Most people have two kidneys. However, scientifically, even one healthy kidney is enough to maintain normal body function. In simple words, you can live a normal life with just one working kidney.

Kidneys are located at the back of the abdomen, on either side of the spine, just below the rib cage. In simple terms, they sit in your lower back area.

Kidneys remove metabolic waste like urea (from protein breakdown), creatinine (from muscle activity), and toxins. Simply put, they remove harmful substances that your body does not need.

Kidneys regulate fluid balance by adjusting how much water is excreted in urine. Scientifically, they respond to hormones like ADH (antidiuretic hormone). In simple terms, they decide how much water your body should keep or remove.

Dialysis is needed when the kidneys are no longer able to remove waste and excess fluids properly. It is usually recommended in advanced kidney disease based on medical evaluation.

There are two main types: Hemodialysis and Peritoneal Dialysis. Hemodialysis uses a machine to clean the blood, while peritoneal dialysis uses the body’s abdominal lining.

Yes, kidney transplantation is a safe and effective treatment when done by experienced specialists. It helps improve quality of life with proper care and follow-up.

Stay hydrated, eat a balanced diet, control blood pressure and sugar levels, and avoid unnecessary medications. Regular check-ups also help in early detection.

AKI develops rapidly, often within hours to a few days. Unlike chronic kidney disease, it is not a slow process. In simple words, kidney function drops suddenly.

Common causes include dehydration, severe infections (sepsis), low blood pressure, certain medicines, and blockage of urine flow. Simply put, anything that reduces blood flow to kidneys or directly damages them can cause AKI.

Yes. Severe dehydration reduces blood supply to the kidneys, leading to injury. In simple terms, not having enough fluid in the body can harm your kidneys.

Yes, especially severe infections like sepsis. These can reduce blood flow and cause direct kidney damage. Simply put, serious infections can shut down kidney function.

Yes. Painkillers (NSAIDs), some antibiotics, and contrast dyes used in scans can cause AKI. In simple words, unnecessary or excessive medicines can harm your kidneys.

Urine output may decrease significantly or even stop (called oliguria or anuria). However, in some cases, urine may appear normal. Simply put, reduced urine is a warning sign.

Symptoms may include reduced urine, swelling in legs or face, fatigue, nausea, confusion, and shortness of breath. In simple terms, the body starts retaining fluid and toxins.

Yes. Early AKI may not cause noticeable symptoms and is detected only through blood tests. Simply put, it can be silent in the beginning.

People with diabetes, high blood pressure, elderly individuals, hospitalized patients, and those with pre-existing kidney disease are at higher risk. Simply put, vulnerable patients need extra care.

Creatinine is a waste product measured in blood to assess kidney function. In AKI, creatinine levels rise. Simply put, higher creatinine means poorer kidney function.

Oliguria means reduced urine output (less than normal). It is an important sign of kidney dysfunction. Simply put, passing less urine than usual is concerning.

Yes. Both can lead to dehydration and reduced blood flow to kidneys. Simply put, fluid loss from the body can damage kidneys.

In many cases, yes—if treated early and the cause is corrected. However, severe or delayed cases can lead to permanent damage. Simply put, early treatment improves recovery.

AKI is diagnosed using blood tests (creatinine), urine tests, and sometimes imaging like ultrasound. Simply put, doctors check your blood and urine.

Yes, in severe cases where kidneys cannot remove waste or excess fluid. Dialysis may be temporary until kidneys recover. Simply put, a machine may help clean the blood.

Severe breathlessness, no urine, confusion, and swelling are serious signs. These require urgent medical attention. Simply put, these are emergency symptoms.

Yes, especially in high-risk patients. This is called contrast-induced kidney injury. Simply put, certain scans can affect kidney function.

Stay well hydrated, avoid unnecessary medicines, control BP and diabetes, and seek early treatment for infections. Simply put, good care and awareness can prevent AKI.

If you notice reduced urine, swelling, vomiting, diarrhea, or weakness—especially if you have risk factors. Simply put, don’t ignore early warning signs.

CKD develops slowly and is usually permanent, while AKI is sudden and often reversible.

Diabetes and high blood pressure are the most common causes. Others include glomerulonephritis, genetic diseases, and long-term drug use.

Yes. High blood sugar damages kidney filters (glomeruli), leading to diabetic nephropathy.

Yes. Long-standing hypertension damages kidney blood vessels.

