The kidneys play key roles in body function, not only by filtering the blood and getting rid of waste products, but also by balancing levels of electrolyte levels in the body, controlling blood pressure, and stimulating the production of red blood cells. The kidneys are located in the abdomen toward the back, normally one on each side of the spine. They get their blood supply through the renal arteries directly from the aorta and send blood back to the heart via the renal veins to the vena cava. (The term “renal” is derived from the Latin name for kidney.)
The term “kidney disease” can refer to any type of condition that greatly reduces the functioning of the kidneys. Some forms of kidney disease are acute, which means that the damage is sudden and symptoms reveal themselves very quickly. Chronic kidney disease means that the decline in kidney function is slow and progressive. There are several different types of kidney disease, some of which are worse than others-
Kidneys play a critical role in keeping the body healthy by cleaning and processing the blood. Working together, the 2 million nephrons filter and process 3-4 liters of blood approximately every 5 minutes, 24 hours a day, 7 days a week.It is important to be aware of any problems you may be having with your kidneys and get treatment quickly. Some common symptoms and signs of kidney problems are:
Kidney disease can be caused by a number of conditions, though in many cases no cause can be determined. By getting an early diagnosis and learning how to manage your condition, you and your doctor might help delay or even prevent the onset of kidney disease.
When kidney function is decreased, substances such as urea, creatinine, and certain electrolytes begin to build up in the bloodstream. The following blood and urine tests measure changing levels of these substances in the bloodstream and can help estimate how well your kidneys are working.
Blood Tests: The simplest way to monitor kidney function is to obtain blood tests for BUN (blood urea nitrogen) and creatinine.
Urine Tests: One of the primary functions of the kidneys is to filter blood and remove waste products. Urine tests measure how well your kidney filters are working.
Measuring Kidney Function: The filtering function of the kidneys may be measured or estimated in several ways:
Imaging Tests: Various imaging tests can provide useful information about the kidneys with little or no discomfort and minimal risk to the patient. Various tests are;
Kidney Biopsy: The procedure of obtaining and examining a small tissue sample from the kidney is called a kidney, or renal biopsy.
Treatment of acute renal failure depends partly on the cause and extent of the failure. The patient should be referred to a kidney specialist (nephrologists) for care. The first goal is to pinpoint the exact cause of the kidney failure, as that will partly dictate the treatment. Secondly, the degree to which accumulating wastes and water are affecting the body will impact treatment decisions about medications and the need for dialysis.
The goal of treatment for chronic kidney disease is to prevent or slow additional damage to your kidneys. One of the most important parts of treatment for chronic kidney disease is to control the disease that is causing it. If you have diabetes or high blood pressure, you and your doctor will create a plan to aggressively treat and manage your condition to help slow additional damage to your kidneys. Your doctor will also check you for other conditions or diseases that may cause kidney damage, including a blockage (obstruction) in the urinary tract or long-term use of medicines that can damage the kidneys, such as antibiotics or pain relievers (such as NSAIDs).
In medicine, dialysis (from Greek “dialusis”, meaning dissolution, “dia”, meaning through, and “lysis”, meaning loosening) is primarily used to provide an artificial replacement for lost kidney function in people with renal failure.
Dialysis is the artificial process of getting rid of waste (diffusion) and unwanted water (ultrafiltration) from the blood. This process is naturally done by our kidneys. Some people, however, may have failed or damaged kidneys which cannot carry out the function properly – they may need dialysis. In other words, dialysis is the artificial replacement for lost kidney function (renal replacement therapy). Dialysis may be used for people who have become ill and have acute kidney failure (temporary loss of kidney function), or for fairly stable patients who have permanently lost kidney function.
Hemodialysis: Hemodialysis is the process of pumping blood through a machine which takes blood from the patient via a catheter, filtering the blood through a semipermeable membrane and returning the filtered blood through another catheter back into the patient. Most often the treatment is performed three times a week for 3 to 5 hours each time. Twice a week sessions are limited to patients who have some residual kidney function.
