Kidney Biopsy
Kidney Health Care - David Mangusan Jr., PTRP
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Biopsy of the Kidney - A Diagnostic Procedure
A biopsy is a diagnostic procedure that doctors use in order to see a tissue sample under a microscope. A kidney biopsy, also called renal biopsy, involves collection of small pieces of kidney tissue, usually through the use of a needle. This test is helpful in finding or confirming a diagnosis. Performing a biopsy of the kidney is also useful in determining the best course of treatment.
The doctor may recommend kidney biopsy if a patient has
There are several ways of obtaining kidney tissue samples, including
Percutaneous (through the skin) biopsy. The doctor uses a locating needle and an x-ray or ultrasound to find the right spot and then a collecting needle to obtain the tissue sample. The entire procedure usually takes about an hour.
Kidney biopsy through an open operation. If percutaneous biopsy is not advisable because the patient is prone to bleeding problems, open operation to obtain kidney tissue samples may be recommended by the doctor.
Transjugular biopsy. In this procedure, a needle is inserted through a catheter that enters the patient’s jugular vein located in the neck. The needle threads down through the blood vessel to the right kidney in order to get the tissue sample from the inside without puncturing the outside skin of the kidney.
Points to Remember:
Before the Test:
Talk with your doctor to make sure you understand the need for a biopsy.
Sign a consent form.
Inform your doctor about medicines you take and allergies you have.
Avoid food and fluid 8 hours before the test.
After the Test:
Your doctor will likely advise you to lie on your back, or stomach (if you have a transplanted kidney), for 12 to 24 hours.
You should inform your health care provider if you experience or notice problems, such as
References:
National Kidney and Urologic Diseases Information Clearinghouse. Your Kidneys and How They Work: What medical tests will my doctor use to detect kidney disease? National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–3195, August 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/index.htm#6. Accessed July 2008
National Kidney and Urologic Diseases Information Clearinghouse. Kidney Biopsy. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 05—4763, January 2005. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/biopsy/index.htm. Accessed July 2008
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A biopsy is a diagnostic procedure that doctors use in order to see a tissue sample under a microscope. A kidney biopsy, also called renal biopsy, involves collection of small pieces of kidney tissue, usually through the use of a needle. This test is helpful in finding or confirming a diagnosis. Performing a biopsy of the kidney is also useful in determining the best course of treatment.
The doctor may recommend kidney biopsy if a patient has
Blood in his or her urine (hematuria)The doctor who will study the kidney tissue sample is called a pathologist. The pathologist will check the sample for scarring, unusual deposits, or infecting organisms. The result of the kidney biopsy may reveal
Excessive protein in his or her urine, a condition called proteinuria
Impaired kidney function, which causes wastes to build up in the blood.
A kidney condition that can be treated or curedDuring the procedure, the patient may be fully awake with light sedation, or may be asleep under a general anesthesia.
How quickly a kidney failure is progressing
Why a transplanted kidney is not working properly
There are several ways of obtaining kidney tissue samples, including
Percutaneous (through the skin) biopsy. The doctor uses a locating needle and an x-ray or ultrasound to find the right spot and then a collecting needle to obtain the tissue sample. The entire procedure usually takes about an hour.
Kidney biopsy through an open operation. If percutaneous biopsy is not advisable because the patient is prone to bleeding problems, open operation to obtain kidney tissue samples may be recommended by the doctor.
Transjugular biopsy. In this procedure, a needle is inserted through a catheter that enters the patient’s jugular vein located in the neck. The needle threads down through the blood vessel to the right kidney in order to get the tissue sample from the inside without puncturing the outside skin of the kidney.
Points to Remember:
Before the Test:
Talk with your doctor to make sure you understand the need for a biopsy.
Sign a consent form.
Inform your doctor about medicines you take and allergies you have.
Avoid food and fluid 8 hours before the test.
After the Test:
Your doctor will likely advise you to lie on your back, or stomach (if you have a transplanted kidney), for 12 to 24 hours.
You should inform your health care provider if you experience or notice problems, such as
***Note: This is a general information regarding kidney biopsy. Like any other diagnostic procedure, you should talk with your doctor about the risks involved and what information might be obtained from this procedure.
- Bloody urine more than 24 hours after the test
- Fever
- Worsening pain in the biopsy site
- Inability to urinate
- Faintness or dizziness
References:
National Kidney and Urologic Diseases Information Clearinghouse. Your Kidneys and How They Work: What medical tests will my doctor use to detect kidney disease? National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–3195, August 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/index.htm#6. Accessed July 2008
National Kidney and Urologic Diseases Information Clearinghouse. Kidney Biopsy. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 05—4763, January 2005. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/biopsy/index.htm. Accessed July 2008
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Articles on Kidney and Urologic Disorders
Kidney Health Care - David Mangusan Jr., PTRP
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Comprehensive List of Common Kidney and Urologic Problems or Diseases.
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
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This Page Last Revised: November 7, 2009
A B C D E F G H I J K L M N O P Q R S T U V W X Y Z
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- Abnormal Contents of Urine
- Acquired Cystic Kidney Disease
- Acute Kidney Failure
- Analgesic Nephropathy
- Amyloidosis and Kidney Disease
- Anemia in Kidney Disease
- Cancer of the Urinary System
- Caring For The Kidneys When You Have Diabetes
- Child's Bedwetting: Should You Be Concerned?
- Complications
- Complications of Kidney Failure Treatments
- Contents of Urine
- Cystocele
- Cysts
- Getting Screened for Kidney Disease
- Glomerular Diseases
- Glomerular Filtration Rate
- Goodpasture's Syndrome
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- Kidney Biopsy
- Kidney Birth Defects
- Kidney Cysts
- Kidney Damage from Painkillers
- Kidney Disease
- Kidney Disease: Are You At Risk?
- Kidney Diseases Dictionary
- Kidney Dysplasia
- Kidney Dysplasia (Overview)
- Kidney Failure in Children
- Kidney Failure Related Conditions and Their Treatments
- Kidney Health
- Kidney Health Care News
- Kidney Infection
- Kidney (Normal)
- Kidney Stone Prevention Through Diet
- Kidney Stones
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- Polycystic Kidney Disease (PKD)
- Prostate Cancer
- Prostate Problems
- Prostatitis (Inflamed Prostate)
- Proteinuria
- Pruritus (Itching)
- Pyelonephritis
- Talking To Your Doctor About Kidney Disease
- Tests and Diagnostic Procedures For Kidney Function
- Tests for Prostate Problems
- The Kidney: Structures and Functions
- The Nephron
- The Urethra
- The Urinary System: Structures and Functions
- Total Kidney Failure: Treatment Options
- Understanding Glomerular Filtration Rate
- Ureters
- Urethra
- Urinary Incontinence
- Urinary Tract Infection (UTI)
- Urostomy
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This Page Last Revised: November 7, 2009
Tests to Detect Kidney Disease
Kidney Health Care - David Mangusan Jr., PTRP
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Medical Tests to Detect Kidney Disease
Kidney disease may occur initially without any signs or symptoms. The doctor may first detect the condition through routine blood and urine tests. To detect kidney disease, the doctor may use the following tests and diagnostic procedures.
Blood Pressure Measurement
High blood pressure, like kidney disease, may not have early signs or symptoms. High blood pressure can lead to kidney disease. In addition, it may also be a sign that the kidneys are already impaired. Having blood pressure measured by a health professional is the only way to know whether it is high. The result is expressed as two numbers. For example, 120/80 (expressed as 120 over 80). The top number represents the pressure when the heart is beating. It is called the systolic pressure. The bottom number, which is called the diastolic pressure, represents the pressure when the heart is resting between beats. A blood pressure is considered normal when it stays below 120/80. The National Heart, Lung, and Blood Institute (NHLBI) recommends that people with kidney disease should keep their blood pressure below 130/80.
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Tests for Microalbuminuria and Proteinuria
Microalbuminuria is a condition where small amounts of albumin leak into the urine. This may be a sign that kidney function is slowly deteriorating. Normally, the kidneys work to take wastes out of the blood but leave protein. However, impaired kidneys may not be able to separate the blood protein called albumin from the wastes. Proteinuria occurs when large amounts of albumin and other proteins leak into the urine. The doctor may test for protein by using a dipstick in a small urine sample. The color of the dipstick indicates the presence or absence of proteins in the urine.
Another more sensitive test for proteins or albumin in the urine involves laboratory measurement and calculation of the protein-to-creatinine or albumin-to-creatinine ratio. Experts suggest that this test should be used to detect kidney disease in people at high risk, especially those with diabetes. If the first test reveals high levels of protein, another test should be done 1 to 2 weeks later. Persistent proteinuria is the term used when the second test also shows high levels of protein. Additional tests and procedures should be used to determine kidney function.
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Glomerular Filtration Rate Based on Creatinine Measurement
Glomerular filtration rate, or GFR, is a calculation of how the kidneys are efficiently filtering wastes from the blood. GFR calculation requires measurement of creatinine in a blood sample along with weight, age, and values assigned for sex and race.
Creatinine is a waste product that results from the normal breakdown of muscle cells during activity. The kidneys normally take this waste out of the blood and put in the urine. However, when the kidneys are not working properly, creatinine builds up in the blood.
