Apex foundation Day

A treat to our kidney patients and their families…

Apex Foundation Day was celebrated on the 3rd of February 2013 at the renowned Birla MatooshreeSabhagraha at Marine lines, Mumbai with great enthusiasm. The whole concept of the program was to entertain the patients who are suffering from kidney disease and are on dialysis treatment or have received kidney transplant. An audience of about 1500 including patients, their escorts and the staff of the Apex Kidney Foundation attended the program. The foundation conducted this program free for all the attendees. Also free transport arrangements form various suburbs were made and foods and drinks were provided to all the patients and their families.

All the dialysis technicians and administrative staff and also the doctors of Apex Kidney Care staged dances, skits and songs for the patients. Each dialysis unit of Apex Kidney Care staged a program which was professionally directed giving attention to the smallest detail including costume and choreography.

The highlight of the program was the performance by ShriAnupJalota and his team. He along with his team of musicians and singers enthralled the audience who enjoyed every moment gauged by the overwhelming response. Mr AnupJalota, is one of the leading singers of India particularly renowned for his performances in the Indian musical form of Bhajan and the Urdu form of poetry- Ghazal.He is popularly known as the BhajanSamraat (Emperor of Bhajans).Last year he was awarded the Padmashree (one of the highest civilian awards in India) by the President of India.

Patient education material including books, brochures and CDs was made available for free distribution in stalls.

This occasion gave a great opportunity for the patients and their families to interact with the nephrologists and the dialysis staff and come closer to them. This is so very important in the treatment of patients with chronic diseases requiring lifelong treatment. Apex Kidney Foundation plans to conduct this program every year.

Click here to view the photos

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Kidney Infection

Encourage your family and friends to donate their organs after death. Find answers to your questions.

1. Infection of the kidney happens with the germs travel up to the kidney from the urine passage or come to the kidney form the blood.

The medical term for this is “pyelonephritis”. It is a more serious condition than the more common and simple urine infection which affects lower urinary passage and not the kidney. If a kidney infection is not treated correctly, it can get worse and cause permanent kidney damage. Early and adequate treatment can prevent partial or complete kidney damage and hence it is important to see your doctor as soon as you get symptoms of urine infection.

2. What are the symptoms of kidney infection?

Feeling feverish to having high grade fever, painful and frequent urination, blood in the urine, chills and pain in the loin area ie back and side at the area of lower side of the rib cage. All or some of these can be present in a given individual.

3. When to see your doctor?

Any of the above symptoms should prompt you to see your doctor immediately. You may need admission to the hospital. Most kidney infections need prompt treatment with antibiotics,either oral or intravenous depending on severity of infection, to stop the infection from damaging the kidneys or spreading to the bloodstream. In rare cases, a kidney infection can cause further problems. These include spread of infection to the blood stream (sepsis) and build-up of pus in the kidney called an abscess.

4. What causes a kidney infection?

Kidney infection happens when a germ (bacteria) enters the urine passage and travels upwards. Also the infection can come to the kidney directly from the blood stream.

5. Who's at risk?

Kidney infections are rare. They can happen at any age and in both sexes. However they are more common in women. In fact, women are six times more likely to get a kidney infection than men. This is because a woman's urethra is shorter, making it easier for bacteria to reach the kidneys.Younger women are most at risk because they tend to be more sexually active, and having frequent sex increases the chances of getting a kidney infection. Elderly males who have prostate problem are also susceptible to urine infections as they do not empty their bladder completely. Patients with kidney stones are at risk so also the ones with defects in the urinary tract form birth. Those who have diabetes and other reasons for decreased immunity too are at risk of frequent urine infections.

6. How to prevent kidney infections?

Proper hygiene can prevent urine infections. Women should void urine after intercourse. They should wash themselves after stools from front to back and not the other way. They should not was the vagina dry of its secretions during shower. They should drink plenty of fluids. If diabetic, keep the sugar well under control. Elderly patients with prostate problem should get themselves checked regularly by the urologist. Elderly lady should get yearly gynaecology check done to see if hormone deficiency has caused problems such as “atrophic vaginitis.”

