Dr Kagiso Motse

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• Chronic kidney disease and renal failure: The kidneys are bean-shaped organs responsible for ridding the body of waste while also maintaining the balance of minerals and water, controlling blood pressure and producing vitamin D and red blood cells. When there’s damage to these essential organs as a result of chronic kidney disease (CKD), further complications can arise from anaemia, nutritional disorders, nerve damage and heart disease. If not monitored, chronic kidney disease can progress to renal failure. A late stage of chronic kidney disease occurs when the kidneys start malfunctioning to a point where patients require dialysis or a kidney transplant to survive. As an expert in her field of nephrology, Dr Kagiso Motse demonstrates her extensive experience in diagnosing, managing and treating chronic kidney disease and renal failure.
• Acute kidney injury: Unlike chronic kidney disease that progresses over time, acute kidney injury occurs suddenly and may result in renal failure because of a restriction of blood flow to the kidneys. This restriction of blood flow could be a result of sepsis, allergic reactions, injury or organ failure. Patients already in intensive care, as well as elderly patients, are likely to develop acute kidney injury experiencing symptoms of fatigue, nausea, chest pain, and urinary difficulties. Treatment depends on the stage of kidney failure as well as any underlying condition that could worsen the injury. If the disease is caught early before its progression to a late stage of kidney failure, treatment through medication and hydration will prevent further deterioration.
• Glomerular diseases (GNS): Your kidneys are comprised of a million tiny structures referred to as nephrons and its filter, the glomeruli function similarly to strainers. The glomeruli are responsible for filtering the body by separating ions, small molecules and water from the blood, filtering out toxins from the passing of urine and returning molecules to the blood. By attacking the glomeruli, glomerular diseases have a severe effect on kidney functions. Patients with glomerular diseases will notice signs of blood in their urine referred to as haematuria, or for some, their urine will appear light brown or pink from traces of blood. An excess of protein in the urine or proteinuria is also a sign of glomerular disease caused by protein seeping into the urine, and may, as a result, appear foamy. Dr Kagiso Motse diagnoses glomerular diseases through a urinalysis to detect haematuria or proteinuria. In some cases, Dr Motse may conduct a kidney biopsy to formulate the most effective treatment for her patients.
• HIV associated kidney diseases: HIV patients will commonly experience complications related to renal diseases, particularly acute kidney injury, HIV-associated nephropathy (HIVAN) and comorbid chronic kidney disease. Glomerulonephritis, prevalent among HIV patients, results in inflammation of the glomeruli. This condition disrupts its filtering system causing the kidneys to malfunction and eventually progresses to renal failure. However, with the widespread use of antiretroviral therapy (ART), HIV-associated nephropathy is becoming less common. Patients who are HIV positive or those under antiretroviral therapy should seek expert advice from a specialist physician and nephrologist such as Dr Kagiso Motse who will diagnose and manage kidney disease in her HIV patients before the damage extends to renal failure. Once HIV-associated nephropathy (HIVAN) is diagnosed, Dr Kagiso Motse will change the grade of antiretroviral medications and utilise dialysis to manage your condition and improve the functioning of the kidneys.
• Electrolyte and acid-base disorders: The kidneys play a crucial role in regulating electrolytes and balancing the body's acidic substances. An imbalance of electrolytes and acid-bases as a result of chronic kidney disease causes hyperkalaemia and metabolic acidosis. Hyperkalaemia occurs when there’s a high concentration of serum potassium that has severe neurological and hemodynamic complications and can be fatal in cases of respiratory paralysis and cardiac arrest. Hyperphosphatemia is referred to as an electrolyte disorder that occurs when there’s an unusually high level of phosphate in the blood. The electrolyte, phosphate is responsible for strengthening teeth and bones, building cell membranes and producing energy but a high level of this in the system can lead to muscle and bone problems and therefore increases your likelihood of developing a stroke. Metabolic acidosis is a result of excess acid in the body and can, in some cases, become life-threatening. Dr Kagiso Motse treats advanced chronic kidney disease through renal replacement therapy utilising dialysis, but in most cases, kidney transplantation is needed to treat electrolyte and acid-based illnesses.
