Question 1

Who is the best nephrologist in Ahmedabad?

Accepted Answer

"Best" depends on your specific condition, and any doctor claiming the title outright should be treated with caution. What you should look for is verifiable super-specialisation in nephrology, hospital affiliation and whether the doctor explains your reports in a language you follow. Dr. Pritish Shah holds MBBS, MD (Internal Medicine), DrNB (Nephrology), is registered with the Gujarat Medical Council (G 45244), and practises at Apollo Hospitals International Limited, Ahmedabad, consulting in English, Hindi and Gujarati.

Question 2

When should I see a nephrologist instead of a general physician?

Accepted Answer

See a nephrologist if your eGFR is below 60, if protein or blood appears in your urine on more than one test, if your creatinine is rising, if your blood pressure needs three or more medicines, or if you have diabetes and have never had a kidney screen. A physician manages risk factors well; a nephrologist is needed once the kidney itself is involved.

Question 3

What are the first signs of kidney problems?

Accepted Answer

In early stages there are usually none — which is the central problem with kidney disease. When signs do appear they include swelling of the feet or face, foamy urine, passing urine more often at night, persistent fatigue, poor appetite and blood pressure that is becoming harder to control. Detection before this point requires a blood and urine test.

Question 4

What does a kidney consultation cost?

Accepted Answer

Consultation with Dr. Shah is ₹1,000 as listed on his Apollo 24|7 profile. Investigations are billed separately by the hospital. A basic screening — creatinine with eGFR plus a urine albumin-to-creatinine ratio — is inexpensive relative to what it detects.

Question 5

Where does Dr. Pritish Shah practise?

Accepted Answer

At Apollo Hospitals International Limited, Apollo Hospitals International Ltd, Plot No. 1A, Bhat GIDC Estate, Gandhinagar 382428, Gujarat. The hospital is on the Ahmedabad–Gandhinagar highway near Indira Bridge, convenient for patients from Chandkheda, Motera, Sabarmati, Gandhinagar and north Ahmedabad. Online consultation is also available through Apollo 24|7.

Question 6

Which languages can I consult in?

Accepted Answer

English, Hindi or Gujarati — whichever you are most comfortable in. This matters more than it sounds: patients who understand their own diagnosis follow treatment far more reliably, and kidney care depends almost entirely on long-term adherence.

Question 7

Can I get a second opinion on reports from another hospital?

Accepted Answer

Yes. Second opinions are welcome and common in nephrology, particularly before starting dialysis or committing to a transplant pathway. Bring the complete set of reports in chronological order — the sequence of values over time usually tells more than any single result.

Question 8

Is online consultation available?

Accepted Answer

Yes, through Dr. Shah's Apollo 24|7 profile. Online consultation suits follow-up reviews, report interpretation and second opinions well. A first consultation for a complex problem, or anything involving swelling, breathlessness or reduced urine output, should be in person.

Question 9

Do I need a referral to book an appointment?

Accepted Answer

No. You can book directly. If a physician, diabetologist or cardiologist has referred you, bring their note along with your reports — it gives useful context, but it is not a requirement.

Question 10

How often should kidney function be tested if I am at risk?

Accepted Answer

At least annually if you have diabetes, hypertension, obesity, a family history of kidney disease, or are over 60. Every three to six months if an abnormality has already been found. Testing means both a blood eGFR and a urine albumin test — the urine test is the one most often skipped.

Question 11

My sugar is well controlled. Can I still get kidney damage?

Accepted Answer

Yes. Good control lowers the risk substantially but does not remove it. Blood pressure, duration of diabetes, genetics and albumin leak all contribute independently. Annual kidney screening is recommended regardless of how good your HbA1c is.

Question 12

What is microalbuminuria and does it matter?

Accepted Answer

It means small amounts of albumin are leaking into urine — an early, still-treatable stage of kidney damage. It matters a great deal, because intervening at this point can prevent progression, and in some patients it can be brought back to normal.

Question 13

Can diabetic kidney disease be cured?

Accepted Answer

Early damage can sometimes be substantially reversed, particularly at the microalbuminuria stage. Once significant scarring and a reduced eGFR are established, the realistic goal shifts to slowing progression and protecting the function that remains.

Question 14

Are SGLT2 inhibitors safe if my kidney function is already reduced?

Accepted Answer

They are approved and beneficial down to fairly low eGFR levels and are often continued even as function declines. There is usually a small, expected dip in eGFR when starting, which is not harm — it reflects the drug working. This needs a nephrologist's supervision.

Question 15

Can high blood pressure damage kidneys without any symptoms?

Accepted Answer

Yes, and that is the usual course. Both hypertension and early kidney damage are silent. Damage is typically detected only through a blood test for eGFR and a urine test for albumin, which is why periodic screening matters for anyone with high blood pressure.