A GFR calculation is more accurate for determining whether a person has impaired kidney function.
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Blood Urea Nitrogen (BUN)
Urea, a compound that contains nitrogen, is a waste product that results after the cells have used protein. Normally, the kidneys take urea out of the blood and put it in the urine. Urea will build up in the blood when the kidneys are not working well.
A deciliter of normal blood contains 7 to 20 milligrams of urea. A BUN more than 20 mg/dL might indicate that kidney function is impaired. Dehydration and heart failure may also cause BUN to become elevated.
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Additional Tests for Kidney Disease
Additional tests may be required to help the doctor identify the cause of problem if blood and urine tests indicate reduced kidney function.
Kidney Imaging. The doctor will use kidney imaging, also known as renal imaging, to take pictures of the kidneys. It includes ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) scan. These imaging tools are helpful in finding unusual growth or blockages to urine flow.
Kidney biopsy. Also called renal biopsy, kidney biopsy is a procedure that requires a sample of kidney tissue that is studied under a microscope. The doctor gets the kidney tissue sample by inserting a needle through the person’s skin into the back of the kidney. The patient may be fully awake with light sedation, or may be asleep under general anesthesia. This kidney test helps the doctor to identify problems at the cellular level.
Top of Page
References:
National Kidney and Urologic Diseases Information Clearinghouse. Your Kidneys and How They Work. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07-3195. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/index.htm. Accessed July 2008
National Kidney and Urologic Diseases Information Clearinghouse. Kidney Biopsy. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 05–4763, January 2005. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/biopsy/index.htm. Accessed July 2008
Top of Page
Article Sections on This Page
Kidney disease may occur initially without any signs or symptoms. The doctor may first detect the condition through routine blood and urine tests. To detect kidney disease, the doctor may use the following tests and diagnostic procedures.
Blood Pressure Measurement
High blood pressure, like kidney disease, may not have early signs or symptoms. High blood pressure can lead to kidney disease. In addition, it may also be a sign that the kidneys are already impaired. Having blood pressure measured by a health professional is the only way to know whether it is high. The result is expressed as two numbers. For example, 120/80 (expressed as 120 over 80). The top number represents the pressure when the heart is beating. It is called the systolic pressure. The bottom number, which is called the diastolic pressure, represents the pressure when the heart is resting between beats. A blood pressure is considered normal when it stays below 120/80. The National Heart, Lung, and Blood Institute (NHLBI) recommends that people with kidney disease should keep their blood pressure below 130/80.
Top of Page
Tests for Microalbuminuria and Proteinuria
Microalbuminuria is a condition where small amounts of albumin leak into the urine. This may be a sign that kidney function is slowly deteriorating. Normally, the kidneys work to take wastes out of the blood but leave protein. However, impaired kidneys may not be able to separate the blood protein called albumin from the wastes. Proteinuria occurs when large amounts of albumin and other proteins leak into the urine. The doctor may test for protein by using a dipstick in a small urine sample. The color of the dipstick indicates the presence or absence of proteins in the urine.
Another more sensitive test for proteins or albumin in the urine involves laboratory measurement and calculation of the protein-to-creatinine or albumin-to-creatinine ratio. Experts suggest that this test should be used to detect kidney disease in people at high risk, especially those with diabetes. If the first test reveals high levels of protein, another test should be done 1 to 2 weeks later. Persistent proteinuria is the term used when the second test also shows high levels of protein. Additional tests and procedures should be used to determine kidney function.
Top of Page
Glomerular Filtration Rate Based on Creatinine Measurement
Glomerular filtration rate, or GFR, is a calculation of how the kidneys are efficiently filtering wastes from the blood. GFR calculation requires measurement of creatinine in a blood sample along with weight, age, and values assigned for sex and race.
Creatinine is a waste product that results from the normal breakdown of muscle cells during activity. The kidneys normally take this waste out of the blood and put in the urine. However, when the kidneys are not working properly, creatinine builds up in the blood.
A GFR calculation is more accurate for determining whether a person has impaired kidney function.
Top of Page
Blood Urea Nitrogen (BUN)
Urea, a compound that contains nitrogen, is a waste product that results after the cells have used protein. Normally, the kidneys take urea out of the blood and put it in the urine. Urea will build up in the blood when the kidneys are not working well.
A deciliter of normal blood contains 7 to 20 milligrams of urea. A BUN more than 20 mg/dL might indicate that kidney function is impaired. Dehydration and heart failure may also cause BUN to become elevated.
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Additional Tests for Kidney Disease
Additional tests may be required to help the doctor identify the cause of problem if blood and urine tests indicate reduced kidney function.
Kidney Imaging. The doctor will use kidney imaging, also known as renal imaging, to take pictures of the kidneys. It includes ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT) scan. These imaging tools are helpful in finding unusual growth or blockages to urine flow.
Kidney biopsy. Also called renal biopsy, kidney biopsy is a procedure that requires a sample of kidney tissue that is studied under a microscope. The doctor gets the kidney tissue sample by inserting a needle through the person’s skin into the back of the kidney. The patient may be fully awake with light sedation, or may be asleep under general anesthesia. This kidney test helps the doctor to identify problems at the cellular level.
Top of Page
References:
National Kidney and Urologic Diseases Information Clearinghouse. Your Kidneys and How They Work. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07-3195. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/index.htm. Accessed July 2008
National Kidney and Urologic Diseases Information Clearinghouse. Kidney Biopsy. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 05–4763, January 2005. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/biopsy/index.htm. Accessed July 2008
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Goodpasture's Syndrome
Kidney Health Care - David Mangusan Jr., PTRP
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Also called anti-glomerular basement antibody disease, Goodpasture’s syndrome is a rare disease that can affect the lungs and kidneys. The condition is a type of an autoimmune disease in which the body’s immune system attacks the body’s normal tissues.
Normally, the immune system creates antibodies to fight off germs or other infections. In Goodpasture’s syndrome, however, the immune system makes antibodies that attack the lungs and kidneys. The reason why this happens is not fully known. Researchers have identified possible causes, which include
Symptoms
Goodpasture’s syndrome may cause people to cough up blood. Bleeding in the lungs can be very serious or even fatal in some cases. However, Goodpasture’s syndrome does not usually lead to permanent lung damage.
Depending on what organ the condition affects, first signs may be vague, such as
Diagnosis
To diagnose Goodpasture’s syndrome, doctors use a blood test, but a kidney or lung biopsy may be necessary to check for the presence of harmful antibodies. In biopsy, a needle is used to extract small samples of kidney or lung tissue for examination under a microscope.
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Treatment
Treatment of Goodpasture’s syndrome may include the use of immunosuppressive drugs and plasmapheresis.
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More Information About Goodpasture’s Syndrome:
American Kidney Fund
Internet: www.kidneyfund.org
National Kidney and Urologic Diseases Information Clearinghouse
Internet: http://kidney.niddk.nih.gov
National Kidney Foundation
Internet: www.kidney.org
Reference:
National Kidney and Urologic Diseases Information Clearinghouse. Goodpasture’s Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07-4558, April 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/goodpasture/index.htm
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Normally, the immune system creates antibodies to fight off germs or other infections. In Goodpasture’s syndrome, however, the immune system makes antibodies that attack the lungs and kidneys. The reason why this happens is not fully known. Researchers have identified possible causes, which include
Presence of an inherited componentTop of Page
Exposure to certain chemicals, including hydrocarbon solvents and Paraquat (a weed killer)
Viral infections
Symptoms
Goodpasture’s syndrome may cause people to cough up blood. Bleeding in the lungs can be very serious or even fatal in some cases. However, Goodpasture’s syndrome does not usually lead to permanent lung damage.
Depending on what organ the condition affects, first signs may be vague, such as
FatigueThese signs may be followed by kidney involvement. Signs or symptoms of kidney damage may include
Paleness
Nausea
Difficulty breathing
Blood in the urine (hematuria)Top of Page
Protein in the urine (proteinuria)
Swelling
Burning sensation while urinating
Diagnosis
To diagnose Goodpasture’s syndrome, doctors use a blood test, but a kidney or lung biopsy may be necessary to check for the presence of harmful antibodies. In biopsy, a needle is used to extract small samples of kidney or lung tissue for examination under a microscope.
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Treatment
Treatment of Goodpasture’s syndrome may include the use of immunosuppressive drugs and plasmapheresis.
Oral immunosuppressive drugs such as cyclophosphamide and corticosteroids are used to keep the immune system from making antibodies.Goodpasture’s syndrome may last only a few days or as long as 2 years. When it causes damage to the kidneys, it may be long-lasting. If the kidneys totally fail to work, dialysis or kidney transplantation may become necessary. Dialysis is a procedure done to remove waste products and extra fluid from the blood.
Corticosteroid drugs may be given intravenously to control bleeding in the lungs.
Plasmapheresis. This procedure may be helpful and necessary to remove harmful antibodies from the blood. This process involves drawing blood from the patient, about 300 ml at a time, and is placed in a centrifuge to separate the red and white blood cells from the blood plasma. The cells without the plasma are then placed in a plasma substitute and returned to the body. Usually, this procedure is done in combination with immunosuppressive drug treatment.
