Chronic Kidney Disease (CKD) Treatment
Chronic kidney disease (CKD) means that your kidneys have suffered irreversible damage. Chronic means it is long term and CKD can get worse over time. CKD usually does not have any symptoms until your kidneys are damaged. Blood and Urine tests are used to determine the amount of kidney damage. Blood creatinine level helps to determine the level of damage to the kidneys.
The level of kidney damage in CKD is classified into 5 stages of kidney damage, from very mild damage in Stage 1 to complete kidney failure in Stage 5.
Patients with CKD can live normal, healthy lives by following lifestyle and diet changes; and taking appropriate medicines for their disease.
Damage to your kidneys is usually permanent. Although the damage cannot be fixed, along with the right medical care, you can take steps to keep your kidneys as healthy as possible for as long as possible. You may even be able to stop the damage from getting worse.
When the kidneys stop working, the work of the kidneys to filter blood is carried out by the dialysis process.
In the dialysis machine, the blood passes through a filter known as a dialyser, which imitates the kidney and filters out impurities and water from the blood. This process is known as Hemodialysis.
Dr. Garima Aggarwal specializes in dialysis planning, vascular access planning and dialysis prescription optimization. She believes dialysis patients should lead healthy, active lives despite being on dialysis.
She has expertise in planning advanced dialysis therapies for critical patients, such as acute hemodialysis, Slow Low Efficiency Dialysis (SLED) and Continuous Renal Replacement Therapy (CRRT) for critical patients who have very low BP or are unstable in the intensive care unit.
Kidney or Renal transplant is carried out for patients with advanced kidney failure, i.e., when the kidney function is irreversibly reduced to below 15% of normal.
During a kidney transplant, a donor’s kidney is placed is placed into the body of a recipient. The damaged kidneys of the patient are not removed unless required in certain circumstances.
Traditionally, kidney transplants were performed with Blood group matched donors.
But now with advances in transplant science, even non blood group matched (ABO incompatible) donors can donate their kidneys to a recipient.
Renal transplantation is Dr Garima Aggarwal's key area of interest and expertise is renal transplantation. She has more than a decade of experience in kidney transplantation at premier transplant institutes around the country. She is adept at handling complex, high risk transplants such as ABO incompatible renal transplants, second or third transplants and sensitized transplants. She is experienced in both live related and deceased donor transplantation
A kidney biopsy (also called renal biopsy) involves taking one or more tiny samples of the kidney to look at the kidney tissue with a special microscope, for signs of damage or disease.
A kidney biopsy is advised for one of the following reasons:
to diagnose a suspected kidney problem
to see how serious a kidney condition is
to evaluate for chances of kidney recovery
to monitor treatment for kidney disease.
for a kidney transplant that's not working properly
Vascular Access Planning
Before beginning hemodialysis treatment, an access to a patient's bloodstream is needed; this is called a vascular access. The access allows the patient’s blood to travel to and from the dialysis machine at a large volume and high speed so that toxins, waste and extra fluid can be removed from the body.
Vascular access for dialysis is of two types:
Temporary – in the form of catheters in the neck of legs
Permanent – in the form of Arterio venous (AV) Fistula or AV Grafts
Vascular access is the lifeline of a patients on regular hemodialysis. In India, several patients suffer due to lack of vascular access.
Dr. Garima Aggarwal and her team ensure proper and pre-emptive planning for vascular access to ensure adequate hemodialysis.
High blood pressure, or hypertension, is the second leading cause of kidney failure.
Most patients with high blood pressure don’t have any symptoms. Organs like the eyes, heart, brain and kidneys get damaged over time due to hypertension, often without it being recognized.
Hypertension can usually by controlled with the right medications and further damage to organs can be prevented by timely intervention.
Dr. Garima Aggarwal is an expert in diagnosing and treating all kinds of hypertension and hypertensive disorders. She believes in managing hypertension by providing patients with the right advice in several areas including diet, physical activity, stress-free life management techniques, along with medication.
During peritoneal dialysis, a special cleansing fluid is passed through a tube (peritoneal dialysis catheter) into the patient’s abdomen. The lining of the abdomen (peritoneum) acts as a filter and removes waste products from the blood. After a set period of time, the fluid with the filtered waste products flows out of the abdomen and is discarded. This treatment can be done at home, at work or while traveling.
Dr. Garima Aggarwal specializes in planning and initiation of peritoneal dialysis. Planning involves insertion of peritoneal dialysis catheter by a doctor, and initiation involves starting the peritoneal dialysis procedure first under medical guidance, and then training of the family members and patient to continue the treatment at home.