Frequently Asked Questions

Chronic Kidney Disease (CKD) is a progressive condition where the kidneys gradually lose their ability to filter waste from the blood. It is classified into five stages based on the Glomerular Filtration Rate (GFR): Stage 1 (GFR ≥90, kidney damage with normal function), Stage 2 (GFR 60–89, mild loss), Stage 3a/3b (GFR 30–59, moderate loss), Stage 4 (GFR 15–29, severe loss), and Stage 5 (GFR <15, kidney failure requiring dialysis or transplant).

In early stages (1–2), CKD progression can often be slowed or even partially reversed by controlling underlying causes such as diabetes, hypertension, and infections. However, once significant scarring (fibrosis) has occurred in stages 3–5, reversal is generally not possible. Early detection and aggressive management of risk factors are critical to preserving kidney function.

Early kidney disease is often called a “silent disease” because symptoms may not appear until significant damage has occurred. Warning signs include persistent fatigue, swelling in the ankles or face (oedema), foamy or bubbly urine, changes in urination frequency (especially at night), loss of appetite, and unexplained high blood pressure. If you notice any of these, consult a nephrologist promptly.

Adults with risk factors such as diabetes, hypertension, obesity, or a family history of kidney disease should get tested at least once a year with a serum creatinine (for eGFR) and urine albumin-to-creatinine ratio (UACR). Healthy individuals above 40 should consider annual screening as part of a general health check-up.

GFR (Glomerular Filtration Rate) estimates how much blood your kidneys filter per minute, measured in mL/min/1.73m². A normal GFR is above 90. Values between 60–89 indicate mild kidney impairment, 30–59 indicates moderate impairment, 15–29 is severe, and below 15 signals kidney failure. Your doctor uses GFR along with other markers to determine the stage of CKD and guide treatment.

Certain kidney diseases have a genetic component. Polycystic Kidney Disease (PKD), Alport syndrome, and some forms of glomerulonephritis can be inherited. Additionally, a family history of diabetes or hypertension increases your risk of developing CKD. If close relatives have kidney disease, early and regular screening is strongly recommended.

Patients with CKD should avoid or use with extreme caution: NSAIDs (ibuprofen, diclofenac), certain antibiotics (aminoglycosides), high-dose aspirin, some herbal supplements, and contrast dyes used in imaging. Always inform your doctor and pharmacist about your kidney condition before starting any new medication, including over-the-counter drugs and supplements.

Patients with end-stage renal disease (Stage 5 CKD) or those approaching it are potential candidates. Eligibility depends on overall health, absence of active infections or untreated cancers, adequate cardiac function, and psychosocial readiness. Both living-donor and deceased-donor transplants are options. A thorough evaluation by a transplant team determines suitability.

ABO-incompatible (ABOi) kidney transplant allows a patient to receive a kidney from a donor with a different blood group. This is achieved through desensitization protocols that remove or suppress the recipient’s antibodies against the donor’s blood type. Advanced centres use plasmapheresis, immunoadsorption, and targeted immunosuppression to make these transplants successful with outcomes comparable to compatible transplants.

A kidney from a living donor typically functions for 15–20 years, while a deceased-donor kidney lasts about 10–15 years on average. With strict medication adherence, regular follow-up, and a healthy lifestyle, many patients exceed these averages. Some transplanted kidneys have functioned well for over 30 years.

Most patients are hospitalized for 7–10 days post-transplant. Full recovery, including return to normal activities, usually takes 6–8 weeks. During the first 3 months, frequent clinic visits are needed to monitor graft function and adjust immunosuppressive medications. Most patients can resume work and moderate physical activity within 2–3 months.

Yes. Diabetes is one of the most common reasons for kidney failure, and diabetic patients are routinely considered for transplant. In fact, transplantation generally offers better long-term outcomes than remaining on dialysis for diabetic patients. A thorough cardiac evaluation is essential, and blood sugar must be well-controlled before and after surgery.

Daratumumab is a monoclonal antibody originally used in multiple myeloma that targets CD38-positive plasma cells — the cells that produce donor-specific antibodies. In highly sensitized patients who have high levels of pre-formed antibodies, Daratumumab-based desensitization can reduce these antibodies enough to allow a transplant. This is a cutting-edge protocol available at select advanced transplant centres.

Hemodialysis uses a machine to filter blood through an external dialyzer, typically performed 3 times per week at a dialysis centre or at home. Peritoneal dialysis uses the lining of the abdomen (peritoneum) as a natural filter — a special fluid is introduced into the abdominal cavity through a catheter, absorbs waste, and is then drained. Peritoneal dialysis can be done at home and offers more flexibility.

Yes. Both peritoneal dialysis (PD) and home hemodialysis (HHD) are established home-based options. Home dialysis offers greater scheduling flexibility, can improve quality of life, and in some cases provides better clinical outcomes. Patients and a caregiver receive thorough training before starting home dialysis, and the clinical team provides ongoing support.

