World Kidney Day - Interview by Dr. Ravi Bansal, Nephrologist

Dr. Ravi Bansal, As a Nephrologist how was the journey in your life so far?

I did my post graduate degree from most prestigious institute in India, All India Institute of Medical Sciences. Currently I work as a Senior Consultant at PSRI in South Delhi and run few clinics in Delhi. Nephrologists have a tough task. Diseases we deal with are mostly chronic and life threatening. In such conditions patients generally have a poor outcome in the long term. So to convince patient of treatment which is often costly is difficult. But over time there has been a definite change in the outlook of patients. With internet and easy access to information more and more patients are coming forward for treatment, dialysis and kidney transplant.

What is the magnitude of the kidney problems in India? How different are they when compared to western world?

1 out of 10 people in community have a kidney problem. Diabetes and high blood pressure patients are at very high risk of kidney disease. 1.5 lakh new patients of End stage kidney disease occur every year in India.

Difference from western world.- More young patients < 40 year age suffer from kidney disease. Most patients bear the expense of treatment themselves. 90 % patients reaching End stage kidney disease cannot afford any treatment in spite of the cost being very low as compared to western world.

If you were asked what are the three most important factors that affect kidney function?

• Diabetes
• Hypertension and Tobacco use
• Unscrupulous use of Pain killer medicines and Desi- indigenous unpacked medicines
• A lot people only know that Nephrologist does dialysis. What are the all the medical conditions dealt by Nephrologists? Who should reach Nephrologists?

Nephrologist treats following conditions:

• Hypertension ( uncontrolled high blood pressure) – remember kidney disease cause high blood pressure, heart diseases cause low blood pressure.
• Swelling of legs- Nephrotic syndrome
• Blood in urine or urine protein leak
• Too much urine or too little urine, burning in urine, urine leak
• Patients with SLE ( lupus) or vasculitis.
• Kidney failure ( CKD) any degree- detected by high serum creatinine blood test.

Nephrologist treats all the above conditions to prevent you to reach the stage of dialysis. But if your Kidneys are damaged permanently- then nephrologist will take you up for Dialysis or Kidney transplant. Once kidney transplant is done- then close nephrology follow –up lifelong .

How to preserve kidney function till the end of man's life?

• Take less salt.
• Control Hypertension and Diabetes as early as possible.
• If there is some kidney damage detected, follow advice of your nephrologist.
• Don’t smoke- quit Immediately if you smoke.