Facts about Heart and kidney, How are they connected? | دل اور گردے کیسے...

ہماری ہڈیوں کو کیسے مضبوط بنایا جائے۔ |How to Make Our Bone Strong

How to Ensure kidney Health? 6 Important Jobs of our Kidneys.

 

میرا نام انڈس ہسپتال اور ہیلتھ نیٹ ورک کراچی میں ڈاکٹر شوکت میمن کنسلٹنٹ نیفرولوجسٹ ہو۔ ااس ویڈیوhttps://youtu.be/p-dQjhwb38o میں ہم ایک ایک کر کے عام سوالوں پر بات کریں گے یعنی ہمارے گردے کے کام کیا ہیں، گردوں کی صحت کیسے جانیں اور عام طور پر گردوں کے خون کے ٹیسٹ کیا ہوتے ہیں، کیا پانی کے استعمال اور گردے کی صحت کا کوئی تعلق ہے اور اگر گردے ناکام ہو جائیں، کیا پوری زندگی ڈائیلاسز پر رہنے کا مطلب ہے؟۔ ہمیں کوسٹل مارجن بیک سائیڈ سے نیچے دو گردے دیے گئے ہیں جو خون کو مسلسل فلٹر کرتے ہیں اور جسم میں پیدا ہونے والی فاضل اشیاء سے چھٹکارا پاتے ہیں۔ خون کے ٹیسٹ جو ڈاکٹر گردے کی بیماری کو جاننے کے لیے مشورہ دیتے ہیں وہ یوریا اور کریٹینائن ہیں۔ گردوں کا دوسرا کام جسم میں جمع ہونے والے ضرورت سے زیادہ سیال کو نکالنا ہے۔ تیسرا کام جسم میں الیکٹرولائٹس (کیلشیم، فاسفورس، سوڈیم، پوٹاشیم وغیرہ) کا توازن برقرار رکھنا ہے۔ گردے بلڈ پریشر کو کنٹرول میں رکھتے ہیں۔ گردے ہیموگلوبن کو برقرار رکھتے ہیں ہارمون اریتھروپائٹین کو جاری کرکے ہڈیوں کی صحت کو یقینی بنانے کے لیے، گردے وٹامن ڈی کو فعال کرتے ہیں۔ آئیے اب بات کرتے ہیں کہ اپنے گردے کی صحت کو کیسے جانیں۔ اگر ہم ذیابیطس، ہائی بلڈ پریشر، جھاگ دار پیشاب، گردے کی پتھری کے مرض میں مبتلا نہیں ہیں اور خود کو صحت مند محسوس کرتے ہیں تو ہمارے گردوں کی بیماری میں مبتلا ہونے کے امکانات کم ہیں۔ اس کے علاوہ، کڈنی کے معالج کی طرف سے جو ٹیسٹ اکثر تجویز کیے جاتے ہیں وہ ہیں: یوریا، کریٹینائن، پیشاب کی تفصیلی رپورٹ اور گردے کا الٹراساؤنڈ۔ ہم پانی کی مقدار کو درست نہیں کر سکتے کیونکہ یہ کسی کی جسمانی سرگرمی اور ماحولیاتی درجہ حرارت پر منحصر ہے۔ اہم بات یہ ہے کہ پیاس کی پکار کو نظر انداز نہ کیا جائے۔ پیشاب کے رنگ کو دیکھ کر کوئی شخص اپنے جسم کی ہائیڈریشن کی کیفیت کو جان سکتا ہے۔ اگر توجہ مرکوز ہے، یا گہرا پیلا ہے تو پانی کی کمی کی تجویز کرتا ہے، اور تھوڑا سا پیلے رنگ کی سفیدی اچھی ہائیڈریشن کی تجویز کرتی ہے۔ گردے کی خرابی دو طرح کی ہوتی ہے: ایک شدید گردے کی ناکامی اور دوسری دائمی گردے کی ناکامی۔ شدید گردے کی ناکامی میں، عارضی طور پر ڈائیلاسز کی ضرورت پڑسکتی ہے جبکہ دائمی گردے کی بیماری کی صورت میں اگر گردوں کی ناکامی اسٹیج 5 تک پہنچ جائے جو کہ آخری اسٹیج ہے اور اس کے بعد کسی کو گردے کی تبدیلی کی تھراپی یعنی ڈائیلاسز کی ضرورت ہوتی ہے Asalamalaikum My Name is Dr Shoukat Memon consultant Nephrologist at Indus Hospital and Health Network Karachi. In this video ( https://youtu.be/p-dQjhwb38o), we will discuss one by one common questions i.e what are the functions of our kidneys, How to know the health of our kidneys, and what is commonly prescribed blood tests of kidneys, Is there any connection between water intake and kidney health and if kidney get failed, does it means to remain on the support of dialysis for your whole life? We have been given two kidneys below the costal margin back side which constantly filter blood and get rid of waste products produced in the body. Blood tests that doctors advise to know kidney disease are urea and creatinine. The second job of kidneys is to remove the excessive fluid accumulating in the body. The third job is to maintain the balance of electrolytes (Calcium, phosphorus, Sodium, Potassium, etc.) in the body. Kidneys keep blood pressure under control. Kidneys maintain hemoglobin by releasing the hormone erythropoietin. Kidney failure is of two types: one is acute kidney failure and the other is chronic kidney failure. In acute kidney failure, dialysis may be needed temporarily while in the case of chronic kidney disease if renal failure reaches stage 5 which is the last stage and beyond which one needs kidney replacement therapy i.e. dialysis. To ensure bone health, kidneys activate vitamin D. Now let us talk about how to know our kidney health. If we are not suffering from diabetes, The important is that one should not ignore the call of thirst. One can know the hydration status of his/her body by observing the color of urine; if is concentrated, or dark yellow then suggests dehydration, and the whitish of bit yellow suggests good hydration. hypertension, frothy urine, kidney stone, and feeling healthy then there is minimal chance we are suffering from kidney disease. Other than this, the tests which are often recommended by kidney physicians are urea, creatinine, urine detail report, and ultrasound kidneys. we can not fix the healthy amount of water intake as this depends upon one's physical activity and environmental temperature

Metabolic Acidosis Made Easy

 Hello, This is dr Shoukat Memon, working as a consultant Nephrologist in the Indus Hospital and Health Network Karachi.

