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Chronic Kidney Disease

There was a young 29-year-old engineer from Kolkata who discovered us and dropped the message through the website. His creatinine level was increased from 3 to 8.2 in just a year. Moreover, he also had a covid-19 infection which eventually resulted in mild fibrosis in the lungs. When he contacted us, he was undergoing dialysis thrice a week.

The young engineer, Mr Saha, belongs to a decent, well-to-do family with Parents and a young sister. He was planning to get married to his committed girlfriend. Both were in a relationship right from their college days. The happy-to-go couple was full of dreams of marriage, a honeymoon, a new house, and doing something significant for the family.

All the dreams and plans started shattering when Mr Saha started showing the symptoms of kidney disease. The condition started worsening when the Covid-19 infection severely impacted him, and he needs to be hospitalised. There were complications, and he was shifted on oxygen support for ten days.

He eventually won the battle of Covid but with a mild impact on his lungs. There was happiness in the family after winning the fight with covid, but it didn’t last much. In the whole process, his creatinine level has increased from 3 to 8.2.

chronic kidney failure, chronic kidney failure treatment, chronic kidney failure treatment in india
Advanced Therapies for Chronic Kidney failure

Doctors recommended him for a kidney/renal transplant. Though, renal transplant is not a big challenge when you have a donor. His girlfriend was even willing to donate the organ for him. 

However, 29 years is too young an age for a kidney transplant. Even if Mr Saha has a donor today, what would happen if there were a repetitive need after 15-20 years. He might not even get the donor. So, deferring the transplant was best for him.    

MedicoExperts guided him to one of its empanelled stem cell experts who had earlier dealt with many CKD (chronic kidney disorder) cases and generated commendable results. 

He underwent four cycles of stem cell therapy along with supportive therapies.

His creatin levels reduced from 8.3 (at the time of admission) to 5.1 within ten days of discharge from the hospital. Moreover, the creatine levels reduced from 5.1 to 3 in the next six weeks.

At the time of writing this article, the couple is married. The frequency of health updates has reduced drastically. As per the last update, Mr Saha’s creatine level was 1.9. He is on regular kidney medication.

As per the treating stem cell expert, he would not require any significant treatment/procedure at least for ten years if he can manage his lifestyle.  

Let’s now move forward to understand what a kidney is and what its functions are.

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Kidney

What is Kidney, and what it does?

The kidneys are two reddish-brown bean-shaped organs on either side of your spine, below your ribs, and behind your belly. Typically, the size of the kidneys is about 4 or 5 inches long, which is roughly the size of your fist.

The Kidneys remove wastes, control the body’s fluid balance, and keep the correct levels of electrolytes (Electrolytes are minerals in your blood and other body fluids that carry an electric charge). 

One interesting fact, kidney’s filter the blood in your body about 40 times a day! More than 1 million tiny filters inside the kidneys remove the waste, and salt, water, and minerals are adjusted if needed. Then the filtered blood goes back into the body. 

Finally, the waste gets turned into the urine, which collects in the kidney’s pelvis, a funnel-shaped structure that drains down a tube called the ureter to the bladder.

If blood stops flowing into a kidney, tissues of the kidneys will get damaged, and part or all of it could die. That can lead to kidney failure.

what is kidney and its functions
chronic kidney disease

Chronic Kidney disease

What is Chronic Kidney disease?

Chronic kidney disease (CKD), also termed chronic kidney failure, involves a gradual loss of kidney function that filters wastes and excess fluids from your blood, which are then removed from your urine. The function of the kidneys slowly gets worse with time.

Advanced chronic kidney disease can build up dangerous levels of fluid, electrolytes, and wastes in your body. 

Let’s understand which are the stages of kidney failure.

What are the Stages of Chronic Kidney Disease?

Chronic kidney disease (CKD) refers to all five stages of kidney damage, from mild damage in stage 1 to complete kidney failure in stage 5. 

The stages of kidney disease are categorized depending upon how much extra fluid and waste the kidneys can filter out of the blood. 

In the early stages of kidney disease, your kidneys can still filter out waste from your blood. 

In the later stages, your kidneys must work harder to get rid of waste and may stop working completely.