Often there are no symptoms in early stages.

Swelling, fatigue, loss of appetite, nausea, decreased urine, itching, and breathlessness.

Estimated Glomerular Filtration Rate (eGFR) measures how well kidneys filter blood.

Creatinine is a waste product in blood used to assess kidney function.

CKD cannot usually be cured, but progression can be slowed with proper treatment.

CKD is divided into 5 stages based on eGFR—from mild (Stage 1) to kidney failure (Stage 5).

Yes. If untreated, CKD can progress to end-stage kidney disease requiring dialysis or transplant.

Blood test (creatinine, eGFR) and urine test (protein/albumin).

Protein leakage in urine (albuminuria) is an early sign of kidney damage.

Yes. Long-term use of NSAIDs can damage kidneys.

It causes fluid retention, anemia, bone disease, and electrolyte imbalance.

Depends on stage and doctor advice. Early CKD → normal hydration; advanced CKD → fluid restriction.

Low salt, controlled protein, low potassium/phosphorus (in advanced stages).

Control diabetes and BP, avoid unnecessary drugs, maintain healthy lifestyle.

If you have diabetes, BP, swelling, or abnormal reports.

Dialysis is required when kidneys fail to remove toxins and fluid from the body, usually in advanced kidney disease (Stage 5 CKD) or severe AKI. In simple terms, it is needed when kidneys stop working adequately.

There are two main types: Hemodialysis (blood cleaned by a machine) and Peritoneal Dialysis (using the abdomen lining as a filter). In simple terms, one uses a machine, the other uses your body's lining.

Hemodialysis involves passing blood through a machine (dialyzer) that filters waste and returns clean blood to the body. In simple terms, blood is cleaned outside the body using a machine.

Peritoneal dialysis uses the inner lining of the abdomen (peritoneum) to filter blood using dialysis fluid. In simple terms, fluid inside your abdomen helps remove waste.

Hemodialysis is usually done 2–3 times per week, each session lasting 3–5 hours. Peritoneal dialysis is done daily. In simple terms, machine dialysis is a few times weekly, while home dialysis is daily.

If transplantation is likely to be the long-term treatment, avoiding dialysis can spare patients the physical, emotional and lifestyle challenges associated with dialysis.

It also provides an opportunity to undergo transplantation while the patient is still in relatively good overall health.

Avoiding dialysis means avoiding regular dialysis sessions and the need for dialysis access, while reducing exposure to dialysis-related complications.

It can also provide greater freedom for work, travel, family life and everyday activities.

Not everyone is a candidate. The decision depends on the patient's kidney disease, overall health, rate of kidney function decline, transplant suitability and availability of a suitable donor.

Early evaluation is important because transplant assessment and donor evaluation take time.

Yes. When a suitable living donor is available, the donor and recipient can be evaluated together and the transplant can often be planned in advance.

This allows transplantation to be performed electively, before dialysis becomes necessary, when medically appropriate.

Do not wait until dialysis becomes unavoidable.

If your kidney function is progressively declining, discuss transplantation early with your nephrologist and transplant team. Early planning gives you time to understand your options, complete the necessary evaluation and consider whether pre-emptive transplantation is right for you.

Haemodialysis performs some of the kidney's filtration functions, but it cannot completely reproduce the continuous filtration, endocrine and metabolic functions of a healthy kidney.

A successful transplant provides continuous kidney function and can offer better control of fluid and electrolytes, improved anaemia and bone-mineral management, greater freedom from dialysis and dietary restrictions, and improved physical, mental, sexual and psychosocial well-being.

A functioning transplanted kidney can provide:

• Continuous removal of waste products and excess fluid
• Better regulation of electrolytes and acid-base balance
• Better control of fluid status and blood pressure
• Improvement in kidney-related anaemia
• Better calcium, phosphate, vitamin D and parathyroid hormone balance
• Improved nutritional and metabolic health
• Freedom from regular dialysis sessions and dialysis vascular access
• Greater flexibility in diet, fluid intake, travel and daily activities

Healthy kidneys produce erythropoietin, a hormone that stimulates red-blood-cell production.

After successful transplantation, the transplanted kidney can restore endogenous erythropoietin production to a substantial degree. Anaemia related to kidney failure therefore often improves, and many patients may no longer require erythropoiesis-stimulating treatment.

Kidney failure can cause abnormalities in calcium, phosphate, vitamin D and parathyroid hormone regulation.