Email: drshoukatmemon@gamail.com We will discuss following: I have highlighted the following areas in discussion in this video: 1. What is AG, how is it calculated, and its significance? 2. Seeing Anion Gap from a different angle. It is an increase in Anions or a decrease in Cations that both give rise to raised AG. 3. Unmeasured Cations when subtracted from Unmeasured Anions give as same gap. 4. Reviewing the range of AG from a study done on thousands of patients. The currently commonly used range of AG is 8 to 12. 5. Metabolic acidosis with rasied AG and Normal AG. 6. How to Get Corrected Anion Gap. Under normal circumstances, the body is based on neutrality which means whatever number of Aations are there, they are balanced with Anions. Examples of Cations: Na, K, Ca, Mg, Globulin; And Anions: Cl, HCO3, Albumin, So4, Po4 For the sack of understanding to manage patients, Anion Gap (AG) has been devised arbitrarily by Substracting sodium ions minus Cloride+Bicarbonate In other words, we can say, Anion Gap is the Unmeasured Anions minus unmeasured cations. Typically AG value has been set as 8 - 12. When we find raised AG, It suggests some unknown anions have been accumulated. To see this from a different angle, we can say either increase in unmeasured anions or a decrease in unmeasured cations, both can give rise to raised AG. Now from a practical perspective, if we take the example of Renal/Kidney Failure, we find raised AG and that is because of the accumulation of sulfate and phosphate anions. In uncomplicated or simple acid base disorder , we find same amount of accumulated (anions which is raised above 12 ) is the decrease in Bicarbonate from 24. For example if anion is increased 8 from cut-off 12 (AG:20) , Bicarbonate would be 16 (24 - 8). In condition where we find normal AG metabolic acidosis i.e. Diarrhea, Renal tubular acidosis. In these condition decrease in bicarbonate is compensated by accumulation of chloride anions and this keep the AG unchanged but metabolic acidosis is there. We need to see AG always in the setting of serum albumin value as we know AG is mainly contributed by serum albumin. If we find serum serum albumin 1 lower than 4 (s.albumin 3 mg/dl) then we need to add 2.5 in calculated AG of that particular patient.

Proteinurea

 

Asalam-Alaikum My name is dr Shoukat Memon and I am working as a consultant Nephrologist in this Indus Hospital and Health Network Karachi. Today we are going to discuss Proteinuria which means protein in urine. Many people ask the question that Is it normal to have protein in urine? And if this is not normal then how much worrisome it is? does it run in the family? What are the symptoms of this disease? We are going to answer (discuss) all of these questions. Normally a person can produce protein in urine up to the level of 150 mg in a day which includes albumin protein along with other proteins. Once this exceeds 150 mg in 24 hour period the doctor tells you this is not normal and condition known as Proteinuria. If protein in urine is more than 150 mg but less than 1 gram ( or 1000 mg) then it is not as worrisome as we find more than 1 gm in some of the people and usually 2gm or more than 2gm where the doctor (nephrologist) often advise kidney biopsy. Kidney/renal biopsy is a procedure in which the patient is supposed to lie down on the abdomen and the doctor inserts an injection after anesthetizing the back (kidney area). This is done under the guidance of an ultrasound machine in which the doctor keeps looking patient’s kidney in real time while doing a kidney biopsy. The kidney tissue which is removed in this procedure is hair-likeand generally, this procedure is very safe and rarely complication occurs. This condition of significant proteinuria (usually equal to 3 gm in 24 hour period) is also called Nephrotic syndrome. Regarding the manifestation of this disease, patient notices froth in urine, swelling in legs and feet which produce dip on pressure and there is periorbital puffiness around the eyes especially when patient wakes up in the morning. Swelling of body may be seen in other condition too but here we are talking about swelling related to an inflammation of natural filters (glomeruli). If proteinuria is associated with diabetes then kidney biopsy and other medicine are not useful and only the needful is to maintain blood sugar and blood pressures targets as follows: Fasting Blood Sugar <150 mg/dl Random Blood Sugar <200 mg/dl HBA1C <7.5% BP <140/90 mmHg Then if a kidney biopsy is done and certain medicines are advised i.e. deltacortil and anotherconditions immunosuppressive in those patients who are not suffering from diabetic kidney disease and proteinuria is significant with or without renal function (serum creatinine) derangement. The question is often asked how worrisome this disease is? the answer is yes if proteinuria is significant then it may take some time and roughly it responds in 2/3 of cases and the rest of the people may lead to end-stage renal disease which means they would survive on dialysis therapy. Other questions often asked by nephrologists are whether these diseases run in families? The answer is not many; very few run in the family; one of them is familial FSGS, some cystic diseases, etc. The final and take-home message is that one should discuss with the doctor regarding proteinuria if someone is suffering. Discuss with the doctor how much protein is leaking and let the doctor do some more tests and discuss treatment options so that a rational approach can be devised. Thank you very much and take care.