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More Information About Goodpasture’s Syndrome:
American Kidney Fund
Internet: www.kidneyfund.org
National Kidney and Urologic Diseases Information Clearinghouse
Internet: http://kidney.niddk.nih.gov
National Kidney Foundation
Internet: www.kidney.org
Reference:
National Kidney and Urologic Diseases Information Clearinghouse. Goodpasture’s Syndrome. National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07-4558, April 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/goodpasture/index.htm
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Solitary Kidney - Living With One Kidney
Kidney Health Care - David Mangusan Jr., PTRP
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Can People Live With Only One Kidney?
Most people have two kidneys, one on each side of the spinal column just below the rib cage. The kidney, about the size of a fist, contains about 1 million nephrons—the tiny filtering units of the kidney. They help in taking out wastes and excess water from the blood and put it in the urine to be excreted out of the body.
Some people may have only one kidney. However, most people with one (solitary) kidney can live normal, healthy lives. Reasons why a person may have only one kidney include:
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Changes Occurring with One Kidney
People living with one kidney may not notice that changes in his or her kidney are already occurring. Changes that may result from having a single kidney may include the following:
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Protecting the remaining kidney.
Possible kidney damage may occur if symptoms remain unnoticed and untreated. You can do your part in preventing these complications by:
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References:
National Kidney and Urologic Diseases Information Clearinghouse. Your Kidneys and How They Work. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–3195, August 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/index.htm. Accessed July 2008
National Kidney and Urologic Diseases Information Clearinghouse. Solitary Kidney. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–5390 July 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/solitarykidney/index.htm. Accessed July 2008
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This Page Last Revised: January 2011
Most people have two kidneys, one on each side of the spinal column just below the rib cage. The kidney, about the size of a fist, contains about 1 million nephrons—the tiny filtering units of the kidney. They help in taking out wastes and excess water from the blood and put it in the urine to be excreted out of the body.
Some people may have only one kidney. However, most people with one (solitary) kidney can live normal, healthy lives. Reasons why a person may have only one kidney include:
- Birth defects such as renal agenesis and renal dysplasia. The word “renal” means something related to or pertaining to the kidneys. Renal agenesis is a condition in which the person is born with only one kidney. A birth defect that causes one kidney to be unable to normally function is called renal dysplasia. People with renal agenesis or renal dysplasia may not know they have it because they do not feel any symptoms. In fact, the doctor may notice these abnormalities while performing tests for other health problems.
- One kidney removed because of cancer or other diseases or injuries. Nephrectomy is the operation done to remove the kidney.
- The person has donated one of his or her kidney to be transplanted to another person.
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Changes Occurring with One Kidney
People living with one kidney may not notice that changes in his or her kidney are already occurring. Changes that may result from having a single kidney may include the following:
High blood pressure. Many people who lose or donate a kidney are found to have an elevated blood pressure after several years.A person may have these conditions and still feel fine. But these conditions should be regularly monitored for any changes that might possibly occur.
Proteinuria. People living with one kidney for several years are often found to have higher levels of protein in their urine. Proteinuria, a condition where there is excessive protein in the urine, may be a sign of a damaged kidney.
A decline in GFR. The glomerular filtration rate (GFR) indicates how well the kidneys are working in removing wastes from the blood. People with one kidney may have reduced GFR, which indicates kidney damage.
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Protecting the remaining kidney.
Possible kidney damage may occur if symptoms remain unnoticed and untreated. You can do your part in preventing these complications by:
- Having your blood pressure monitored regularly and keeping it under control.
- Having your urine tested for protein. When high levels of protein are found in your urine, it may mean that damage to your kidneys has occurred.
- Having your GFR measured.
- Following a healthy eating plan. Choose fruits, vegetables, grains, and low-fat dairy products. Limit your daily salt (sodium) intake if your already have high blood pressure. You should limit your alcohol and caffeine intake as well.
- Avoid high-protein diets. Excessive protein intake can put extra burden on the remaining kidney. But don’t completely eliminate protein in your diet. Eating moderate amounts of protein is still important for proper nutrition. A dietitian can help develop a healthy eating plan for you.
- Avoiding injury. Try to avoid high-contact sports such as boxing, football, and hockey. However, having a solitary kidney should not automatically disqualify you from sports participation. Some athletes with one working kidney even have participated in sports competitions at the highest levels. One study pointed out that motor vehicle and bike riding accidents were more likely to seriously damage the kidneys than sports injuries.
Children should be encouraged to engage in some form of physical activity. Wearing protective gears like padded vests worn under a uniform may make limited contact sports such as basketball or soccer safe.
***You should consider the risks of any activity and decide whether the benefits outweigh those risks.
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References:
National Kidney and Urologic Diseases Information Clearinghouse. Your Kidneys and How They Work. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–3195, August 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/index.htm. Accessed July 2008
National Kidney and Urologic Diseases Information Clearinghouse. Solitary Kidney. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–5390 July 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/solitarykidney/index.htm. Accessed July 2008
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This Page Last Revised: January 2011
Kidney Damage from Painkillers
Kidney Health Care - David Mangusan Jr., PTRP
Sponsored Ads
Analgesics: The Effect on the Kidneys.
Two different forms of kidney damage, acute renal failure and analgesic nephropathy, have been associated with analgesic use.
Analgesics are medicines intended to relieve pain. Over-the-counter (OTC) analgesic drugs are painkillers that are available without a prescription. OTC painkillers may include acetaminophen, ibuprofen, and naproxen sodium. Although these drugs present no danger for most people when taken in their recommended dosage, some of these common painkillers may be dangerous for the kidneys when used improperly. Other conditions can make taking these drugs damaging to the kidneys as well.
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Acute Kidney Failure
Acute kidney failure is the sudden and temporary loss of kidney function. Some case reports have attributed incidents of acute kidney failure to the use of OTC painkillers, including aspirin, ibuprofen, and naproxen sodium. Some patients in these reports had risk factors such as:
Analgesic Nephropathy
Analgesic nephropathy, a form of chronic kidney disease, results from long-term or chronic use of painkillers. That is, taking painkillers everyday for several years. Chronic use of analgesics can gradually cause irreversible kidney damage, which may eventually lead to kidney failure. Total kidney failure, or end-stage renal disease, requires dialysis or kidney transplantation to maintain life.
Experts estimate that four out of 100,000 people will develop analgesic nephropathy. The disease is more common in women over 30 years of age.
People who take painkillers or pain relievers regularly should talk to their doctor to make sure the drugs are not damaging their kidneys. Also, people with conditions that put them at risk for acute kidney failure should check with their physician before taking any OTC analgesic medicines.
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Treatment
Treatment may include:
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References:
National Kidney and Urologic Diseases Information Clearinghouse. Your Kidneys and How They Work. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–3195, August 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/index.htm. Accessed July 2008
National Kidney and Urologic Diseases Information Clearinghouse. Analgesic Nephropathy (Painkillers and the Kidneys). National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–4573, September 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/analgesicnephropathy/index.htm. Accessed July 2008
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Two different forms of kidney damage, acute renal failure and analgesic nephropathy, have been associated with analgesic use.
Analgesics are medicines intended to relieve pain. Over-the-counter (OTC) analgesic drugs are painkillers that are available without a prescription. OTC painkillers may include acetaminophen, ibuprofen, and naproxen sodium. Although these drugs present no danger for most people when taken in their recommended dosage, some of these common painkillers may be dangerous for the kidneys when used improperly. Other conditions can make taking these drugs damaging to the kidneys as well.
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Acute Kidney Failure
Acute kidney failure is the sudden and temporary loss of kidney function. Some case reports have attributed incidents of acute kidney failure to the use of OTC painkillers, including aspirin, ibuprofen, and naproxen sodium. Some patients in these reports had risk factors such as:
Systemic lupus erythematosusTop of Page
Advanced age
Chronic kidney disease
Recent heavy consumption of alcohol
Analgesic Nephropathy
Analgesic nephropathy, a form of chronic kidney disease, results from long-term or chronic use of painkillers. That is, taking painkillers everyday for several years. Chronic use of analgesics can gradually cause irreversible kidney damage, which may eventually lead to kidney failure. Total kidney failure, or end-stage renal disease, requires dialysis or kidney transplantation to maintain life.
Experts estimate that four out of 100,000 people will develop analgesic nephropathy. The disease is more common in women over 30 years of age.
People who take painkillers or pain relievers regularly should talk to their doctor to make sure the drugs are not damaging their kidneys. Also, people with conditions that put them at risk for acute kidney failure should check with their physician before taking any OTC analgesic medicines.
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Treatment
Treatment may include:
Discontinuation of analgesic useGoal of treatment focuses on preventing or delaying the onset or progression of kidney damage. If some kidney damage has occurred, have your doctor monitor your kidney function with regular urine and blood tests.
Emergency dialysis. People with analgesic-related acute kidney failure may require dialysis to clean the blood. Kidney damage is frequently reversible.
Dietary changes
Medications to avoid anemia and bone problems caused by kidney disease
Practice of alternative methods of controlling chronic pain such as behavior modification or relaxation techniques.
