Podcast Transcript
Identifying "Kidney Attacks" and Early Detection
Host: Here is something wild: 2.2 lakh (220,000) new patients in India reach end-stage kidney disease every year.
That’s like an entire city of people needing dialysis or transplants, and many don’t even realize it until it’s too late.
So today, we are talking about how to catch CKD early and what lifestyle changes can actually protect your kidneys.
We are pleased to welcome Dr. Vishal Saxena, Senior Director of Nephrology at PLK Max Super Specialty Hospital, New Delhi. Welcome to the podcast.
The Silent Symptoms of Kidney Damage
Duration: 00:01:18 – 00:02:30Dr. Vishal Saxena: Thank you very much, Vyomesh. It’s nice meeting you.
Host: Nice to meet you, too. Okay, Vishal sir. So, I am totally going to keep it real with you.
The first question that I am going to throw at you is: how do you know if your kidneys are healthy?
Dr. Vishal Saxena: Every organ in our body gives us symptoms. Signs and symptoms, which sometimes we know and sometimes we don’t.
Like, suppose someone has a heart attack. Now people are very clear—left-sided chest pain radiating to the neck, palpitations—he will rush to the emergency.
He knows it's his heart attack. But "kidney attack"? Nobody knows because nobody has defined a kidney attack as anything.
Okay, what is a kidney attack?
Basically, it is when your kidneys slowly get damaged, and you still don’t know. By the time you find out, already 50% of your kidney is lost.
That's because the symptoms are very subtle. Very small symptoms appear for kidney damage, like loss of appetite, fatigue, or dizziness.
In young boys, especially if blood pressure starts getting high, or in the elderly, if high blood pressure starts, swelling starts in the legs or face, or blood starts appearing in the urine.
The Importance of Urine Analysis: Lessons from Japan
Duration: 00:02:30 – 00:03:36Dr. Vishal Saxena: And I will tell you one thing very important about how to detect whether you have this thing. There is a disease known as IgA Nephropathy.
Host: I am suffering with it.
Dr. Vishal Saxena: Okay. So in the world, this is the commonest glomerulonephritis—the disease of the kidney filters (sieves) is called glomerulonephritis.
IgA Nephropathy was the commonest one, but nobody knew how it happened. So the Japanese started seeing that their young people were developing IgA Nephropathy.
So what they started doing, right from school, they started monitoring their urine. Okay? Now, a urine test doesn't hurt a child; he just has to pass urine in a container.
And when they started doing it, they found that the incidence was far, far higher—almost 40-50%.
And that gave the world the insight to detect early, diagnose early, and treat early. And you know what happened after that?
As a father, I have two kids. As a father, I do my children’s urine analysis once a year. Okay?
And I tell everybody, don’t wait for 40 or 50. In India, everything comes at 20s and 30s because of life, lifestyle, and our genetics.
That's the problem.
The Lack of Screening Culture in India
Duration: 00:03:36 – 00:04:39Dr. Vishal Saxena: So eat healthy, do healthy, everything is fine. But what happens is, we don’t screen. None of us gets a urine test done until we reach the hospital.
Until someone has a stone, they don’t get a urine test. And the biggest problem with stones is people sit with them for years.
Host: In India, going to the hospital is seen as a compulsion. Yeah, because nobody wants to see our faces there.
Routine checkups—this isn't our culture in India.
Dr. Vishal Saxena: So my suggestion to everybody, including corporate and government setups, is that during school time, children should have an annual checkup.
Once you are entering college, there should be a baseline checkup. Once you are entering the corporate, there should be a basic checkup.
Once you are entering a job, there should be a basic checkup. If you have these annual checkups, you know—and give some incentives, subsidize it—you will start doing that. You will catch things very early.
Host: Yeah. So by the time you reach that stage, we require a trial, transplant, or something like that.
Defining "Kidney Failure" and Lifestyle Risks
Duration: 00:04:39 – 00:06:08Dr. Vishal Saxena: You know, doctors break down that bad news that the kidney has "failed". It’s a very dramatic statement.
Very sad but very dramatic. So I am somebody who is very scared of that word "failure". So I don’t say it has failed, but I say it is working less.
You know, to make it more subtle and more patient-friendly. Failure means less than 15% function.
Even less than 90% can be a failure. Okay, or even if your GFR is 90—suppose your kidney function, which we calculate is called GFR—if your GFR is 90 and you just have one kidney by birth, you are a CKD patient. Okay?
