Diseases of the kidneys


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Kidney Diseases

Diseases of the kidneys

Most kidney diseases attack both kidneys simultaneously. The Kidney diseases mostly target nephrons. Nephrons  can be damaged quickly making them incapable of filtering. Damage to nephrons, however is a slow and silent process. Its only after several years or sometimes, even decades that the damage becomes evident.

Causes :

The most common cause of a kidney disease is Diabetes and High blood pressure. People having a family history of any kind of kidney problem, are also at the risk of getting one too.

Diabetes:

Diabetes is a disease which keeps the body from absorbing the glucose. Gloucose is good if it beaks down and gets absorbed. If it stays in the blood, it can be a poison. The unused, unabsorbed glucose damage the nephrons.  Maintaining a low glucose level can help delay or even prevent the kidney disease.

 

High blood pressure:

High blood pressure can damage the small blood vessels in the kidneys. The damaged vessels cannot filter wastes from the blood as they are supposed to.
 

 

 

 

Glomerular: The early signs Glomerular disease are proteinureia (too much protein in urine) and/or hematuria (blood in urine). As the name suggests, Glomerular disease attacks the tiny blood vessels or glomerulli within the kidney, slowly deteriorating the kidney function. Several types of kidney diseases come under this category including autoimmune diseases, infection-related diseases, and sclerotic diseases.

Hereditary: Some kidney diseases are hereditary. For example Polycystic kidney disease (PKD) is a genetic disorder in which a large amount of cysts grow within the kidney and gradually replace much of the kidney mass, reducing renal function and ultimately kidney failure.

Over-the-counter medications:

 

Other causes of kidney disease are various medications. Some over the counter pills can dangerous to kidneys if taken regularly for a long period of time. People who take painkillers regularly should check with the doctor if their kidneys are not in trouble.

The kidneys, like all other organs or parts of body, are subject to disorders from the presence of surplus waster of irritating character. A simple inflammation and congestion of these organs is called acute nephritis, and when this process is prolonged it becomes chronic. In this case the kidney passes off some of the more solid ingredients of the blood which show in the urine in the form albumen, fat, white corpuscles, red corpuscles. If abscesses from in the kidneys there will be pus in the urine.

Diseases of the kidneys are never primary conditions but are preceded by other disorders, perhaps of the liver or valvular heart trouble or arterio sclerosis. The immediate cause is overwork of these organs from excess pressure in the blood vessels or an excess of irritating wastes or extraneous materials in the blood, intestinal toxins, drugs, vaccines, serums, antitoxins, etc.

Sometimes insoluble materials deposit in the kidneys forming “gravel” or stones and called calculi. These stones may lodge in the ureter in the way to the bladder and block the passage of urine seriously affecting the function of the kidney.

Another condition occasionally met with is a “movable kidney”. The kidney is normally imbedded in fat which holds or anchors the kidney in place. This may also occur as a result of injury.

The kidneys may also be affected with a tubercular process when this disease is present in the body.

Any disease of the kidneys is a serious matter as it prevents the normal discharge of poisonous wastes and very often permits the loss of the normal ingredients of the blood if the passage of urine is entirely obstructed, the patient will die of uremia poisoning in a very few hours.

Analysis of the urine will tell us whether or not the kidneys are functioning properly, and if not, the abnormal products or quantities of certain products will indicate the cause of the trouble. In this short article we cannot go into the details of the subject,

However, we warn you not to rely on the symptoms of kidney trouble recited in patent medicine advertisements. A pain in the “small of the back” does not necessarily indicate a disease of the kidneys. This may come from muscle strain. Constipation, generative trouble or sexual excess. People who have indulged too freely in alcoholic liquors, tobacco, coffee, sugar, candy and pastry or who have habitually taken physics are liable to kidney disorders.

Fasting and dieting to purify the blood are essential to promote the proper cure. The diet  should consist largely of fresh fruits, and vegetables, with a few nuts, meat, eggs, cheese, bread, coffee, alcohol, tobacco, condiments and salt must be entirely eliminated from the diet.

In case of calculi the patient should use plenty of grapefruit, oranges, lemons and limes with two tablespoons of olive oil, night and morning. A diet of this kind will also help to restore a movable kidney to normal kidney position.

Situated in the upper part of the abdominal cavity, behind the peritoneum (the membrane lining the interior of this cavity) and on either side of the spinal column are the world’s most complex and amazing filtering plant created by man’s in genuity has ever been able to reproduce their remarkable construction and precise workings. And understandably so. For the kidney is the most important of all the organs concerned with maintaining the constancy of the internal environment.

