World Kidney Day 2010

• Better Kidneys for Better Health !

Dr R K GopalaKrishna

Fortis Hospitals and Kidney Institute

Kolkata

Kidney : An Amazing Organ

• A kidney is the size of a computer mouse or the human fist

Kidney: An Amazing Filter !

• Unique blood purifier : filters, reabsorbs and secretes

• 1 million nephrons in each kidney• Entire blood volume of 5 litres in our body

circulates thru kidneys every 4 minutes• 180 litres body water filters out thru the

nephrons• Almost all of this is reabsorbed, and only 2

litres passes out as urine !

Myths/Misconceptions

• Myth 1: Only one kidney works at a time !• Reality : They always work together

• Myth 2: People with a single kidney cannot take up strenuous work and should restrict their diet

• Reality : They are as fit as anyone else !If renal function is normal ,they eat

normally

• Myth 3 : Kidney failure means that they have stopped working completely

• Reality: Even with a 20% kidney function, dialysis may not be necessary

• Myth 4: with dialysis or after kidney transplant, life becomes highly restrained

• Reality: Normal life is quite possible !

• Myth 5: Kidney cancer means ‘ end of the road ’

• Reality: Kidney cancer is curable !

Kidney cancer

Statistics

• Kidney cancer is the most lethal of urinary cancers

• Childhood kidney cancer is different from adult kidney cancer

• Children affected are usually before 4 yrs • Adult onset maximum between 50-70 yrs

Statistics

• Men > women• Incidence in India : 4 per 1lakh populatio• in USA : 8.7 per 1lakh populatio• 4% have family history

• 40% mortality for advanced kidney cancer

Risk factors for kidney cancer

• Smoking• Obesity • Workplace exposure to asbestos,benzene• High blood pressure• Dialysis patients• Genetic factors like VHL gene• Family history

How do I detect early kidney cancer ??

• Periodic health check up with ultrasonogram• Positive family history• Do not ignore back/ abdominal pains which

does nt go away• Any blood in urine• Persisting ill health,anaemia, wt. loss

Advantages of early detection in kidney cancer

• The cancer is curable• Only the tumor may be removed if small,

preserving rest of the kidney• This is called ‘nephron sparing surgery’• Very suitable in patients with single kidney or

in patients with low overall kidney function

Illustration of kidney preserving cancer surgery

• 52 yr old ENT surgeon went for health check for diabetes

• U/S showed 4 cm kidney tumor , confirmed on CT scan

• Had partial nephrectomy done • Postoperative CT scan at 3 months shows

nearly 70% preservation of kidney with normal function

4cm tumor

Kidney After operation

Can we prevent kidney cancer

• Difficult – as cause is often not known• Avoid risk factors – smoking, obesity, high

blood pressure, environmental pollutants, • Diet – high fruit and fibre

Whats new in Kidney cancer therapy

• Nephron sparing surgery – for early cancer• Laparoscopic nephrectomy- removal of kidney

tumor by key hole surgery• Cryosurgery for small tumors• Medications- targeted therapy

autologous vaccines

Questions

Thank You