetes, kidney transplants, or low immunity, they can turn life-threatening in days. 👉 Don’t ignore symptoms like burning urination, fever, or back pain. Seek help early — your kidneys may be silently asking for it. 🌟 In the Words of a Survivor “Infections don’t always knock at the door. Sometimes, they barge in. I learnt it the hard way — now I listen to my body.”— A 65-year-old recovered patient  

“Your kidneys are silent workers. But when they start leaking protein, it’s time to pay attention.”   👨‍⚕️ What Is Proteinuria? Proteinuria means that protein is leaking into your urine. Normally, kidneys filter waste but retain important substances like proteins in your blood. When this filter becomes leaky or damaged, proteins like albumin escape into the urine. 👉 A small amount of protein in urine may be harmless (especially after exercise or fever), but persistent protein leak is often a sign of kidney disease. 🚨 Why Is Protein in Urine a Concern? Protein is essential for: Building muscles Fighting infections Maintaining fluid balance When too much is lost in urine: Your body becomes weak You may develop swelling in the legs, feet, or face It may signal underlying kidney damage 🔍 Common Causes of Proteinuria Diabetes – High sugar levels damage kidney filters Hypertension – Increased pressure injures small blood vessels in kidneys Glomerulonephritis – Inflammation of kidney filters Nephrotic Syndrome – Heavy protein loss Autoimmune diseases like lupus Preeclampsia – In pregnancy Overuse of painkillers or certain antibiotics Inherited kidney diseases 👉 Even stress, intense physical activity, or fever can cause temporary protein leak. ⚠️ Symptoms to Watch For Foamy or frothy urine Swelling (especially around eyes or ankles) Fatigue Unexplained weight gain Decreased appetite High blood pressure ⚠️ Often, early proteinuria has no symptoms at all — making routine urine checks important. 🧪 How Is It Diagnosed? Urine dipstick test – Simple, quick test Urine albumin-to-creatinine ratio (ACR) – Detects even small protein leaks 24-hour urine protein test – Measures total protein loss Blood tests – Kidney function (creatinine, eGFR) Kidney imaging or biopsy – If needed to assess the underlying cause 🩺 Can Proteinuria Be Treated? Yes, treatment depends on the cause. Managing the root condition often improves or halts protein leak. 🩹 Treatment strategies may include: Controlling blood sugar (if diabetic) Managing blood pressure – often with ACE inhibitors or ARBs Reducing salt and protein intake Using medications to suppress inflammation (if glomerulonephritis) Monitoring kidney function regularly 🍎 Lifestyle Measures to Protect Your Kidneys ✅ Eat a low-sodium, kidney-friendly diet✅ Avoid over-the-counter painkillers or herbal medicines✅ Stay hydrated, but avoid overhydration✅ Maintain a healthy weight and blood pressure✅ If diabetic, keep blood sugar under control✅ Quit smoking 🧠 Patient Story: “Foamy Urine Was My First Sign” “I ignored it at first, thinking I wasn’t drinking enough water. But the foam in my urine kept getting worse. I finally got tested and found out I had early kidney damage from long-standing diabetes. With regular check-ups and treatment, my protein leak has come down, and my kidneys are stable now.”— Ravi Kumar, 52, Chennai 📌 Key Takeaways Protein in urine is not normal and may be an early sign of kidney disease Often silent at first, it can lead to severe kidney damage if ignored Early detection and treatment can prevent progression If you notice frothy urine, swelling, or fatigue, don’t delay a check-up 🧬 Time for a Kidney Check? A simple urine test could save your kidneys. 👉 If you’re over 40, have diabetes, high BP, or a family history of kidney problems — ask your doctor for a urine protein test today.  