Perhaps this needs some explaining. The cells of our body (and those of the other higher organisms) live in a fluid environment which Claude Bernard, one of the most celebrated figures in the history of physiology, named the “milieu interieur” or internal environment.

This internal environment, or the “extra cellular fluid” as it is also called, consists of

  1. the tissue fluids which circulate slowly, bathing and soothing the cells

  2. the lymph, which goes from the tissues to the blood

  3. the blood which circulates rapidly within a closed system (i.e. the arteries, arterioles, veins, venules and capillaries).

The composition of this extra cellular fluid must be kept stable, within very narrow limits, if the organism id ti continue functioning properly and independently. Bernard called this the “fixity of the internal environment” and pointed out that the functions of the human body to maintain steady states by many complex but coordinated physiological processes which involve the brain, nerves, heart, kidneys. Lungs. Etc

The Last Word

Now since in the long run this internal environment is determined, not so much by what is taken in, as by what is retained and what is excreted, it is pretty obvious that kidneys have the final say in keeping the internal environment stable. It is also obvious that if the kidneys are overstrained and suffer a loss of function, the individual cell and, consequently, the whole body will be the worse  off. As a matter of fact, the kidneys can be overstrained to such a point that death may follow in a matter of hours. This point, fortunately, in a fairly young and normally healthy person is far off for the kidneys have been remarkably constructed to withstand an awful lot of abuse. After years of long living, however, this point comes uncomfortably closer. That is why, for those who have passed middle age and especially those with previous kidney complaints, it is so important to do everything to regain and maintain the health of their kidneys.

How can they go about doing this?

The answer, of course, is to see that the kidneys are not strained beyond theer capacity. And to do this it would be best to learn something about how the kidneys work to keep the internal environment stable.

Variations in urine

In the normal adult man from 1000 – 1500 cc. (1 to 1 ½ quarts) of urine are excreted by the kidney. (Children excrete from 3-4 times as much urine per kilogram of body weight as adults.) however, urinary volume varies with amount of fluids which are taken in and dependinding upon the amount which is eliminated via the skin, lungs and intestines. It also varies depending upon:

  1. Diet: A protein diet increases the amount if urea and i=other toxic substances which must be excreted so that urinary volume also increases.

  2. Temperature: A high temperature causes sweating and so increases the amount of water eliminated through the skin. Consequently, urinary volume decreases.

  3. Posture: Urinary volume increases while in a horizontal position.

  4. Exercise: After short, violent exercise, kidney blood flow decreases, diminishing the filtration rate of the kidneys and thus the urinary output.

  5. Disease. A diseased condition signifies an increase in the amount of toxins in the blood and so increased need in excreting them, urinary output, therefore, increases. In the case of diabetes, the high concentration of glucose in the renal tubes prevents the reabsorption of water so that, again, urinary output is increases. However in certain kidney disorders, urinary output may decrease or diminish depending upon the disorder. If for example, the kidneys lose their capacity to concentrateurine, urinary output will increase, if the kidneys lose capacity to excrete sodium, which retains water in the tissues, urinary output will decrease. For this reason, it is very important to determine the effect of the kidney disorder by careful blood and urine analysis before proceeding with treatment.

  6. Pregnancy: Pregnancy increases urinary volume because the kidneys are taxed by the end products of metabolism of both mother and child.

Kidney Reserve

From this much simplified picture of kidney function you can understand why and how the capacity of the kidneys is much above normal needs. As a matter of fact, it's been estimated that their ca­pacity  is  roughly  about  400%   above their normal work load. But you can also understand   why   anything   which   will irritate   or   obstruct   the   work   of   the nephron will diminish kidney function and predispose the kidney to infection and disease. If the irritation is constant, kidney  function   will  progressively   de­teriorate until a chronic renal disease re­sults, very probably followed by an early death unless steps are taken to correct the condition.

Such was the case of a woman who as a child lacked the resistance to ward off a streptococci infection (such as scarlet fever) which further developed into an acute case of glomerular nephritis  (an acute inflammation of the glomerulii). During the acute phase of this disease, her kidney function deteriorated to such an extent that its capacity fell below the normal work load and permanent dam­age to the kidneys resulted. After the acute phase had subsided, her kidneys remained in  a weakened  condition so that the disease became latent. Complete kidney   capacity  was  never  recovered, though the existing capacity was m than   enough   under   normal   circumstances. At the age of 25 the woman came pregnant and her kidneys ag were taxed beyond their capacity. Ag; permanent kidney damage resulted ; kidney function deteriorated still m1 Because   of   the   kidneys'    remark; power  to  take  abuse,  the  woman covered from her complicated pregnancy but with  considerably weaker kidneys. Though these could still handle a normal work load, a typically rich, high protein diet (on the assumption that she to build up her "strength") did the : The woman died, at the age of fifty-i of uremia  (blood poisoning due to failure of the kidneys to eliminate t wastes). If a rational, natural program of treatment had been started following childhood disease, or even after pregnancy, her case history need not 1 ended in an early death.