Before we begin with the stages of chronic kidney disease, let’s first understand what eGFR is.

eGFR (Estimated Glomerular Filtration Rate) is the test to measure your level of kidney function and determine your stage of kidney disease. The value of eGFR is calculated by your blood creatinine test results, age, body size, and gender.

eGFR tells how much kidney function you have. A Kidney disease goes worse if GFR goes down.

stages of chronic kidney disease

If you have an eGFR of 90 or greater, which means you are in Stage 1 CKD and you have mild kidney damage.

Primarily, an eGFR of 90 or greater implies your kidneys are healthy and working well, but you have other signs of kidney damage. 

Some of the signs of kidney damage could be protein in your urine (pee) or physical damage to your kidneys. 

Ways that help you to slow down the kidneys damage in Stage 1 kidney disease are as following:

  • Control your blood sugar
  • Control your blood pressure
  • Eat a healthy diet
  • Don’t smoke
  • Be active 30 minutes a day, five days a week
  • Control your weight, Stay at a healthy weight, check your BMI on a regular interval of period
  • Meet a nephrologist (kidney doctor) on a priority basis. This is a time to move from general doctor to specialist.
  • Take medicines that your nephrologist prescribed which will help to protect your kidneys.

If you have an eGFR between 60 and 89, you have Stage 2 CKD, a mild kidney damage stage. Your kidneys are healthy and working well, but you have more signs of mild kidney damage.

Signs are similar to stage 1 signs, but the intensity is more.

Ways that help you to slow down the kidneys damage in Stage 2 kidney disease are as following:

  • Control your blood sugar
  • Control your blood pressure 
  • Eat a healthy diet 
  • Do not smoke
  • Be active 30 minutes a day, five days a week
  • Stay at a healthy weight
  • You should see a nephrologist even if you already have a general doctor.
  • Ask your doctor if there are medicines to protect your kidneys.

If you have an eGFR between 30 and 59, that means you have Stage 3 CKD, and there is some damage to your kidneys, and they are not working as well as they should. 

Stage 3 CKD is divided into two stages: 

  • Stage 3a: eGFR between 45 and 59
  • Stage 3b: eGFR between 30 and 44

In Stage 3 kidney disease, some people might not have any symptoms. In some people, there are symptoms like:

  • Swelling in hands and feet
  • Regular Back pain
  • Frequent or less Urination (peeing) than normal

In this stage, health complications start showing up as waste builds up in your body and your kidneys are not working well, such as:

  • High blood pressure
  • Anaemia (a condition in which red blood cells are deficient)
  • Bone related disease

Ways that help you to slow down the kidneys damage in Stage 3 kidney disease are as following:

  • Control your blood sugar
  • Control your blood pressure 
  • Do not smoke
  • Eat a healthy diet 
  • Be active 30 minutes a day, five days a week
  • Stay at a healthy weight

At stage 3, you have to visit a nephrologist (kidney doctor). After analysing your condition doctor will make a treatment plan that is right for you and tell you how often you will need to have your kidneys checked in.

Apart from consulting with a nephrologist, you should also meet with a dietitian, who will help you follow a healthy diet.

Also, regularly check your blood pressure and diabetes and get regular medicine. 

If you have an eGFR between 15 and 29, that means you have Stage 4 CKD. In this stage, your kidneys are moderately or severely damaged and are not working as they should. Stage 4 kidney disease is a serious condition – it is the last stage before kidney failure.

Many people have symptoms in stage 4 CKD such as:

  • Swelling in your hands and feet
  • Regular Back pain
  • Frequent or less Urination (peeing) than normal

At Stage 4, your health condition deteriorating further as waste builds up in your body and your kidneys are not working well, such as:

  • High blood pressure 
  • Anaemia  (a situation in which red blood cells are deficient)
  • Bone related disease

To keep kidney disease from getting worse at this stage, you should follow the below things.

  • You are having regular visits to a nephrologist, who will guide you and can advise you on the treatment plan that is most appropriate for you. The doctor will also suggest to you the frequency with which you need to have your kidneys examined.
  • Diet is important. Consult a dietitian, who will suggest a healthy diet plan. 
  • Nephrologists may also suggest specialised blood pressure medicines like ACE inhibitors and ARBs (Angiotensin Receptor Blockers) depending upon your vital parameters and comorbidities.

