Frequently Asked Questions

Chronic Kidney Disease (CKD) is a progressive condition where the kidneys gradually lose their ability to filter waste products and excess fluids from the blood. It is classified into 5 stages based on your Glomerular Filtration Rate (GFR):

• Stage 1: GFR 90+ (normal function, but kidney damage present)
• Stage 2: GFR 60-89 (mild decrease)
• Stage 3a/3b: GFR 30-59 (moderate decrease)
• Stage 4: GFR 15-29 (severe decrease)
• Stage 5: GFR below 15 (kidney failure, dialysis may be needed)

Early detection through regular blood and urine tests is crucial for slowing progression.

Kidney disease is often called the "silent disease" because early stages may have no noticeable symptoms. Warning signs to watch for include:

• Foamy or bubbly urine (indicating protein leakage)
• Blood in urine (pink, red, or cola-colored)
• Swelling in ankles, feet, or around eyes
• Persistent fatigue and low energy
• Loss of appetite and nausea
• Muscle cramps, especially at night
• Frequent urination, particularly at night (nocturia)
• Difficulty concentrating
• Dry, itchy skin

If you experience any of these, schedule a kidney function test immediately.

Testing frequency depends on your risk factors:

• Healthy adults: Annual KFT as part of routine health checkup
• Diabetics: Every 3-6 months (urine albumin + serum creatinine)
• Hypertension patients: Every 6 months
• Family history of kidney disease: Every 6 months
• CKD patients (Stage 1-2): Every 3-6 months
• CKD patients (Stage 3-5): Every 1-3 months

A simple blood test (serum creatinine) and urine test (for protein/albumin) can detect kidney problems early.

It depends on the stage and cause:

• Acute Kidney Injury (AKI): Often reversible with prompt treatment
• CKD Stage 1-2: Can be stabilized and sometimes improved with strict management of diabetes, blood pressure, diet, and medications
• CKD Stage 3: Progression can be significantly slowed with proper care
• CKD Stage 4-5: Generally irreversible, but the goal is to delay dialysis as long as possible

New medications like SGLT2 inhibitors (Dapagliflozin) have shown remarkable results in slowing CKD progression, even in non-diabetic patients.

GFR (Glomerular Filtration Rate) measures how effectively your kidneys filter blood. It is estimated (eGFR) using a formula that considers:

• Serum creatinine level
• Age
• Gender
• Body size

Normal GFR: 90-120 mL/min/1.73m2. A GFR below 60 for 3+ months indicates CKD. Your doctor may also use Cystatin C for more accurate estimation in certain populations.

Creatinine is a waste product from muscle metabolism, filtered by the kidneys. Normal ranges:

• Males: 0.7 - 1.3 mg/dL
• Females: 0.6 - 1.1 mg/dL

A high creatinine can indicate reduced kidney function, but can also be elevated due to heavy exercise, high protein diet, certain medications, or dehydration. A single elevated reading should always be confirmed with repeat testing and GFR calculation. Do not panic over one abnormal result.

Living kidney donors must meet these criteria:

• Age 18-65 years (ideally under 55)
• Good general health with no diabetes, hypertension, or kidney disease
• Compatible blood group (or participate in swap/paired exchange programs)
• Related to the recipient (as per Indian Transplant of Human Organs Act) or authorized by an Authorization Committee for non-related donors
• No history of cancer, active infections, or major organ diseases
• Two healthy kidneys with normal function

A comprehensive evaluation including blood tests, imaging, and psychological assessment is required before donation.

Average graft survival:

• Living donor kidney: 15-20 years (some last 25+ years)
• Deceased donor kidney: 10-15 years

Longevity depends on medication compliance (immunosuppressants must be taken lifelong), regular follow-up visits, avoiding infections, maintaining blood pressure and sugar control, and overall lifestyle. Some patients may need a second transplant or transition to dialysis if the graft eventually fails.

Approximate costs in Delhi NCR:

• Pre-transplant evaluation: Rs 50,000 - 1,00,000
• Surgery + hospitalization: Rs 4,00,000 - 8,00,000
• Monthly medications (post-transplant): Rs 10,000 - 25,000
• Annual follow-up costs: Rs 30,000 - 60,000

Government hospitals offer transplants at subsidized rates. Insurance and government schemes like CGHS, ECHS, and Ayushman Bharat can cover significant portions of the cost.