“It’s possible not just to survive, but to thrive and to live a healthy, wonderful life again.” — Erika Evans, Cancer Survivor 👩‍👩‍👧 A Subtle Beginning Just a few months ago, my aunt — an active, independent woman in her late 50s — noticed something unusual.Her urine had a darker color than usual, and she wasn’t eating well. There was no pain, no fever, no major complaints — just a quiet change in her body’s signals. Being someone who never ignored her health, she decided to visit me for a checkup. 🔬 The Diagnosis I conducted a thorough clinical examination and ordered a few baseline tests.Her kidney function was normal, but an abdominal ultrasound showed a suspicious swelling in the upper part of her left kidney. A contrast-enhanced CT scan confirmed our suspicion: it looked like kidney cancer. Fortunately, her PET-CT scan revealed that the tumor hadn’t spread beyond the kidney.There were no signs of metastasis to her lungs, bones, or lymph nodes. We sat down with the family and had a candid conversation. She was calm.Her only question: “Can it be cured?” 🧠 Understanding Kidney Cancer Kidney cancer, also known as renal cell carcinoma, occurs when normal kidney cells start multiplying uncontrollably without the natural checkpoints that regulate cell growth. While not as common as lung or oral cancers, kidney cancer is rising in incidence due to lifestyle risk factors like: Smoking Hypertension Obesity Long-term exposure to industrial chemicals or solvents 🚨 Symptoms of Kidney Cancer Kidney cancer often doesn’t show early symptoms, but when it does, you might notice: Blood in the urine (hematuria) – painless and intermittent Pain or fullness in the lower back or side Unexplained weight loss Fatigue or low appetite 👉 In my aunt’s case, the symptoms were subtle — a reminder of how easily it can be missed if we’re not attentive. 🧪 Tests to Confirm Diagnosis Her diagnostic journey included: Ultrasound (USG Abdomen) CT Scan (Contrast-enhanced) PET-CT Scan Kidney function tests & blood counts ➡️ The key aim of these tests is to localize the tumor, understand if it’s limited to the kidney, and detect any spread (metastasis). ⚔️ Our Treatment Plan ✅ Surgery – The Cornerstone Because her tumor was confined to the kidney, the best approach was surgical removal. She underwent a laparoscopic partial nephrectomy — only the cancerous part of her kidney was removed, preserving the remaining function. Post-surgery, her other kidney compensated fully, and her renal function remained stable. 💊 No Chemotherapy Needed As the cancer hadn’t spread, she did not require chemotherapy or immunotherapy. However, had it been advanced, targeted therapy or immunotherapy would have been considered. 💡 Life After Kidney Cancer Today, six months post-surgery, my aunt is back to gardening, cooking, and going on long walks. Her appetite is better, her smile brighter. She now undergoes regular scans every 6 months to ensure there is no recurrence — and continues to inspire others by sharing her story. 🧭 Key Takeaways Kidney cancer is curable if caught early A simple urine change or weight loss can be the first warning sign Early detection through imaging is crucial Surgery is the best option when the tumor is localized Modern treatment is increasingly personalized and effective, even in advanced cases “Modern medicine can defy the notion – Cancer is incurable.” — This is a story of resilience, science, and timely intervention.  