At Stage 4, kidney disease is a very crucial stage, do ask your nephrologist about how to prepare for kidney failure. Once your kidney function starts deteriorating beyond a point, a nephrologist will start dialysis, and high severity may also suggest a kidney transplant. 

  • Preparing for dialysis: Dialysis is a procedure to remove waste products and excess fluid from the blood, which helps clean your blood when your kidneys have to stop working correctly. There are several things to think about, such as the type of dialysis, plan your treatments and how it affects your life and daily activity. What is the thing you should avoid doing? What will happen when you delay your dialysis.
  • Preparing for a transplant: A kidney transplant is a surgical procedure in which a healthy kidney from a living or deceased donor is taken and placed into a person whose kidneys are no longer functional. Learn more about kidney transplants.

If you have an eGFR of less than 15, that means you have Stage 5 CKD. Your kidneys are getting very close to failure or have entirely failed. 

If your kidneys fail, waste builds up in your blood, your health day by day getting more deteriorating.

Symptoms of kidney failure were:

  • Itching
  • Muscle cramps
  • Feeling sick and throwing up
  • Not feeling hungry
  • Swelling in your hands and feet
  • Back pain
  • Frequent or less urination (peeing)
  • Getting trouble while breathing
  • Sleeplessness 
  • Anxiety 

Once your kidneys have failed, you have left two traditional treatment options, which your doctor will suggest.

  • Regular Dialysis
  • Kidney transplantation

causes

What are the causes of Kidney failure?

Diseases and conditions that cause chronic kidney disease (CKD) include:

  • Type 1 or type 2 diabetes
  • High blood pressure
  • Glomerulonephritis is an inflammation of the kidney's filtering units (glomeruli)
  • Interstitial nephritis, an inflammation of the kidney's tubules and surrounding structures
  • Polycystic kidney disease(PKD) or other inherited kidney diseases
  • Obstruction in the urinary tract for a very long time. It may result due to conditions such as enlarged prostate, kidney stones and in some cancer cases.
  • Vesicoureteral reflux is a condition that will cause urine to back up into your kidneys.
  • Pyelonephritis is a recurrent kidney infection.
causes of kidney disease

Signs and symptoms

Signs and symptoms of kidney failure

Some of the signs and symptoms of kidney failure depending upon how severe the kidney’s condition is are as follows,

  • Nausea
  • Vomiting
  • Loss of appetite
  • Fatigue and weakness
  • Sleep problems
  • Urinating more or less
  • Decreased mental sharpness
  • Muscle cramps
  • Swelling of feet and ankles
  • Dry, itchy skin
  • High blood pressure (hypertension)
  • Shortness of breath, if fluid is accumulating in the lungs
  • Chest pain, if fluid start surrounding the lining of the heart

Diagnosis

Diagnosis and Tests for Chronic Kidney Disease

A urinalysis is a test of your urine that is used to detect and manage a wide range of disorders, such as urinary tract infections, diabetes, inflammation, microscopic bleeding, and kidney damage.

A kidney ultrasound is a painless, non-invasive diagnostic exam that produces images, which are used to assess the size, shape, and location of the kidneys. It is performed to detect blockages in urine flow, stones, cysts, or suspicious masses in the kidneys.

A computerized tomography (CT) scan combines a series of X-ray images taken from different angles, creating detailed images of the kidneys.

Magnetic Resonance Imaging (MRI) is a non-invasive imaging technology that creates three-dimensional detailed anatomical images of the kidneys. This test is used to detect tumours in the kidneys.

In this test, blood cultures are used to detect bacteria or fungi in the blood. After infection gets detected, cultures of the blood and urine may identify which bacteria are responsible for it. According to it, target antibiotic therapy will be done.

It is a minimally invasive method to treat kidney stones as well as stones located in the ureter. In this, an endoscope (which is a flexible tube with a camera on its end) is passed through the urethra into the bladder and ureters. It helps treat conditions that also affect the ureters.

A kidney biopsy is a procedure that involves taking a small piece of kidney tissue for examination with a special microscope. The sample may be taken in one of two ways, such as 1. Percutaneous (through the skin) biopsy, 2. Open biopsy(during surgery)

Conventional treatment for Kidney Failure in India

In traditional treatment, the doctor will control the signs and symptoms which is caused by kidney disease, reduce complications, and prescribe you the medication which slows the progression of the disease. If your kidneys become severely damaged, you might need dialysis and transplantation.

