Nephrology

Amyloidosis, characterised by protein misfolding and subsequent organ infiltration, is a rare disease with potentially life-threatening consequences. Addressing this challenging condition, Max Hospital stands as a beacon of hope, offering comprehensive and advanced treatment options for patients battling this complex condition. At Max Hospital, our team of highly qualified and experienced specialists, spanning various disciplines like haematology, nephrology, cardiology, and neurology understands the unique complexities of amyloidosis, and works in close collaboration to provide personalised and evidence-based care for each patient. From early diagnosis to advanced treatment options, we are here to guide and support individuals on their journey toward better health and improved quality of life. Also, we believe that comprehensive care extends beyond medical interventions, So, we provide the required support and guidance to our patients and their families throughout their journey, helping them cope with the challenges of amyloidosis and navigate the treatment process with hope and strength.

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In autosomal dominant polycystic kidney disease (ADPKD), clusters of cysts develop within the kidneys causing the kidneys to enlarge and hypofunction. This is a benign, inherited condition that has fluid-filled round cysts. Moreover, these cysts can grow large but often vary in size. Their size can greatly affect renal function and may involve the liver and other organs. This disease has severe complications if not attended to on time. Some complications are associated with a rise in blood pressure and renal failure. However, these complications are preventable. The severity of the disease varies significantly. Hence, making lifestyle changes and getting treated for the condition helps reduce the damage to the kidneys and further the progression of the disease.

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Cystic Fibrosis (CF), one of the most challenging genetic conditions, affects multiple organs, predominantly the lungs and digestive system. Its impact extends far beyond physical symptoms, deeply affecting the lives of individuals and their families. At Max Hospitals, we recognize the criticality of this condition and the urgent need for comprehensive care and support. With our multidisciplinary team of experts comprising pulmonologists, gastroenterologists, nutritionists, and specialised CF nurses, we are dedicated to providing compassionate and advanced care to patients battling CF. Our integrated approach combines cutting-edge treatments, personalised management plans, and ongoing support to improve the quality of life for individuals living with CF.