Reflections for the Modern Clinician In today’s medical world, we’ve become increasingly skilled at extending life.But in doing so, have we lost the ability to honor its natural end? Across specialties — from oncology to nephrology, critical care to cardiology — we witness the same dilemma:The tools to prolong life have improved, but our conversations about how and when to stop have not. ⚖️ The Cost of “One More Intervention” Every clinician has faced it: The elderly patient with multiple comorbidities who keeps bouncing back to the ICU. The frail individual on maximal therapy, with no hope of recovery, but still undergoing procedures. The family that asks, “Do everything,” even when the patient is visibly suffering. Sometimes, these efforts don’t extend life in a meaningful way —👉 they only extend dying. 💡 From Doing More to Doing Right Good medicine is not always about doing more.It’s about asking better questions: “What matters most to this patient now?” “Will this intervention bring comfort or just prolong decline?” “Have we offered the choice to step back, not just push forward?” It’s not giving up —👉 it’s giving space for dignity. 🌿 Graceful Dying Is Not a Failure Choosing comfort-focused care, honoring a patient’s wish to decline aggressive treatment, or simply sitting with a family in grief — these are acts of healing too. We must normalize conversations around: Palliative care not as “last resort,” but as core care Withdrawing or withholding interventions when burdens outweigh benefits Supporting patients to live — and die — on their own terms 📢 A Call to All Clinicians In an age of advancing medical frontiers, the most humane act may sometimes be to step back and ask: “Are we saving a life — or are we simply postponing a death that deserves more peace?” “To cure sometimes, to relieve often, to comfort always.” — Hippocrates  

🌙 Bedwetting in Children: What Every Parent Should Know “Every child is different. Some need a little more time — and a little more understanding — to grow out of the nighttime wetting phase.” Bedwetting — medically called nocturnal enuresis — is a common concern among children, especially in early childhood.For parents, it can feel frustrating and worrying. For children, it may be embarrassing or confusing. But here’s the good news: bedwetting is usually not a disease, and most children outgrow it naturally. 🧒 What Is Bedwetting? Bedwetting means involuntary urination during sleep after the age when a child is expected to stay dry at night (usually by age 5). It’s classified into two types: Primary enuresis – The child has never had six months or more of dry nights. Secondary enuresis – The child was dry for at least six months, but has started wetting again. This often points to a medical or emotional cause. 📊 How Common Is It? 15–20% of 5-year-olds wet the bed 5–10% by age 10 1–2% into teenage years 👉 You’re not alone — and neither is your child. 🔍 What Causes Bedwetting? Bedwetting is not due to laziness or bad behavior. Common causes include: Delayed bladder maturity – The bladder and brain aren’t fully in sync yet. Deep sleep – The child doesn’t wake up when the bladder is full. Low ADH hormone at night – Less hormone means more urine production. Constipation – A full bowel presses on the bladder. Family history – Runs in families. UTI or Diabetes – Especially in secondary bedwetting. Emotional stress – New school, sibling birth, or family changes can trigger it. 🩺 When to See a Doctor Seek medical advice if: Bedwetting persists beyond 7 years It starts again after months of dryness There are daytime symptoms (urgency, pain, dribbling) The child snores loudly (possible sleep apnea) There’s weak urine stream or back pain 🧴 Tips to Manage Bedwetting at Home 🚱 Limit evening fluids – Encourage more in the day, less after 6–7 p.m. 🥤 Avoid caffeine/soft drinks – They irritate the bladder. 🚽 Toilet before bedtime – “Double void” to empty fully. 💡 Use a nightlight – Make nighttime bathroom visits easier. 🌟 Praise, don’t punish – Encourage dry nights positively. ⏰ Bedwetting alarms – Help train bladder awareness. 🛏 Mattress protection – Waterproof covers reduce stress. 💊 Is Medication Needed? In select cases, doctors may prescribe Desmopressin to reduce urine production at night — useful during sleepovers or camps.But medication should never be the first step. Always consult a pediatrician. 🧠 Emotional Support Matters Children who wet the bed may feel ashamed or anxious. Reassure them: It’s common. It’s not their fault. With time, most kids outgrow it. 👪 Final Thought for Parents Bedwetting can test patience, but with understanding, reassurance, and simple strategies, most children will grow out of it. “Children are not things to be molded, but people to be unfolded.”— Jess Lair  

🩺 Early Detection & Prevention of Kidney Disease “No terrifying calamity will happen to the wise,who (foresee) and guard against coming evils.”— Thirukkural 429 “The doctor of the future will give no medicine,but will interest his patient in the care of the human frame,in diet and in the cause and prevention of disease.”— Thomas Edison, 1903 ⚠️ The Silent Nature of Kidney Disease Did you know?👉 Up to 90% of kidney function can be lost without any symptoms in some patients. That’s why early detection is the key to prevention. 🧪 Essential Kidney Health Checks Master Health Check-ups – Comprehensive exams help catch problems early. Urine Examination – Detects protein, blood, or sugar — all early signs of kidney damage. Urea & Creatinine – Simple blood tests that indicate kidney function. Ultrasound Scan – Reveals kidney size, structure, and changes. GFR (Glomerular Filtration Rate) – Calculated from creatinine; gives an accurate measure of kidney function.   🔍 Other Important Tests Cholesterol – High cholesterol damages blood vessels, including those in the kidneys. Microalbuminuria – Detects tiny amounts of protein in urine; an early warning sign of kidney disease. HbA1c – Indicates long-term blood sugar control; critical in diabetes-related kidney disease. 💰 Planning for the Future Lifestyle diseases are on the rise, leading to unexpected hospital admissions and skyrocketing medical expenses. ✅ Health Insurance Matters Protects against the high cost of dialysis and kidney transplantation. Most policies cover advanced treatments. Always discuss with your insurance provider to choose a plan that best suits your health risks.   🏀 A Real-Life Reminder “I’m a prime example of the way kidney disease strikes silently.In my experience, you can identify and prevent kidney disease by simple urinary examination.”— Sean Elliott, Legendary Basketball Player & Kidney Transplant Recipient 🌿 Key Takeaways Kidney disease often strikes silently. Regular screening can save lives. Lifestyle management + early detection = prevention. Health insurance provides essential financial protection.  