That happens. All kidney donors have CKD.
Host: So I was asking you about lifestyle. This weekend, beer, opening a beer on Saturday night, smoking cigarettes—this is becoming very cool nowadays.
Can this also cause kidney problems?
Dr. Vishal Saxena: See, after "cool" comes "cold". Okay? So this cool concept... people used to live very nicely in old times without all these fads of drinking, vaping, and smoking, and they were still cool.
So my definition of cool is looking good, looking smart, and having a healthy lifestyle. I mean, of course, there is peer pressure. Every generation has peer pressure.
So what you can do is, if somebody offers you a mug of beer, you can hold it.
Okay, right, and you can continue the whole party with it. You don’t have to have four or five pints, you know.
Host: Yeah, that’s what I feel.
Dr. Vishal Saxena: Yeah. So one pint of beer isn't going to harm you much. But as a doctor, I am not supposed to endorse alcohol.
Smoking, Vaping, and Gym Supplements
Duration: 00:06:08 – 00:07:53Dr. Vishal Saxena: As far as smoking is concerned, it’s a strict no-no. Because smoking has a direct correlation with your kidney diseases. Okay?
Smoking leads to hypertension (high blood pressure), and hypertension will lead to kidney damage.
And the problem with smoking is that it's so easy to do that when you become habitual to it, you don't even realize.
You start with one, then come to two, then you hide in the washroom to smoke.
And nowadays, vaping culture has come; young kids are using vapes. That has even more chemicals.
Even more chemicals and irritants that damage both lungs and kidneys.
Host: So that means we can get CKD from lifestyle, too?
Dr. Vishal Saxena: Absolutely. And especially people who are using gym supplements. Okay? Who are into bodybuilding without a proper trainer?
Host: I want to ask this. You mentioned bodybuilding. Bodybuilding itself won't cause it, right? I think supplements can cause CKD.
Dr. Vishal Saxena: Exactly. So whenever you want to do bodybuilding, do it, but under proper training. Just like a student needs a good teacher, similarly, for a body trainer, you need a qualified body trainer.
Not somebody you just find at a gym. You see peers building biceps, triceps, squatting, cardio, and then they are taking those gym supplements.
Host: Keeping your point in mind, I want to tell you I am a certified personal trainer and Level 2 nutritionist.
But at the same time, I definitely don't know about kidney health. How much androgenic effect a supplement will give me, how much body it will build, how much protein I need—that's all I know.
But I don't know if I take 2 grams of protein per kg of body weight, how much load it will put on my kidneys. This is what a trainer would never know.
Protein and the "Tea Strainer" Analogy
Duration: 00:07:53 – 00:08:49Dr. Vishal Saxena: So that is the problem. Whatever extra protein you take, the kidneys will get damaged. Okay?
So extra protein... what is protein? Protein is a type of fat (nutrient). And the kidney is like a sieve. Okay? Have you ever strained tea?
Host: No... well, like filtered tea? Yes.
Dr. Vishal Saxena: Have you ever filtered ghee through a tea strainer?
Host: No.
Dr. Vishal Saxena: Why? Because whenever you try to remove fat through the kidneys (strainer), what will it do? It will damage the kidneys. Okay?
And your high-protein diet is going to make the kidneys work more.
Host: So, talking about supplements, is it a no-no for everyone? Or are there a few supplements a bodybuilder can take?
Dr. Vishal Saxena: As far as I know and have researched, whey proteins are still okay, but in moderation. Okay?
But other than that, all these creatines and all, I am totally against. Eat natural food. Eat eggs, eat chicken, eat fish, avoid red meat.
Reversing Kidney Damage
Duration: 00:08:49 – 00:09:40Host: So, if we got CKD from taking supplements, overbodybuilding, or eating too much protein, is it reversible?
Dr. Vishal Saxena: To some extent. It will depend on how much damage there is and the duration of the supplements you have taken.
Once you reach a stage of CKD, okay, then sometimes it becomes difficult. But it is possible.
Yes, it is possible if you stop doing that. If you go on a strict diet plan, eat well, and eat at the right time in the right amount, then there are chances of it reversing to a great extent.
Host: Okay. So if the level is high, it is very difficult to bring it down. So I’ll come to my next question.
There are myths related to CKD—try this treatment, try that treatment. Is it valid?