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References:
National Kidney and Urologic Diseases Information Clearinghouse. Your Kidneys and How They Work. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–3195, August 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/index.htm. Accessed July 2008
National Kidney and Urologic Diseases Information Clearinghouse. Analgesic Nephropathy (Painkillers and the Kidneys). National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–4573, September 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/analgesicnephropathy/index.htm. Accessed July 2008
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Acute Kidney Failure Causes, Symptoms, and Treatment Options
Kidney Health Care - David Mangusan Jr., PTRP
Sponsored Ads
When the Kidneys Suddenly Stop Working.
Acute kidney failure, also called acute renal failure (ARF), is the sudden and temporary loss of kidney function. Normally, the kidneys help in removing waste products from the blood and put it in the urine to be excreted out of the body. However, in kidney failure, the damaged kidneys will not be able to remove these wastes and may cause their build up in the blood.
Acute kidney failure may lead to permanent loss of kidney function, a condition called end-stage renal disease, if not treated promptly. But if the kidneys are not seriously damaged, the condition may be reversed.
Top of Page
Causes
Acute renal failure causes may be include:
Accident that injures the kidneys and direct or forceful blows to the kidneys.
Losing a lot of blood. Any injury that results in loss of blood may reduce kidney
function temporarily, but once blood supply is replenished, the kidneys usually return to normal.
Drugs and toxic substances such as heavy metals (lead), solvents and fuels.
Other kidney diseases such as hemolytic uremic syndrome and nephrotic syndrome.
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Signs and Symptoms
Acute kidney failure symptoms may vary depending on the underlying cause. Symptoms of acute kidney failure may include
Top of Page
Acute Kidney Failure Treatment Options
Treatment of acute kidney failure depends on the underlying cause. For example, replacing the lost blood from severe bleeding through blood transfusion. In severe cases, however, acute kidney failure may require several sessions of dialysis to temporarily take over the kidney’s job of filtering wastes from the blood. This is done to help with the healing of the kidneys. Dialysis is a way to remove the waste products and extra water from the blood of patients with acute kidney failure.
Where can I get more information?
National Kidney Foundation
Internet: www.kidney.org
National Kidney Disease Education Program
Internet: http://www.nkdep.nih.gov
National Kidney Disease Information Clearinghouse
Internet: http://kidney.niddk.nih.gov
Top of Page
References:
National Kidney and Urologic Diseases Information Clearinghouse. Your Kidneys and How They Work. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–3195, August 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/index.htm. Accessed July 2008
National Kidney and Urologic Diseases Information Clearinghouse. Overview of Kidney Diseases in Children. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 06–5167, June 2006. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/childkidneydiseases/overview/index.htm. Accessed July 2008
National Kidney and Urologic Diseases Information Clearinghouse. Kidney Failure Glossary. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 03–4894, April 2003. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/glossary/index.htm. Accessed July 2008
National Kidney and Urologic Diseases Information Clearinghouse. Hemolytic Uremic Syndrome. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 06–4570, December 2005. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/childkidneydiseases/hemolytic_uremic_syndrome/index.htm. Accessed July 2008
Top of Page
This Page Last Revised: November 14, 2009
Acute kidney failure, also called acute renal failure (ARF), is the sudden and temporary loss of kidney function. Normally, the kidneys help in removing waste products from the blood and put it in the urine to be excreted out of the body. However, in kidney failure, the damaged kidneys will not be able to remove these wastes and may cause their build up in the blood.
Acute kidney failure may lead to permanent loss of kidney function, a condition called end-stage renal disease, if not treated promptly. But if the kidneys are not seriously damaged, the condition may be reversed.
Top of Page
Causes
Acute renal failure causes may be include:
Accident that injures the kidneys and direct or forceful blows to the kidneys.
Losing a lot of blood. Any injury that results in loss of blood may reduce kidney
function temporarily, but once blood supply is replenished, the kidneys usually return to normal.
Drugs and toxic substances such as heavy metals (lead), solvents and fuels.
Other kidney diseases such as hemolytic uremic syndrome and nephrotic syndrome.
Top of Page
Signs and Symptoms
Acute kidney failure symptoms may vary depending on the underlying cause. Symptoms of acute kidney failure may include
Decreased urine outputAcute kidney failure can be a complication of some other serious disorder. You should call your doctor immediately if you or your child experience unusual bleeding, extreme fatigue, swollen limbs, or decreased urine output.
Swelling around the eyes, limbs and belly
Proteinuria—protein in the urine
Paleness
Fatigue
Drowsiness
Top of Page
Acute Kidney Failure Treatment Options
Treatment of acute kidney failure depends on the underlying cause. For example, replacing the lost blood from severe bleeding through blood transfusion. In severe cases, however, acute kidney failure may require several sessions of dialysis to temporarily take over the kidney’s job of filtering wastes from the blood. This is done to help with the healing of the kidneys. Dialysis is a way to remove the waste products and extra water from the blood of patients with acute kidney failure.
Where can I get more information?
National Kidney Foundation
Internet: www.kidney.org
National Kidney Disease Education Program
Internet: http://www.nkdep.nih.gov
National Kidney Disease Information Clearinghouse
Internet: http://kidney.niddk.nih.gov
Top of Page
References:
National Kidney and Urologic Diseases Information Clearinghouse. Your Kidneys and How They Work. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–3195, August 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/index.htm. Accessed July 2008
National Kidney and Urologic Diseases Information Clearinghouse. Overview of Kidney Diseases in Children. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 06–5167, June 2006. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/childkidneydiseases/overview/index.htm. Accessed July 2008
National Kidney and Urologic Diseases Information Clearinghouse. Kidney Failure Glossary. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 03–4894, April 2003. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/glossary/index.htm. Accessed July 2008
National Kidney and Urologic Diseases Information Clearinghouse. Hemolytic Uremic Syndrome. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 06–4570, December 2005. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/childkidneydiseases/hemolytic_uremic_syndrome/index.htm. Accessed July 2008
Top of Page
This Page Last Revised: November 14, 2009
Understanding Glomerular Filtration Rate
Kidney Health Care - David Mangusan Jr., PTRP
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A Patient’s Guide
Glomerular filtration rate (GFR) is an estimate or calculation of how well the kidneys are filtering wastes from the blood. The doctor can calculate it from routine measurement of creatinine in the blood. Creatinine is a waste product formed from the normal breakdown of muscles during activity. The healthy kidneys remove creatinine out of the blood and become part of the urine. Creatinine will build up in the blood when the kidneys are not working properly.
Normal GFR may vary according to age, race, and gender. As people get older, the average GFR drops. However, when the GFR number is below 60, it may indicate that some damage to the kidneys has occurred.
The GFR number is an important indicator of how well the kidneys are working. The number is also used to determine a patient’s stage of kidney disease. The doctor will also look at other factors, including:
Protein (albumin) in the urine
Diabetes
High blood pressure or hypertension
Top of Page
In 2002, the National Kidney Foundation published treatment guidelines that identified five stages of chronic kidney disease (CKD) based on the declining measurements of GFR. The guidelines recommend different actions based on the stage of kidney disease.
Top of Page
You can keep your kidneys healthy no matter what your GFR result is:
Keep your blood pressure controlled below 130/80 mmHg.
Keep your blood sugar and cholesterol levels under control.
Eat healthy and cut back on salt. If you have kidney disease, follow a low protein diet.
Be physically active
Stop smoking
Take medicines the way your doctor tells you to.
Taking steps to prevent or slow progression of kidney disease is very important before a lot of damage is done. If your kidneys fail, dialysis and a kidney transplant are the only options to maintain life. Work with your kidney health care team on the best treatment plan for you.
Top of Page
Where can I get more information?
National Kidney Foundation
Internet: www.kidney.org
National Kidney Disease Education Program
Internet: http://www.nkdep.nih.gov
National Kidney Disease Information Clearinghouse
Internet: http://kidney.niddk.nih.gov
Top of Page
References:
National Kidney Disease Education. Explaining GFR: A Tear-off Pad for Clinical Use. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. June 2008. Available at http://www.nkdep.nih.gov/resources/ExplainingGFR.htm. Accessed July 2008.
National Kidney Disease Education. Understanding GFR: A Guide for Patients. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. December 2005. Available at http://www.nkdep.nih.gov/resources/glomerular_filtration_rate.htm. Accessed July 2008.
National Kidney and Urologic Diseases Information Clearinghouse. Your Kidneys and How They Work. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–3195, August 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/index.htm. Accessed July 2008
Top of Page
Glomerular filtration rate (GFR) is an estimate or calculation of how well the kidneys are filtering wastes from the blood. The doctor can calculate it from routine measurement of creatinine in the blood. Creatinine is a waste product formed from the normal breakdown of muscles during activity. The healthy kidneys remove creatinine out of the blood and become part of the urine. Creatinine will build up in the blood when the kidneys are not working properly.
Normal GFR may vary according to age, race, and gender. As people get older, the average GFR drops. However, when the GFR number is below 60, it may indicate that some damage to the kidneys has occurred.
The GFR number is an important indicator of how well the kidneys are working. The number is also used to determine a patient’s stage of kidney disease. The doctor will also look at other factors, including:
Protein (albumin) in the urine
Diabetes
High blood pressure or hypertension
Top of Page
In 2002, the National Kidney Foundation published treatment guidelines that identified five stages of chronic kidney disease (CKD) based on the declining measurements of GFR. The guidelines recommend different actions based on the stage of kidney disease.