Different Forms of kidney disease

Most people lump all kidney under one name:  Bright's Disease. group of symptoms, that doctors today recognize different forms of this disease:

Glomerulonephritis

An   inflammation of the glomeruli, most often result­ing in the destruction of nephrons and, thus, in diminished kidney capacity. This disease entity is recognized in two forms: the acute and the chronic forms. Acute glomerulonephritis usually occurs only in children and young adults; cases of this disease in those already past the forty year mark are very rare. It begins sud­denly—usually following some infection of the upper respiratory tract—its course is stormy, but given the proper care and attention, it will be overcome by the body without any or little permanent damage to the kidneys resulting. Chronic glom­erulonephritis, on the other hand, is an­other story. Its onset is insidious—pos­sibly tracing its beginnings to a poorly tended   childhood   attack   of   nephritis which  instead  of being cured became latent—and it is this very characteristic of unsuspected existence that makes this form of the disease so dangerous. Too often extensive, irreparable damage is done to kidneys before the victim is aware of its presence and then it's too late.

Hematuria : Blood in Urine

The condition of blood in Urine is termed as Hematuria. The presence of blood in the urine is probably one of the first noticeable—and certainly one of the most consistent— signs  of   glomerulonephritis.  The same may be caused due to Improper functioning of Kidney’s, Stone in Urinary Bladder, some infection, sudden weather climate changes or presence of some parasites, some injury or trauma are few reasons for the same. Headache may give an indication of the rise in blood   pressure   which   usually   accom­panies kidney damage. Edema or dropsy is also very often an accompaniment of it. The victim may complain of weak­ness, backache and loss of appetite. This may result pain in Kidneys, Urine may show blood which could have come with or without pain, there can be burning sensation, and however the burning sensation is in rare case. In such cases as it is advised to consume food devoid of meat, fats, fish, fried, alcohol, spicy food, fruits as well. It is suggested to take plenty of boiled and then cooled water, alkaline, soda water even coconut water is advised. Patient is advised to take Bed rest and preferably with legs raised avoiding strain on Urinary passage. In case Non-diabetic patients Sugarcane juice is recommended. Tea, coffee, cold drinks should be avoided. A urinalysis will usually show—in addition to blood in the urine—the presence of protein and casts and a decreased capac­ity to excrete nitrogen. In the final stages of the disease, the patient will complain of "blurred" or "failing" vision.

Albuminuria ( Albumin/Protein in Urine):

The condition in which albumin is present in urine is called as Albuminuria. Serum Albumin is protein soluble in water which is found in blood plasma. In case where Liver is unable to synthesize Albumin the same can lead to Chronic Liver disease called Cirrhosis of Liver.

This condition can be caused due to Acute Nephritis, Diabetes Mellitus, Nervous disorders, can also be caused due excess of blood in vessels supplying blood to body, syphilis, cystitis, etc. In case such conditions are lasting for longer period resulting to Blood pressure, Hypertension the diagnosis is grave. In such cases normally if it is acute case iron and Calcium Lactate is advised by doctors. Also, patient can be benefited by drinking plenty of water, liquid, lasix to cause free flow of urine. Also spicy, fatty, fried food should be avoided.

  • Nephrosis (or degenerative Bright's disease), a degenerative change in the glomeruli and tubules* without any ap­parent signs of inflammation. Acute nephroses usually accompanies an in­fectious disease or intoxication or poi­soning, Lipoid nephroses is a childhood disease associated with a disturbance in protein metabolism. Chronic nephrosis is a slowly progressive degeneration of the glomeruli and tubules usually asso­ciated with some kind of metabolic dis­ease gout, diabetes, etc. Unlike glomerulonephritis, there is no blood in the urine and the blood pres­sure remains the same. For some reason, though, the basal metabolism rate is low­ered without any apparent change in the functioning of the thyroid gland. Like glomerulonephritis, this disease is char­acterized by marked edema (dropsy) and by the presence of casts and protein in the urine. In addition, the plasma (blood) protein level is lowered while the blood lipids and cholesterol levels are high.