Question 16

My creatinine rose after starting a BP tablet. Should I stop it?

Accepted Answer

Do not stop it on your own. A small rise in creatinine after starting an ACE inhibitor or ARB is expected and usually indicates the drug is protecting the kidney. A larger or continuing rise does need review. Either way, this is a decision for your nephrologist.

Question 17

Will I need blood pressure medicines lifelong?

Accepted Answer

In most cases, yes — but the dose and number of drugs can often be reduced with sustained weight loss, salt restriction, treatment of sleep apnoea and regular activity. Where a secondary cause is found and corrected, medication can sometimes be stopped altogether.

Question 18

Is home BP monitoring reliable?

Accepted Answer

A validated upper-arm automatic monitor is reliable and often more informative than clinic readings. Wrist devices are less accurate. Measure while seated with your back supported and arm at heart level, twice each morning and evening, and keep a written log.

Question 19

Is acute kidney injury reversible?

Accepted Answer

Frequently, yes. When the cause is dehydration, obstruction or a nephrotoxic drug and it is corrected early, kidney function often returns to near baseline. Recovery is less complete when injury has been prolonged, severe or superimposed on pre-existing kidney disease.

Question 20

If I need dialysis for AKI, is it permanent?

Accepted Answer

Usually not. Dialysis in AKI is temporary support while the kidney recovers, and most patients come off it. A minority with severe or prolonged injury do not recover function and transition to long-term dialysis.

Question 21

Can painkillers really cause kidney failure?

Accepted Answer

Yes. NSAIDs such as diclofenac, ibuprofen and nimesulide reduce blood flow to the kidney. In someone who is dehydrated, elderly, or already has reduced kidney function, even a short course can precipitate AKI. This is one of the most common avoidable causes we see.

Question 22

How long does recovery from AKI take?

Accepted Answer

It varies widely. Mild pre-renal AKI can correct within days of rehydration. More severe injury such as acute tubular necrosis typically takes two to six weeks, and some patients pass through a temporary high-urine-output phase during recovery that needs monitoring.

Question 23

Is dialysis painful?

Accepted Answer

The dialysis itself is not painful. Inserting the needles causes brief discomfort that most people adjust to within a few weeks, and numbing cream can help. Cramps or fatigue during sessions usually indicate that fluid removal or dry weight needs adjusting rather than being an unavoidable part of treatment.

Question 24

Can I work and travel while on dialysis?

Accepted Answer

Yes. Many patients work full-time. Peritoneal dialysis and evening or night haemodialysis shifts fit around employment well. Travel is possible with advance planning — dialysis sessions can be booked at centres in other cities, and peritoneal dialysis supplies can be delivered to your destination.

Question 25

Once dialysis starts, can it ever be stopped?

Accepted Answer

In chronic kidney failure, dialysis is generally lifelong unless you receive a transplant. In acute kidney injury it is usually temporary and most patients recover. A successful kidney transplant is the one route that reliably ends the need for dialysis.

Question 26

Which is better — haemodialysis or peritoneal dialysis?

Accepted Answer

Neither is universally better. Survival is broadly comparable. Peritoneal dialysis offers independence, home treatment and gentler fluid removal; haemodialysis offers supervised care and no daily self-management. The right choice depends on your home, work, support and clinical situation.

Question 27

Why do I need a fistula instead of just using a catheter?

Accepted Answer

A fistula lasts years, carries a far lower risk of bloodstream infection and delivers better dialysis. A neck catheter is convenient at the start but has significantly higher infection and clotting rates. Fistulas need two to three months to mature, which is why they should be created early.

Question 28

How long does a transplanted kidney last?

Accepted Answer

Outcomes vary, but living-donor kidneys commonly function well for fifteen to twenty years or more, and deceased-donor kidneys somewhat less. Longevity depends heavily on medication adherence, blood pressure control and how promptly rejection episodes are detected and treated.

Question 29

Who can donate a kidney to me?

Accepted Answer

Under Indian law, living donation is permitted from near relatives — parents, siblings, children, spouse and grandparents — with authorisation committee approval required for others. Donors must be adults, medically fit and donating voluntarily without any financial inducement.

Question 30

Is donating a kidney safe for the donor?

Accepted Answer

For a properly evaluated donor, the risks are low and long-term life expectancy is close to that of the general population. The remaining kidney compensates for most of the lost function. Donors do need lifelong annual monitoring of blood pressure and kidney function.

Question 31

Can I have a transplant without starting dialysis first?

Accepted Answer

Yes, and it is preferable where possible. Pre-emptive transplantation, performed before dialysis begins, is associated with better graft and patient survival. This requires referral at CKD stage 4 rather than waiting until dialysis becomes necessary.