For example, if I talk straight about Ayurvedic, Homeopathic, Water Therapy—does this work?
Alternative Medicine Risks and Mental Health
Duration: 00:09:40 – 00:11:54Dr. Vishal Saxena: See, I am not an expert in all these therapies. I am only an expert in Allopathy.
I’ll tell you a very simple example. Have you ever heard of a malaria medicine called Quinine?
Host: No?
Dr. Vishal Saxena: So there is a malaria medicine called Quinine. It used to be very famous. It is made from the bark of a tree. Right?
So it's a natural thing. We use it in Allopathy. But if you overdose, you lose your eyes, you lose your GI system. So every drug that has an effect will have a side effect. So nothing is 100% safe.
Host: So my next question is: how does kidney disease affect your mental health?
Dr. Vishal Saxena: So, kidneys, per se, trouble your whole body. Kidney is a very important organ that makes our hormones, controls our blood pressure, concerns our minerals and bone disease, and controls our hemoglobin.
So kidney has a lot of effects which people don’t know. People think kidneys only remove waste products. It's not like that.
And whenever, suppose your hemoglobin drops, your bones become weak, your BP rises—will you be alright?
No. So what will happen? It will affect you mentally. Right?
And when you Google it out—what are the side effects of kidney disease—when you read them, they are so depressing.
Host: Yeah, I have suffered it all. I personally feel when I was on dialysis, going to the hospital three days a week just to get blood purified stops your life.
You feel caged. And moreover, the catheter in your neck... You are not even able to move your neck. If I were on a catheter now, I couldn't turn like this and talk to you.
So that hinders your mental health. You don't feel normal. They reduce your water, reduce proteins, stop juice, soup, dry fruits, chutney, papad, bhujia, pickles—everything.
I still remember on dialysis, water wasn't allowed. I was told to drink one liter. It’s such a penance (tapasya)—how can someone quench their thirst? That’s why I say prevention is better than cure.
Anemia and Artificial Creatinine Lowering
Duration: 00:11:54 – 00:13:27Host: I started realizing the early signs of kidney disease, and tried to avoid toxic things. What is the harm in an annual checkup?
Oh, I had another question. Can anemia be related to kidney disease?
Dr. Vishal Saxena: To a great extent. We have many patients who come with hemoglobin of 4 or 5. They go everywhere, but nobody has done a kidney function test.
Their creatinine comes back at 8 or 9, and then they feel that this was all because of kidneys.
So kidney makes a hormone known as Erythropoietin, and that hormone gets activated in the kidneys. Kidney patients also have iron deficiency anemia because their appetite is gone.
The alternative therapies you were talking about—what they do is artificially lower your creatinine.
How?
They will only feed you bottle gourd, ridge gourd, and apple gourd. Okay?
You will crave kidney beans (rajma) and chickpeas (chole). For non-vegetarians they stop everything.
There will be no protein in the diet. If there is no protein, where will muscle mass come from?
What is creatinine? It is muscle mass. Okay? So creatinine will automatically go down.
So this is an artificial way of lowering your creatinine. Or the medicines are basically forcing us to lose our muscles, which brings creatinine down just for the time being.
And that makes you weak, yes, and weaker, and that affects your mental health.
Host: Okay. So they are all interrelated.
Steps After Diagnosis: Biopsy and Treatment
Duration: 00:13:27 – 00:15:38Host: So what other treatment options do you believe in besides Allopathy? And within Allopathy, what is the best course of action? If someone's creatinine has reached around 2.
Dr. Vishal Saxena: So if someone’s creatinine is around 2, their kidney function is approximately 50%.
Maybe 40-50% depending on age, weight, etc. So in this case, first of all, you have to look at why it happened.
We see two types of patients. One whose kidneys have shrunk (small); in that, we can't do much because we can't biopsy and don't know the reason.
But if the kidney size is normal, then at creatinine 2, we should definitely do a kidney biopsy. Next question is: as soon as the biopsy comes, you will know the cause.
Suppose you had IgA Nephropathy, or Minimal Change Disease, or FSGS—these are treatable diseases. SLE Lupus, or Myeloma (blood cancer type)—they are all treatable. People live long lives without dialysis on these things.
Host: So, if we go step-wise, if someone is detected with CKD, what should be the first step?
Dr. Vishal Saxena: First, go to a nephrologist. Connect with your nephrologist. You have to win over your fears. Don't be scared.