  • Nephrosclerosis (arterioscler-otic Bright's disease), a progressive thick­ening of the small kidney arteries which is characterized by high blood pressure. The clinical symptoms of the benign form of this disease are very like chronic glo­merulonephritis with the exception that  no blood is found in the urine and that the elevated blood pressure precedes the usual signs of kidney involvement, i.e. the presence of protein and casts in the urine, edema and nitrogen retention. As the disease progresses, the patient com­plains of vague digestive disorders, head­aches, etc.  In the still more advanced stages, the heart becomes enlarged and person's     vision     becomes     "blurred" (Bright's blindness). The signs of this benign form are so relatively mild and apparently   generalized   that,   in   many cases, it is this last symptom which leads the patient to seek help .. . when it is already too late. Usually, death comes because of the effects of high blood pres­sure  and  concurrent  vascular  changes rather than failure of the kidneys.

Pelvic Disorders
 

Pyelonephritis

an inflammation of the kidney and the renal pelvis, resulting in the destruction of kidney tissue, its fibrosis and its subsequent contraction, so that the kidney actually becomes smaller. If the destruction of kidney tis­sue is sufficiently widespread, death will result from uremia (blood poisoning from metabolic wastes because of the kidney’s failure to execute them. Pyelonephritis usually follows an in­fection of the urinary tract or mechanical obstruction of the lower urinary tract. (This latter factor plays an important role in the kidney ailments of the older male, since enlargement of the prostate is quite frequently associated with kidney impairment.) The onset of the acute form of this disease is sudden, possibly following a few days of malaise with chills, fever, headache and pain in the groin and in the back. The urine contains bacteria, albumin and pus and there is frequency and burning on urination. Chronic pyelonephritis is more common among women often arising from an acute attack during childhood or during pregnancy when this additional phy­siological strain causes a "lightening up" of an old infection. As in the other forms of chronic kidney ailments, the symp­toms, similar to those of the acute form, may be so mild that the disease may not be recognized until after it has reached the final stages. Recurring bouts of fever with headarhe. lumbar nain and tenderness on palpation of the kidney, as well as the usual urinary symptoms, become more and more common as the disease progresses and should lead to suspicion of the existence of pyelonephritis. The presence of pus and bacteria in the urine should then be convincing evidence of kidney infection.

Inflammation of Pelvis and Renal Colic

Pelvis is the Kidney Part from which urine drains into ureter. By any means in case bacterial infection results into functioning of free flow of urine is called as Pyelitis. Normally, this obstruction can be partial or full part of Urine flow.

In such case patient shows High Temperature also may shiver and show resistance. There can be pain resulted in Loins. In such cases any antibiotic with its normal dosage days can be suggested to stop infection going further. Paracetamol or Antispasmodic can be suggested to relieve pain. Dosage is to be adhered to as per Medical Advice. During and after medication Urine examination has to be carried out. In case of any blockage or congestion it is advisable to take plenty of fluid to reduce burning, irritation and make urine basic/alkaline. In case of severe pain patient can be injected with pain killer medication.

Renal Colic:

There can be pain in Kidneys due to infections or presence of Stone in Kidney. This pain can result due to bloating of kidneys resultant of accumulation of urine. Also, movement of Kidney stones or process in which stone is about to leave Kidney can cause this pain.

This condition causes unbearable pain which can be felt in Urethra or Pelvis as well. Patient may have a feeling of urinal however actually urine may come in drops and not properly. The pain may further reach to thighs and be intermittent in nature. This pain can subside in case of restoration of normal functioning of urination.

In such condition Lasix can be suggested to restore normal flow of urine. Also to reduce pain Anti-spasmodic can be suggested. Externally, massage or Hot water treatment can be given on outer part of Kidney/abdomen. Water/fluid intake is increased and patient may be made to consume oral liquids like coconut water, aerated soda water or milk mixed with water with more amount of water and less milk.

Nephroptosis

When there is mobility witnessed of kidneys, it is called as Nephroptosis. Such situation can be known by X-ray or else physical examination of patient can determine the same. This can be caused due to lifting heavy things, putting in very tight outfit, physical labor, and pressure on organs like Liver.

Patient shows symptoms of uneasiness in bladder, constipation, heavy lower abdomen. These are symptoms though not objective symptoms. In such cases doctors generally operate patient to proper wandering Kidneys. . In case of movable kidneys pad binders on abdomen are also tried and are successful in solving problems and providing almost complete relief to patients.