A standard in-centre hemodialysis session lasts about 4 hours and is performed 3 times per week. Peritoneal dialysis exchanges take 30–40 minutes each, done 4–5 times daily (CAPD), or can be performed overnight by a machine (APD) over 8–10 hours while you sleep. Your nephrologist prescribes the optimal schedule based on your clinical needs.

Yes, with advance planning. Hemodialysis patients can arrange guest dialysis sessions at centres near their travel destination — most cities in India and abroad have facilities that accept visiting patients. Peritoneal dialysis patients have even more flexibility since they can carry supplies. Inform your nephrologist well in advance so arrangements can be made.

Dialysis is typically initiated when GFR drops below 10–15 mL/min or when symptoms of uraemia (nausea, fluid overload, severe fatigue, cognitive changes) become significant and cannot be managed conservatively. The decision is individualized — some patients benefit from starting earlier, while others may defer safely under close nephrological supervision.

CKD patients should generally limit high-sodium foods (pickles, processed foods, papad), high-potassium foods (bananas, oranges, coconut water, potatoes), high-phosphorus foods (dairy, colas, processed meats), and excessive protein. The specific restrictions depend on your CKD stage, lab values, and whether you are on dialysis. A renal dietitian can create a personalised meal plan.

Fluid intake for CKD patients is highly individualised. In early CKD (stages 1–3), adequate hydration (typically 1.5–2 litres per day) is usually recommended. In advanced CKD and dialysis patients, fluid may need to be restricted based on urine output and fluid retention. Your nephrologist will advise the right amount based on your specific condition.

A moderate protein restriction (0.6–0.8 g/kg/day) is often recommended for CKD stages 3–5 (pre-dialysis) to reduce the workload on the kidneys and slow progression. Once on dialysis, protein requirements actually increase (1.0–1.2 g/kg/day) to compensate for losses during the dialysis process. The key is quality protein — lean meats, egg whites, and plant-based sources.

High-potassium foods include bananas, oranges, coconut water, tomatoes, potatoes, spinach, dates, dried fruits, nuts, and chocolate. Elevated potassium (hyperkalemia) can cause dangerous heart rhythm abnormalities. Cooking techniques like leaching (soaking cut vegetables in water) can reduce potassium content. Your renal dietitian will guide you on safe portion sizes.

Yes, in controlled portions. Lean chicken, fish, and egg whites are good-quality protein sources for kidney patients. Red meat should be limited as it is higher in phosphorus and saturated fat. The quantity depends on your CKD stage and whether you are on dialysis. Your nephrologist and dietitian will specify the right amount for your condition.

Persistently foamy or frothy urine often indicates proteinuria — the presence of excess protein (especially albumin) in the urine. This is one of the earliest signs of kidney damage and can be caused by conditions like diabetic nephropathy, glomerulonephritis, or hypertensive kidney disease. If you notice consistent foam in your urine, get a urine albumin test promptly.

Swelling (oedema) in the legs, ankles, and feet is common in kidney disease because the kidneys cannot remove excess fluid and sodium effectively. It can also result from protein loss in urine (nephrotic syndrome) causing low blood albumin levels. Persistent swelling warrants a kidney function test, urine examination, and consultation with a nephrologist.

Key blood tests include serum creatinine (used to calculate eGFR), blood urea nitrogen (BUN), serum electrolytes (sodium, potassium, calcium, phosphorus), haemoglobin, and parathyroid hormone (PTH). Urine tests — specifically the urine albumin-to-creatinine ratio (UACR) and routine urine analysis — are equally important. Together, these provide a comprehensive picture of kidney health.

Proteinuria refers to abnormal amounts of protein leaking into the urine, typically more than 150 mg per day. It is a significant marker of kidney damage and an independent risk factor for CKD progression and cardiovascular disease. Treatment focuses on the underlying cause and often includes ACE inhibitors or ARBs, blood pressure control, and in some cases, SGLT2 inhibitors.

Most major health insurance plans in India cover kidney transplant surgery, including pre-transplant evaluation, the surgery itself, post-operative care, and initial immunosuppressive medications. Coverage varies by insurer and plan — some may have waiting periods or sub-limits. Government schemes like Ayushman Bharat and state-level health schemes also provide transplant coverage at empanelled hospitals.

In Delhi NCR, a kidney transplant typically costs between ₹5–8 lakhs in government hospitals and ₹10–20 lakhs in private hospitals, depending on the complexity of the case, donor evaluation, and post-operative care. ABO-incompatible or highly sensitized transplants may cost more due to desensitization protocols. Lifelong immunosuppressive medication adds approximately ₹8,000–15,000 per month.

Yes. Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (PM-JAY) covers both hemodialysis and peritoneal dialysis at empanelled government and private hospitals. Eligible beneficiaries can receive dialysis at no cost under the scheme. Coverage includes the dialysis procedure, consumables, and associated medications during the session. Check your eligibility at pmjay.gov.in or at your nearest empanelled hospital.