🌍 Environment, Pollution & Kidney Disease: A Silent Link “We won’t have a society if we destroy the environment.”— Margaret Mead The environment is getting contaminated and the air is getting polluted across the world. Industrialization has improved human progress, but it has also accelerated disease patterns at an alarming rate. In the case of kidney failure, new and concerning patterns are emerging. While genetics cannot be modified, simple preventive measures — including protecting our environment — can go a long way in reducing the burden of kidney disease. ⚠️ Can Diabetes and Hypertension Alone Be Blamed? Diabetes and high blood pressure remain the leading causes of kidney failure.But focusing on only these two risks ignores other critical factors. Research shows that lesser-known contributors — such as pollution, maternal health, and environmental toxins — play a significant role in the rise of kidney disease. Addressing these risks can enormously reduce the incidence of end-stage kidney failure, even in people with diabetes and hypertension. 👶 The Problem Starts in the Womb Vulnerability to kidney disease begins as early as fetal life. Poor maternal nutrition Nutritional deficiencies Certain drugs during pregnancy … all impact birth weight and future kidney function. ➡️ Good pregnancy care with balanced nutrition and proper fetal scans is vital in preventing kidney ailments that may only manifest years after birth. 🌫️ Air Pollution Studies in the USA and China have shown that people in cities with high air pollution have lower kidney function compared to those in less polluted regions. In India, the Air Quality Index (AQI) is often 3x higher than the safe upper limit. If this trend continues, we may soon see drastic public health measures like oxygen parlors becoming mainstream. 💧 Water Pollution Contaminated drinking water accelerates kidney damage. Industrial effluents, excessive fertilizers, and pesticide residues in agricultural products are increasingly implicated in chronic kidney disease (CKD). 📌 Image 1 – The link between contaminated water and kidney damage ❓ Kidney Failure Without a Known Cause Traditionally, diabetes and hypertension accounted for most kidney failures. But in the past decade, something new is happening: 👉 Over 20% of kidney failure cases now have no identifiable cause. This rise in CKD of unknown cause (CKD-u) is becoming a major concern among nephrologists worldwide. Hypotheses include: Industrial pollution Excessive use of fertilizers Contamination in food and water Climate change 🧬 A Comprehensive Approach Genetics plays a role in diabetes, hypertension, and kidney disease. While kidney disease cannot be completely prevented, environmental and lifestyle factors often determine how early and how severely it manifests. “The root cause of each problem should be sought and tackled.” 🌿 Key Takeaways Kidney health is not just about controlling blood sugar and blood pressure. Environmental toxins — in air, water, food, and even during pregnancy — shape future risks. Early detection and prevention strategies must now include environmental health measures. Protecting the environment is also protecting our kidneys.