Face it and talk to your nephrologist about your problem and how to deal with it. He will tell you all the good things—how to modify lifestyle, diet plan, and if a biopsy is required.
If he is able to find the cause, we should treat the basic cause. As the cause, so the remedy. Right?
And if you know it is irreversible CKD, then we do diet modification, maintain hemoglobin, avoid blood transfusions.
And as it progresses, CKD is a progressive disease. If any doctor says, "I will stop your CKD here", he is lying.
So you will progress. But then you are mentally prepared.
And for a young person, especially, since we have transplant as one of the best options, we promote that you get a transplant from a life-related donor or family member with the same blood group.
Transplants and Organ Donation Awareness
Duration: 00:15:38 – 00:17:35Host: I feel since we are on the topic of transplants... I feel we can't get a transplant from the donor list in India.
Being a transplant patient myself, I registered on the list, and the first answer I got was "Brother, your number won't come before 10 years."
That is a very harsh truth about India. What would you say? Can something be done in India? Because people like me had to take a kidney from their mother.
They feel immense pain in their heart that "I am in a situation where, for my survival, I have to put my mother in pain."
Dr. Vishal Saxena: There are two ways for this. One, we should increase awareness about organ donation. India has multiple cultures.
When there is so much diversity, there is a North-South divide. If you look at organ donation, it is highest in the South because Tamil Nadu and Kerala have almost 100% literacy.
Fads are less. And their social networking, social workers, and donor advocates are trained in donation.
In the West, if you go to Gujarat, they are doing a lot of brain-dead donations. So we should educate society. Don't be scared.
You have to tell people what we will do with your kidneys after death? Our culture is to cremate; that's okay.
But if one life can save eight lives, then why not? It’s a very noble cause, boss.
This is "Moksha" (salvation); it is nowhere else. Everything is here. You live here, you die here. Who sees what happens after birth? They say, "Living is being useful to someone."
Organ Donation Policy: Spain vs India
Duration: 00:17:35 – 00:19:00Dr. Vishal Saxena: And the second part of your question was how to do this more. I’ll tell you an example of Spain.
I have done my perceptorship in Barcelona, so I have been to Spain a couple of times.
In Spain, the policy is that the moment you apply for a driving license, by default, you become an organ donor.
Host: Why don't such policies come to India?
Dr. Vishal Saxena: Because in India, there will be politics on policies. A lot of people will walk out because of religion or biases. You know how we behave.
Host: Now that we have established that CKD is mostly irreversible, how can we slow down its progression?
Dr. Vishal Saxena: Again, medicines. Suppose someone has diabetic kidney disease. Diabetes is the leading cause of kidney disease in India.
Second is hypertension. Third is glomerulonephritis (unknown/idiopathic). Idiopathic means "idiotic to the doctor and pathetic to the patient." The doctor doesn't understand the cause, and the patient suffers.
Slowing Progression and The Will to Fight
Duration: 00:19:00 – 00:21:03Dr. Vishal Saxena: So when you find out you have a progressive disease like diabetic kidney disease... compared to 20 years ago, we have progressed.
We have drugs like ACE inhibitors, ARBs, and new drugs like SGLT2 inhibitors. They slow the progression of diabetes, proteinuria, and kidney disease.
Almost you can delay the time from diagnosis to dialysis by 8 years with medicines. Even if 40% is damaged, we can delay it 8 years if you take the right medicine at the right time.
Dr. Vishal Saxena: A lot of people think, "Kidney disease is here, what will we do now?" First, you must have the spirit to fight. I realized this a bit after diagnosis.
At first, I gave up quickly—"CKD, IgA, end result is transplant/dialysis." I felt my downfall coming. But as soon as I accepted my fate."
This has happened to me, now I have to fight it. It is a problem, and I am the solution."—I realized it is a fight or flight situation.
Either get depressed, sit at home, leave everything... or view this problem as just a problem, find the solution, and continue life systematically with precautions.
That's why I said come to "fight mode" first. When you are ready to fight, you will have weapons ready: drugs, lifestyle, and food habits.
When you inculcate these habits, you can slow down progression.
When to Start Dialysis: Timing and Prep
Duration: 00:21:03 – 00:23:05Host: Okay, slowing down. Now I want to talk about dialysis. Is there a particular creatinine level to start dialysis?
I have seen people start at 6 or 8. Very few wait till 10. But some people have no symptoms even at 15. Is it healthy to wait?
