Your kidneys filter your blood , regulate your blood pressure , produce hormones , and balance the delicate chemistry that keeps every organ in your body functioning normally . Every moment of your life , your kidneys work silently and tirelessly . Most people don’t think about their kidneys until something goes wrong with them. By the time symptoms appear, kidney disease may have been quietly progressing for months or even years.
The good news is that most kidney conditions are treatable when diagnosed and treated in a timely manner and many can be treated completely. Getting the right specialist at the right time is crucial. Whether it’s kidney stones causing agonising pain, kidney tumours best treated surgically before they spread, or chronic kidney disease that can be slowed and its complications managed.
The kidneys are two fist-sized, bean-shaped organs that are situated on either side of the spine, just below the rib cage. Together they hold roughly two million nephrons , tiny filtering units , that filter your entire blood volume roughly 40 times a day . This is a huge workload, and explains why even partial loss of kidney function has huge implications for overall health.
Most people know that the kidneys produce urine. But kidney function is far more than simple waste removal. The kidneys are sophisticated endocrine and regulatory organs whose roles impact nearly every system in the body. The table below summarises the key functions of the kidney and what happens when those functions are lost:
Kidney Function | What It Does | What Goes Wrong When Kidneys Fail |
Blood filtration | Filters 200 litres of blood daily; removes urea, creatinine & toxins | Toxins accumulate, uraemia, confusion, coma |
Urine production | Produces 1–2 litres of urine daily to remove waste | Reduced urine output; fluid overload; oedema |
Blood pressure control | Produces renin to regulate blood pressure | Uncontrolled hypertension; stroke risk |
Red blood cell production | Produces erythropoietin (EPO) to stimulate bone marrow | Anaemia, fatigue, breathlessness, pallor |
Bone health | Activates vitamin D; regulates calcium & phosphate | Renal bone disease; fracture risk; muscle weakness |
Electrolyte balance | Regulates sodium, potassium & bicarbonate levels | Dangerous potassium elevation; cardiac arrhythmia |
Acid-base balance | Maintains blood pH within normal limits | Metabolic acidosis, weakness, rapid breathing |
Understanding these functions helps us understand why kidney disease can lead to such a range of symptoms – such as swollen legs and anaemia, uncontrolled blood pressure and bone pain. It also explains why kidney health is inextricably linked to heart health, bone health and general quality of life. Protecting kidney function is not only about the kidneys, it’s about protecting every organ that depends on the work the kidneys do.
Here are some of the most common kidney problems seen in clinical practice and which also forms the basis of the kidney care programme by Dr Vikas Singh in Indore:
Kidney Stones (Renal Calculi)
Kidney stones are a very common and painful urological problem. They affect about 10 to 15 per cent of the population at some stage of their life, with a high recurrence rate. Stones are formed when minerals and salts (most commonly calcium oxalate) crystallise in the urine and deposit in the collecting system of the kidney. Spontaneous passage of small stones with pain and fluids. Larger stones require medical or surgical treatment. This may include RIRS (Retrograde Intrarenal Surgery with laser), PCNL (Percutaneous Nephrolithotomy) or ureteroscopic laser stone removal. Dr. Vikas Singh has performed thousands of kidney stone procedures and provides the full range of modern stone treatments in Indore. For more detailed information on the treatment of kidney stones, please see the dedicated Kidney Stone page.
Kidney Cancer & Renal Tumours
Kidney cancer , most frequently renal cell carcinoma (RCC) , is the most common kidney malignancy in adults. Most kidney tumours are now detected incidentally on ultrasound or CT scans performed for other reasons, before any symptoms develop. The primary treatment for kidney cancer is surgery and it is highly curable if caught at an early localised stage. The gold standard for tumours less than seven centimetres is a partial nephrectomy where only the tumour is removed and the kidney is preserved. Dr Vikas Singh, Laparoscopic and Robotic Assisted Partial Nephrectomy in Indore, Kidney Sparing Cancer Surgery For Patients Near You Without Going To Big Metro Centres. For more information, please consult the dedicated Kidney Cancer page.
