What steps are important for preventing kidney failure?
The question sounded short, but to be honest the answer needs to be somewhat broader. That is because there are many kidney diseases. There are diseases of the kidney itself, and there are diseases located “before” the kidney — we call these prerenal — then renal diseases, and postrenal ones.
All of these are among the causes of kidney failure. As I said, kidney failure has a prerenal form. For example, high blood pressure, diabetes, or disease or narrowing of the vessels supplying the kidney — all of these belong to the prerenal form, and they are among the causes that can lead to kidney failure.
Or there are diseases in the kidney itself — glomerulonephritis, or collagenoses — which break down and damage the structure of the kidney, and as a result the kidney can no longer perform its function. And finally there is the postrenal form, which is considered the urological form. That is, there is some kind of obstruction in the pathways that drain the kidney.
Or if there is some other disease there, it counts as one of the urological causes. And in such cases, I would say, we can be of much greater help to patients from the urological side. Because this form is very often overlooked.
Even by some nephrologists. They examine and treat only the nephrological side, but they don’t check whether the patient has a stone that has blocked the duct, or an enlarged prostate that causes the bladder to fill up and leads to hydronephrosis, dilation of the kidney. All of these are postrenal, urological causes, and in such cases, if there is timely intervention, the patient will almost never develop kidney failure.
As I said earlier, diabetes or high blood pressure — if these are treated at an early stage and treated correctly, this too can help eliminate a cause of kidney failure. In the same way, stone disease, for example, which is counted among kidney diseases, is itself considered a urological disease, so if the stones are cleared and the kidney’s function improves from a urological standpoint, this can prevent kidney failure. And there is glomerulonephritis, for example, or there are collagenoses, which damage the function and tissue of the kidney.
In such cases, if the diagnosis is made correctly using the appropriate examination methods, even biopsy, a very complex treatment is applied, and we can be of great help to the patient. Although this is considered a nephrological treatment, unfortunately I have come across cases where nephrologists did not treat it correctly; the patients came to me, I took on the treatment, and it was completed successfully. In such cases hormone therapy is also used.
The treatment is long-term and requires some patience. In these cases, as I said, the form has to be differentiated: prerenal, renal or postrenal.
As for kidney diseases, there can also be masses in the kidney — benign masses and malignant masses. In these cases a definitive diagnosis can be made using modern methods: CT, MRI or ultrasound. It is even possible to find out whether a mass is really benign or not.
If it is malignant, surgical methods must be used. Another of the diseases that belong to kidney diseases is pyelonephritis. This is an inflammation of the pelvicalyceal system.
Here again there are chronic and acute forms, and the cause must be investigated, because it never happens without a cause. If it is treated in time, with a correct diagnosis, the progression of this disease to kidney failure can be completely prevented. I’ll say it again: in kidney diseases a specific examination method must be used. It must be known which examination is needed in which situation, and then, by applying the appropriate treatment for the patient, the disease can be stopped and its progression to kidney failure prevented.
The experiences described in this interview are not typical results: treatment outcomes differ from patient to patient and cannot be guaranteed in advance. Chronic diseases can take a long time to treat and require regular medical follow-up.
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