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KIDNEY DISEASE AND YOU
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medcialonline-Urology & Nephrology

Tamilnadu is an fine destiny for Medical tourism. We shall discuss some of diseases under Urology on www.medicalonline.in

Kidneys are a pair of bean shaped organs in our body, which work silently in maintai-ning the normal status of our blood. It is in the kidney that the substances in the blood, which are usually produced by our intake of food and subsequent digestion, are filtered from the blood and excreted in the urine, along with water.
In most conditions of impaired kidney function the external signs and symptoms are usually manifest only when over more than 90% of the kidney is malfunctioning.
The best chance for kidney disease to be treated or managed depends solely on early detection and inter-vention. Diseases in different organs can affect the kidney and in the same vein when the kidney does not function it alters the working of many systems in the body. The diag-nosis is done by a combination of history taking, examination and mandatory laboratory tests, as kid-ney disease cannot be detected from the external alone.
Kidney disease can be divided into two types. Acute kidney disease and chronic kidney disease. Certain chronic diseases like diabetes and hypertension over the course of many years can lead to gradual wor-sening of the kidney function and cause chronic kidney disease. Usually chronic kidney disease cannot be cured, but has to be mana-ged, to limit progression, under the care of a nephrologist.
Acute kidney injury is that usually which occurs suddenly or if there is rapid change in the kidney function from baseline over days or weeks. This needs to be investigated emer-gently as recovery depends on early diagnosis of cause and treatment. Certain causes of Acute kidney injury can be treated, leading to recovery.
Many conditions can cause kidney failure and need to be asked for by the treating doctor e.g.:Diabetes, Hypertension, Immune mediated diseases in which the persons own immune cells attack parts of the kid-ney e.g.: rheumatologic diseases like lupus, certain types of medications or medications in excessive doses, heavy metals, infections, stones, obstruction etc.
Signs and symptoms of chronic kidney disease develop slowly and can mimic other disease processes. Common symptoms include nausea, vomiting, loss of appetite, decreased or no urine output, fatigue, and sleep problems, itching.
It is possible to have significant kid-ney disease with good urine output that could be misleading, so patients with conditions like diabetes and hypertension should be investigated before symptoms begin.
Acute kidney disease may present itself with sudden increase in blood pressure, blood in urine, generalized swelling, frothy urine along with the other symptoms.
Complications secondary to kidney failure can affect almost any part of the body.
Generalized body swelling, high BP, abnormal blood tests like high creatinine, high potassium and high urea occur. Anaemia due to low hemoglobin can cause tiredness and shortness of breath. Bone changes occur with abnormalities in blood calcium and phosphorous values. There is an increased risk for heart disease and infections.
Urea, creatinine, potassium, bicar-bonate, calcium, phosphorous, uric acid, hemoglobin are basic blood tests needed for diagnosis. Urine examination is done to check for blood and protein in urine. Imaging studies like ultrasound abdomen may be done.
In some select cases renal biopsy to study a piece of kidney tissue under the microscope is required. Addi-tional tests may be needed based on the medical history.
Management of underlying disease like Diabetes, hypertension, and cholesterol is crucial. The BP control aim should be below 130/80. 
Nutrition consultation to adjust the diet for the blood changes is an important treatment modality. Gene-ral recommendations would include fluid restriction, salt restriction and pro-tein restriction to reduce load on kidney. It is best that nutritional adjustments are tailor made to the individual based on the blood repo-rts. Periodic review with the nephro-logists is needed to assess the blood reports and progress of the disease.
Treatment with drugs is directed to treating cause of kidney failure. Sometimes the kidney failure may progress despite the treatment, then the focus is mainly in treating blood pressure with kidney protective medicine like Angiotensin receptor blocker, medicine for lowering cholesterol, medication to reduce anemia called erythropoietin, diure-tics to reduce swelling, medication to protect the bones like calcium and vit D supplement, phosphate lowe-ring medication to lower phospho-rous in the blood and protect the bones.
When kidney function is less than 15% it is called end stage renal disease and the nephrologists would recommend need for dialysis or kid-ney transplantation. The options of peritoneal dialysis and hemodialysis can be offered. Transplantation options of living donor or cadaver in keeping with the laws of the land need to be discussed.
The diagnosis and treatment of renal patients is very draining emotionally for the patient and the care giver. It is imperative that both the patient and the care giver develop coping strate-gies after an open discussion with the doctor. Finding a support group, following a normal, routine exercise and an active social life help in improving quality of life.
Prevention is the name of the game as worldwide the incidence of end stage renal disease is increasing, with diabetes being the major cause.  An investment in prevention, with lifestyle changes and early detection would limit the financial, emotional and physical burden of this disease.