Renal Cyst (Simple & Complex Kidney Cysts)
Kidney cysts are sacs of fluid that develop either inside or on the surface of the kidney. Simple cysts , smooth walled , uniform fluid content , are very common , especially in adults over 50 , and are almost always benign . Most cases require no treatment but periodic imaging surveillance. The Bosniak system classifies complex cysts , which have thick walls , internal septa , solid parts or calcifications , and different degrees of chance of being cancerous . High-risk Bosniak III and IV cysts need to be removed surgically. Dr. Vikas Singh evaluates and manages all varieties of renal cysts ranging from surveillance of benign simple cysts to laparoscopic excision of complex cysts. See the dedicated Renal Cyst page for detailed information.
Hydronephrosis (Swelling of the Kidney)
Hydronephrosis occurs when the collecting system of the kidney (the renal pelvis and calyces) becomes distended and enlarged due to a blockage that prevents the normal passage of urine from the kidney to the ureter and bladder. Causes include a kidney stone blocking the ureter, a narrowing (stricture) of the ureter, a blood vessel compressing the ureter (pelviureteric junction obstruction) or a tumour pressing on the urinary tract. Hydronephrosis if left untreated will slowly damage the kidney . The back pressure from the obstruction will slowly destroy nephron function over weeks to months . Prompt diagnosis and relief of the obstruction , either by stone removal , pyeloplasty for PUJ obstruction , ureteric stenting or nephrostomy drainage , is essential to preserve kidney function. See the dedicated page on Hydronephrosis for more information.
Pain in the Back, Flank or Side (Loin Pain)
The warning signs above should lead to a general medical assessment, but the specific situations below should lead to a direct and prompt referral to a urologist or kidney specialist, as they require specialist investigation and management beyond the scope of a general practitioner or physician.
Sudden Severe Flank Pain With Vomiting (Renal Colic)
The classical presentation of ureteric colic due to a kidney stone is sudden onset, severe, colicky flank pain, usually radiating from the back towards the groyne and genitalia, often associated with nausea and vomiting, inability to find a comfortable position and sometimes microscopic or visible haematuria . This requires urgent urological assessment, pain management (often requiring intravenous analgesia), imaging to confirm the size and position of the stone, and a treatment plan for stone removal if spontaneous passage is unlikely. Same day assessment is appropriate.
Blood in Urine Even Without Pain
Painless haematuria is defined as the presence of macroscopic blood in the urine in the absence of associated pain. It is one of the most important warning signs in urology and should never be attributed to infection or dismissed without full investigation. It may be caused by bladder cancer, kidney cancer, kidney stones, glomerulonephritis or other serious conditions, and not having pain does not mean the cause is benign. Any patient with a single episode of painless visible haematuria should be referred for urological assessment including CT urogram, urine cytology and cystoscopy as a matter of urgency.
Recurrent Kidney Infections Not Responding to Medicines
Pyelonephritis is a urinary tract infection involving the kidney and associated with fever, rigours, loin pain, systemic illness and urinary symptoms. If these infections recur in spite of adequate antibiotics or if a single severe episode needs hospitalisation, then underlying structural causes must be excluded including kidney stones, hydronephrosis, renal scarring, an obstructed kidney or an anatomical abnormality providing a reservoir for persistent bacterial colonisation. A urological work-up is indicated to identify and treat the underlying cause rather than medically managing recurrent infections.
Incidental Finding of Kidney Mass or Cyst on Ultrasound
If there is a kidney mass or a complex kidney cyst seen on ultrasound, CT scan or MRI scan for any reason, it is mandatory to have specialist urological assessment even if there are no symptoms. Today, the vast majority of kidney cancers are detected incidentally, in patients who feel perfectly well. The most important single factor in achieving curative treatment is early detection at this asymptomatic stage. There should be no delay in management planning and referral to a urologist for further characterisation (contrast-enhanced CT or MRI, and biopsy where indicated).