The doctor will control your kidney disease complications to make you more comfortable. Treatments might include:

  • High blood pressure medications
  • Medications to relieve swelling
  • Medications to treat anaemia
  • Medicines to lower cholesterol levels
  • Medications to protect your bones
  • A lower protein diet to minimise waste products in your blood

If your kidneys function has deteriorated, i.e. Kidneys can’t do waste and fluid clearance on their own, which is actually an indication that you develop complete or near-complete kidney failure, and you have end-stage kidney disease. At that point, you need dialysis or a kidney transplant.

Dialysis artificially performs the functionality of the kidney and removes waste products and extra fluid from your blood. This is required when your kidneys can no longer do this function. In hemodialysis, a machine filters waste and remove excess fluids from your blood.

In peritoneal dialysis, a thin tube inserted into your abdomen fills your abdominal cavity with a dialysis solution that absorbs waste and excess fluids. After a time, the dialysis solution drains from your body, carrying the waste with it.

A kidney transplant involves surgically placing a healthy kidney from a donor into your body. Transplanted kidneys can come from deceased or living donors.

After a transplant, you’ll need to take medications for the rest of your life to keep your body from rejecting the new organ. You don’t need to be on dialysis to have a kidney transplant.

Alternative and Advanced Therapies for Chronic Kidney Failure in India

If you don’t have a donor for the transplant and got the disease in the early stages of life, does that mean you need to live the rest of the life waiting for the worst?

The answer and the good news is NO. There are other options available to you. However, you need to be smart enough to choose the right one depending upon the stage of disease, your age and the availability of donors in the long run.

Ayurveda Medicine for chronic kidney disease

Ayurvedic medication is in the category of alternative therapies and has its pros and cons.

Ayurveda is a centuries-old science that works on the fundamentals of root cause analysis and correction. These medications are herbal and very often recommended in parallel to lifestyle changes and management. 

These medications do work and give sustainable results, but the outcomes are slow. Since these medications are focused on correcting the root cause, the derived effects of the corrections typically take time to show the visible impacts on disease and its symptoms.  You should not expect immediate symptom suppressant effects from these medications.

The best time to have these Ayurvedic medications is when the CKD is in the early stages. If you start the Ayurvedic Medication in stages 1 and 2 of the disease and show patience and commitment towards suggested lifestyle changes, you can even permanently come out of the disease.

The Ayurvedic Medications can go hand in hand with the allopathic medicines and gradually the doses of Allopathic medications (with medicine having effects opposite to the symptoms) will start reducing. Since these medications are herbal and natural in nature they typically have near-zero side effects. 

One more very important point. You must keep your regular doctor informed that you are also having ayurvedic medication along with Allopathic medicines. He should be aware and understand the improvements and start reducing the dosages of the allopathy medicines. However, this step will be tricky as some allopathic doctors will say we don’t understand allopathy, and hence we don’t recommend ayurvedic medication. If this is the case you also encounter, you need to search for an allopathic doctor who understands both the words of medicine and is willing to take you to a permanent cure by correcting the root causes.

We mentioned earlier that ayurvedic medication is the best when the disease is in its early stages. Does that mean Ayurvedic is not an option for you in the advanced stages of the disease? The answer is yes, but you should expect more to slow down the progression of the disease rather than complete correction. 

If your disease is at the end stage, perhaps you are too late for Ayurvedic medications as they need time to show their outcomes. However, it doesn’t mean that you don’t have any other option besides the kidney transplant.

Let’s understand the other option which is more appropriate for advanced stages and end stages of the disease.

stem cell therapy for chronic kidney disease

Stem cell therapies are in advanced treatment categories, and the research on stem cell therapies and their applicabilities in different diseases is continuously going on. 

Stem cell therapy works on the fact that stem cells are the basic building blocks of the body and they do have capabilities to convert them into specific cells.

If you’re new to stem cell therapies, please do visit the page what are stem cells.