A functioning transplanted kidney can substantially improve these disturbances and restore more normal mineral and bone metabolism. Some longstanding abnormalities, particularly severe secondary hyperparathyroidism, may persist and require continued treatment.

Successful transplantation often improves energy, appetite, physical functioning and exercise capacity. Patients are no longer dependent on regular dialysis sessions and can generally participate more freely in work, travel, exercise and everyday activities.

Many patients also experience improvement in mood, confidence, social participation and overall quality of life because of greater independence and freedom from the physical and time-related burden of dialysis.

Kidney failure can adversely affect sexual function, fertility and reproductive hormones.

Successful transplantation can improve many of these hormonal and metabolic abnormalities. Sexual function and fertility may therefore improve after transplantation. Pregnancy is possible after a successful kidney transplant, but it should be carefully planned with the transplant and obstetric teams because specialized monitoring and medication adjustments are required.

For appropriately selected patients, successful kidney transplantation generally provides a survival advantage compared with remaining on long-term dialysis.

The benefit varies between individuals and depends on factors such as age, cardiovascular health, other medical conditions, donor characteristics and long-term transplant function.

Kidney transplantation can broadly be classified according to the source of the kidney:

• Living-donor kidney transplantation – the kidney is donated by a medically suitable living person.
• Deceased-donor kidney transplantation – the kidney comes from an eligible deceased organ donor.
• Living-donor transplantation may further involve related donation, ABO-compatible or ABO-incompatible transplantation, and kidney-paired exchange or swap transplantation.

A living-donor transplant uses a kidney donated voluntarily by a healthy person who has undergone detailed medical, surgical, psychological and legal evaluation.

The donor must be sufficiently healthy to live safely with one kidney, and donation must be voluntary and free from commercial consideration or coercion.

A deceased-donor kidney comes from a person who has died under circumstances in which organ donation is legally and medically possible.

Allocation of deceased-donor kidneys is carried out through the appropriate organ-allocation system according to applicable national and state regulations.

This is a transplant in which the donor and recipient have a legally recognized biological or marital relationship that qualifies under the applicable Indian transplant regulations.

Examples may include parents, children, siblings, grandparents, grandchildren and spouse, subject to the applicable legal requirements.

Donation by a person who is not a legally defined near relative may be possible in selected circumstances, but it requires additional scrutiny and approval by the appropriate Authorisation Committee.

The purpose of this process is to establish that the donation is genuine, voluntary and free from commercial consideration, coercion or inducement.

ABO compatibility refers to compatibility between the blood groups of the donor and recipient.

In an ABO-compatible transplant, the recipient does not have the naturally occurring anti-A or anti-B antibodies expected to directly react against the donor kidney blood-group antigens.

Blood-group compatibility is important, but it is only one component of the overall transplant compatibility assessment.

An ABO-incompatible transplant occurs when the donor and recipient have blood groups that would ordinarily be incompatible.

In selected patients, transplantation can still be performed using specialized protocols to reduce and control the recipient's anti-A or anti-B antibodies. Such transplantation requires careful antibody monitoring and should be undertaken in an experienced transplant centre.

A kidney-paired exchange is an option when a willing living donor cannot directly donate to the intended recipient because of blood-group or immunological incompatibility.

For example, Donor A may be compatible with Recipient B, while Donor B is compatible with Recipient A. The two donor-recipient pairs can exchange kidneys, allowing both recipients to receive compatible kidneys.

Swap transplantation is permitted within the Indian legal framework and requires the appropriate statutory approval.

A pre-emptive transplant is performed before the patient starts dialysis.

When kidney disease is progressing toward kidney failure, transplantation can be planned in advance. If a suitable living donor is available and both donor and recipient complete the necessary medical and legal evaluation, transplantation may be performed before dialysis becomes necessary.

Pre-emptive transplantation avoids exposure to dialysis before transplantation and may help preserve residual kidney function and quality of life.

It also provides time to evaluate the donor, perform compatibility testing, optimize the recipient’s health and complete the required legal procedures without the pressure of an urgent dialysis requirement.

The recipient undergoes a comprehensive evaluation to determine whether transplantation is appropriate and to identify conditions that need treatment before transplantation. This may include assessment of:

• Kidney disease and overall health
• Heart and blood-vessel health
• Infections
• Cancer screening
• Nutritional and metabolic status
• Bone and mineral health
• Previous surgeries
• Vaccination status
• Psychosocial circumstances
• Ability to take lifelong immunosuppressive medicines

Kidney failure can be associated with cardiovascular and other systemic diseases. Transplantation is also a major surgical procedure.