Swollen Kidney Found on Routine Scan
Hydronephrosis, dilatation of the collecting system of the kidney seen on any imaging study, should prompt urgent urological assessment for the cause of the obstruction and planning for relief prior to irreversible renal damage. Asymptomatic mild hydronephrosis is also worth investigating. The necessity for emergent intervention depends on the degree of obstruction, whether it is bilateral, and whether there is concurrent infection (the infected obstructed kidney is a urological emergency and requires emergent drainage). If a scan shows a ‘swollen kidney’ this needs urgent follow up with a kidney specialist.
Reduced Kidney Function on Blood Reports (High Creatinine)
Serum creatinine and estimated glomerular filtration rate (eGFR) are routinely measured in blood panels. If creatinine is rising or eGFR falling, investigation is required to determine whether the cause is urological (obstruction, stone, tumour or structural disease) or nephrological (glomerulonephritis, diabetic nephropathy, hypertensive nephropathy), even within ranges that may not be immediately concerning. Urological causes of reduced kidney function are often reversible with prompt treatment , but cause permanent damage to the kidney if left untreated . If creatinine rises or eGFR falls without an obvious explanation refer to a nephrologist.
Prevention is better than cure and when it comes to the kidneys, many of the most damaging conditions are preventable or can be significantly delayed with the right lifestyle choices and early screening. Here’s what the evidence to date recommends for keeping kidneys healthy:
How Much Water Should You Drink Daily for Kidney Health
The single most important lifestyle factor for prevention of kidney stones and overall kidney health is adequate hydration. The kidneys need a good flow of dilute urine to wash away minerals and waste products which would otherwise build up and crystallise or cause inflammation. For most healthy adults the target daily fluid intake is two to three litres, to produce at least two litres of urine per day. The colour of urine is the most practical indicator. If it is a pale straw yellow colour this is a sign that the body is adequately hydrated. If it is a dark yellow or amber colour it is a sign that the body is under hydrated and the minerals in the urine are becoming concentrated and potentially harmful. Water is the best fluid for kidney health; juices, soft drinks and alcohol are not substitutes and in some cases directly increase stone risk.
Fluid intake is especially important for patients with a history of kidney stones . Hydration is the most evidence-based recommendation for the prevention of stone recurrences , reducing the risk of stone formation by ~50% in adherent patients. Fluid requirements are markedly increased in hot climates and in the setting of physical activity, and failure to compensate for sweat losses is a common inciting factor for the development of stones in susceptible individuals.
Foods That Harm the Kidneys – What to Avoid
Some food choices cause direct damage to the kidneys or increase the risk of progression of kidney disease. Excessive salt (sodium) intake raises blood pressure, increasing mechanical stress on the glomerular capillaries and hastening kidney damage in patients with pre-existing CKD or hypertension. The recommended maximum intake of sodium per day is five grammes (roughly one teaspoon of salt) but most Indians consume much more than that. A diet high in red meat and animal protein increases the acid load on the kidneys and increases uric acid levels, which promotes formation of uric acid stones and may accelerate progression of CKD. Excessive sugar intake, especially fructose in soft drinks, increases uric acid production and results in obesity, diabetes and hypertension, all of which damage kidneys. Kidney stone patients should eat oxalate-rich foods (spinach, nuts, chocolate, tea) in moderation and always with adequate calcium intake at the same meal.
Role of Diabetes & Hypertension in Kidney Damage
The two most common causes of chronic kidney disease worldwide are diabetes mellitus and hypertension, and they account for roughly 50 to 60 percent of all CKD cases. Diabetes damages the kidneys in two ways: high blood glucose levels directly damage the glomerular filtration membrane (diabetic nephropathy), and the chronic inflammation and vascular damage of diabetes accelerate atherosclerosis of the renal arteries. Hypertension, over time, mechanically stresses the glomerular capillaries and progressively scars the kidney . Both conditions are silent damagers, patients may have significant kidney damage before symptoms are apparent. Tight blood glucose control (HbA1c < seven percent) and blood pressure control (target < 130/80 mmHg for CKD patients) dramatically slow disease progression and are the most important modifiable risk factors for preserving renal health.