Generally the same situation is seen more in women. In case of women showing excessive mobility resulting into pain and improper flow of urine, doctors generally operates patient (Nephropexy). Proper binding and padding ensures normalcy. In case of thin ladies if such situation occurs they are generally advised by doctors to put on weight, consume fat and protein rich diet and improve on physical activity. In case of patient complaining of pain normally analgesics are advised by doctors to relive pain.


There are, of course, other recognized forms of kidney ailments: tumors of the kidney, tuberculosis of the kidney, etc. These disorders are comparatively un­common so that they will not be dis­cussed as such in this article. One should bear in mind, however, that even in these cases anything which will improve the overall health of the patient and so of the kidneys, will be of benefit.

Silent Danger

Given half the chance, the kidneys, with their amazing reserve capacity and superlative recuperative powers, in child­hood and early adulthood, will naturally throw off the acute forms of disease. This is not generally the case as age creeps up on us and, so, because of its unsuspected prevalence and hidden dangers, especially for those over 40 the remainder of this "article will dwell at some length on chronic kidney disease.

This deceptive aspect of chronic renal disorders—not often taken into account by the family doctor—is, perhaps, best expressed by Drs. Edwards J. Stieglitz and S. T. Kimble in their chapter on the nephropathies in "Geriatric Medicine" —a standard work on the problems of aging, edited by Dr. Stieglitz, himself.

"The silence of degenerative disease processes cannot be overemphasized. It must be kept in mind constantly if diag­noses are to be made and treatment in­stituted before irreparable damage has occured (italics ours). Attention often is not attracted to the kidneys by symptoms until their vast reserves are depleted and decompensation supervenes . . . Initial symptoms as well as signs may be re­ferred to other symptoms of the body. For example, persistent headache or the sudden blindness of retinal hemorrhage may be the first subjective signal of dan­ger. Only while performing thorough physical examinations and not being sa­tisfied bv routine urinalyses . . . will  physicians diagnose nephropathy in the elderly while there is still an opportunity to salvage appreciable kidney function." There are several factors which in­crease the kidney's susceptibility to dis­ease with advancing years. The patient, and the attending doctor, should be aware of them if any progress is to be made in the prevention and control of kidney impairment.

The human kidney decreases in size as well as in the number of blood vessels it has servicing it, even when there has been no history of kidney disease. A mi­croscopic examination would show the obliteration of many of the functional units (the nephrons). The kidney, there­fore, not only has decreased in size, but in functional capacity.

"Obviously," say Drs. Stieglitz and Kimble, "the probability of previous renal injury increases with age. The silently accumulative injury and its func­tional consequence, however, are . . . dif­ficult to detect."

Previous damage to the kidneys may have resulted from a variety of apparent­ly unimportant factors: repeated exposure to bacterial and non-bacterial toxins such as lead, arsenic, mercury, alcohol, carbon tetrachloride, etc., etc. so often encountered by modern man; mechanical obstruction in the lower urinary tract from an enlarged prostate gland or kidney stones; repeated insults from faulty dietary habits, etc.

"The effect of previous renal damage, whatever the cause, is to leave the patient with fewer functional units (nephrons) and consequently less kidney reserve. He may develop no signs or symptoms of in­sufficiency under the usual work load, but when the renal burden is sufficiently increased as by a severe febril infection or by dehydration, decompensation may occur."

There are other outside factors which affect the kidneys' susceptibility to injury as one's age advances. For example, changes in the circulatory system have a strong effect on renal capacity. The kid­neys are not able to clear the blood of metabolic wastes unless the circulation is adequate. As the years progressively take their toll, circulation reserve becomes less and less.

The liver’s capacity to render toxic substances harmless also diminishes with age. And, so, the kidneys, even though their reserves have been lowered, are called upon to take an added burden. The margin of safety thus becomes smaller.

Tissue Repair Retarded

The rate of tissue repair also decreases with advancing age. It has been calcul­ated—and with a high degree of ac­curacy—that an additional day is neces­sary for the healing of tissue with each five years of age. Translated in terms of kidney function, this means that—even in the absence of kidney disease—the re­covery of a nephron (or nephrons), dam­aged, let us say, by some toxic substance, requires more time in some one over forty than in a young adult. Much too often further strain is placed heedlessly upon the weakened nephron or nephrons before complete healing has been effected and, thus, all chance of future recovery is obviated.

Surely, all these factors point to the need of easing the burden of life— the daily work load – of not just the kidneys but of all the vital organs as one grows older. Unfortunately, many doctors, pa­tients and non-patients alike seem to think that the rules only apply to the other fellow.

The rules of Nature are universal: it's in trying to disregard them that we make our mistakes.