Evaluation of the heart, lungs, blood vessels and other relevant organs helps identify conditions that may increase surgical or post-transplant risk and allows them to be treated or optimized before transplantation.

HLA stands for human leukocyte antigen. HLA molecules help the immune system distinguish the body’s own tissues from foreign tissues.

HLA typing of donor and recipient helps assess immunological compatibility and contributes to assessment of the risk of rejection.

Donor-specific antibodies, or DSA, are antibodies present in the recipient that are directed against HLA antigens carried by the potential donor.

Their presence, strength and clinical significance are important in assessing the immunological risk of transplantation.

A crossmatch tests whether the recipient has antibodies that react against cells from the potential donor.

It is an important part of pre-transplant immunological evaluation, particularly for living-donor transplantation.

CDC stands for complement-dependent cytotoxicity.

In this test, the recipient's serum is tested against donor lymphocytes in the presence of complement. A positive reaction indicates antibody-mediated injury to donor cells.

CDC is a traditional physical crossmatch technique and remains an important part of immunological assessment in many transplant programmes.

A flow-cytometry crossmatch is a more sensitive physical crossmatch technique that detects antibody binding to donor lymphocytes using flow cytometry.

It can detect lower levels of donor-reactive antibodies that may not be detected by conventional CDC testing.

CDC crossmatch detects antibody-mediated complement-dependent cell injury and is generally less sensitive.

Flow crossmatch detects antibody binding to donor cells with greater sensitivity.

The results of both tests must be interpreted together with HLA antibody testing, donor-specific antibodies, previous transplants, blood transfusions, pregnancies and other sensitizing events.

A living donor is a healthy person undergoing major surgery for the benefit of another person. Therefore, donor safety is the first priority.

The evaluation is designed to confirm adequate kidney function, acceptable cardiovascular and metabolic health, suitable kidney anatomy, absence of important transmissible disease or malignancy, and acceptable long-term health risk.

Depending on the individual donor, evaluation may include:

• Detailed medical and family history
• Physical examination and blood-pressure assessment
• Blood and urine investigations
• Kidney function and urine albumin assessment
• Blood-group testing
• HLA typing and immunological testing
• Infection screening
• Diabetes and cardiovascular risk assessment
• Appropriate cancer screening
• Kidney and urinary-tract imaging
• Assessment of renal vascular anatomy
• Measured GFR when required
• Psychosocial assessment
• Surgical evaluation

The exact evaluation is individualized according to the donor’s age, medical history and transplant-centre protocol.

A donor must have sufficient kidney function to safely live with one kidney.

When estimated GFR does not provide sufficient information, the transplant team may perform a more accurate measured GFR assessment. A radionuclide study such as 99mTc-DTPA may be used in selected cases and can also help assess the relative function of each kidney.

CT angiography provides detailed information about kidney anatomy, including:

• Number and position of kidneys
• Renal arteries and veins
• Accessory vessels
• Kidney size and structure
• Collecting-system anatomy
• Other abdominal findings relevant to surgery

This information helps the surgical team select the appropriate kidney and plan the safest donor operation.

No. Donation is considered only after comprehensive assessment of kidney function, blood pressure, urine findings, metabolic and cardiovascular health, kidney anatomy, infections, malignancy risk, psychosocial health and predicted long-term risk.

The decision is based on the overall safety of the donor, rather than on a single normal test.

Potential contraindications include significant kidney disease or inadequate kidney function, significant albuminuria/proteinuria, uncontrolled or high-risk hypertension, diabetes or significant glucose abnormalities, significant cardiovascular disease, active malignancy, serious chronic infection, major urinary or kidney abnormalities and conditions that substantially increase surgical or long-term health risk.

Some conditions may be absolute contraindications, while others require individualized assessment.

Selected donors with well-controlled hypertension and no significant target-organ damage may be considered after careful assessment.

However, uncontrolled hypertension or hypertension associated with kidney or cardiovascular damage generally makes donation inappropriate.

Established diabetes is an important concern because of its potential long-term kidney and cardiovascular consequences.

Candidates with diabetes or significant abnormalities of glucose metabolism require careful individualized assessment, and many programmes will not accept them for donation.