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Diabetic nephropathy is a severe complication of type 1 diabetes and type 2 diabetes. It is also called diabetic kidney disease.  Diabetic nephropathy interferes with the kidneys' ability to remove waste products and extra fluid from the body. The ideal way to prevent or delay the onset of diabetic nephropathy is to maintain a healthy lifestyle, work out regularly, and manage blood sugar levels and high blood pressure efficiently. Kidney disease may progress to kidney failure, which is also called end-stage renal disease. Kidney failure is a life-threatening condition. At this stage, treatment options are dialysis or a kidney transplant. Symptoms of Diabetic Nephropathy No signs and symptoms of diabetes are evident during the early stages of diabetic nephropathy. In later stages, the signs and symptoms may include: Worsening blood pressure control Protein in the urine Drowsiness Muscle twitching Increased need to urinate Swelling of feet, ankles, hands, or eyes Loss of appetite Shortness of breath Reduced need for insulin or diabetes medicine Confusion or difficulty concentrating Nausea and vomiting Persistent itching Fatigue As the renal damage progresses, kidneys cannot function properly, thereby building up waste in the body that may reach toxic levels, a condition known as uremia. People with uremia are often confused and occasionally become comatose. Stages of Diabetic Nephropathy The stages of kidney disease depend on the GFR, representing the percentage of effective kidney function. Stage 1: Kidney damage but normal kidney function and a GFR of 90% or more. Stage 2: Kidney damage with loss of function and a GFR of 60–89%. Stage 3: Mild to serious loss of function along with GFR of 30–59%. Stage 4: Loss of function and GFR of 15–29%. Stage 5: Renal failure and a GFR of less than 15%. Causes of Diabetic Nephropathy Kidney damage can put pressure on other healthy organs and prevent them from functioning well. When this happens: the body loses protein through the urine the kidneys fail to remove waste products from the blood the kidneys fail to balance healthy fluid levels in the body Diabetic nephropathy is the result of uncontrolled diabetes. It develops slowly over the years. Kidney disease is also common in people with diabetes for less than ten years. Also, if there are no clinical signs of nephropathy 20–25 years after diabetes is diagnosed, there are fewer chances of developing it. Diabetic nephropathy is less likely to develop if a person with diabetes manages their glucose levels effectively. Increased blood glucose levels increase the risk of high blood pressure. This happens because of the damage done to blood vessels. Hypertension may also contribute to kidney disease. Diabetic Nephropathy Diagnosis Diabetic nephropathy is diagnosed during routine examination as a part of diabetes management. Screening for diabetic nephropathy is recommended at least five years after diagnosis of type 1 diabetes. With type 2 diabetes, the screening begins at its diagnosis. Routine screening tests include: Urinary albumin test: This test detects the blood protein albumin in the urine. Under normal circumstances, the kidneys don't filter albumin out of the blood. Excessive protein in the urine may indicate poor kidney function. Albumin/creatinine ratio: Creatinine is a waste product filtrated from the blood by healthy kidneys. The albumin/creatinine ratio helps assess kidney function. Glomerular filtration rate (GFR): It is the measure of creatinine in a blood sample that helps estimate how quickly the kidneys filter blood (glomerular filtration rate). The glomerular filtration rate is low for a kidney that is not functioning. Other diagnostic tests include: Imaging tests: X-rays and ultrasound tests help assess the kidneys' structure and size. CT scans and magnetic resonance imaging (MRI) may also be advised to determine blood circulation within the kidneys. Kidney biopsy: A kidney biopsy is recommended to study the anatomy of kidney tissue.  Diabetic Nephropathy Treatment The first line of treatment for diabetic nephropathy is treating and controlling diabetes and hypertension. This includes changes in diet and lifestyle, adding exercise to the routine, and prescription medications. Good blood sugar and hypertension management can prevent or delay the onset of kidney dysfunction and other such complications. Medications The early stages of diabetic nephropathy can be managed with medications that include: Blood pressure control: Medicines such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin-2 receptor blockers (ARBs) are prescribed to manage high blood pressure. Blood sugar control: Medicines that help control high blood sugar in people with diabetic nephropathies, such as metformin, improve insulin sensitivity and lower glucose production in the liver. Glucagon-like peptide 1 (GLP-1) receptor agonists reduce blood sugar levels by slowing digestion and stimulating insulin secretion in response to rising glucose levels. SGLT2 inhibitors limit glucose to return to the bloodstream, leading to increased glucose excretion in the urine. High cholesterol: Cholesterol-lowering drugs called statins are prescribed to lower high cholesterol levels and reduce protein in the urine. Kidney scarring: Finerenone disrupts molecular activity that causes inflammation and tissue scarring in diabetic nephropathy. Research suggests that the drug may lower the risk of kidney function decline, kidney failure, nonfatal heart attacks, cardiovascular death, and hospitalisation for heart failure in patients with chronic kidney disease associated with type 2 diabetes. Kidney transplant If kidney disease progresses to kidney failure (end-stage kidney disease), care is focused on either replacing the kidneys' function or making the patient more comfortable. In some situations, the best option is a kidney transplant or a kidney-pancreas transplant. If a kidney transplant is chosen, the patient's eligibility as a recipient is tested. Complications Of Diabetic Nephropathy The complications of diabetic nephropathy develop gradually over months or years. These include: Fluid retention causes swelling in the arms and legs, high blood pressure, or fluid in the lungs (pulmonary oedema) Increase in potassium levels in the blood (hyperkalemia) Heart and blood vessel disease (cardiovascular disease) can lead to stroke Prolonged high sugar levels can damage the blood vessels of the light-sensitive tissue at the back of the eye, called diabetic retinopathy Pregnancy complications that carry risks for the mother and the developing fetus Anaemia: Reduced number of red blood cells to transport oxygen  Foot sores, erectile dysfunction, diarrhoea, and other disorders related to damaged blood vessels and nerves Particular bone and mineral disorders due to the inability of kidneys to balance calcium and phosphorus levels in the blood Irreversible damage to the kidneys is called end-stage kidney disease, which eventually needs either dialysis or a kidney transplant for survival Risk Factors Factors that contribute to an increased risk of diabetic nephropathy include: Uncontrolled high blood sugar (hyperglycemia) Uncontrolled high blood pressure (hypertension) Being a smoker Age: above 60 years High blood cholesterol Obesity It is more common in men than in women A family history of diabetes and kidney disease Chronic inflammation Insulin resistance  Elevated levels of blood lipids (fats) Prognosis The progression of kidney disease depends upon many factors. Following the treatment plan and making recommended lifestyle changes can slow the disease’s progression and keep the kidneys healthy for a longer duration. Review  Reviewed by Dr. Manoj Arora, Director - Nephrology, on 7 Dec 2024.