Question 32

What happens if I stop my immunosuppressant medicines?

Accepted Answer

The graft will be rejected, often within weeks, and the loss is frequently irreversible. This is the leading preventable cause of transplant failure. If cost, side effects or availability are a problem, raise it at your appointment — there are almost always alternatives.

Question 33

What is CRRT and how does it differ from normal dialysis?

Accepted Answer

CRRT is continuous renal replacement therapy — dialysis delivered slowly over 24 hours rather than in a four-hour session. Because fluid and waste are removed gradually, blood pressure stays far more stable, which makes it suitable for critically ill patients who could not tolerate conventional dialysis.

Question 34

If my relative needs dialysis in the ICU, will it be permanent?

Accepted Answer

In most cases, no. ICU dialysis usually supports the kidney through an acute illness, and the majority of survivors recover enough function to come off it. A minority with severe or prolonged injury go on to need long-term dialysis, and this becomes clear over the weeks after recovery.

Question 35

Why can't conventional dialysis be used in the ICU?

Accepted Answer

It often can, but conventional dialysis removes fluid quickly, which can cause dangerous drops in blood pressure in patients already on vasopressor support. For unstable patients, CRRT or SLED delivers the same clearance far more gently.

Question 36

Can I request a nephrologist review for a relative admitted elsewhere?

Accepted Answer

Formal ICU care requires admission under the treating hospital. For families seeking clarity, a second-opinion consultation to review reports and explain the situation can be arranged — but urgent clinical decisions must always be made by the team physically caring for the patient.

Question 37

Which tests should I do for a basic kidney check-up?

Accepted Answer

Two are essential: serum creatinine with eGFR from a blood sample, and a urine albumin-to-creatinine ratio. Blood pressure should be measured at the same visit. This combination detects the large majority of early kidney disease and is inexpensive.

Question 38

My routine health package said kidney function is normal. Is that enough?

Accepted Answer

Not necessarily. Most standard packages include creatinine but omit the urine albumin test — and albumin frequently turns abnormal years before creatinine does. If your package did not include a urine ACR, an important part of the assessment was missed.

Question 39

How often should someone with diabetes get a kidney test?

Accepted Answer

At least once a year, starting from the diagnosis of type 2 diabetes and from five years after diagnosis in type 1. If an abnormality is already present, testing is repeated more frequently — typically every three to six months.

Question 40

Does drinking a lot of water protect my kidneys?

Accepted Answer

Normal hydration is good, and it reduces kidney stone risk. But deliberately drinking very large volumes does not improve kidney function and can be harmful in people with heart failure or advanced kidney disease, where it causes dangerous fluid overload and low sodium.

Question 41

Can kidney disease be prevented entirely?

Accepted Answer

Much of it can. The majority of kidney failure in India stems from diabetes and hypertension, both of which are modifiable. Controlling blood sugar and blood pressure, avoiding habitual NSAIDs, staying at a healthy weight and screening annually prevents or substantially delays a very large proportion of cases.

Question 42

Can chronic kidney disease be reversed?

Accepted Answer

Established scarring cannot be reversed, but progression can very often be slowed or stopped. The earlier CKD is found, the more function there is to protect. Many patients diagnosed at stage 2 or 3 maintain stable kidney function for years with correct treatment.

Question 43

Does high creatinine always mean kidney failure?

Accepted Answer

No. Creatinine rises with dehydration, certain medicines, high protein intake and large muscle mass. A single raised value needs to be repeated and interpreted alongside eGFR and a urine test before any diagnosis is made.

Question 44

Will I definitely need dialysis?

Accepted Answer

Most people with CKD never reach dialysis. Only a minority progress to stage 5. Whether you do depends heavily on your stage at diagnosis, your protein leak, your blood pressure control and how consistently treatment is followed.

Question 45

Which CKD stage is serious?

Accepted Answer

Stage 3 onwards needs specialist supervision, and stages 4 and 5 need active planning for kidney replacement therapy. That said, stage 1 or 2 with heavy protein leak can progress faster than stage 3 without it — protein matters as much as stage.

Question 46

Are Ayurvedic or herbal medicines safe for kidney disease?

Accepted Answer

Several herbal and traditional preparations contain heavy metals, aristolochic acid or high potassium loads, and are a recognised cause of kidney injury in India. Please bring any such product to your consultation so it can be reviewed before you continue it.

Kidney questions, answered straight

About consulting Dr. Shah

Diabetic Kidney Disease

Hypertension & Kidneys

Acute Kidney Injury

Dialysis

Kidney Transplant

Critical Care Nephrology

Preventive Screening

Chronic Kidney Disease