Kidneys filter wastes and excess fluids from the blood to be excreted in urine and make hormones that keep bones and blood healthy. Kidney failure occurs when the kidneys can no longer perform these functions. Chronic kidney disease develops gradually over months to years from conditions like diabetes, high blood pressure, infections, or genetic disorders. Symptoms may not appear until kidney function is significantly impaired. Treatment focuses on managing the underlying cause to slow progression and includes medications, dialysis, or transplantation for end-stage kidney failure. Lifestyle changes like controlling blood pressure, eating a healthy diet low in salt and protein, drinking water, and avoiding pain medications can help support kidney function.

1. How To Prevent Kidney failure
Subhas Chandra Aryal [subasaryal98@gmail.com]
Nalang-3 dhading
Msc medical microbiology
Goldengate international college
Kidneys filter wastes andexcess fluids from blood, whichare thenexcretedin the urine. They alsomake hormones that keep our bones strong
andour bloodhealthy. Thegradual loss of these kidneyfunctions is calleda kidney failure. Acute kidney failurehappens suddenly within hours
to days, whereas chronic kidney failurehappens gradually over a period ofmonths toyears. In both conditions, the kidneys shutdownand can
no longer filter wastes or excess water outoftheblood.As a result, poisons start tobuild upin the blood and causevarious complications that
can affect various body systems.When the failure (also called as CKD – chronic kidney disease) reaches an advanced stage, the body starts
accumulating harmful levels of fluid, electrolytes and wastes.
In the early stages of chronic kidneydisease, theremaybe fewsigns or symptoms. Chronickidneydisease may not become apparent until the
kidney function is significantly impaired.
Causes of chronic kidney disease include:
 Type 1 or type 2 diabetes
 High blood pressure
 Glomerulonephritis, an inflammation of the kidney's filtering units (glomeruli)
 Interstitial nephritis, an inflammation of the kidney's tubules and surrounding structures
 Polycystic kidney disease
 Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers
 Vesicoureteral reflux, a condition that causes urine to back up into your kidneys
 Recurrent kidney infection, also called pyelonephritis.
The symptoms includes
 Soreness of waist and backache at early stage.
 Red blood cells present in urine,A microscopic haematuria at early stage.
 If disease develops into uremia,patients always have high blood pressure which also cannot be controlled easily.
 Can have edema[puffy eyes, hands, and feet ] in early stage to lesser degree,such as eyelid and facial edema.
 After aggravation ofdisease,patients will have serious edema on lower limbs and more seriously ,they could have systemic
edema.

2. The condition of kidney is determined by doing blood panel readings of our BUN (blood urea nitrogen) [ 10-20 mg/dl
Higher indicates kidney problem]and creatininelevels[0.4-1.4mg/dl] and our eGFR (Estimated Glomerular Filtration Rate) [Levels below 60
mL/min/1.73 m2 for 3 or more months are a sign ofchronic kidney disease]numbers.
The treatment for renalfailure is todelay theprogression ofthe diseaseby treating the main causeofthefailure. Antibiotics are used in
case of bacterial infections as well as diuretic medication{or water pills}is taken tomake the body excrete more water and salt. Ifthe failure
reaches the -end-stage kidney failurethen the treatmentfor a patientis dialysis or a kidneytransplant. Dialysis or transplantation treats end-
stage kidney failure.In hemodialysis,blood is filtered through a tubethat's inserted inthevein. Thetube is connected toa machine that cleans
the blood of wastes and the "clean blood"is returned to the body through another tube. In peritoneal dialysis, the space between the
abdominalwalland organs is filled witha cleansing solution thatabsorbs toxins from the abdominallining. Thesolution is thendrainedoutinto
a bag. This procedureis doneat homeoneto four times a day,seven days a week or overnight using a cycling machine. The government of
Nepal is sponsoring fully in any type ofdialysis for all nepali patient.
In kidney transplantation, diseased kidneys are replaced with a healthy one. The greatest danger is that the body might reject the
transplant.To prevent this, transplant recipients aregiven powerful medications to suppress the immune system; these have t he potential
drawback of making one more susceptible to other infections and to some types ofcancer too.
What should patient do ?
 Should limit the intakeofsalt reasonably.Ifpatienthavehigh Blood pressure,they should take low salt diet and 2 grams will be
good.
 Shouldnot eat pickled food,because nitrate which is harmful to kidneys is also very high in pickled food except for salt.
 Limit theintake ofprotein appropriately. In order to reduce the burden ofkidney,protein intake must be suitable to the
discharge capacity ofkidneys.
 Eat fresh fruits andvegetables richin vitamins such as lemons,spinach etcbut out-of-seasonfruitmay contain hormone which
is harmful to patient.
 Patients with severe edema and less urine should reduce their intake to water appropriately.
Becausekidney diseases canbe symptom-free,we may not noticeanything wrong beforewe’vesuffered irreparabledamage.
To prevent getting in that situation, I advise to:
 Drink enough water: drink one-halfounce of water for every pound you weight
 Take daily probiotics: Probiotics (good bacteria)like yoghurt help our kidneys process wastematerials andcontributeto overall
digestive health.
 Lower our phosphorousintake: weonly need800mg to 1,200mg ofphosphorus eachday; higheramounts phosphorus
accumulates in thebody, causing potentially serious conditions,such as boneand heartdisorders, as well as calcification
(hardening) oftissues.
 Drink green juice: Green foods aidin detoxification, a greens supplement is a good alternative
 Eat kidney-supportivefoods like Watermelon,Cranberries, Blueberries,Strawberries, Apples, Cabbage, Cauliflower, Peppers,
Garlic, Onions,Olive oil,etc
 Lose weight
 Avoid pain relievers, especially non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin, ibuprofen (Advil, Motrin,
Nuprin), naproxen(Aleve), and acetaminophen(Tylenol). Products likethese areveryhard on thekidneys
 Take a bath in Epsom salts: Removing waste andtoxins gives ourkidneys a boostwhileimproving our overall health.Control
your blood: Highblood pressure anddiabetes are two big threats toour kidney function.Controlling our bloodsugar and blood
pressure areyourbestbets for maintaining normal kidney function.
 Stop smoking or other uses oftobacco.The toxins damage our kidneys.