Body weight is considered as part of the donor’s overall risk assessment.

Significant obesity may increase surgical and long-term metabolic risk. Weight reduction may therefore be recommended before donation in selected individuals.

The operation is called a donor nephrectomy.

It can be performed through an open approach or by minimally invasive surgery, most commonly laparoscopic or hand-assisted laparoscopic nephrectomy.

The choice depends on donor anatomy, previous operations, surgeon expertise and the facilities and experience of the transplant centre.

Laparoscopic donor nephrectomy uses several small abdominal incisions rather than one large incision. Its usual advantages include:

• Less postoperative pain
• Smaller scars
• Earlier mobilization
• Shorter recovery
• Earlier return to normal activities

In experienced centres, recipient graft outcomes are comparable to those achieved with open donor nephrectomy.

Laparoscopic surgery requires specialized equipment and considerable surgical expertise. The operation may also need to be modified or converted to an open procedure in unusual anatomical or surgical circumstances.

The priority is always donor safety, rather than choosing a particular surgical technique.

Open nephrectomy is an established and safe technique and may be particularly useful in selected donors with complex anatomy or previous abdominal surgery.

Its main disadvantages are a larger incision, more postoperative discomfort and generally a longer recovery compared with minimally invasive surgery.

Yes. A carefully selected healthy donor can generally live a normal and active life with one kidney.

The remaining kidney undergoes physiological adaptation and increases its functional contribution. Donation is nevertheless a lifelong decision, and maintaining a healthy lifestyle and regular medical follow-up is important.

For appropriately selected donors, the overall long-term health outlook is very good. However, donation is not completely risk-free.

Because the donor has one remaining kidney, prevention and early detection of conditions such as hypertension, diabetes, obesity and kidney disease are particularly important.

Long-term follow-up should include monitoring of:

• Blood pressure
• Weight and general health
• Serum creatinine/eGFR
• Urine albumin

Donors should also maintain a healthy lifestyle and receive routine preventive healthcare appropriate to their age and circumstances.

Kidney transplantation is a major surgical procedure, but it is a well-established treatment with high success rates in experienced transplant centres.

As with any major surgery and lifelong medical treatment, complications can occur. Careful donor and recipient selection, modern surgical techniques, immunological testing and regular follow-up help reduce these risks.

Early complications may include:

• Bleeding or collection of blood around the transplant
• Renal artery or renal vein thrombosis
• Urinary leakage or obstruction
• Delayed or slow graft function
• Surgical or urinary infections
• Other infections during the early period
• Acute rejection

Most patients are closely monitored during this period so that complications can be detected and treated promptly.

Rejection occurs when the recipient’s immune system recognizes the transplanted kidney as foreign and mounts an immune response against it.

Modern immunosuppressive medicines have significantly reduced the risk of rejection, and many rejection episodes can be successfully treated when detected early.

Long-term complications may include:

• Gradual or chronic decline in transplant kidney function
• Chronic rejection or antibody-mediated rejection
• Recurrence of the original kidney disease in selected patients
• Infections related to immunosuppressive treatment
• High blood pressure, diabetes or lipid abnormalities
• Cardiovascular disease
• Medication-related complications
• Increased risk of certain cancers

Regular transplant follow-up helps detect and manage these problems early.

No. Many transplanted kidneys function successfully for many years. The duration of graft function varies between individuals and depends on donor and recipient factors, immune response, infections, medication adherence and other health conditions.

Modern transplant medicine continues to improve long-term graft survival.

Most kidney-transplant recipients require lifelong immunosuppressive medicines to prevent rejection.

These medicines require regular monitoring. The aim is to provide enough immunosuppression to protect the transplanted kidney while minimizing medication-related complications.

A kidney transplant is much more than an operation. It provides a functioning kidney that continuously performs many of the body’s important filtration, endocrine and metabolic functions.

For a suitable patient, successful transplantation can provide better kidney function, better metabolic and endocrine balance, greater physical independence, improved mental and psychosocial well-being, and better quality of life.

At the same time, transplantation requires careful evaluation, lifelong medicines and regular medical follow-up.

The goal of modern kidney transplantation is not simply to free a patient from dialysis, but to provide the best possible long-term health, independence and quality of life.

If you or a family member has advanced kidney disease, discuss transplantation early with your nephrologist and transplant team. Early evaluation provides more options and allows the safest pathway to be planned for both donor and recipient.