• Autosomal dominant polycystic kidney disease: Polycystic renal disease is a hereditary disorder that develops when one gene from DNA is damaged and the proteins forming this gene lead to abnormal kidney cell growth, stimulating the formation of cysts. Most people living with autosomal dominant polycystic kidney disease are asymptomatic and only become aware of the condition when experiencing symptoms during their 30s or 40s or when renal failure occurs. If left undiagnosed and untreated, autosomal dominant polycystic kidney disease can lead to brain aneurysms, pancreatic or liver cysts, kidney stones, urinary tract infections and kidney failure. Through genetic testing, CT scans, MRI tests and ultrasounds, Dr Kagiso Motse can diagnose autosomal dominant polycystic kidney disease and treat the condition managing the health of your kidneys to prolong and improve your quality of life.
• Drug-induced kidney injury: Laxatives, pain medication, alcohol, amphetamines, heroin, ecstasy and cocaine are associated drugs that cause kidney damage. Nephrotoxicity is a widespread kidney problem that occurs when the body is exposed to toxic substances, including illegal drugs. Nephrotoxicity could either be temporary as a result of dehydration or may be a sign of renal failure. When there’s kidney damage, your body is unable to remove waste and urine, and because of this, your electrolytes will rise. Dr Kagiso Motse may conduct a blood urea nitrogen (BUN) test assessing the amount of nitrogenous waste in the body which the kidneys should have filtered. If there’s an excess amount of nitrogen compound in the blood, it could signal kidney problems leading to the development of uremia (DrEsselstyn). Dr Motse administers fluids and treats high blood pressure through ACE inhibitors to preserve protein and prevent further damage to the kidneys.
• Diabetic and hypertensive nephropathy: Diabetic nephropathy (DN), common in diabetes I and 2, occurs when high blood sugar related to unmanaged diabetes causes high blood pressure, and damages the kidneys’ intricate filtration system leading to kidney failure. A severe reduction in the glomerular filtration rate (GFR), increased arterial blood pressure (BP), hypertension and high blood sugar are characteristic signs of diabetic and hypertension nephropathy. People with diabetic and hypertension nephropathy will develop symptoms of high blood pressure, nausea, vomiting, fatigue, intense itching, as well as swollen hands and ankles. If diabetic nephropathy is left untreated, it’s highly likely that there will be a build-up of potassium in the blood known as hyperkalaemia and there’s an increased risk of cardiovascular disease, anaemia and a late-stage of renal failure. Dr Kagiso Motse treats diabetic and hypertension nephropathy addressing high blood pressure as well as elevated glucose levels prescribing medication based on the severity of the condition.
• Cardio-renal syndrome: Diabetes is an isolated condition that can affect both the kidneys and the heart leading to the cardio-renal syndrome. The elderly suffering from high blood pressure, diabetes or those who have a history of kidney or heart disease are more susceptible to developing this condition. Congestive heart failure (CHF) hinders the heart’s ability to supply the arteries with blood. As a result, the body triggers a flight or fight response causing the constriction of the arteries to increase blood pressure. As a result of the pituitary gland pumping the ADH hormone forcing the retention of fluid, the kidneys are unable to filter waste. People suffering from cardio-renal syndrome will experience shortness of breath or swelling from fluid retention. Recognising that heart failure is the cause of increased fluid, Dr Kagiso Motse treats the condition through diuretic medication and should this fail, dialysis will be necessary.
• Hepato-renal syndrome: Hepato-renal syndrome arises from severe liver malfunctioning as a result of progressive liver failure often recognised in people living with liver cirrhosis, or autoimmune diseases, hepatitis or liver tumours. Portal hypertension occurs in severe liver diseases, limiting blood supply to the kidneys. From portal hypertension, the kidney’s blood vessels constrict triggering the kidneys retention of water and salt. Because of retention, the kidneys are starved off blood supply and as a result, are unable to function correctly. Since the kidneys are malfunctioning because of the underlying liver disease, Dr Kagiso Motse utilises medication and dialysis for severe kidney damage until the liver disease is resolved.