Q What is chronic kidney failure or End Stage Renal Disease (ESRD)?

A When the kidneys — producing urine to keep the blood clear of the waste products of the body — fail in their primary function, the products accumulate in the blood, giving rise to decreased urine output, and a marked rise in blood urea and serum creatinine. We call this chronic kidney failure.

Q What conditions give rise to chronic kidney failure?

A Certain important causes like hypertension, diabetes mellitus, chronic glomerulonephritis, kidney infection and some other medical disorders.

Q How do we treat ESRD?

A The cause must be treated. At first, the medical regimen is started — a low protein, low-fat and primarily carbohydrate diet with vitamins, then haemodialysis. The patient’s blood is passed through a machine which performs the kidney’s functions and removes waste products. If the blood urea and serum creatinine are still high (blood urea — 40 mgm; serum creatinine 1.4 mgm, kidney transplantation is undertaken.

Q What is kidney transplantation?

A It is a procedure by which one kidney, which has been tissue -matched and blood-group-matched from a human donor, whose either kidney is normal, is removed and transplanted in a patient. Both donor kidney harvesting and transplanting into the recipient are performed by two teams simultaneously at two different tables in the same operation theatre. Post-operatively, blood transfusion, antibiotics, pain-relievers and immunosuppressives are given. The patient is kept in the transplant ward; the medical and paramedical staff are fully masked. They wear sterile clothes.

Q What is the legal aspect of kidney transplantation?

A The Union Ministry of Health brought the Human Organ Transplant Act in 1994 to stop unethical organ-trading. The Organ Retrieving and Banking Organisation (ORBO) is a part of the Act. But now, as per the Act, if the brain is dead even if the heart continues to beat, the person is dead. Doctors, who are not involved in transplants, have to certify the brain dead stage.