Increased risk of CKD.In addition to tracking your GFR, blood tests can show when substances in your blood are out of balance. If phosphorus or potassium levels start to climb, a blood test will prompt your health care provider to address these issues before they permanently affect your health. (National Kidney and Urologic Diseases Information Clearinghouse, August 2007)
A GFR of 90 or above is considered normal. Even with a normal GFR, you may be at increased risk for developing CKD if you have diabetes, high blood pressure, or a family history of kidney disease. The risk increases with age: People over 65 are more than twice as likely to develop CKD as people between the ages of 45 and 65. African Americans also have a higher risk of developing CKD.
Stage 1: Kidney damage with normal GFR (90 or above).
Kidney damage may be detected before the GFR begins to decline. In this first stage of kidney disease, the goals of treatment are to slow the progression of CKD and reduce the risk of heart and blood vessel disease.
Stage 2: Kidney damage with mild decrease in GFR (60 to 89).
When kidney function starts to decline, your health care provider will estimate the progression of your CKD and continue treatment to reduce the risk of other health problems.
Stage 3: Moderate decrease in GFR (30 to 59).
When CKD has advanced to this stage, anemia and bone problems become more common. Work with your health care provider to prevent or treat these complications.
Stage 4: Severe reduction in GFR (15 to 29).
Continue following the treatment for complications of CKD and learn as much as you can about the treatments for kidney failure. Each treatment requires preparation. If you choose hemodialysis, you will need to have a procedure to make a vein in your arm larger and stronger for repeated needle insertions. For peritoneal dialysis, you will need to have a catheter placed in your abdomen. Or you may want to ask family or friends to consider donating a kidney for transplantation.
Stage 5: Kidney failure (GFR less than 15).
When the kidneys do not work well enough to maintain life, you will need dialysis or a kidney transplant.
Top of Page
You can keep your kidneys healthy no matter what your GFR result is:
Keep your blood pressure controlled below 130/80 mmHg.
Keep your blood sugar and cholesterol levels under control.
Eat healthy and cut back on salt. If you have kidney disease, follow a low protein diet.
Be physically active
Stop smoking
Take medicines the way your doctor tells you to.
Taking steps to prevent or slow progression of kidney disease is very important before a lot of damage is done. If your kidneys fail, dialysis and a kidney transplant are the only options to maintain life. Work with your kidney health care team on the best treatment plan for you.
Top of Page
Where can I get more information?
National Kidney Foundation
Internet: www.kidney.org
National Kidney Disease Education Program
Internet: http://www.nkdep.nih.gov
National Kidney Disease Information Clearinghouse
Internet: http://kidney.niddk.nih.gov
Top of Page
References:
National Kidney Disease Education. Explaining GFR: A Tear-off Pad for Clinical Use. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. June 2008. Available at http://www.nkdep.nih.gov/resources/ExplainingGFR.htm. Accessed July 2008.
National Kidney Disease Education. Understanding GFR: A Guide for Patients. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. December 2005. Available at http://www.nkdep.nih.gov/resources/glomerular_filtration_rate.htm. Accessed July 2008.
National Kidney and Urologic Diseases Information Clearinghouse. Your Kidneys and How They Work. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–3195, August 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/index.htm. Accessed July 2008
Top of Page
Lupus And The Kidneys
Kidney Health Care - David Mangusan Jr., PTRP
Sponsored Ads
Lupus Nephritis
Lupus nephritis is caused by a disease of the immune system called systemic lupus erythematosus (SLE). In lupus nephritis, the kidneys become inflamed. People with the lupus nephritis may also have other disorders in other parts of the body. The immune system of people with SLE attacks healthy cells and tissues. This can damage many parts of the body such as the joints, skin, heart, lungs, brain, and the kidneys.
The cause of SLE is not fully understood. But experts believe that many factors may play a role or trigger the disease.
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Symptoms of lupus nephritis:
Some people with lupus nephritis may have no apparent symptoms. Others may experience
Top of Page
Diagnosis of lupus nephritis:
There is no single test to diagnose lupus. But for lupus nephritis, diagnosis may require urine and blood tests as well as kidney biopsy.
Urine test. This test will reveal if there are blood and proteins in the urine, which may indicate kidney damage.
Blood test. High levels of creatinine and urea in the blood indicate kidney function is impaired. Creatinine and urea are waste products normally removed by the kidneys from the blood. However, damaged kidneys may not be able to remove these wastes, which can build up in the blood. Your doctor will estimate your glomerular filtration rate (GFR) based on your creatinine score. GFR is a calculation of how efficiently the kidneys are filtering wastes from the blood.
Kidney biopsy. This is a procedure used that can confirm the diagnosis of lupus nephritis and help to determine how far the disease has progressed. In biopsy, a tissue sample is obtained from the kidney and is examined under a microscope.
Top of Page
Treatment of lupus nephritis:
Treatment of the disease depends on the symptoms and test results. Treatment options may include medications and dietary changes.
Medications. Your doctor may prescribe drugs to
An ultimate goal of treatment for lupus nephritis is to prevent or avoid progression of the disease. It is important that you take an active role in your treatment. Learning about lupus and its effect on other organs of the body is important as well. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, patients who are informed and involved in their own cure:
References:
National Institute of Arthritis and Musculoskeletal and Skin Diseases. Fast Facts About Lupus. National Institutes of Health, Department of Human Health and Services. September 2005. Available at http://www.niams.nih.gov/Health_Info/Lupus/lupus_ff.asp. Retrieved July 2008.
National Kidney and Urologic Diseases Information Clearinghouse. Lupus Nephritis. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–4622, June 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/lupusnephritis/index.htm. Retrieved July 2008.
Top of Page
Lupus nephritis is caused by a disease of the immune system called systemic lupus erythematosus (SLE). In lupus nephritis, the kidneys become inflamed. People with the lupus nephritis may also have other disorders in other parts of the body. The immune system of people with SLE attacks healthy cells and tissues. This can damage many parts of the body such as the joints, skin, heart, lungs, brain, and the kidneys.
The cause of SLE is not fully understood. But experts believe that many factors may play a role or trigger the disease.
Top of Page
Symptoms of lupus nephritis:
Some people with lupus nephritis may have no apparent symptoms. Others may experience
Weight gainSince people with the disease may also have affectations of other parts of the body, other signs and symptoms may be experienced as well, including
High blood pressure
Swelling around the eyes, legs, ankles, or fingers
Dark urine
Blood in the urine (hematuria)
Proteinuria
Pain or swelling in jointsSymptoms of lupus may come and go. The times when a person is having symptoms are called flares, which can range from mild to severe. New symptoms may appear at any time.
Fever with no known cause
Muscle pain
Red rashes, most on the face
Chest pain when taking a deep breath
Hair loss
Mouth ulcers
Sensitivity to the sun
Pale or purple fingers or toes
Swollen glands
Feeling tired.
Top of Page
Diagnosis of lupus nephritis:
There is no single test to diagnose lupus. But for lupus nephritis, diagnosis may require urine and blood tests as well as kidney biopsy.
Urine test. This test will reveal if there are blood and proteins in the urine, which may indicate kidney damage.
Blood test. High levels of creatinine and urea in the blood indicate kidney function is impaired. Creatinine and urea are waste products normally removed by the kidneys from the blood. However, damaged kidneys may not be able to remove these wastes, which can build up in the blood. Your doctor will estimate your glomerular filtration rate (GFR) based on your creatinine score. GFR is a calculation of how efficiently the kidneys are filtering wastes from the blood.
Kidney biopsy. This is a procedure used that can confirm the diagnosis of lupus nephritis and help to determine how far the disease has progressed. In biopsy, a tissue sample is obtained from the kidney and is examined under a microscope.
Top of Page
Treatment of lupus nephritis:
Treatment of the disease depends on the symptoms and test results. Treatment options may include medications and dietary changes.
Medications. Your doctor may prescribe drugs to
Reduce swelling and painDiet. Your doctor may advise you to cut back or limit protein, sodium, and potassium in your diet.
Prevent or reduce flares
Calm the immune system. Use of corticosteroids and additional immunosuppressive drugs that can decrease swelling and inflammation by suppressing the immune system.
Reduce or prevent damage to joints
Control blood pressure
An ultimate goal of treatment for lupus nephritis is to prevent or avoid progression of the disease. It is important that you take an active role in your treatment. Learning about lupus and its effect on other organs of the body is important as well. According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, patients who are informed and involved in their own cure:
Have less painTop of Page
Make fewer visits to the doctor
Feel better about themselves
Remain more active.
References:
National Institute of Arthritis and Musculoskeletal and Skin Diseases. Fast Facts About Lupus. National Institutes of Health, Department of Human Health and Services. September 2005. Available at http://www.niams.nih.gov/Health_Info/Lupus/lupus_ff.asp. Retrieved July 2008.
National Kidney and Urologic Diseases Information Clearinghouse. Lupus Nephritis. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07–4622, June 2007. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/lupusnephritis/index.htm. Retrieved July 2008.
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High Blood Pressure Effects on the Kidneys
Kidney Health Care - David Mangusan Jr., PTRP
Sponsored Ads
Uncontrolled High Blood Pressure Can Lead to Permanent Kidney Damage.