Peritoneal Dialysis: In peritoneal dialysis, the patient’s peritoneum, or lining of the abdomen, acts as a blood filter. A catheter is surgically inserted into the patient’s abdomen. During treatment, the catheter is used to fill the abdominal cavity with dialysate. Waste products and excess fluids move from the patient’s bloodstream into the dialysate solution. After a waiting period of six to 24 hours, depending on the treatment method used, the waste-filled dialysate is drained from the abdomen and replaced with clean dialysate.
A kidney stone is a hard mass developed from crystals that separate from the urine within the urinary tract. Normally, urine contains chemicals that prevent or inhibit the crystals from forming. These inhibitors do not seem to work for everyone, however, so some people form stones. If the crystals remain tiny enough, they will travel through the urinary tract and pass out of the body in the urine without being noticed.
Kidney stones may contain various combinations of chemicals. The most common type of stone contains calcium in combination with either oxalate or phosphate. These chemicals are part of a person’s normal diet and make up important parts of the body, such as bones and muscles. A less common type of stone is caused by infection in the urinary tract. This type of stone is called a struvite or infection stone. Another type of stone, uric acid stones, are a bit less common, and cystine stones are rare.
Urothelial cancer: This is also referred to as transient cellular carcinoma.It makes up 5-10% of kidney cancers diagnosed in adults.Urothelial carcinoma starts in the region of the kidney where urine gets collected.
Sarcoma: Kidney sarcoma is a rare condition. It is normally treated by surgery. However, sarcoma usually returns to the renal area or propagates to other parts of the body. Another surgical procedure or chemotherapy may be recommended following the initial surgery.
Wilms tumor: Wilms tumor is better treated with radiation and chemo than other types of kidney cancer in conjunction with surgery. The outcome was a different approach to treatment.
Lymphoma: Lymphoma can enlarge both kidneys and is associated with large lymph nodes, known as lymph node disease, in other parts of the body, including the neck, chest, and abdominal cavity. If lymphoma is a possibility, your physician can do a biopsy and suggest chemo instead of surgery.
Kidney stones are one of the most painful and common disorders of the urinary tract. Depending on where they are located, kidney stones are known as urinary calculi, urinary tract stone disease, renal calculi, nephrolithiasis, ureterolithiasis and urolithiasis.
Fortunately, most stones can be treated without surgery. About 90 percent of all kidney stones can pass through the urinary system spontaneously with the help of plenty of water (two to three quarts a day) to help the stone move along. In addition to extra water consumption, the doctor may prescribe antibiotics to fight infection. For bigger stones, or stones that have more problems getting out of the kidneys, there are small tools a doctor can use to take them out or surgery may be required. Following are the various types of kidney stone treatment available;
Extracorporeal shock wave Lithotrispy (ESWL): Extracorporeal shock wave Lithotripsy (ESWL) uses highly focused electromagnetic waves projected from outside the body to crush kidney stones anywhere in the urinary system. The stones turn out to be sand-like and are passed. For removal of this procedure, patients are located in a tub of warm, purified water or onto a water cushion machine that operates as a means for passing on these non-electrical shockwaves.
Percutaneous Nephrostolithotomy (PCNL): Percutaneous Nephrostolithotomy is a minimal invasive procedure. Percutaneous (i.e., through the skin) removal of kidney stones (lithotomy) is accomplished through the most direct route. A telescope along with a mechanical lithotriptor is inserted to break stone into fine particles to achieve stone-free status in large and complicated stones.
Ureteroscopic Lithotrispy with Holmium Laser: This procedure is performed to treat stones located in the middle and lower ureter. A small, fiberoptic instrument (ureteroscope) is passed into the ureter. Large stones are fragmented using 100-Watts Coherent Holmium Laser. The laser fragments stone into sand like particles, which are then flushed out through the natural urinary passage.
Open (incision) Surgery: This last removal method for kidney stone includes opening the affected area and removing the stone(s). In this procedure, run in an operating room after a person has been given anesthesia, the surgeon creates an incision in the skin and unlocks the pelvis of the kidney or the ureter in order that the stone can be manually removed. Since open surgery is a principal operation, healing may need four to six weeks.