Medicines & Painkillers That Can Damage Kidneys
Nephrotoxic medications, drugs that can directly damage kidney cells or impede kidney blood flow, represent an important and preventable cause of both acute kidney injury and chronic kidney disease. NSAIDs (non-steroidal anti-inflammatory drugs) including ibuprofen, diclofenac, naproxen and high-dose aspirin reduce kidney blood flow by prostaglandin inhibition and can cause acute kidney injury, particularly in patients who are already dehydrated, elderly or have pre-existing CKD. NSAIDs , even at over-the counter doses , are particularly harmful in patients with CKD when used regularly . Other important nephrotoxins include aminoglycoside antibiotics (gentamicin, amikacin), contrast dye used in CT scans and angiograms, some chemotherapy agents and herbal remedies with aristolochic acid. Any patient with any degree of kidney disease should ensure that all prescribing doctors are aware of their kidney function before starting any new medication.
Regular Screening for High-Risk Individuals
We recommend annual screening of kidney function (serum creatinine, eGFR, urine albumin-creatinine ratio [to detect early diabetic nephropathy], and blood pressure) in all people who have one or more of the following risk factors: diabetes mellitus (any type), hypertension, a family history of kidney disease or failure, previous kidney stones (especially recurrent or bilateral), obesity (BMI > 30), age > 60 years, previous acute kidney injury, and regular use of nephrotoxic medications. Knowing early on that the kidneys are not functioning as well as they should be , even before symptoms show up , is a chance to get on top of things that could slow the disease down a lot and maybe even help you avoid dialysis . Simple blood and urine test every year is all that’s necessary.
You want a doctor who knows the surgical as well as the medical aspects of kidney disease and can provide the highest level of care from the moment of diagnosis through the most complex surgery. Here’s why patients from Indore and Central India trust Dr. Vikas Singh as their kidney specialist:
A nephrologist is a specialist in internal medicine who treats medical kidney diseases , chronic kidney disease , glomerulonephritis , dialysis and non-surgical kidney problems . A urologist is a surgeon who specialises in structural and surgical conditions of the kidney, kidney stones, kidney tumours, kidney obstruction, kidney transplant and other conditions that require procedural or surgical intervention. Dr Vikas Singh is a urologist with special training in genito-urinary oncology and kidney transplant surgery. He is the right specialist for kidney stones, kidney cancer, kidney cysts, hydronephrosis, kidney transplant evaluation and any kidney disorder that needs surgical or procedural treatment. Dr. Singh collaborates with his nephrology colleagues to provide comprehensive care for patients with both surgical and medical kidney problems.
Blood in urine , whether visible ( frank haematuria ) or detected on urine testing ( microscopic haematuria ) is always clinically significant and should never be ignored or attributed to trivial causes without proper investigation . It can be caused by kidney stones, kidney cancer, bladder cancer, urinary tract infection, glomerulonephritis, or others. Even a single episode of painless visible haematuria should be referred urgently for CT urogram, urine cytology and cystoscopy because bladder and kidney cancers can present this way and early detection dramatically improves outcomes. Seek assessment without waiting for the haematuria to recur.
The kidney does have a limited but real ability to recover from acute insult, especially if the cause of the insult is removed quickly. If the obstruction has not been longstanding, a kidney that has been obstructed and relieved by stone removal or stent placement can regain a fair amount of function. If you have a urinary tract infection, once it is treated, the kidney can recover well. However, chronic kidney disease, which is the progressive and permanent destruction of nephrons over months to years, is not reversible. Lost nephrons do not regrow. This is why the importance of early detection and treatment of reversible causes of kidney damage (stones, obstruction, infection) and of slowing the progression of irreversible CKD by blood pressure and blood sugar control is the key long-term management goal.