Kidneys are a pair of bean shaped organs in our body, which work silently in maintai-ning the normal status of our blood. It is in the kidney that the substances in the blood, which are usually produced by our intake of food and subsequent digestion, are filtered from the blood and excreted in the urine, along with water.

In most conditions of impaired kidney function the external signs and symptoms are usually manifest only when over more than 90% of the kidney is malfunctioning.

The best chance for kidney disease to be treated or managed depends solely on early detection and inter-vention. Diseases in different organs can affect the kidney and in the same vein when the kidney does not function it alters the working of many systems in the body. The diag-nosis is done by a combination of history taking, examination and mandatory laboratory tests, as kid-ney disease cannot be detected from the external alone.

Kidney disease can be divided into two types. Acute kidney disease and chronic kidney disease. Certain chronic diseases like diabetes and hypertension over the course of many years can lead to gradual wor-sening of the kidney function and cause chronic kidney disease. Usually chronic kidney disease cannot be cured, but has to be mana-ged, to limit progression, under the care of a nephrologist.

Acute kidney injury is that usually which occurs suddenly or if there is rapid change in the kidney function from baseline over days or weeks. This needs to be investigated emer-gently as recovery depends on early diagnosis of cause and treatment. Certain causes of Acute kidney injury can be treated, leading to recovery.

Many conditions can cause kidney failure and need to be asked for by the treating doctor e.g.:Diabetes, Hypertension, Immune mediated diseases in which the persons own immune cells attack parts of the kid-ney e.g.: rheumatologic diseases like lupus, certain types of medications or medications in excessive doses, heavy metals, infections, stones, obstruction etc.

Signs and symptoms of chronic kidney disease develop slowly and can mimic other disease processes. Common symptoms include nausea, vomiting, loss of appetite, decreased or no urine output, fatigue, and sleep problems, itching.

It is possible to have significant kid-ney disease with good urine output that could be misleading, so patients with conditions like diabetes and hypertension should be investigated before symptoms begin.

Acute kidney disease may present itself with sudden increase in blood pressure, blood in urine, generalized swelling, frothy urine along with the other symptoms.

Complications secondary to kidney failure can affect almost any part of the body.

Generalized body swelling, high BP, abnormal blood tests like high creatinine, high potassium and high urea occur. Anaemia due to low hemoglobin can cause tiredness and shortness of breath. Bone changes occur with abnormalities in blood calcium and phosphorous values. There is an increased risk for heart disease and infections.

Urea, creatinine, potassium, bicar-bonate, calcium, phosphorous, uric acid, hemoglobin are basic blood tests needed for diagnosis. Urine examination is done to check for blood and protein in urine. Imaging studies like ultrasound abdomen may be done.

In some select cases renal biopsy to study a piece of kidney tissue under the microscope is required. Addi-tional tests may be needed based on the medical history.

Management of underlying disease like Diabetes, hypertension, and cholesterol is crucial. The BP control aim should be below 130/80. 

Nutrition consultation to adjust the diet for the blood changes is an important treatment modality. Gene-ral recommendations would include fluid restriction, salt restriction and pro-tein restriction to reduce load on kidney. It is best that nutritional adjustments are tailor made to the individual based on the blood repo-rts. Periodic review with the nephro-logists is needed to assess the blood reports and progress of the disease.

Treatment with drugs is directed to treating cause of kidney failure. Sometimes the kidney failure may progress despite the treatment, then the focus is mainly in treating blood pressure with kidney protective medicine like Angiotensin receptor blocker, medicine for lowering cholesterol, medication to reduce anemia called erythropoietin, diure-tics to reduce swelling, medication to protect the bones like calcium and vit D supplement, phosphate lowe-ring medication to lower phospho-rous in the blood and protect the bones.

When kidney function is less than 15% it is called end stage renal disease and the nephrologists would recommend need for dialysis or kid-ney transplantation. The options of peritoneal dialysis and hemodialysis can be offered. Transplantation options of living donor or cadaver in keeping with the laws of the land need to be discussed.

The diagnosis and treatment of renal patients is very draining emotionally for the patient and the care giver. It is imperative that both the patient and the care giver develop coping strate-gies after an open discussion with the doctor. Finding a support group, following a normal, routine exercise and an active social life help in improving quality of life.

Prevention is the name of the game as worldwide the incidence of end stage renal disease is increasing, with diabetes being the major cause.  An investment in prevention, with lifestyle changes and early detection would limit the financial, emotional and physical burden of this disease.

For more information contact: 0091 4442271001

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