Hemodialysis (HD):

• Blood is filtered through a machine with an artificial kidney (dialyzer)
• Typically done 3 times/week, 4 hours per session
• Requires vascular access (fistula, graft, or catheter)
• Can be done at a centre or at home (with training)

Peritoneal Dialysis (PD):

• Uses the peritoneal membrane in your abdomen as a natural filter
• Done daily at home (CAPD: 4 exchanges/day, or APD: overnight machine)
• Requires a permanent catheter in the abdomen
• More flexibility and independence

Both are equally effective. The choice depends on lifestyle, medical conditions, and patient preference. Dr. Bhatt also offers home hemodialysis programs for eligible patients.

Dialysis is typically started when:

• GFR falls below 10-15 mL/min (Stage 5 CKD)
• Symptoms become difficult to manage (severe fluid overload, uncontrollable nausea, confusion, pericarditis)
• Dangerous levels of potassium or acid build-up

The decision is individualized. Some patients start earlier if symptoms are severe, while others with minimal symptoms may delay safely under close monitoring. Early preparation with AV fistula creation (3-6 months before anticipated need) is strongly recommended.

Yes. Dr. Bhatt is a pioneer in home hemodialysis in Delhi NCR. Options include:

• Home Hemodialysis: Compact machines (like NxStage) allow dialysis at home after proper training. Sessions can be more frequent and shorter, offering better quality of life.
• Peritoneal Dialysis (CAPD/APD): Done at home using the abdominal lining as a filter. Very well-suited for working professionals and elderly patients.

Benefits of home dialysis include flexible scheduling, reduced infection risk, no travel time, and better overall outcomes. Comprehensive training for patients and caregivers is provided.

Dietary restrictions depend on CKD stage and lab values, but commonly restricted items include:

• High Sodium: Pickles, papad, canned soups, processed/packaged foods, chips
• High Potassium: Bananas, oranges, coconut water, potatoes (unless leached), tomatoes, spinach
• High Phosphorus: Cola drinks, dairy in excess, organ meats, nuts in large amounts, whole grains in excess
• Excess Protein: Large portions of meat, dal in excess (adjusted per stage)
• Others: Star fruit (toxic for CKD patients), excessive fluid (if advised)

Use our Diet Planner Tool for stage-specific guidelines.

Water intake varies by CKD stage:

• CKD Stage 1-3 (without fluid retention): 1.5-2 liters/day is generally safe
• CKD Stage 4-5 (with reduced urine output): May need restriction to previous day's urine output + 500 ml
• Dialysis patients: Typically restricted to 500-1000 ml/day between sessions
• Kidney stone patients: Should drink MORE water (2.5-3 liters/day)

Always follow your nephrologist's specific advice. Fluid includes tea, coffee, soups, curd, and fruits with high water content.

Most health insurance plans in India cover dialysis:

• Private insurance: Covers dialysis as part of hospitalization or daycare procedures. Pre-existing condition waiting period (2-4 years) may apply.
• CGHS/ECHS: Covers dialysis at empanelled centres with referral
• Ayushman Bharat (PM-JAY): Covers dialysis for eligible BPL families at government and empanelled hospitals
• State government schemes: Many states have free dialysis programs

Our centre assists with insurance documentation and cashless claims. Contact our help desk for guidance on your specific policy.

Yes, Dr. Bhatt offers teleconsultation for patients who cannot visit in person:

• Video Consultation: Rs 800 (15-20 minutes)
• Follow-up Video Call: Rs 500 (within 30 days)
• Report Review (Written): Rs 500
• Second Opinion (Detailed): Rs 2,000

Teleconsultation is ideal for follow-up visits, medication adjustments, report reviews, and patients from other cities/states. Book via WhatsApp or call our clinic.

Consultation fees vary by location:

• OPD Consultation (First Visit): Rs 800 - 1,500 depending on hospital
• Follow-up (within 30 days): Rs 500 - 800
• Emergency/After-hours: Additional charges may apply

Insurance cashless facility is available at empanelled hospitals. Payment modes accepted: Cash, UPI, Cards, and Insurance.