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Information on Peritoneal Dialysis (CAPD)

Peritoneal dialysis works on the same principle as hemodialysis, but the blood is cleaned inside the body rather than through a machine .Your abdomen has a peritoneal cavity lined by a thin membrane called the peritoneum. That surrounds the intestine and other internal organs .The peritoneal cavity is filled with dialysis fluid that enters the body through a permanently implanted catheter. Excess water and wastes pass through the peritoneum into the dialysis fluid. This fluid is then drained from the body and discarded .The process is repeated between three and five times a day. In most cases this treatment can be performed without assistance, at home or at work.

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Cadaver Kidney Transplant

Encourage your family and friends to donate their organs after death. Find answers to your questions.

1. What is organ donation?

Organ donation is a noble act which gives us an opportunity to save many lives after our death. The donated organs are transplanted into patients who are suffering from end stage organ failure. As many patients suffer from end stage disease of various organs, the organ donation is the only ray of hope for them.

2. What is organ transplantation?

Human organ transplantation is the achievement of the modern medical science where through surgical procedure the healthy organ from a living or dead person is transplanted on an individual suffering from end stage organ failure. This is established surgical treatment available for the needy patients.

3. Which organs can be donated?

The vital organs like heart, liver, two kidneys, pancreas, intestine, lungs etc. can be donated if we die a brain death. However cornea [eyes], skin and other tissues can be donated after cardiac death. The living person can donate limited organs like kidneys [as we have two kidneys] or part of the liver and only to his/her close relative. The other vital organs can be retrieved only from brain dead individual.

4. What is brain death?

Any individual whose brain stem, an important part of a central nervous system is irreparably damaged is declared brain dead. Brain stem dead individual can not regain his consciousness and breathing as brain stem has the centre for both. The heart can continue to function due to ventilator and other support for a max. time of 36 to 72 hrs. As the blood supply to organs can be maintained for few hours, it is during this period the organs can be retrieved after obtaining consent from the close relative. This death can occur only in Intensive Care Unit.

5. How is brain death declared?

Brain death is declared by the brain death committee which involves team of four doctors recognized by the Govt. and who are not involved in performing the transplant surgery. The team has to perform the brain stem death tests twice at the gap of 6 hrs. This death is declared in the hospitals recognized for transplantation. Brain death is accepted worldwide and the brain death certificate is issued to the relatives.

6. Is there any chance of survival of a brain dead individual?

No. Brain dead individual is declared dead and cannot come back. There is no question of survival of the individual as the set of tests done by the experts’ leave no possible doubts of the diagnosis of brain death.

7. What is the difference between comatose patients and brain dead patients?

Brain death has nothing to do with mercy killing; the organs are taken only after the person is declared brain dead. There is a difference between comatose patients and brain dead individuals. The comatose patients are not dead whereas brain death is the stage beyond coma and individual is declared dead. Organs are never taken at the cost of donor’s life.

8. Does the donor have to die only in hospital?

Yes. As Brain death can occur only in ICU, one who becomes organ donor dies in ICU of the hospital. No vital organs can be retrieved if the death occurs at home. However, eyes can be retrieved up to 6 hrs. after the heart stops beating hence this could be done even if the individual dies at home.

9. Is it legal?

Yes. In India, The Human Organ Transplantation Act was passed in 1994 which mainly covers 3 areas. It recognizes brain stem death. It regulates removal, storage and transplantation of organs for therapeutic purposes. It prevents commercial dealings in human organs. No human organ can be bought or sold.

10. Is the donor’s body given back to the relatives?

Yes. The body is given back to the relatives to perform the last rites after the retrieval of organs. The organs are retrieved only for therapeutic purposes. This is different than body donation where the whole body is given to the anatomy dept. of the Medical College for the research purpose.