The kidneys play a major role in maintaining normal blood pressure. However, uncontrolled high blood pressure, also called hypertension, can slowly damage the blood vessels in the kidneys. This may eventually lead to kidney failure.
Blood pressure is the measure of the force of blood against the blood vessels’ walls. If blood pressure remains higher than normal, it is called hypertension. An increase in extra fluid in the blood and narrow or clogged blood vessels can raise the blood pressure.
Over time, a sustained high blood pressure makes the heart work harder and can eventually damage the blood vessels throughout the body. Damaged blood vessels in the kidneys can result in their inability to remove wastes and extra fluid from the body. This can further raise blood pressure.
High blood pressure is one of the leading causes of kidney failure, also called end-stage renal disease (ESRD). People whose kidneys stopped working, must either undergo regular dialysis or kidney transplantation.
Experts recommend that people, especially those with kidney damage, should keep their blood pressure below 130/80.
Top of Page
Symptoms
High blood pressure itself usually has not signs or symptoms. Most people with this condition may have it for years without knowing it. In some people, headaches may be the only symptom they experience.
Some people may only learn that they have high blood pressure after the damage has caused problems, such as stroke, heart disease, or kidney failure.
A way to know whether your blood pressure is high is to have it checked by a health care professional.
High blood pressure can damage the kidneys over time. Kidney damage, like high blood pressure, usually has no symptoms and is detected only through medical tests.
Top of Page
Treatment
Treatment of hypertension includes lifestyle changes and medications. Sticking to the treatment plan is important to prevent or delay problems with the kidneys and other complications and help you to live and stay active longer.
Lifestyle changes include following a healthy eating plan, getting plenty of exercise, maintaining a healthy weight, and limiting caffeine and alcohol intake.
For some people, lifestyle changes alone can control their blood pressure, however, many people also need to take blood pressure medicines to keep their blood pressure controlled.
There are many types of blood pressure medicines but there are two groups of medications that lower blood pressure and have protective effect on the kidneys. They are angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB). Diuretics, also called “water pills”, may also be prescribed by the doctor in addition to ACE inhibitor or ARB. Diuretics help to flush excess water and salt from the body. This would lessen the amount of fluid in the blood, thus lowers blood pressure.
Even if you don’t feel anything, you should have your blood pressure checked regularly. Early detection of high blood pressure and treating it early can help prevent future damage to your kidneys and other complications.
References:
Diseases and Conditions Index. High Blood Pressure, What is. National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. April 2008. Accessed July 2008. Available at http://www.nhlbi.nih.gov/health/dci/Diseases/Hbp/HBP_WhatIs.html
National Kidney and Urologic Diseases information Clearinghouse. High Blood Pressure and Kidney Disease. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 05-4572, August 2005. Accessed July 2008. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/highblood/index.htm
Top of Page
The kidneys play a major role in maintaining normal blood pressure. However, uncontrolled high blood pressure, also called hypertension, can slowly damage the blood vessels in the kidneys. This may eventually lead to kidney failure.
Blood pressure is the measure of the force of blood against the blood vessels’ walls. If blood pressure remains higher than normal, it is called hypertension. An increase in extra fluid in the blood and narrow or clogged blood vessels can raise the blood pressure.
Over time, a sustained high blood pressure makes the heart work harder and can eventually damage the blood vessels throughout the body. Damaged blood vessels in the kidneys can result in their inability to remove wastes and extra fluid from the body. This can further raise blood pressure.
High blood pressure is one of the leading causes of kidney failure, also called end-stage renal disease (ESRD). People whose kidneys stopped working, must either undergo regular dialysis or kidney transplantation.
Experts recommend that people, especially those with kidney damage, should keep their blood pressure below 130/80.
Top of Page
Symptoms
High blood pressure itself usually has not signs or symptoms. Most people with this condition may have it for years without knowing it. In some people, headaches may be the only symptom they experience.
Some people may only learn that they have high blood pressure after the damage has caused problems, such as stroke, heart disease, or kidney failure.
A way to know whether your blood pressure is high is to have it checked by a health care professional.
High blood pressure can damage the kidneys over time. Kidney damage, like high blood pressure, usually has no symptoms and is detected only through medical tests.
Top of Page
Treatment
Treatment of hypertension includes lifestyle changes and medications. Sticking to the treatment plan is important to prevent or delay problems with the kidneys and other complications and help you to live and stay active longer.
Lifestyle changes include following a healthy eating plan, getting plenty of exercise, maintaining a healthy weight, and limiting caffeine and alcohol intake.
Follow a healthy eating plan.Medicines Get plenty of exercise, be physically active. Check with your health care provider about how much and what kinds of exercise or activity are safe for you. Get at least 30 minutes of moderate-intensity activity on most days of the week unless your doctor tells otherwise. Moderate-intensity activities include brisk walking, riding a bicycle, dancing, and cleaning the house.
- Limit your daily salt intake to 2,000 milligrams or lower.
- Avoid foods high in fats and cholesterol.
- Limit your alcohol intake. Too much alcohol consumption can raise blood pressure.
- If you already have kidney damage, your doctor may ask you to cut back on your protein intake.
Maintain a healthy weight. Following your recommended healthy eating plan and exercise can help you maintain a healthy weight.
Limit caffeine and alcohol intake.
For some people, lifestyle changes alone can control their blood pressure, however, many people also need to take blood pressure medicines to keep their blood pressure controlled.
There are many types of blood pressure medicines but there are two groups of medications that lower blood pressure and have protective effect on the kidneys. They are angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARB). Diuretics, also called “water pills”, may also be prescribed by the doctor in addition to ACE inhibitor or ARB. Diuretics help to flush excess water and salt from the body. This would lessen the amount of fluid in the blood, thus lowers blood pressure.
Even if you don’t feel anything, you should have your blood pressure checked regularly. Early detection of high blood pressure and treating it early can help prevent future damage to your kidneys and other complications.
References:
Diseases and Conditions Index. High Blood Pressure, What is. National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD. April 2008. Accessed July 2008. Available at http://www.nhlbi.nih.gov/health/dci/Diseases/Hbp/HBP_WhatIs.html
National Kidney and Urologic Diseases information Clearinghouse. High Blood Pressure and Kidney Disease. National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 05-4572, August 2005. Accessed July 2008. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/highblood/index.htm
Top of Page
Ectopic Kidney (Abnormal Position of the Kidney)
Kidney Health Care - David Mangusan Jr., PTRP
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Ectopic kidney is a birth defect of the urinary tract in which a kidney is located in an abnormal position. Normally, the kidneys are located near the back and one on each side of the spine. They are partially protected by the lower ribs at the back.
It is estimated that ectopic kidney occurs once in every 1,000 births. One kidney is usually affected. Often, people with this disorder do not experience signs or symptoms. In some cases, however, the ectopic kidney may cause blockage to urine flow, urinary tract infection (UTI), or urinary stones.
If ectopic kidney does not cause any complications, it may not require any special medical treatment.
Cause
The baby’s kidneys first appear as buds inside the pelvis during fetal development. The fetal kidneys, as they develop, gradually climb toward their normal position near the rib cage at the back. However, in some cases, one of the kidneys fails to make the climb or remain in the pelvis. In other cases, an ectopic kidney may cross over and become fused with the other kidney.
Symptoms
Many people with the disorder may not notice that they have an ectopic kidney because they do not experience any symptoms. Some of the signs may include a lump in the abdomen or abdominal pain.
Some signs or symptoms may also occur as a result of complications of ectopic kidney.
Complications and their signs and symptoms:
Urinary tract infection
Since ectopic kidney may not cause any symptoms, you may not notice that you have it. Your doctor may discover the kidney in an abnormal position while checking for other health problems.
Imaging tests are important diagnostic tools in the diagnosis of ectopic kidney. These include ultrasound, intravenous pyelogram (IVP), or voiding cystourethrogram (VCUG).
Additional tests, such as blood tests, may be recommended by your doctor to determine how well your kidneys are working.
Treatment
Treatment may not be necessary if your doctor finds no blockage and urinary function is normal. However, continuous monitoring of your condition should be done in case a change occurs.
Surgery may be necessary only if obstruction is present that blocks normal urine flow. The position of the kidney is corrected to allow better drainage of urine.
In some cases where extensive damage has occurred, the surgeon may need to remove the kidney. Losing one kidney is not a problem as long as the other kidney is working properly. Although caring for the remaining kidney is necessary to prevent future damage. Many people with one normal kidney, either they have donated one or they were born with one kidney, live normal, productive lives.
With proper testing and treatment, if necessary, an ectopic kidney should cause no serious health problems.
Reference:
National Kidney and Urologic Diseases Information Clearinghouse. Ectopic Kidney. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/ectopicKidney/index.htm
National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07-5869, April 2007. Retrieved July 3, 2008
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It is estimated that ectopic kidney occurs once in every 1,000 births. One kidney is usually affected. Often, people with this disorder do not experience signs or symptoms. In some cases, however, the ectopic kidney may cause blockage to urine flow, urinary tract infection (UTI), or urinary stones.
If ectopic kidney does not cause any complications, it may not require any special medical treatment.
