Keep your kidneys in ship shape

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On 26 Nov, 2023, Seniors Today hosted their weekly Health Live Webinar with Dr Jatin Kothari, Director Nephrology and Chief Consultant in Renal Transplant Medicine at Nanavati Max Super Speciality Hospital, Mumbai and he spoke on and answered questions about Kidney Care for Senior Citizens.

Dr Jatin Kothari is Director – Nephrology & Chief Consultant – Renal Transplant Medicine at Nanavati Max Super Speciality Hospital, Mumbai.

He is a DM in Nephrology and MD in Medicine from Bombay University following his MBBS also from Mumbai. He has done a Clinical fellowship in Nephrology and Transplantation from the University of Toronto. He is a Visiting ISPD Scientist at the  University of Missouri Health Sciences, Columbia, USA, an International Society of Nephrology Education Ambassador, he has done the ISN Global Outreach Programme, the International Transplant Observership at the Massachusetts General Hospital, Boston, USA, and the Roche Preceptorship in kidney transplantation, University of Alabama, Birmingham, USA. He has an ISN-ANIO Fellowship in Nephropathology and Preceptorship in Kidney Transplantation at the University of Toulouse in France.

Dr Kothari is  a former Joint Secretary of the Zonal Transplant Coordination Committee (ZTCC)-Maharashtra, India-2010-16, a Fellow of the International Society of Nephrology. He is a Postgraduate teacher for DNB Nephrology since 2006 at the Hinduja Hospital.

He has done a Transformational Leadership course for Healthcare Management from the International School of Business, Hyderabad and a Certificate course on Entrepreneurship in Emerging Economies – HarvardX (Online initiative of Harvard University). He is currently pursuing his PhD in Social entrepreneurship at the Tata Institute of Social Sciences (TISS), Mumbai.

Ageing affects kidney function, just as it does for the rest of our body. Causing reduction in the kidney function as a process of ageing.

Beyond the age of 40 years, has a drop in kidney function by 1% every year.

Thus, at the age of 80, you will only have 60% of the kidneys functioning for you. And because it is the normal dictum of life, if an 80 year old has 60% of kidney function, that individual is not labelled as someone with kidney disease.

You can get your kidney functions evaluated by undergoing certain simple investigations such as:

• Blood investigations- S. Creatinine
• Urine test/ Urinalysis- presence of protein/ its traces in your urine will need to be further evaluated to see if you have an underlying kidney disease which is not manifesting as signs and symptoms; and can thus help us in detecting the kidney disease early.

Diabetes Mellitus Type II and hypertension are two of the common causes for chronic kidney disease in the world.

Having both diabetes and hypertension simultaneously increases the risk of developing kidney disease by five fold. These individuals need to be more careful and get their kidneys evaluated for their function annually.

It is important for diabetic patients to understand that diabetic kidney disease is divided into 5 stages and the first 2 stages in diabetes in kidney disease- your kidney function might be absolutely normal. And the only way to pick up on kidney disease is through urinalysis as previously mentioned.

There is a specialised test called Urine Albumin:Creatinine- is advised to all diabetic patients- it helps diagnose early diabetic kidney disease. Because if diagnosed early, it can sometimes even be reversed and you can be free of diabetic kidney disease.

Occasionally, seniors have complaints such as difficulty to start the stream, difficulty in passing urine, inability to control urine, urinary retention, etc. all of these complaints predispose the elderly to frequent urinary tract infections. And it is more difficult to treat a UTI in the elderly population. This is because of 2 reasons:

1. In patients with poor urinary flow, it can lead to urinary retention further decreasing the renal function, thereby impacting the kidneys.
2. Most antibiotics used in the treatment and management of urinary tract infections, can lead to more side effects in elderly patients.

The elderly men should bear in their knowledge the fact that as they age, their prostate gland increases in size. The mere increase in the size of the prostate does not mean that you have cancer, it is benign/ age related enlargement of the prostate which can lead to urinary issues such as urinary urgency, increase in the frequency of passing urine. In such situations, regular check ups can help us detect the enlargement beforehand / early on.

You can also get a blood test which is called Prostate Specific Antigen (PSA), life elevated above the normal range, can help us detect any benign enlargement or infection in the prostate, and can therefore be appropriately treated.

Elderly men should keep a watch out for any urinary symptoms, if any symptoms are present, you should get yourself checked and evaluated by a urologist.

You can benefit 8-10 lives by donating your organs.

Organ donation can be done by:

1. Posthumous- the organs are donated when we die but we pledge our organs when we are alive. Make sure that you sign an organ donor card. You will also have to communicate your wish to your next of kin while you are alive.
2. While you’re alive. This can only be done for a few organs and only to your relative/ next of kin/ family. You cannot donate your organs to a stranger while you are alive. The only organs which fall under this category are the kidney and part of your liver.

There is no age cut off for organ donation.

Use of self medication in the elderly, without consulting a doctor due to apprehension of seeing one is common in the Senior population.

In the elderly, sometimes even the benign/over the counter medications can have severe side effects due to low muscle mass, lower kidney function, etc.

This especially applies to people who self medicate with antibiotics, antacids.