11. Are the organs given to only rich?

No. As per the priority criteria like age, blood group, waiting period, Clinical status of the recipients the organs are given to the most needy and suitable recipient. In Maharashtra the Govt. has given guidelines to give the priority score to all the waiting recipients to distribute the organs. Money, race, religion are not the criteria for distribution

12. Will the donor family know to whom the organs are given?

No. The name and address of the recipient is not given to the donor family and vice versa.

13. Is there any disfigurement after organ donation?

No. The organs are removed carefully by taking the donor to the operation theatre and there is no disfigurement. There is cut on the body which is sutured just like any other surgery performed on the living person.

14. Does our religion support organ donation?

Yes. All the religions in India consider it as the noble act.

15. Is any compensation or payment made to the donor family?

NO. It is pure donation and hence it becomes the noble act. However, the family is not charged for the investigations after the consent for organ donation is given.

16. How can one become an organ donor?

Sign an organ donor card. Share the wish with the close relatives as their consent is required before retrieving the organs even if the donor has signed a donor card. The donor card has to be kept with the person who has signed it.

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Basic Information on Kidney Transplant

Renal Transplant-Renal transplant is now widely considered the best way of treating renal failure .Your Nephrologist will tell you if you are suitable to have a kidney transplant after a detail health assessment and based on organ availability.

What are the types of kidney trans-plants possible?

There are two types of kidney transplants: a living donor transplant and a cadaveric transplant. Living Donor Transplantation. In a living donor transplant, a kidney from a donor, usually a blood relative is transplanted into your body. The donor must have a compatible blood group and tissue type. The most suitable donors usually are members of your immediate family, but sometimes a spouse, a friend, or a more distant relative are able to be living donors. Extensive testing and assessment of both donor and recipient, by members of the health care team, are necessary before approval is given for this type of transplant. Living donor transplants have very good success rates, and there are few risks to healthy donors.

What does transplant surgery involve?

Transplant surgery usually takes two to four hours. The new kidney and ureter (the tube through which the urine flows into the bladder) are placed in the lower abdomen near the groin, and are attached to your blood vessels and bladder. The transplanted kidney may not work immediately, so you may need dialysis until it does. After the transplant, you receive anti-rejection medication and specialized nursing care. Many tests are done to make sure your new kidney is working properly and to watch for any signs of rejection.

What about rejection?

Because the transplanted kidney is foreign to your body, anti-rejection drugs, or immunosuppressive, must be taken for as long as the transplanted kidney functions. They work by blocking the activity of the immune system. There are a number of side effects associated with the anti-rejection drugs. Rejection episodes are quite common in the early months after transplantation. Usually, they can be treated successfully with medication. However, rejection may occur any time after a transplant, even when drugs are taken faithfully. If the transplant fails, you will be able to go back on dialysis.

What are the changes in living with a new kidney?

Kidney transplantation is the only treatment that may replace normal kidney function. The new kidney is able to do the work of two healthy ones. With a successful transplant, you do not need dialysis, but you will have to take medications and visit a transplant clinic regularly. You will have few restrictions in your diet, and have more energy to resume work, enjoy other activities, as well as have more freedom to travel. However, kidney transplantation does have requirements and considerations as well as advantages. Your health care team can provide information and support to help you make a decision about what is the best treatment for you. It is important to discuss all the options and ask any questions which you or your family may have.

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About Fistula Surgery

You can be attached to the dialysis machine in several ways. The most common permanent access is an internal AV-Fistula in your arm. This is also termed as a Lifeline and it helps the patients’ blood to travel to and from the hemo dialysis machine. In advanced stage your Nephrologist will advise you to get an AV-Fistula made. This involves having an artery and vein connected surgically under local anesthesia. When they are joined the stronger blood flow from the artery causes the vein to become larger over a period of 6weeks to 4 months. Needles can be inserted in the enlarged vein to connect you to the dialysis machine. Another way to provide access to the blood stream is to make an internal graft. In this procedure an artery is connected to a vein with a short piece of special tubing placed under the skin. Needles can then be inserted into the graft.