Cause
The baby’s kidneys first appear as buds inside the pelvis during fetal development. The fetal kidneys, as they develop, gradually climb toward their normal position near the rib cage at the back. However, in some cases, one of the kidneys fails to make the climb or remain in the pelvis. In other cases, an ectopic kidney may cross over and become fused with the other kidney.
Symptoms
Many people with the disorder may not notice that they have an ectopic kidney because they do not experience any symptoms. Some of the signs may include a lump in the abdomen or abdominal pain.
Some signs or symptoms may also occur as a result of complications of ectopic kidney.
Complications and their signs and symptoms:
Urinary tract infection
Painful or frequent urinationUrinary stones
Back or abdominal pain
Fever and chills
Extreme pain in the back, sides, or pelvisKidney failure
Blood in the urine (hematuria)
Fever or chills
Vomiting
Nausea
Burning sensation while urinating
Feeling very tiredTests
Swelling in the legs or abdomen
Headaches
Nausea
Since ectopic kidney may not cause any symptoms, you may not notice that you have it. Your doctor may discover the kidney in an abnormal position while checking for other health problems.
Imaging tests are important diagnostic tools in the diagnosis of ectopic kidney. These include ultrasound, intravenous pyelogram (IVP), or voiding cystourethrogram (VCUG).
Additional tests, such as blood tests, may be recommended by your doctor to determine how well your kidneys are working.
Treatment
Treatment may not be necessary if your doctor finds no blockage and urinary function is normal. However, continuous monitoring of your condition should be done in case a change occurs.
Surgery may be necessary only if obstruction is present that blocks normal urine flow. The position of the kidney is corrected to allow better drainage of urine.
In some cases where extensive damage has occurred, the surgeon may need to remove the kidney. Losing one kidney is not a problem as long as the other kidney is working properly. Although caring for the remaining kidney is necessary to prevent future damage. Many people with one normal kidney, either they have donated one or they were born with one kidney, live normal, productive lives.
With proper testing and treatment, if necessary, an ectopic kidney should cause no serious health problems.
Reference:
National Kidney and Urologic Diseases Information Clearinghouse. Ectopic Kidney. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/ectopicKidney/index.htm
National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07-5869, April 2007. Retrieved July 3, 2008
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Proteinuria (Protein in the Urine)
Kidney Health Care - David Mangusan Jr., PTRP
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Description
Proteinuria is an abnormal condition in which urine contains high amounts of protein. Proteins are important building blocks of all parts of the body, including muscles and bones. Blood also contain these substances that help to protect the body from infections; help to form clots; and help keep the right amounts of fluid throughout the body.
Normally, waste products are filtered out from the blood by healthy kidneys. Proteins and other needed materials are left in the blood. Most proteins are too large to pass through the kidney’s filters. However, these proteins from the blood can leak into the urine if the kidneys are damaged. The protein that is more likely to appear in urine is albumin. Albuminuria is a term used often when urine tests detect albumin specifically.
Glomerulonephritis, or simply nephritis, is a term used to indicate inflammation in the glomeruli, the actual tiny filtering units of the kidneys. There are different diseases that can cause this inflammation, which can lead to proteinuria. Diabetes, hypertension, and other forms of kidney diseases can cause proteins to seep out by damaging the glomeruli.
Risks
You may be at risk for proteinuria if you
have diabetes
have high blood pressure or hypertension
are overweight
have a family history of kidney disease
If you think that you are at risk of developing the condition, you should ask your doctor about having your urine tested. Several health organizations recommend that people be regularly checked for proteinuria so that kidney problems can be detected and treated or prevented before it progresses.
Symptoms
Signs and symptoms of the condition may include foamy urine and swelling in the hands, feet, abdomen, or the face. These signs result from too much loss of proteins. Some people may have proteinuria without noticing any signs or symptoms. The only way to find out how much protein you have in your urine is to have it tested.
Tests
Your doctor will likely test a sample of your urine for protein. Laboratory tests that measure exact amounts of protein or albumin in the urine are recommended for people at risk for kidney disease, especially those with diabetes. If laboratory tests show high levels of protein, your doctor may advise you to have your urine checked again after a week or two. You have persistent proteinuria if the second test also shows high levels of protein. Your doctor may recommend additional tests to evaluate your kidney or renal function.
Your health care provider may also test a sample of your blood for creatinine and urea nitrogen. Healthy kidneys normally remove these waste products from the blood. If tests reveal high levels of these substances in your blood, it would indicate that the kidney function is impaired.
Treatment
Proteinuria can be managed by treating the underlying cause. If you have diabetes, hypertension, or both, the primary goal of treatment is to control your blood sugar and blood pressure. Diabetes and hypertension can be controlled by
Reference:
National Kidney and Urologic Diseases Information Clearinghouse. Proteinuria. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/proteinuria/index.htm
National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 06-4732, September 2006. Retrieved July 3, 2008
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Page Last Revised: May 24, 2010
Proteinuria is an abnormal condition in which urine contains high amounts of protein. Proteins are important building blocks of all parts of the body, including muscles and bones. Blood also contain these substances that help to protect the body from infections; help to form clots; and help keep the right amounts of fluid throughout the body.
Normally, waste products are filtered out from the blood by healthy kidneys. Proteins and other needed materials are left in the blood. Most proteins are too large to pass through the kidney’s filters. However, these proteins from the blood can leak into the urine if the kidneys are damaged. The protein that is more likely to appear in urine is albumin. Albuminuria is a term used often when urine tests detect albumin specifically.
Glomerulonephritis, or simply nephritis, is a term used to indicate inflammation in the glomeruli, the actual tiny filtering units of the kidneys. There are different diseases that can cause this inflammation, which can lead to proteinuria. Diabetes, hypertension, and other forms of kidney diseases can cause proteins to seep out by damaging the glomeruli.
Risks
You may be at risk for proteinuria if you
have diabetes
have high blood pressure or hypertension
are overweight
have a family history of kidney disease
If you think that you are at risk of developing the condition, you should ask your doctor about having your urine tested. Several health organizations recommend that people be regularly checked for proteinuria so that kidney problems can be detected and treated or prevented before it progresses.
Symptoms
Signs and symptoms of the condition may include foamy urine and swelling in the hands, feet, abdomen, or the face. These signs result from too much loss of proteins. Some people may have proteinuria without noticing any signs or symptoms. The only way to find out how much protein you have in your urine is to have it tested.
Tests
Your doctor will likely test a sample of your urine for protein. Laboratory tests that measure exact amounts of protein or albumin in the urine are recommended for people at risk for kidney disease, especially those with diabetes. If laboratory tests show high levels of protein, your doctor may advise you to have your urine checked again after a week or two. You have persistent proteinuria if the second test also shows high levels of protein. Your doctor may recommend additional tests to evaluate your kidney or renal function.
Your health care provider may also test a sample of your blood for creatinine and urea nitrogen. Healthy kidneys normally remove these waste products from the blood. If tests reveal high levels of these substances in your blood, it would indicate that the kidney function is impaired.
Treatment
Proteinuria can be managed by treating the underlying cause. If you have diabetes, hypertension, or both, the primary goal of treatment is to control your blood sugar and blood pressure. Diabetes and hypertension can be controlled by
Following a healthy diet. Experts recommend restricting or limiting dietary intake of salt and proteins. A registered dietitian can help you develop and follow a healthy eating plan.
Taking your prescribed medicines
Getting plenty of exercise
Reference:
National Kidney and Urologic Diseases Information Clearinghouse. Proteinuria. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/proteinuria/index.htm
National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 06-4732, September 2006. Retrieved July 3, 2008
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Page Last Revised: May 24, 2010
Vesicoureteral Reflux
Kidney Health Care - David Mangusan Jr., PTRP
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Definition
Vesicoureteral reflux (VUR) is a urinary tract disorder in which urine flows back (reflux) into the ureters from the bladder. Normally, urine flows in one direction—from the kidneys, urine flows through narrow tubes called ureters, and into the bladder. It is most commonly diagnosed in infancy and childhood after the patient has a urinary tract infection (UTI). In fact, about one-third of children with UTI are found to have VUR. Infection occurs when urine remains in the urinary tract, which provides a place for bacteria to grow. In some cases, the infection itself is the cause of VUR.
This disorder has two types, primary and secondary VUR. In primary VUR, the child is born with an impaired valve where the ureter meets with the bladder. This usually occurs during the development of the fetus in the womb where the ureter did not grow long enough. Urine backs up from the bladder to the ureters and even the kidneys because the valve does not close properly. This type of VUR may not require special treatment because the function of the valve may improve as the ureter gets longer when the child grows. However, it requires medical intervention when it causes complications.
Secondary VUR results when there is a blockage in the flow of urine anywhere in the urinary tract. An infection in the bladder that can lead to swelling of the ureter may cause blockage to urine flow. This can also cause urine to reflux to the kidneys.
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Signs and Symptoms
The most common symptom of VUR is an infection. But as the child grows older, other symptoms may also appear, which may include
Tests and Diagnosis
Urinalysis and cultures are two of the most common tests that can reveal the presence of a urinary tract infection.