Stem Cells, based on their basic fundamental characteristics, have the capability to reverse the disease.  In stem cell therapies, the stem cells are extracted from your body and then processed and multiplied in sophisticated stem cell labs and reinjected in the impacted part of the body. The stem cells regenerate themselves and start converting into specific cells and tissues that the deteriorating body badly needs.  The new cells then start fighting the disease, and as the severity of the disease decreases, the creatine level starts decreasing.

These Stem cell therapies are often clubbed with oxygen and ozone therapies to stimulate the newly injected stem cells for better and quicker results. In some cases, stem cell experts may recommend using embryonic stem cells for the treatment. However, stem cell experts give priority to the autologous ( your own) adult stem cells.  

If you have advanced staged disease and don’t have the donors or you even if you have the donor and you don’t want to exhaust the option due to any reason like your and donor age, exact match of organ or any other reason, You should thoroughly evaluate the stem cell therapy for CKD.

The stem cell therapy would defer the need for transplant for 5 to 10 years, depending upon the stage of the disease.

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stem cell procedure for kidney disease

Procedure

Procedure for stem cell therapy for chronic kidney diseases in India

Stem cells are extracted from bone marrow through an injection using local anaesthesia. The extracted bone marrow is then processed in the Stem cells lab where the stem cells are segregated from other tissues and further multiplied in the lab environment.

After that, the  Stem cells are injected back into the body through the Intravenous route. The stem cells reach the organ that needs stem cells badly and start converting themselves into the cells of desired functionality. These new cells start the healing process of the organ.  

There might be multiple cycles of stem cell therapies based on the severity of the disease and other factors like comorbidities, age and current symptoms of the patient.

The stem cells are often supported by oxygen therapy and ozone therapies to stimulate the recovery process.

Stem cell prerequisite for chronic kidney disease treatment in India

In most cases, if the patient has only Kidney diseases and the kidney has not shrunk drastically, Stem cell experts are willing to take cases and can give good results.

If the patient is having cardiac complications or onco complications or high levels of hypertension and diabetes, Stem cell experts would typically like to evaluate first and then give the treatment plan and expected results accordingly.

Treatment cost

Treatment cost of Stem cell therapy for kidney failure in India

The patients suffering from chronic kidney disease no longer need to undergo a transplant, but it can be reversed with advanced treatment for kidney failure. With the Kidney’s failure in purifying the fluids, the fluids get collected in the body and begin affecting entire body functionality and lead to swelling in the legs. In due time, the whole body swells up.

The cost of stem cell therapy in India starts from 80,000 to 150,000 Rs. for one cycle.

The number of cycles depends upon the patient’s condition, the treating doctor, and the protocol followed. 

The number of days for kidney failure treatment varies between 10-15 days. In certain cases, depending on the suggested treatment, the treatment can continue up to 15 to 30 days.

The cost of stem cell therapy to reverse kidney failure in India is relatively low in comparison to the cost of treatment in developed countries. However, the hospital’s medical facilities are of the highest quality, meeting international medical standards and using cutting-edge technology.

Success rates of stem cell therapy for chronic kidney disease (CKD) in India

80% of the patients are able to see the promised results. The results of the treatment from stem cell therapy varies from person to person depending upon many factors including severity, age of the patient, protocol of the therapy, supporting therapies etc.

The treating doctor explains to you the expected outcomes after examining your reports. This discussion with the patient or family member on outcomes happens mandatorily before the treatment so that you can make informed decisions.

Frequently Asked Questions and patient concerns:

1. How long can you live with kidney failure?

With dialysis life expectation is not more than 7 to 8 years. With a Kidney transplant, life expectation is 12 to 15 Years.

2. What are the best treatment options for kidney failure?

The first thing is medical management, secondly dialysis and then a kidney transplant. Stemcell Therapy is the advanced option for kidney failure.

3. What are the symptoms of kidney failure?

Symptoms vary and can be general or absent altogether but some of the symptoms are Decreased urine output, although occasionally urine output remains normal, fluid retention, causing swelling in your legs, ankles or feet.

4. What we don't provide.

We do not provide kidneys for kidney transplants.

5. Can failed kidneys be cured?

When your kidneys fail, it means they have stopped working well enough for you to survive without treatment. But, many people live long lives after alternative therapy.

6. What stage of kidney failure requires dialysis?

You need dialysis when you develop end-stage kidney failure, usually by the time you lose about 85 to 90 per cent of your kidney function and have a GFR of <15

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