Having an AV-Fistula in place well before beginning hemodialysis will give it time to mature so that it is ready to use. As compared to other access AV Fistulas give greater blood flow and are at a low risk for infection and clots. A temporary hemodialysis catheter is always an emergency or last resort for a patient requiring dialysis.

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Basic Information on HemoDialysis

Dialysis is a way to clean the blood by removing wastes and excess water. There are 2 types: hemodialysis and peritoneal dialysis .During

Hemodialysis using your vascular access the blood is circulated through an artificial kidney machine .The artificial kidney cleans blood in almost the same way that the healthy kidneys do. The wastes and excess water pass through the membrane into the dialysis fluid and then are discarded. The cleaned blood is returned to your blood stream. You will be able to eat during the session .The session may further be fortified by administration of multivitamin ,iron , Vitamin D, Erythropoietin(blood building hormone) injections based on your needs at a dose suitable for you.

1. What is the frequency of hemodialysis ?

The treatment is performed usually three times a week on an out-patient basis with each session lasting for four hours .This is because only a small amount of blood is out of the body at one time. Therefore your blood must circulate through the machine many times before it is cleaned fully.

2. Is hemodialysis painful?

Insertion of needles causes pain but only for a brief time.

4. What changes are needed with hemodialysis?

Diet

Planning work/school schedules as per hemodialysis

Travel-Planning in advance and informing the dialysis unit so as to make arrangements for outstation hemodialysis.

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Treatment for Chronic Kidney Diseases

Your kidneys are two bean shaped organs located in the lower back. They play an important role in the body by functioning as filters. They help in cleaning wastes and getting rid of extra fluids from the body .The kidney also produces and balances many hormones and chemicals necessary for normal function of the body. Kidneys can be affected on a temporary basis termed as Acute kidney injury or a permanent basis which is called as Chronic kidney disease .Chronic Kidney disease ranges from near normal kidney function [stage1] to kidney failure [stage5] which requires dialysis or transplant .The treatment options vary depending upon the stage of the disease and are aimed at slowing the progress for better quality of life.

When the kidney disease progresss to end stage the patients need either dialysis or kidney transplantation. Dialysis options-Apex kidney care offers various dialysis choices that can suit your personal lifestyle.

• In center hemodialysis-You will be looked after by caring and trained professional dialysis nurses and technicians .This modality also gives you an opportunity to interact with other fellow patients on hemodialysis.
• Peritoneal dialysis-Needle free dialysis done in the comfort of home or work involving fluid exchange thrice a day via the abdomen
• Home-hemodialysis-Perform hemodialysis in the privacy of your own home with the assistance of a trained technician.

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Appam Balls

SERVINGS : 1

Diet Type

Hypertension :

Diabetes :

CKD on Dialysis :

Dialysis Patient :

Transplant Patients :

Nutrient per Serving

Carbohydrates:

38.3

Proteins:

5.7

Fat:

5.8

Energy:

229

Sodium:

19.2

Potassium:

115.8

Calcium:

25.5

Phosphorous:

83.5

Ingredients

Rawa: 1 Cup (50g)

Curd: 2tsp (10g)

Cabbage:

Carrot: 2 tsp (10g)

Capsicum:

Salt: from the prescribed daily allowance

Jeera: ½ tsp

Oil: 1 tsp (5ml)

Dal chutney powder: 1 tsp

Method

Mix all the above ingredients, add 1 cup water to it and mix well. Now take an appam pan, grease it slightly with oil. Heat the pan and then add the batter in the grooves. Steam it for 5-7 mins and then flip the ball. Steam it again for 5 mins. Serve hot with dal chutney powder.

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