The following imaging tests may also be recommended by the doctor to view abnormalities in the urinary tract:
Treatment
Vesicoureteral reflux can lead to permanent damage to the kidneys if not treated promptly. Preventing the occurrence of kidney damage is the primary goal of treatment in patients with VUR.
When infections occur, it should be treated immediately with antibiotics to prevent the infection from traveling into the kidneys. A reflux caused by an infection is usually corrected with medically supervised antibiotic therapy.
Surgery may be necessary only when severe reflux has caused infection that can’t be treated with antibiotics.
References:
National Kidney and Urologic Diseases Information Clearinghouse. Vesicoureteral Reflux. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/vesicoureteralreflux/index.htm.
National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07-4555, November 2006. Retrieved July 3, 2008
National Kidney and Urologic Diseases Information Clearinghouse. Kidney Diseases Dictionary:U-W. http://kidney.niddk.nih.gov/kudiseases/pubs/kdictionary/U-Z.htm#V.
National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 03-4359, May 2003. Retrieved July 3, 2008
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Vesicoureteral reflux (VUR) is a urinary tract disorder in which urine flows back (reflux) into the ureters from the bladder. Normally, urine flows in one direction—from the kidneys, urine flows through narrow tubes called ureters, and into the bladder. It is most commonly diagnosed in infancy and childhood after the patient has a urinary tract infection (UTI). In fact, about one-third of children with UTI are found to have VUR. Infection occurs when urine remains in the urinary tract, which provides a place for bacteria to grow. In some cases, the infection itself is the cause of VUR.
This disorder has two types, primary and secondary VUR. In primary VUR, the child is born with an impaired valve where the ureter meets with the bladder. This usually occurs during the development of the fetus in the womb where the ureter did not grow long enough. Urine backs up from the bladder to the ureters and even the kidneys because the valve does not close properly. This type of VUR may not require special treatment because the function of the valve may improve as the ureter gets longer when the child grows. However, it requires medical intervention when it causes complications.
Secondary VUR results when there is a blockage in the flow of urine anywhere in the urinary tract. An infection in the bladder that can lead to swelling of the ureter may cause blockage to urine flow. This can also cause urine to reflux to the kidneys.
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Signs and Symptoms
The most common symptom of VUR is an infection. But as the child grows older, other symptoms may also appear, which may include
BedwettingTop of Page
High blood pressure or hypertension
Foamy urine
Proteinuria (presence of protein in the urine)
Fever
Kidney failure
Tests and Diagnosis
Urinalysis and cultures are two of the most common tests that can reveal the presence of a urinary tract infection.
The following imaging tests may also be recommended by the doctor to view abnormalities in the urinary tract:
Kidney and bladder ultrasound. This test uses sound waves to examine the bladder and kidney. It shows shadows of the kidney and bladder that may point out certain abnormalities in them. However, this test cannot reveal all important urinary abnormalities or measure how well the kidneys are working.Top of Page
Voiding cystourethrogram (VCUG). This test is used to examine the urethra and bladder while the bladder fills and empties. It can reveal abnormalities in the inside of the urethra and bladder. The test can also determine whether urine flow is normal as the bladder empties.
Intravenous Pyelogram (IVP). This test can be used to examine the whole urinary tract. A liquid that can be seen on x rays is injected into a vein. The substance, as it travels through the kidneys and bladder can reveal possible obstructions in the tract.
Treatment
Vesicoureteral reflux can lead to permanent damage to the kidneys if not treated promptly. Preventing the occurrence of kidney damage is the primary goal of treatment in patients with VUR.
When infections occur, it should be treated immediately with antibiotics to prevent the infection from traveling into the kidneys. A reflux caused by an infection is usually corrected with medically supervised antibiotic therapy.
Surgery may be necessary only when severe reflux has caused infection that can’t be treated with antibiotics.
References:
National Kidney and Urologic Diseases Information Clearinghouse. Vesicoureteral Reflux. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/vesicoureteralreflux/index.htm.
National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07-4555, November 2006. Retrieved July 3, 2008
National Kidney and Urologic Diseases Information Clearinghouse. Kidney Diseases Dictionary:U-W. http://kidney.niddk.nih.gov/kudiseases/pubs/kdictionary/U-Z.htm#V.
National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 03-4359, May 2003. Retrieved July 3, 2008
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Glomerular Diseases
Kidney Health Care - David Mangusan Jr., PTRP
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Glomerular Diseases: Description
Glomerular diseases involve many conditions that damage the glomeruli—the tiny structures within the kidney. The glomeruli (singular form is glomerulus) help to clean the blood of wastes by acting as filters.
When a glomerular disease damages the glomeruli, proteins and red blood cells can leak into the urine. Proteins in the blood like albumin are important in taking out extra fluid from the body. It acts like a sponge that draws the extra fluid into the bloodstream, where it stays until the kidneys remove it. However, when albumin leaks into the urine, the blood will not be able to absorb the excess fluid from the body. This results in fluid accumulation in the face, hands, feet, or ankles, which lead to swelling.
Glomerular diseases can also interfere with the clearance of waste products by the kidneys, which results in wastes building up in the blood.
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Signs and Symptoms:
Signs and symptoms of a glomerular disease may include:
Blood in the urine (hematuria). Urine may be colored pink or the color of cola.
Foamy urine. This is due to the large amounts of protein in the urine—a term called proteinuria.
Swelling (edema) in the hands and ankles, especially at the end of the day, or around the eyes when awakening in the morning.
Reduced glomerular filtration rate (GFR). GFR is a calculation of how efficiently the kidneys are filtering wastes from the blood.
Hypoproteinemia: low concentration of proteins in the blood
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Causes
A variety of diseases can result in glomerular disease. It may result from infection or drugs that are toxic to the kidneys. Diseases that affect the entire body like diabetes and lupus can also cause it to develop. Others may also cause swelling or scarring of the glomerulus.
Causes of glomerular disease may include
Autoimmune diseases, such as lupus, Goodpasture’s syndrome, and IgA nephropathy. An autoimmune disease occurs when the body’s immune system attacks the body itself.
Infections. Glomerular disease can sometimes develop rapidly after an infection in other parts of the body. This may include acute post-streptococcal glomerulonephritis (PSGN), bacterial endocarditis, and HIV—the virus that leads to AIDS.
Sclerotic diseases, such as glomerulosclerosis, diabetic nephropathy, and focal segmental glomerulosclerosis (FSGS). These conditions can cause scarring or hardening of structures within the kidneys.
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Tests and Diagnosis
Your doctor may test a sample of your urine for significant amounts of protein. If it shows high levels of protein, it is referred to as “nephrotic range”. In some forms of glomerular disease, red blood cells in the urine are frequent findings. Urine analysis is an important diagnostic tool in providing information about kidney damage by indicating levels of protein and red blood cells in the urine.
To know whether the filtering capacity of the kidneys is impaired, your doctor will also check a sample of your blood. Blood tests are used to provide information about levels of waste products such as creatinine and urea nitrogen in the blood.
If laboratory tests indicate kidney damage, the doctor may recommend renal imaging such as ultrasound or an x ray. These are used to see whether there are abnormalities in the size or shape of the kidneys.
The doctor may also recommend kidney biopsy, which may be helpful in confirming glomerular disease and identifying the cause. In biopsy, a needle is used to extract a small sample of kidney tissue for examination with different types of microscopes. This will show different aspects of the tissue. Kidney biopsy helps to identify problems of the kidneys at the cellular level.
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Treatment
Although glomerular disease has different causes, it can lead to kidney failure. Kidney or renal function may be lost in a matter of days or weeks or may slowly and gradually deteriorate over the years.
Treatment or management of the early stages of kidney failure depends on the disease causing the damage. For example, people with diabetic nephropathy can help slow down damage to their kidneys by controlling their blood sugar through healthy eating, physical activity, and medications.
When glomerular disease causes the kidneys to totally stop working, dialysis or kidney transplantation may be the only options of treatment. By working with their kidney health care team, many people with total kidney failure continue to lead full, productive lives.
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References:
National Kidney and Urologic Diseases Information Clearinghouse. Glomerular Diseases. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/glomerular/index.htm#failure
National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 06-4358, April 2006. Retrieved July 3, 2008
National Kidney and Urologic Diseases Information Clearinghouse. Proteinuria. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/proteinuria/index.htm
National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 06-4732, September 2006. Retrieved July 3, 2008
National Kidney and Urologic Diseases Information Clearinghouse. Your Kidneys and How They Work. Available at http://kidney.niddk.nih.gov/kudiseases/pubs/yourkidneys/index.htm#rate
National Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, MD. NIH Publication No. 07-3195, August 2007. Retrieved July 3, 2008
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Kidney Cysts, Simple
Kidney Health Care - David Mangusan Jr., PTRP
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Article Sections
What are kidney cysts?
Kidney cysts (SISTS), also known as renal cysts, are abnormal fluid-filled sacs that form in the kidneys. There are several types of kidney cysts, but the most common is a simple kidney cyst. Unlike the cysts that form in people with polycystic kidney disease, which is inherited, simple kidney cyst is not an inherited disorder. It becomes more common as people age. According to the National Kidney and Urologic Diseases (NIDDK), nearly 30 percent of people over the age of 70 have at least one kidney cyst. However, its cause is not fully understood.
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