Kidney disease is often called a “silent killer” because symptoms appear only in the later stages, when damage is irreversible. Delayed diagnosis and treatment can have life-threatening consequences, yet many patients fail to recognise the warning signs until it’s too late.
Dialysis and kidney transplants are the only viable options for those with end-stage renal disease, but misconceptions and delays often cost lives. With nearly 80% of kidney disease patients undiagnosed, experts weigh in on the importance of early detection, the dangers of hypertension and diabetes, and how lifestyle choices like alcohol consumption and obesity impact kidney health.
Dialysis vs. Transplant: What every kidney patient should know
Dr. Mohit Khirbat, Consultant, Nephrology, CK Birla Hospital, Gurugram: Chronic kidney disease (CKD) is a growing health problem around the world, and for end-stage renal disease (ESRD) patients, two major treatment options are available—dialysis and kidney transplant. The choice between the two is based on various considerations, including medical suitability, personal preference, and treatment availability. An understanding of the differences between dialysis and transplant is critical for kidney patients to make an informed decision.
Dialysis: A lifeline for patients
Dialysis is a medical procedure designed to remove waste, excess fluids, and toxins from the blood when the kidneys are unable to perform this function. There are two main types of dialysis: hemodialysis and peritoneal dialysis. Hemodialysis involves using a machine to filter the blood outside the body, typically performed in a hospital or dialysis center several times a week. Peritoneal dialysis, on the other hand, utilises the peritoneum membrane in the abdominal cavity to filter the blood through a catheter, allowing patients to undergo treatment at home.
One of the key strengths of dialysis is that it is suitable for the majority of patients and does not require surgery. Additionally, peritoneal dialysis offers the convenience of being performed at home. However, dialysis also has its weaknesses. It is a time-consuming and restrictive process, carries a higher risk of infections and complications, and does not fully restore kidney function.
Kidney transplant: A long-term solution
A kidney transplant involves surgically replacing a non-functioning kidney with a healthy one from a living or deceased donor. It is regarded as the ideal treatment for eligible patients due to its long-term benefits.
The advantages of a kidney transplant include an improved quality of life with fewer dietary restrictions, lower long-term costs compared to dialysis, and a higher survival rate. However, there are also disadvantages, such as the need for a compatible donor match, the risk of organ rejection requiring lifelong immunosuppressive medications, and the surgical risks associated with the procedure, along with a lengthy recovery period.
Which choice is right for you?
Dialysis or transplant is determined by one’s health condition, age, and medical fitness. Even though dialysis provides immediate and fast treatment, a transplant provides a better long-term result. Patients are advised to meet a nephrologist to determine the best choice for their condition.
Importance of timely dialysis for kidney patients
Dr. Yogesh K. Chhabra, Director, Nephrology and Renal Transplant Medicine, Fortis Hospital (Shalimar Bagh), explains that when kidney function declines to a critical level, dialysis is needed to remove toxins and maintain body function. Haemodialysis, performed thrice weekly, filters blood externally, while peritoneal dialysis allows fluid exchange at home. Delaying dialysis leads to toxin buildup, causing nausea, confusion, and even death. Electrolyte imbalances can trigger sudden fatalities. Timely dialysis prevents complications like heart disease and stroke, ensuring better health and quality of life. It serves as a bridge to renal transplant and stabilises the body’s internal environment.
Transplant: Preferred choice for stage 5 CKD patients
Dr Sanjeev Gulati, Principal Director Nephrology and Kidney Transplant at Fortis Hospital Vasant Kunj: In Stage 5 CKD, dialysis and kidney transplant are the only survival options. Social media claims of alternative treatments are unscientific. Kidney transplant surpasses dialysis in cost-effectiveness and long-term outcomes. Donations come from family or cadaveric donors. Dialysis has a 75% one-year survival rate, dropping to 20% at five years, with frequent hospitalizations. In contrast, kidney transplant boasts a 99% one-year survival, 95% kidney survival, and 95% patient survival at five years. It restores normalcy, enabling work, studies, and independence. A pre-emptive transplant, performed before dialysis, offers better outcomes and reduced costs, making it the preferred choice.
Link between alcohol consumption and kidney cancer
Dr. Mohit Khirbat, nephrologist at CK Birla Hospital highlights that excessive alcohol consumption harms kidney function by causing dehydration, oxidative stress, and inflammation, increasing the risk of kidney cancer. Alcohol disrupts fluid and electrolyte balance, leading to hypertension—a key factor in kidney disease. It also promotes obesity, insulin resistance, and chronic inflammation, further elevating cancer risk. Reducing alcohol intake, maintaining hydration, and adopting a balanced diet with regular exercise can help protect kidney health and lower the risk of complications. Proactive lifestyle choices play a crucial role in preventing alcohol-related kidney damage.
Hypertension and diabetes’ impact on kidney health
Dr. Mohit Khirbat, Consultant, Nephrology, CK Birla Hospital, Gurugram, warns that hypertension and diabetes silently damage kidneys, often without symptoms. High blood pressure strains kidney blood vessels, impairing waste filtration, while excess glucose from diabetes deteriorates kidney function. Together, they heighten the risk of chronic kidney disease (CKD) and kidney failure. Early detection, optimal blood pressure and sugar control, a kidney-friendly diet, and exercise are key preventive measures. Routine health check-ups enable timely intervention. Small lifestyle adjustments and proactive health management can significantly reduce the risk of kidney disease, ensuring long-term well-being.
Warning signs of & importance of regular checkups
Dr. Shailesh Kakade Consultant- Nephrologist, Jupiter Hospital, Pune: Kidneys filter waste from the blood, but when they malfunction, toxins accumulate, causing fatigue, weakness, and difficulty concentrating. This occurs due to reduced red blood cell production, leading to inadequate oxygen supply. Nearly 80% of kidney disease patients remain undiagnosed. Early detection is simple with:
Urine Albumin-Creatinine Ratio (uACR): Detects abnormal protein levels in urine, signaling kidney issues.
Estimated Glomerular Filtration Rate (eGFR): Assesses kidney function through blood creatinine levels.
Obesity & Kidney Disease: The Link & Prevention
Obesity raises the risk of diabetes and hypertension—leading causes of chronic kidney disease (CKD). Even without these conditions, excess weight accelerates CKD progression. Losing weight through a healthy diet, exercise, and lifestyle changes can help prevent or slow kidney damage.
Kidney Health for Diabetics
High blood sugar damages kidney blood vessels, impairing function. Many diabetics also develop hypertension, further increasing the risk. About one-third of diabetic adults have kidney disease. Since kidney damage occurs gradually, managing blood sugar, blood pressure, and maintaining a healthy lifestyle can prevent or delay its onset.
Healthy habits for healthy kidneys
Dr. Varun Verma, Associate Director, Nephrology, Max Super Speciality Hospital (Patparganj), emphasises that kidney health is affected by lifestyle choices. Obesity raises the risk of hypertension, diabetes, and kidney disease, making weight management crucial. Excessive salt and sugar intake contribute to hypertension and diabetes, impacting renal function. Smoking and alcohol damage the kidneys and increase disease risk. Dehydration leads to kidney stones and infections, while frequent painkiller use can cause kidney failure. Maintaining a healthy lifestyle—balanced diet, regular exercise, hydration, and avoiding harmful habits—ensures kidney well-being. Simple lifestyle changes can prevent kidney-related disorders and promote overall health.