Most stones produce acute pain (renal colic) when they obstruct the ureter but pass spontaneously over days to weeks without permanent kidney injury. However , stones that completely block the ureter , especially with infection , can cause serious complications such as pyonephrosis ( infected obstructed kidney ) , urosepsis ( life threatening blood poisoning from kidney infection ) , and permanent kidney damage if the obstruction is not quickly relieved . Large stones in the kidney that do not cause acute obstruction can cause progressive, often asymptomatic, kidney damage over months to years. Any stone that causes a complete blockage, infection or significant pain should be assessed urgently by a urologist.
Today most kidney cancers are discovered incidentally on ultrasound or CT done for other reasons, the patient usually having no symptoms at diagnosis. When a renal mass is detected on imaging, contrast-enhanced CT of the chest, abdomen and pelvis is the standard work-up for characterisation and staging of the lesion. MRI is used in some situations instead of or in addition to CT. Percutaneous renal mass biopsy is performed in selected cases when imaging is indeterminate and the result would change management. Blood tests to check kidney function and health. In many cases, the imaging findings and clinical evaluation will permit a confident diagnosis and management plan without the need for biopsy.
Many kidney diseases can be prevented or delayed substantially with appropriate lifestyle choices and medical management. The most important preventive measures are: good control of blood sugar in diabetes (the leading cause of kidney failure globally); good control of blood pressure (below 130/80 mmHg); good hydration (particularly important for kidney stone prevention); avoiding regular use of NSAIDs and other nephrotoxic medications; maintaining a healthy body weight; not smoking; and annual kidney function screening . if you have risk factors (diabetes, high blood pressure, family history, previous stones, age over 60). Early detection of kidney disease and aggressive management of modifiable causes results in a much slower progression of disease than in disease that is not detected and treated.
A kidney cyst is a sac of fluid that develops in or on the kidney. Simple kidney cysts are fluid-filled, smooth-walled sacs with no solid components. They are very common in adults (about 50 percent of people over 50) and are almost always benign. Simple cysts do not require treatment , but require only periodic ultrasound surveillance to document stability . The Bosniak system classifies complex cysts, which have thick walls, internal septa, solid nodules or calcification. Cysts classified as Bosniak III and IV require surgical evaluation because of significant risk of malignancy. If you have been told you have a kidney cyst, the most important thing to establish is whether it is simple or complex. This will require a consultation with a kidney specialist and appropriate imaging.
There are two simple tests that are widely available to assess kidney function. Serum creatinine and eGFR (estimated glomerular filtration rate) are blood tests and a urine albumin-creatinine ratio (ACR) is a urine test that detects protein leaking from damaged kidneys. Normal eGFR is >90 ml/min/1.73m². eGFR 60-90 ml/min/1.73m² indicates mildly reduced function. eGFR <60 ml/min/1.73m² indicates CKD Stage 3 or worse and requires specialist nephrology or urology review. These are part of most routine health screening panels. If you have any risk factors for kidney disease, the most practical thing you can do to monitor your kidney health is to ask your doctor to do these specific tests every year.
Hydronephrosis is the dilation of the kidney collecting system caused by an obstruction to urine flow. Severity depends on the degree of obstruction, how long it has been there, whether it is one or both kidneys and whether infection is present. Mild intermittent hydronephrosis may be asymptomatic or produce slowly progressive symptoms. Acute kidney failure may develop within hours to days from severe complete obstruction, particularly if it is bilateral or in a solitary kidney . Infected obstructed hydronephrosis (pyonephrosis) is a urological emergency that requires urgent drainage. Imaging should be done promptly and if there is hydronephrosis then the severity of the hydronephrosis should be assessed by a kidney specialist to determine the cause and plan treatment.
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