Health

Kidney disease is inherently complex, and the challenges associated with managing it are immense. However, in the Pakistan-India region, cultural factors significantly exacerbate these challenges, making the journey even more difficult for patients and healthcare providers alike. This article delves into what I term the "Dark Side of Kidney Disease"—the layers of despair that surround the condition, both from within and from the broader cultural context. The Emotional Weight of Chronic Kidney Disease (CKD) The emotional burden of CKD is profound, often deepened by a lack of awareness and understanding. Patients frequently struggle with feelings of hopelessness, which can intensify the disease's impact. To counteract this, I regularly incorporate stories of resilience and hope in my CKD management approach. Recently, I shared the stories of Asad Abbas and Bhanu Pratap in a two-part series, highlighting their experiences to provide insight into the broader conte...

Kidney health is a critical aspect of overall well-being, yet it's often overlooked until a serious issue arises. A common scenario many people face is finding elevated creatinine levels in their blood tests, leading to confusion about whether it's a sign of Acute Kidney Injury (AKI) or Chronic Kidney Disease (CKD). This confusion is particularly prevalent in regions like Pakistan and India, where regular health screenings aren't as common, and many individuals only discover kidney issues when symptoms have significantly progressed. In this article, we'll explore the differences between AKI and CKD, helping you understand how to identify each condition, and discuss some basic but essential steps you can take to manage your kidney health effectively. Introduction: The Prevalence of Kidney Issues in South Asia In South Asia, particularly in countries like Pakistan and India, kidney-related issues are more common than many realize. This prevalence is partly due...

We have completed nearly 79 episodes so far, with a primary focus on chronic kidney disease (CKD)—its management, and raising awareness among the general public. Our goal has been to help people better understand kidney disease and improve its management. Now, we're starting a new journey, shifting our focus towards glomerular diseases and kidney transplants. However, before diving into these topics, it's crucial to understand one of the most important diagnostic procedures in nephrology: the kidney biopsy. A kidney biopsy is essential for diagnosing glomerular diseases, which makes it vital to grasp its significance before moving forward. In this two-part series, I will first explain what a kidney biopsy is, including its indications, who should avoid it, and the associated risks. In the next episode, I will teach you how to interpret a kidney biopsy report. Assalamualaikum, I am Dr. Vaseeka from Expert Consult Clinic of Lahore, speaking to you from our clinic stud...

Welcome to this third episode in our kidney biopsy series. In our first episode, we discussed the indications, contraindications, and potential complications of kidney biopsies. The second episode covered what a patient can expect on the day of their kidney biopsy. Today, in this third and final episode, we’ll focus on understanding and interpreting your kidney biopsy report. Kidney biopsies are essential diagnostic tools, particularly when we need to understand complex kidney diseases. The majority of kidney biopsies are performed to diagnose glomerular diseases—conditions affecting the glomeruli, which are tiny filters in the kidney. One other key indication for a biopsy is in cases of acute kidney injury (AKI) when the cause is unclear despite thorough clinical evaluation, and the kidney function isn't improving. It’s important to note that the role of a biopsy is primarily to diagnose conditions where effective treatments are available. For example, in glomerular diseases, the ...

Thank you for being a part of our growing community. Over the course of 80 episodes and several shorts, we've explored various aspects of chronic kidney disease, including its screening, management, and impact on patients. Throughout these discussions, one question has frequently appeared in the comments: "How can I protect my kidneys and maintain their health?" In response to this vital query, today's episode will outline 13 essential habits that can help you safeguard your kidneys and enhance their health. These practices are particularly beneficial for those who are at risk of kidney disease or want to prevent it altogether. 1. Prioritize Water Intake Maintaining adequate hydration is crucial for kidney health. Aim to drink 2 to 3 liters of water daily. Water helps the kidneys in flushing out toxins and keeps them functioning efficiently. For those with healthy kidneys, higher water intake is generally safe. However, if you have heart conditions, you ...

When I was undergoing my nephrology fellowship in the United States, which is specialized training in kidney diseases, I encountered a patient who left a lasting impression on me. This patient had a unique case that intrigued me greatly—his kidney function had remained stable at Stage 4 for the past five to seven years. Remarkably, he displayed no significant physical symptoms that typically accompany such advanced kidney disease. Even during my two-year training period, his condition showed no deterioration. Curious about his unusual stability, I decided to delve deeper into his history. I spent time listening to his full story and consulted with my mentor, who had been treating this patient for the past decade. Through these discussions, I embarked on a path of research that ultimately led me to an important discovery: exercise can be incredibly beneficial for individuals suffering from kidney disease. In today's video, I will share my experiences from that time and t...