Dr. Vishal Saxena: I will tell you. When we were studying, we were told to start dialysis when the GFR is below 15.
It has no link to creatinine directly. Creatinine is linked to GFR. But age matters. If an 80-year-old lady has creatinine 4, her GFR is 15.
A 20-year-old bodybuilder with creatinine 4 might have a GFR of 18-20. So you have to be prepared that the day dialysis is needed, we will do it.
For preparation, when the patient is in CKD Stage 4 or 5, get a Fistula made. It is a small operation that connects artery and vein, and takes 2 months to mature.
Once you are ready, you can wait. Whether creatinine is 6, 8, or 10, it doesn't matter.
When you become symptomatic—breathlessness, hemoglobin dropping, loss of appetite, confusion, swelling—it is never the number that decides dialysis.
It is the symptomatology of the patient. For diabetics, sometimes early initiation is told.
Host: Like I was personally told by a doctor because I had a lot of muscle. So even though my creatinine was 10, they said, "You will sustain."
But within a month, I got confusion, hallucinations, vomiting, and suddenly had to install a catheter.
Catheter vs. Fistula and Hygiene
Duration: 00:23:05 – 00:24:58Host: So is a catheter better or the fistula?
Dr. Vishal Saxena: Fistula first, always.
Host: But it doesn't bother your hand? I heard you can't take BP or have strength in that hand.
Dr. Vishal Saxena: It is a myth. But yes, you can't take BP or samples from it. But it is far, far better than this (catheter).
The catheter gets infected. You have to take care. As you said, you couldn't move your neck, and you can't bathe properly.
With a catheter, you take a head wash separately. Why go into that? Even better, prepare for a transplant.
Host: That's what I did. I did dialysis for 2 months, and by the end of the 2nd month, my transplant was done.
Dr. Vishal Saxena: That's a very good thing. But the bad thing was you probably never got tested before.
Host: General body tests? Never before. I was always fit, muscular, athletic. Nobody saw it coming. I thought that if a person lives a healthy lifestyle, no need.
But now I feel awareness should have been there. An educated guy like me didn't know to get a blood test once a year. Now I preach it. Looks are deceptive.
Types of Dialysis: Hemodialysis vs Peritoneal
Duration: 00:24:58 – 00:27:00Host: Coming back to dialysis, how many types are there?
Dr. Vishal Saxena: Basically two types. One is Hemodialysis—blood gets purified by machine and goes back. Requires a catheter or a fistula.
Another is Peritoneal Dialysis. Peritoneum is a membrane in our belly. It acts as an artificial kidney using osmosis to pull toxins.
You put a small tube inside the stomach (peritoneum). It’s a 45-minute local anesthesia procedure.
Leave the patient for 2 weeks to heal. Then we train the patient. Water bags come ready-made. No relation to blood.
Peritoneum does the kidney's work. The water bags contain dextrose and amino acids; dextrose pulls water and toxins. Put a bag in, keep it for 4 hours, and drain it out.
That’s why it is called Continuous (CAPD).
Host: I am amazed. I had hemodialysis, but which one is better?
Dr. Vishal Saxena: See, suppose you are a working guy, a model, a film star. You have CKD. Automated Peritoneal Dialysis (APD) involves a small, briefcase-sized machine.
If you travel to Switzerland or for shoots, take that bag.
You shoot all day, sleep at night for 8 hours. Connect yourself to the machine, and it automatically does dialysis. In the morning, you are free.
Host: Is it more expensive?
Dr. Vishal Saxena: No, almost same cost.
Hemodialysis Popularity and Longevity
Duration: 00:27:00 – 00:28:37Host: Then why is Hemodialysis more famous in India?
Dr. Vishal Saxena: Because people don't want to do it daily at home. Also, fear of Peritonitis—if hygiene slips, infection gets in.
But people have lived 10-15 years on that. Same on hemodialysis. Patients from hill stations with no dialysis access do very well on Peritoneal Dialysis. No fear of Hepatitis B, C, or HIV.
Host: You are saying a person can live 15 years average on dialysis?
Dr. Vishal Saxena: I am not God, can't predict longevity. But abroad, data shows they live so long and well.
The only mantra in dialysis is we say the opposite of pre-dialysis: High Protein. Eat well, live well. Dialysis makes you weak and causes protein loss.
