Dr Francisco Salcido-Ochoa

Hi, When there is discoloration of urine it is ideal to figure out if that could be a normal response to dehydration, when the urine is more concentrated and either dark yellow or almost brown. If this indeed happens when you do not drink sufficient water, just try to hydrate yourself better. But it is important to be sure it is not a manifestation of kidney disease, specifically blood in the urine. Many medical conditions like liver disease can also change the colour of the urine to a darker one.

Hi, I am sure anyone would be worried after your experience. First of all, it is possible it was already in the toilet bowl, especially if: 1. you could see it with your naked eye and 2. you have no urinary symptoms However, it is also possible that the organism could have been "dragged" by the urine from the skin, vagina or anus during the urination process in women. This is because the urine stream can "washout" the genitals before going into the toilet bowl.

Hi, Malnutrition in patients with chronic kidney disease Patients with chronic kidney disease can suffer from malnutrition, especially when the disease progresses to more advanced stages.

Hi, I am sorry to hear that your grandmother has diabetes and she is at risk of developing diabetic kidney disease (aka diabetic nephropathy); which means diabetes affecting the kidney, damaging it and potentially leading to kidney failure. In fact, diabetes is the most common cause of total kidney failure worldwide and in Singapore. Around 40% of patients with diabetes develop kidney problems. Many of them can progress to total kidney failure, needing dialysis or kidney transplant to remain alive.

Hi, Please let me define first what chronic kidney disease and renal failure are. Chronic kidney disease is the consequence of many different disorders and diseases in the kidneys. Chronic kidney disease results in progressive damage, which eventually impairs all the functions of the kidneys. On the other hand, renal failure is when your kidneys completely stop working as t and this is typically irreversible. When your kidney function drops below 10%, patients can become very ill, the situation can be life-threatening, and dialysis or a transplant needs to be performed.

Hi, Here's the summarised answer to your concerns: First and foremost, diabetes is a common cause of protein leaking in the urine, hence, it's important to rule this out as a cause. Regarding the exact treatment of protein leaking in the urine, this will depend mainly on the cause and the severity of protein leakage. As there are many possibilities and more permutations, you should seek out a formal consultation with your doctor or nephrologist.

Hi, Intravenous fluids play an important role in the management of many patients, especially if they are (1) dehydrated or not drinking well; (2) losing bodily fluids rapidly, eg through vomiting, diarrhoea, high fever or certain kidney diseases or other medical problems; (3) should be fasting and told not to drink because going for surgery; (4) when need certain fluids to correct salt imbalances in the body; or (5) to administer certain medicines intravenously. Thus, intravenous fluids can contribute to the improvement of patient's condition.

Hi, Kidney transplantation can prolong and improve the lives of patients with kidney failure, in comparison to their outlook if remaining on dialysis forever. Kidney transplantation can also give patients a better quality of life by allowing them to regain their freedom to do many of the things that they used to do or they used to enjoy before developing kidney failure and needing dialysis.

Hi, Thank you for your question. Chronic kidney disease includes different types of diseases of the kidneys, like diabetes, high blood pressure, different types of inflammation of the kidneys, allergies, urine flow problems, rare diseases, recurrent infections, etc. So, the treatment will be divided in a) specific treatment to control the original disease, b) to treat other accompanying conditions to minimize further damage to the kidneys, and c) other general strategies to try to prolong the life of the kidneys.

Hi, Thank you for your question. Age is one of the factors determining the type of dialysis, but more important than age, in my experience, it is the fitness, fragility, frailty, nutrition and mobility of the patient what matters the most; either due to age or the impact that accompanying medical conditions have like heart problems, arthritis, amputations, lung disease, blindness. I have met patients over 80 years all which are fitter than even 40 or 50 years old ones, because disease and lifestyle takes a huge toll on people’s health, lifespan and quality of life.

Hi, Thank you for your question. The fees charged will depend whether you are doing it privately or obtaining government subsidies. For example, the fees for haemodialysis in the private sector can range from 200-500 dollars per session, depending if it is a satellite basic dialysis centre or a centre inside a private hospital with more comfort and other features and/or more capabilities to respond to emergencies. A centre located inside a private hospital will be more responsive to emergencies, than a centre in the local neighbourhood.

Hi, Peritoneal dialysis is regarded as a self-care therapy, that is, you do it by yourself, after being trained, contrary to haemodialysis, in which typically the nurses do all the procedures and steps for you. The fact that you do peritoneal dialysis by yourself gives you certain freedom and independence of timing and place where you perform the peritoneal dialysis therapy, and makes traveling less cumbersome than haemodialysis, because you need to book a centre overseas and plan your trip around that schedule.

Hi, Thank you for your question. Indeed, reaching total kidney failure and needing dialysis is a big event with a significant impact in your life, requiring in occasions huge modifications in your lifestyle. It can get in the middle of your work life (especially if you have a corporate or full-time job, because indeed each session takes half of your day); your social life; your family life; and your personal life, which can affect your mood and overall wellbeing.

Hi, Choosing between peritoneal dialysis and haemodialysis can be a difficult decision because there are many factors to consider and it is a significant event in patient’s life. There are patients who have medical contraindications for one therapy or for the other and therefore they do not have much choice, or patients that have certain medical conditions for which the doctors would recommend one therapy over the other one. Said that, most patients do have a choice.

Hi, Progressive and severe injury to the kidneys can cause permanent and irreparable damage to the kidneys, leading to total kidney failure. If total kidney failure is confirmed by your doctor, dialysis will be needed for life. Alternatively, a kidney transplant is another option in these circumstances. And dialysis will be for life because, unfortunately, permanent and severe damage cannot be repaired and the kidney function will not recover. We use different methods to assess the degree of kidney dysfunction and to confirm if the kidney function is low.