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Glomerulonephritis (Nephritis) is a serious condition that can be life-threatening and requires immediate attention and treatment. Max Hospitals, one of the leading kidney hospitals in Delhi, India, offers the highest quality of care and treatment options for individuals facing kidney-related issues, leaving no stone unturned to help ensure the best possible outcomes. Our commitment to excellence in nephrology care makes us one of the most preferred kidney hospitals for those seeking the expertise of the best nephrologists in Delhi, India.

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Kidney failure is a severe and challenging condition that can profoundly affect one's health and daily life. It impairs the kidneys' ability to filter waste and maintain fluid balance, leading to symptoms like extreme fatigue, swelling, and potentially life-threatening complications. Managing kidney failure effectively requires a combination of precise medical treatment and compassionate support. At Max Hospital, we understand the complexities of kidney failure and are equipped to provide the support and treatment needed. Our dedicated team of specialists including nephrologists and urologists along with our advanced facilities are here to ensure that each patient receives comprehensive care. We are committed to addressing the unique needs of those with kidney failure, helping them manage their condition effectively and improve their quality of life.

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Max Healthcare, one of the best nephrology hospitals in India, offers comprehensive care for patients with lupus nephritis, a type of chronic autoimmune kidney inflammation caused by systemic lupus erythematosus (SLE). Our experienced and qualified nephrologists, rheumatologists, and other specialists work together to develop a personalised treatment plan for each patient, taking into account their individual needs and condition. Our goal is to help patients achieve and maintain remission from lupus nephritis, preserve kidney function, and prevent complications. We also offer supportive care to help patients manage the symptoms of lupus nephritis and live full and active lives.

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Nephrotic syndrome, a kidney disorder that causes the body to excrete excessive protein in the urine, demands specialised medical intervention. At MAX Healthcare, renowned as one of the top nephrology centres in India, we understand the complexities associated with nephrotic syndrome and are dedicated to delivering expert care and guidance. Our approach encompasses a range of advanced treatment options and a nurturing environment to effectively manage nephrotic syndrome. Ensuring the patient's overall health and well-being remains at the forefront of our mission as we collaboratively address this renal challenge.

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Pyelonephritis is a type of kidney infection that can pose serious health risks if left untreated or not managed properly, with potential complications including kidney damage, abscess formation, and systemic infections. At Max Hospitals, we offer comprehensive pyelonephritis treatment to effectively combat this infection and prevent its adverse consequences. Our team of experienced nephrologists possesses in-depth knowledge of the condition and its management strategies. We employ a patient-centric approach, tailoring treatment plans to individual needs and ensuring the best possible outcomes.Equipped with advanced diagnostic tools, we are able to ensure a high degree of accuracy in determining the causes of pyelonephritis and the severity of the infection. This meticulous approach to diagnosis lays the foundation for personalised treatment plans that effectively target the specific bacteria responsible for the infection. Our commitment to patient care extends beyond treatment as we provide comprehensive education and support to empower patients to effectively manage their condition and prevent future infections.

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