Dialysis Treatment: Ways He Delayed Dialysis

Dr. Sanjeev Gulati is the Director of Nephrology and Kidney Transplant at Fortis Group of hospitals in NCR Delhi. In his 30 years of experience, he was frequently asked this one question how to lessen or maintain creatinine level? Which he considers being a very valid question(i,e Ways He Delayed Dialysis). 

What is urea creatinine? 

• First, he explained what creatinine is and how it is produced in our bodies.  
• Tracing back to your biology days, there are four main food components. 
• Protein, carbohydrates, fat and vitamins and minerals. 

Dr. Sanjeev explained that when protein enters the body, its metabolism takes place in the liver, which results in the production of urea and creatinine. They go to the kidney through the blood, where urea, creatinine, and water are filtered out. The kidney filters filter out urea and creatinine and retain the vitamins and minerals. This way, the kidney plays a vital role in removing urea and creatinine from the body, which implies that any kidney damage may increase urea and creatinine in the body. 

What can we do to reduce urea and creatinine in the body?

The best way to control the creatinine level is to save your kidney from damage. Dr. Sanjeev Gulati listed the three primary reasons for kidney damage.

1) Diabetes

Dr. Sanjeev was in PGI and published research in 2002, which stated that diabetes is the number one cause of kidney damage. At that time, diabetes was considered the disease of the rich or associated with the developed nation. But later studies from PGI, All India Institue Delhi, from the south confirmed that diabetes is a significant cause of kidney damage. 

Dr. Sanjeev further explained that one must keep his/her sugar level in check to reduce creatinine as inflation in sugar level blocks the kidney’s filters and weakens the filtration capacity. This way, less creatinine is excreted in the urine and eventually mixed in the blood, increasing creatinine in the body. 

2) Blood Pressure 

B.P. is a significant cause of chronic kidney diseases or kidney damage. According to Dr. Sanjeev, high blood pressure in people who already suffer from kidney diseases can increase the level o urea and creatinine in the blood five times faster than usual. 

So he suggested maintaining your blood pressure to control urea and creatinine. For a patient 120-130 or 140-150, systolic is high blood pressure. Controlling B.P. can help reduce the urea and creatinine in the blood. 

3) Protein Leakage

According to Dr. Sanjeev, kidney diseases’ core cause is protein leakage. The more the protein leakage, the faster is the rate of kidney damage. Now the question arises, how to control protein leakage? To answer this, Dr. Sanjeev suggests taking Angiotensin receptor Blockers, which you can get a prescription from the kidney doctor you visit. He also said that the doctor would later prescribe medicines to control your Blood pressure and your protein leakage. The best way to reduce creatinine in the blood is to take these prescribed medicines to slow the progression by 10times.

“Middle path is the best path.” quoting Gautam Buddha, Dr. Sanjeev highlighted the importance of a balanced diet. He also said that most of the misconceptions about kidney diseases ar3e about diet. He also requests people to not completely cut off protein intake under the pretext that no protein intake means no protein leakage and eventually no lesser creatinine in the blood. He firmly states not to do this as your body requires a certain amount of protein as it is a defence mechanism and helps boost immunity and repairs damaged tissues alongside. So cutting out protein sources from your diet will temporarily reduce urea and creatinine, but it results in weakness and low immunity and increases the chances of infections. And once the patient is infected, it puts pressure on the kidney and speeds up the damage; if the life of the damaged kidney were 5-6 years now, it would fail in mere six months. 

So now what should be done? Answering this, Dr. Sanjeev pointed out the non-vegetarian or western diet, where the patient eats meat, fish, eggs, chicken for breakfast, lunch and dinner. But our Indian diet does not contain such a high percentage of protein. He also states, the average protein intake is calculated to be 0.6 to 0.8 gm/kg, and if one gets this amount of protein from vegetables and serials, one should stay away from non-veg. He also spoke about research published in 2019 where two groups were compared, one non-vegetarian ad the vegetarians. The results proved that there was considerably more creatinine in a non-vegetarian person’s body. 

Dr. Sanjeev requested kidney patients not to switch to a vegetarian diet completely, but you can have one egg per day and meat once a week. 

According to him, a vegetarian diet or a plant-based diet produces less urea and creatinine in the blood. 

Another element of the diet that he focused on was ‘salt.’ According to him, the more salt you take, the higher the risk of protein leakage and increased Blood Pressure. 

A kidney patient should have salt in a low amount, and it should be of Tata iodine salt only as low salt substitutes have potassium, which is not suitable for kidney patients because it affects the heart. He suggests that one should consume good-quality salt, about 3-5gm, to boost the medicines you take daily. Dr. Sanjeev also recommends E2 analogue supplements and probiotics. 

Moreover, consult the best nephrologist on time and follow the mentioned above to reduce the creatinine level. It will also help you delay your dialysis.