Kidney disease

Kidney disease: Description, Causes and Risk Factors: Alternative Name: Kidney disorders. Kidney diseaseThe Kidney disease is essential for life. Their major function is to regulate the water content, mineral composition and acidity of the body. They are also involved in the excretion of metabolic waste products and of various chemicals. The kidneys also produce hormones which are involved in the production of blood cells, in the absorption of calcium from food, and in the control of blood pressure. The kidneys can be affected by a variety of factors, including infection, toxic substances, high blood pressure, diabetes, kidney stones, etc. Problems can be sudden or they can build up gradually. Polycystic kidney disease (PKD) is one of the most common types of disorder. Other kidney disease may include pyelonephritis, renal acidosis, nephritis, nephropathy, renal cancer, end-stage renal disease. There are no reliable statistics about kidney patients in world. In the West it is estimated that for every 10-lakh people there are 100 patients developing advanced kidney disease each year. The most common causes of kidney disease include diabetes, high blood pressure, and hardening of the arteries. Some kidney diseases are caused by an inflammation of the kidneys, called nephritis. This may be due to an infection or to an autoimmune reaction where the body's immune or defense system attacks and damages the kidneys. Other kidney diseases, such as polycystic kidney disease are caused by problems with the shape or size of the kidneys (anatomic disorders), while other kidney diseases interfere with the inner workings of the kidneys (metabolic disorders). Most metabolic kidney disorders are rare, since they need to be inherited from both parents. Other common causes of kidney failure include certain medications that can be toxic to kidney tissue, and blockages of the system that drains the kidneys. Symptoms: Many types of kidney disorders have been identified so far. Different types of kidney disease are caused due to different reasons and they show different signs and symptoms. Symptoms may include:
  • General ill feeling and fatigue.
  • Generalized itching (pruritus) and dry skin.
  • Headaches.
  • Weight loss without trying to lose weight.
  • Appetite loss.
  • Nausea.
Other symptoms that may develop, especially when kidney function has worsened:
  • Abnormally dark or light skin.
  • Bone pain.
  • Brain and nervous system symptoms.
  • Drowsiness and confusion.
  • Problems concentrating or thinking.
  • Numbness in the hands, feet, or other areas.
  • Muscle twitching or cramps.
  • Breath odor.
  • Easy bruising, bleeding, or blood in the stool.
  • Excessive thirst.
  • Frequent hiccups.
  • Low level of sexual interest and impotence.
  • Menstrual periods stop (amenorrhea).
  • Sleep problems, such as insomnia, restless leg syndrome, and obstructive sleep apnea.
  • Swelling of the feet and hands (edema).
  • Vomiting, typically in the morning.
Diagnosis:
  • High blood pressure is almost always present during all stages of kidney disease. A neurologic examination may show signs of nerve damage. The health care provider may hear abnormal heart or lung sounds with a stethoscope.
  • A urinalysis may show protein or other changes. These changes may appear 6 months to 10 or more years before symptoms appear.
Tests that check how well the kidneys are working include:
  • BUN.
  • Creatinine levels.
  • Creatinine clearance.
  • Every patient needs to have the following checked regularly, as often as every 2 - 3 months when kidney disease gets worse, complete blood count (CBC), potassium, sodium, albumin, phosphorous, calcium, cholesterol, magnesium, electrolytes, erythropoietin, PTH parathyroid hormone), bone density test.
Imaging Tests:
  • Abdominal CT scan.
  • Abdominal MRI.
  • Abdominal ultrasound.
  • Renal scan.
Treatment: Controlling blood pressure is the key to delaying further kidney damage. The goal is to keep blood pressure at or below 130/80 mmHg. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are used most often. Other treatments may include: Special medicines called phosphate binders, to help prevent phosphorous levels from becoming too high. Treatment for anemia, such as extra iron in the diet, iron pills, special shots of a medicine called erythropoietin, and blood transfusions. Extra calcium and vitamin D (always talk to your doctor before taking). You may need to make changes in your diet. Everyone with chronic kidney disease should be up-to-date on important vaccinations, including:
  • Influenza vaccine.
  • H1N1 (swine flu) vaccine.
  • Pneumococcal polysaccharide vaccine (PPV).
  • Hepatitis B vaccine.
  • Hepatitis A vaccine.
  • When loss of kidney function becomes more severe, you will need to prepare for dialysis or a kidney transplant.
Dialysis: Dialysis depends on different factors, including your lab test results, severity of symptoms, and readiness. You should begin to prepare for dialysis before it is absolutely necessary. The preparation includes learning about dialysis and the types of dialysis therapies, and placement of a dialysis access. Even those who are candidates for a kidney transplant will need dialysis while waiting for a kidney to become available. A recent study has shed light on causes and treatment of nephrotic syndrome. Angiopoietin-like 4 protein is over expressed in case of this kidney disease. Suppressing the over expression of the protein would bring in a change in the disease state, says the study. The researchers also determined that the Angiopoietin-like 4 protein lacks the attachment of adequate amounts of sialic acid, a modified carbohydrate that affects the protein's adhesive properties. Preventive Measures:
  • Do not smoke.
  • Eat meals that are low in fat and cholesterol.
  • Get regular exercise.
  • Take drugs to lower your cholesterol, if necessary.
  • Keep your blood sugar under control.
  • You may need to limit fluids.
  • You may have to restrict salt, potassium, phosphorous, and other electrolytes.
  • It is important to get enough calories when you are losing weight.
  • Always talk to your kidney doctor before taking any over-the-counter medicine, vitamin, or herbal supplement. Make sure all of the doctors you visit know you have chronic kidney disease.
Disclaimer: The above information is educational purpose. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. DISCLAIMER: This information should not substitute for seeking responsible, professional medical care.  

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