Pakistan Kidney and Liver Institute and Research Center’s Director Medical Education Dr. Hafiz Ijaz Ahmadgraciously gave some time for an exclusive question and answer session on human kidneys, kidney problems, causes, prevention and treatment for kidney diseases. He also told us about PKLI’s role in prevention and treatment of kidney diseases. This insightful interview would help you take care of your kidneys better for leading a healthy life. On the occasion of World Kidney Day, which falls on February 14, Pakistan Kidney and Liver Institute and Research Center (PKLIRC) wishes to raise awareness about chronic kidney disease (CKD), which was rapidly spreading in Pakistan, with 17 million patients already. Essentially important for human health, kidneys help remove waste products and extra water, assisting in controlling blood pressure, the production of red blood cells, and keeping the bones healthy.However, when damaged, these kidneys are not able to filter human blood well enough. Most kidney diseases do not occur overnight and happen slowly, in different stages. Most people in the early stages neither report any symptoms nor realise that anything is wrong with their kidneys. Yet, if diagnosed timely, kidney damages can be slowed or even stopped with proper treatment. In case the disease gets worse, waste starts building up in blood, making problems like high blood pressure, weak bones, a low red blood cell count (anaemia), poor nutrition and nerve damage more likely. This poses a higher risk of cardiac diseases and can even result in total kidney failure. Such conditions then require treatments like dialysis or/and a kidney transplant. It should be noted, however, that anyone could suffer from kidney diseases, irrespective of age and gender. Still, some are at a higher risk due to various factors, particularly the incidence of diabetes and high blood pressure, a family history of CKD, excessive use of medicines over the course of many years and old age (over 60 years).Symptoms of CKD Almost no symptoms have been reported at the initial stages. However, patient in later stages complain about tiredness, shortness of breath, trouble in thinking clearly, losing will to eat, trouble with sleeping, dry and itchy skin, muscle cramps at night, going to the bathroom more often at night, swollen feet and ankles, and puffiness around eyes, especially in the morning.Treatments offered at PKLIRC PKLI&RC puts great emphasis on identification of risk factors leading to progression of CKD and interventions against them. Some major risk factors include diabetes, hypertension, hyperlipidemia (cholesterol and lipid-related problems), excessive protein intake and excessive salt intake. The institute aims to properly control diabetes (fasting glucose in 90-130 range and random blood glucose of less than 180) and high blood pressure (keeping it below 130/80), and manage lipid/cholesterol levels (target LDL of less than 100, triglycerides less than 150) through a low protein and low salt diet. This preventive approach helps to avoid dialysis and kidney transplantation in many patients with CKD. For patients with renal failure, PKLI&RC offers maintenance dialysis program and kidney transplantation. Proper control of calcium, phosphorus, intact parathyroid hormone and 25 hydroxyvitamin D levels in patients with CKD is very crucial to prevent and delay the progression of CKD. Avoiding blood transfusion and using erythropoietin and iron injections to keep haemoglobin level between 10 and 11 is extremely important in patients with progressive/CKD. Vaccination of all patients with CKD against hepatitis B is also of utmost importance in a preventive nephrology programme.