Transplant Legalities and Donor Criteria
Duration: 00:28:37 – 00:31:50Host: Coming to transplant. It is a better option than dialysis, definitely. But there are many processes and legal matters. Can you guide us on what is needed?
Dr. Vishal Saxena: Transplant is governed by the Human Organ Transplant Act (1994, updated 2011). Most important: it should be a Live Voluntary Related Donor.
Live, Voluntary, Related. In "Related": Parents, Siblings (brother/sister), Wife/Husband, Children. That's it. Not uncles initially.
Then comes "Extended Criteria": First cousins, Uncles, Aunts, Spouse's parents/siblings. We have to prove DNA relationship.
The Act is to stop exploitation. Even after 20 years, I get scared a patient might lie or bring a fake donor.
Host: I heard the donor's life is more important than the recipient's.
Dr. Vishal Saxena: Exactly. Donor is like a God giving a second life. If something happens to the donor, the whole program suffers.
Secondly, don't prolong the system by asking 10 centers. You are wasting time and getting weaker.
We presented data: preemptive kidney transplant (no dialysis) vs 3 months vs 6 months dialysis. Longer dialysis duration = worse transplant outcomes.
Because you get weak and can't tolerate medicines. The earlier the better.
Life After Transplant and Medication Discipline
Duration: 00:31:50 – 00:34:50Host: Can a person live a normal, healthy life after a transplant?
Dr. Vishal Saxena: Yes. I have patient for 15 years. Girls got married, had children. I have photos of their kids who are now 8 years old. One became a doctor (MD Medicine). It's a nice feeling.
One patient said, "I lived my life, my point was to make my kid somebody." The will to live never dies. Even at 80, nobody wants to die.
If you want to live, you have to fight. Fight for sustenance, survival, discipline. If you don't fight, how will you win?
You have to take the first step. A doctor can't grab you from home. If you stop medicines after a transplant, rejection happens in 4 days.
Where is the doctor wrong? Doctors take an undertaking: Are you ready for medication throughout life?
Immunosuppressants are important. Set alarms. If you go to dinner at 9 PM, carry your tablet.
I am on a shoot today, and I have today's and tomorrow's medicine with me. If I get late, I will pop my pill. That's how discipline works.
Dr. Vishal Saxena: You have to behave yourself with the doctor. The relationship becomes beautiful, like family.
Patients say, "We saw you running in the corridors, young and handsome, now you put on weight." It's a beautiful feeling.
Kidney Lifespan and Positivity
Duration: 00:34:50 – 00:38:12Host: As a transplant patient, curious question: How long can a kidney last?
Dr. Vishal Saxena: Multiple factors. 1. Basic disease (recurrence chances). 2. Immune system strength (rejection chances). 3. Compliance with medicines. 4. Follow-ups. 5. Water/Diet/Lifestyle.
Now, the term "Half-Life". If I do 100 transplants today, 50 will last 12 years. That is the average half-life.
The rest 50 might last longer or less. Never ask "What will happen to me?" Does a normal person know what will happen in 5 minutes? No.
Host: Just out of curiosity.
Dr. Vishal Saxena: 12 years is the half-life statistically. But people have lived 25 to 40 years. Kids grew up, and they became grandparents.
There is always a sad and a good story. Positive thinking leads to positive outcomes. Mentality is important. Positivity begets positivity. If you fight, you win.
Yesterday, I read about a guy with 5 kidneys (3 transplants). He is still surviving. It's about how you want it.
Mother's kidney (50% gene match) has better compatibility than wife's (0% HLA match). But with modern medicines, we have crossed blood group and HLA barriers.
Conclusion and Key Takeaways
Duration: 00:38:12 – EndDr. Vishal Saxena: To summarize: Discipline, Good Lifestyle, Health Checkups (right from birth), Follow up with doctor, and don't get into negative mindset. Maintain positivity.
Host: Thank you, Doctor. Amazing session.
Dr. Vishal Saxena: Thank you. People need this message. In India, can't we just get an annual checkup?
That's the bare minimum. I plead with people: get kids tested. Why take them to a stage where they need supportive therapies?
Host: I feel that too. I still regret that if my disease was caught earlier, my transplant at 25 could have been delayed to 35.
Be cautious. Get tested. Live healthy. Don't follow trends. Use your brain.
Healthy body = Healthy mind. Don't go on looks. Focus on inner self.
Take care of your kidneys. Bye bye.