In today's discussion, we'll delve into how glomerular diseases present themselves and the comprehensive diagnostic process doctors use to determine the exact nature of the condition. Glomerular diseases can manifest in a variety of ways, often depending on the underlying cause and the severity of the condition. Typically, your doctor will perform a detailed workup that includes lab tests, imaging studies, a thorough review of your medical history, and a physical examination. This systematic approach helps in narrowing down the possible diagnoses before moving toward a final diagnosis. Common Symptoms and Indicators of Glomerular Disease One of the early signs that something might be wrong with your kidneys is changes in your urine. You might notice that your urine appears foamy. This foaminess is often due to the presence of protein in the urine, a condition known as proteinuria. Normally, proteins are retained in the bloodstream, but in glomerular disease, the kid...

At the end of every video, I often leave you with a brief message and a small request: to share your experience. This isn’t just for my benefit—it helps other patients and the wider audience learn from your insights. More importantly, it significantly enhances my own learning. I strive to learn something new every day, and I believe no doctor can truly grow without learning from their patients, the local sociopolitical environment, and the happenings in their community. In today’s episode, I want to discuss the significant lessons I’ve learned over the past two years since I returned to Pakistan. There are some major challenges that kidney patients face in their journey towards better health. These challenges not only hinder their recovery but also complicate their overall management. My Journey Back to Pakistan and the Healthcare Reality When I returned to Pakistan in 2021, I was initially impressed by the advancements in healthcare. Large hospitals had been established, a...

In this article, we will discuss glomerular diseases, a critical topic in nephrology that requires a detailed understanding. Previously, we explored how your doctor might classify your condition based on symptoms and lab tests, leading to a specific diagnosis through biopsy. This classification often helps in identifying the type of glomerular disease you might have. Today, we will begin our series on individual glomerular diseases, starting with IgA nephropathy (IgAN), also known as Berger's disease. Overview of Glomerular Diseases Glomerular diseases are not exceedingly common, but some types are more prevalent in certain regions. For instance, IgA nephropathy is particularly common among people of Asian descent. When a patient from this demographic presents with signs of glomerular disease, IgAN is often a primary suspect. However, glomerular diseases are complex, and understanding them fully requires a considerable amount of study. New research continually emerges, ...

When managing kidney disease, it’s crucial to understand that focusing solely on the medical aspects of the condition is not enough. A patient's socio-economic conditions, overall health, and the broader social determinants of health play significant roles in both the progression of kidney disease and the effectiveness of its treatment. This interaction between health and socio-economic status is something I’ve discussed repeatedly in my previous videos. Today, I want to explore how our society’s socio-economic, emotional, mental, and religious health affects kidney disease. This influence is profound and persistent, and unless we change our priorities, our community will continue to face losses due to kidney disease. The Interplay Between Kidney Disease and Socio-Economic Factors It’s essential to recognize that kidney disease doesn’t exist in isolation. It both affects and is affected by a person’s socio-economic status. This means that treating kidney disease involve...

In today’s video, I’ll address one of the most frequently asked questions: "How can I reduce my creatinine levels?" While this video might not provide a direct answer to that question, it aims to offer a scientific demonstration and explanation that could help you understand whether you need to reduce your creatinine levels and, if so, how it might be done. Understanding Creatinine and Kidney Function Before diving into the methods of reducing creatinine, it’s essential to understand the basics of how our kidneys function. On average, the human heart pumps approximately 5 liters of blood throughout the body every minute. Of this, about one-fifth (roughly 1250 milliliters) passes through the kidneys. The kidneys' primary function is to filter this blood, removing waste products and returning the purified blood back to the body. One critical aspect of kidney function is the Glomerular Filtration Rate (GFR). This is a measure of how well your kidneys are filterin...

In Episode 77, I discussed three medications in great detail that are known as renal-protective drugs . These medications not only help protect the kidneys, but they also reduce proteinuria (the presence of excess proteins in urine) and slow down the progression of kidney function decline. Surprisingly, after a whole year, an intelligent individual raised a very valid question in the comments: "If these medications are so important, why aren't Pakistani doctors prescribing them?" This is indeed a legitimate question, and it points to a significant issue in the healthcare practices in our region. This episode aims to explore why such crucial medications are underprescribed in Pakistan. We'll also look at how these medications work and the reasons behind the reluctance in their use. The Situation in Pakistan From my experience, I’ve observed that even though many kidney patients come to clinics, only about 5% to 10% of them are already on these kidney-prote...

Focal Segmental Glomerulosclerosis, commonly referred to as FSGS, is a kidney disorder that, as its name suggests, involves scarring in certain segments of the glomeruli—the filtering units in the kidneys. While the term itself may sound daunting, the disease is even more complex in its pathology, pathophysiology, and terminology. In this article, we will break down FSGS into more understandable terms, focusing on its causes, types, and potential treatment options. What is FSGS? FSGS stands for Focal Segmental Glomerulosclerosis, a term that has been used for many years to describe a specific pattern of kidney damage. "Focal" means that only some of the glomeruli are affected, while "segmental" indicates that only a portion of each affected glomerulus shows scarring. However, as the disease progresses, it can involve entire glomeruli and even spread to affect larger portions of the kidney. This evolving understanding suggests that the definition and cate...