Kidney Diseases

Kidney disease means that your kidneys are damaged and cannot filter the blood as they should. You have an increased risk of kidney disease if you have diabetes or high blood pressure. If you experience kidney failure, treatments include kidney transplant or dialysis.

The kidneys are a pair of fist-sized organs located in the lower part of the rib cage. There is a kidney on each side of the spine.

Also Known As:  Renal Diseases, Kidney Diseases

Disease Panel: Kidney Failure, Chronic Kidney Disease (CKD), Acute Kidney Injury (AKI), Acute Renal Failure (ARF), End Stage Renal Disease (ESRD), Nephrotic Syndrome

Types of Diseases:

• Chronic kidney disease:
  Chronic kidney disease is a long-term condition that doesn’t improve over time. It’s commonly caused by high blood pressure.
• Kidney Stones:
  They occur when minerals and other substances in the blood crystallize in the kidneys, forming solid masses (stones). Kidney stones usually come out of the body during urination. Passing kidney stones can be extremely painful, but they rarely cause significant problems.
• Glomerulonephritis:
  Glomerulonephritis can be caused by infections, drugs, or congenital abnormalities (disorders that occur during or shortly after birth). It often gets better on its own.
• Polycystic kidney disease:
  Polycystic kidney disease is a genetic disorder that causes numerous cysts (small sacs of fluid) to grow in the kidneys.
• Urinary tract infections:
  Urinary tract infections (UTIs) are bacterial infections of any part of the urinary system.

Signs and Symptoms:

Routine lab tests done during a health examination can help detect early warning signs of kidney disease such as:

Blood in the urine (hematuria) and/or protein in the urine (proteinuria)
Decreased estimated glomerular filtration rate (eGFR) and elevated creatinine and urea (blood urea nitrogen or BUN), which are early signs of kidney dysfunction.

Other signs and symptoms may include:

• Swelling or puffiness, particularly around the eyes or in the face, wrists, abdomen, thighs or ankles
• Urine that is foamy, bloody, or coffee-colored
• A marked decrease in the amount of urine
• Problems urinating, such as a burning feeling or abnormal discharge during urination, or a change in the frequency of urination, especially at night
• Mid-back pain (flank), below the ribs, near where the kidneys are located
• High blood pressure (hypertension)

As kidney disease worsens, additional signs and symptoms may include a combination of the following:

• Feeling itchy
• Tiredness, loss of concentration
• Loss of appetite, nausea and/or vomiting
• Numbness in hands and feet
• Darkened skin
• Muscle cramps
• Gout

Acute kidney injury (AKI) is a sudden loss of kidney function and can be fatal. It requires prompt treatment. Symptoms may include:

• Urinating less frequently
• Fluid retention, causing swelling in the legs, ankles or feet
• Drowsiness, fatigue
• Shortness of breath
• Nausea
• Confusion
• Seizures or coma
• Chest pain

Causes of Kidney Diseases

Chronic kidney disease occurs when a disease or condition impairs renal function and makes the kidney damage worse for several months or years.

Diseases and conditions that cause chronic kidney disease include:

• Type 1 or type 2 diabetes
• High blood pressure
• Glomerulonephritis (gloe-mer-u-low-nuh-FRY-tis), an inflammation of the kidney’s filtering units (glomeruli)
• Interstitial nephritis (in-tur-STISH-ul nuh-FRY-tis), an inflammation of the kidney’s tubules and surrounding structures
• Polycystic kidney disease
• Prolonged obstruction of the urinary tract, from conditions such as enlarged prostate, kidney stones and some cancers
• Vesicoureteral (ves-ih-koe-yoo-REE-tur-ul) reflux, a condition that causes urine to back up into your kidneys
• Recurrent kidney infection, also called pyelonephritis (pie-uh-low-nuh-FRY-tis)

Risk factors

Factors that may increase your risk of chronic kidney disease include:

• Diabetes
• High blood pressure
• Heart and blood vessel (cardiovascular) disease
• Smoking
• Obesity
• Being African-American, Native American or Asian-American
• Family history of kidney disease
• Abnormal kidney structure
• Older age

How To Diagnose:

As a first step towards diagnosing kidney disease, your doctor discusses your personal and family history with you. Among other things, your doctor may ask you questions about whether you have been diagnosed with high blood pressure, if you have taken a medication that could affect kidney function, if you have noticed changes in your urinary habits, and if you have any medications. Family members who have kidney disease.

Then, your doctor, whether that is one from www.thekidneydocs.com/ or another office, performs a physical exam, also looks for signs of problems with your heart or blood vessels, and performs a neurological exam.

For the diagnosis of kidney disease, you may also need certain tests and procedures, such as:

• Blood test. Renal function tests look for the level of waste products, such as creatinine and urea, in the blood.
• Urine tests: Analyzing a urine sample may reveal abnormalities that point to chronic renal failure and help identify the cause of chronic kidney disease.
• Imaging tests: Your doctor may use ultrasound to evaluate the structure and size of your kidneys. Other imaging tests may be used in some cases.
• Removal of a sample of renal tissue for analysis. Your doctor may recommend a renal biopsy to remove a sample of kidney tissue. Renal biopsy is often performed under local anesthesia using a long, thin needle that is inserted through the skin and into the kidney. The biopsy sample is sent to a laboratory for analysis to help determine what is causing your kidney problem.

Prevention

To reduce your risk of developing kidney disease:

• Follow instructions on over-the-counter medications. When using nonprescription pain relievers, such as aspirin, ibuprofen (Advil, Motrin IB, others) and acetaminophen (Tylenol, others), follow the instructions on the package. Taking too many pain relievers could lead to kidney damage and generally should be avoided if you have kidney disease. Ask your doctor whether these drugs are safe for you.
• Maintain a healthy weight. If you’re at a healthy weight, work to maintain it by being physically active most days of the week. If you need to lose weight, talk with your doctor about strategies for healthy weight loss. Often this involves increasing daily physical activity and reducing calories.
• Don’t smoke. Cigarette smoking can damage your kidneys and make existing kidney damage worse. If you’re a smoker, talk to your doctor about strategies for quitting smoking. Support groups, counseling and medications can all help you to stop.
• Manage your medical conditions with your doctor’s help. If you have diseases or conditions that increase your risk of kidney disease, work with your doctor to control them. Ask your doctor about tests to look for signs of kidney damage.

Treatment

Depending on the underlying cause, some types of kidney disease can be treated. Often, though, chronic kidney disease has no cure.

• Drugs and medication
  • High blood pressure medications.
  • Medications to lower cholesterol levels.
  • Medications to treat anemia.
  • Medications to relieve swelling.
  • Medications to protect your bones.
  • A lower protein diet to minimize waste products in your blood.
• Dietary and lifestyle changes
  • control diabetes through insulin injections
  • cut back on foods high in cholesterol
  • cut back on salt
  • start a heart-healthy diet that includes fresh fruits, veggies, whole grains, and low-fat dairy products
  • limit alcohol consumption
  • quit smoking
  • increase physical activity
  • lose weight
• Treatment for end-stage kidney disease
  • Dialysis.
    • Hemodialysis
    • Peritoneal dialysis
  • Kidney transplant.