 I am Dr. Sushant Kumar, Consultant Nephrologist, Professor and Head, Department of Nephrology, Custard Board Medical College, Mangalore. Today, briefly I would like to speak about kidney failure and the various options of treatment available. Broadly, there are two types of kidney failure. One we call as acute kidney injury and second one is called as chronic kidney disease. Acute kidney injury, as the name implies, it happens suddenly and usually recovers after a short span of time. The commonest cause for acute kidney injuries, it could be dehydration, it could be some glomerular nephritis, it could be obstruction because of stone, prostate, etc. And acute kidney injury can even be a silently affected kidney because of some systemic problem elsewhere in the body like infection, it could be pneumonia, urine infection, skin infection, etc. Or it can be even due to a major illness like connective tissue, what we call as vasculitis. So kidney ultimately takes the brunt and if detected early, treated promptly, there can be even complete recovery of kidney injury in acute kidney injury. So the treatment in acute kidney injury comprises mainly treating the cause, whatever is the cause, it could be infection, it could be stone removal or it could be a disease like vasculitis, what I just mentioned. When the acute kidney injury is severe, needing dialysis, then dialysis is indicated usually temporarily. So anytime between one week to three weeks generally the kidney recovers, until then we may have to do kidney dialysis in this acute kidney injury form. Second type of kidney disease is called as chronic kidney disease. As the name implies it is chronic that means it is there from a long duration and usually the problem here is it is progressive and not reversible. So the common causes for chronic kidney disease worldwide is diabetes, most common cause. Other causes could be uncontrolled blood pressure or several forms of glomerular nephritis, interstitial nephritis, stone disease, prolonged NSAD use, it could be even congenital or hereditary causes of kidney disease. So coming to the treatment aspect of chronic kidney disease, in the beginning stages we try to maximally slow down the progression of the disease that is the patient reaching to dialysis. This is in various form like you need to have good sugar control, very good blood pressure control, dietary control like protein restriction, salt, potassium restriction, fluid restriction if indicated, and weight reduction, abstinence from alcohol or smoking and anti protein uric measures like different drugs and some nephroprotective drugs what we use. These are all things to indirectly slow the progression of the disease. In a specific nephritis like disease we have to treat with maybe some immunosuppression drugs as well. So ultimately as I said any chronic disease, chronic kidney disease usually progresses to end stage renal disease that is stage 5 of chronic kidney disease wherein dialysis is indicated. Here the dialysis will be permanent life log. So when the patient reaches end stage kidney disease, the option of treatment is either dialysis, could be a hemodialysis or a peritoneal dialysis. Hemodialysis will be done thrice weekly life log wherein the patient has to come to the hospital for the same. If it is peritoneal dialysis that has to be done every day and it will be done at home but both under the supervision of a nephrologist. Next best option for chronic kidney disease treatment is called as renal transplantation. This is the best treatment available for kidney transplantation. Here the suitable donor and a well matched kidney is generally put in a recipient's body and here main thing is patient has to receive immunosuppression lifelong. You cannot stop the immunosuppressive drugs at all because that will trigger rejection and the kidneys can be lost. Take a message what I would like to give here is most of the kidney diseases are silent and can be totally missed. Hence it is better to screen for kidney disease irrespective of age and sex and pick the disease early and get treated. Thank you.