 Polyphenols: Nature’s Kidney Protectors   These powerful plant antioxidants have been extensively studied for their anti-inflammatory, anti-fibrotic, and cell-protective effects — especially in the kidneys, which are highly vulnerable to oxidative damage. Let’s explore how polyphenols from everyday foods like turmeric, berries, and green tea can silently support kidney health.  What Are Polyphenols?   Polyphenols are micronutrients found in plants with strong antioxidant and anti-inflammatory properties. They are classified into four main groups: Flavonoids – fruits, teas, herbs Phenolic acids – coffee, grains Stilbenes – resveratrol from grapes Lignans – seeds, whole grains These compounds are crucial in fighting the oxidative stress and inflammation that drive chronic kidney disease (CKD).  Top 7 Polyphenol-Rich Foods for Kidney Health Food Key Polyphenol Kidney Benefit Turmeric Curcumin Anti-inflammatory, reduces fibrosis Blueberries Anthocyanins Antioxidant, reduces proteinuria (animal studies) Green Tea EGCG Improves GFR, reduces uremic toxins Pomegranate Ellagitannins Lowers oxidative stress Red Grapes Resveratrol Protects kidney tubules Flaxseeds Lignans Lowers blood pressure, anti-inflammatory Olive Oil Hydroxytyrosol Reduces inflammation, supports blood vessels  What the Research Says Curcumin (Turmeric): A 2022 Nutrients meta-analysis found improvements in serum creatinine and inflammation in early CKD. Green Tea Polyphenols: Kidney International Reports showed reductions in proteinuria in diabetic nephropathy models.  Practical Tips for Everyday Use Add ½ teaspoon turmeric to curries/soups (pair with black pepper for absorption). Drink 1–2 small cups of green tea daily (if not fluid-restricted). Use extra virgin olive oil as your main cooking fat. Snack on ½ cup blueberries or grapes (adjust if potassium is restricted). Mix 1–2 teaspoons ground flaxseeds into yogurt or oatmeal.  Final Word Polyphenols are not just trendy nutrition buzzwords — they are science-backed allies in integrative kidney care. From turmeric’s golden spice to the healing hues of berries and tea, these natural compounds reduce inflammation, fight oxidative stress, and protect kidney cells from silent injury. They don’t replace medications, but when used wisely and consistently, polyphenols can enhance kidney health and overall well-being.

Simple measures to take control of your kidney health Beware if you have risk factors DiabetesHigh blood pressureKidney failure / Dialysis / Kidney Transplantation in family membersStroke / Heart attack / Heart failureSmokingEthnic factors Be watchful regarding the symptoms and signs The previous chapters have dealt elaborately regarding the signs and symptoms which heralds the onset of kidney disease. The importance of a master health checkup in diagnosing kidney disease need not be overemphasised.   Take control of risk factorsConventional risk factors like diabetes and hypertension should be under control all the time. Don’t smokeSmoking slows the flow of blood to your kidneys making it difficult for them to function normally. Smoking also increases your risk of developing kidney cancer. DietNo diet is poisonous to completely avoid them. Moderation is best when absolutely healthy. Take the advice of a renal dietitian and nephrologist right from the diagnosis of kidney disease.Identify the real organic foodsIt is proven that foods and drinking water contaminated with pesticides accelerate kidney disease. Take the effort to identify real organic pulses, cereals and vegetables and use them in your diet especially if you have certain risk factors. Many advocate a plant based diet for the same. When do I see a Nephrologist?If you have any one of the followingCongenital kidney ailmentReduced GFR (Glomerular Filtration Rate)ProteinuriaKidney stonesAcute and chronic kidney failureAs advised by your family physician When you go for a Nephrology Consult…….Write down the important questions you wish to ask.  Give details of your drug intake, duration and dose. Go along with your previous laboratory reports. Get the records of home blood pressure and blood sugar values. Note your previous 24 hour urine output and inform the doctor. Remember to tell about the new onset of symptoms. Accept treatment with full confidence and clarity. Keep your health records up to date. When treatment decision for kidney disease has to be madeAsk your Nephrologist,What are the options available?Which treatment option will best suit me?How can I improve my health with the current treatment plan?