Many people receive a lot of misinformation related to kidney functionality and kidney diseases, and are therefore, not suitably aware of how this disease affects our lives. In this post we compare some of the most common myths surrounding kidney diseases and the actual facts about them.
Myth: Kidney disease is rare.
Fact: Kidney disease affects millions across the globe every year, and is quite common. Almost 10% of the world’s population suffers from Chronic Kidney Disease.
Myth: Kidney disease tests are expensive and cumbersome.
Fact: The diagnostic tests required to determine kidney disease are very simple and painless. One is a simple urine test which checks for protein in the urine, while the other is a blood test which checks for GFR (Glomerular Filtration Rate). Both are pretty affordable and accurate.
Myth: If there are no obvious discomforts like difficulty in passing urine, it means the kidneys are fine.
Fact: Kidney diseases don’t present any symptoms until they have progressed to very advanced stages. And hence, the lack of any external symptoms is no guarantee that a person doesn’t have a kidney disease; it should be thoroughly ruled out by conducting appropriate medical tests.
Myth: Kidney disease cannot be prevented for at-risk groups.
Fact: At-risk groups include those with high blood pressure, diabetes, family history of kidney failure, over 60 years of age, and people of Asian, Hispanic, American Indian, Pacific Islander and African-American ethnicities. However, not everyone who falls into these risk groups will develop a kidney disease. By following a healthy lifestyle including balanced diet, regular exercise to maintain weight, controlled blood pressure and blood sugar, and by quitting smoking, among other things, the kidneys can be kept healthy thereby reducing your chances of getting kidney disease.
Myth: Dialysis is the only treatment for kidney disease.
Fact: Dialysis is required by only those patients whose kidney disease has progressed to advanced stages or those who have kidney failure. Otherwise those patients whose disease is diagnosed in early stages usually require only diet modification, exercise and medication.
Myth: Dialysis is a painful and exhaustive process which restricts the patient from working or travelling.
Fact: The dialysis process by itself is painless, and generally the only discomfort caused is by the needles which are inserted in the graft or fistula. Certain patients may experience headaches, cramps, nausea, etc. but this can be avoided by taking proper diet and fluid restrictions. Also, the patients undergoing dialysis feel sufficiently fine to work or travel if they take proper care of themselves and follow the doctor’s advice correctly.
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Chronic Kidney Disease (CKD) is a term used to describe the slow loss of kidney function in a person. Normal kidneys are able to filter wastes and extra fluids from the blood, which then get excreted in the urine. But due to chronic kidney disease this normal functionality is impaired, and when the disease progresses further, it can lead to the building up of dangerous levels of fluid, electrolytes and wastes in the body. When the level of kidney function falls below a certain level, it is called kidney failure.
Chronic Kidney Disease: Quick Facts
- Diabetes and high blood pressure are the two leading causes of kidney disease.
- Kidney disease is likely to cause kidney failure in men more than in women.
- African Americans, Hispanics, Pacific Islanders, and American Indians are at increased risk.
- Kidney disease can develop at any age, but affects the elderly more. Around 50% of people aged 75 and above are estimated to have CKD.
- In the developing countries, around 1 million people die annually due to untreated kidney disease.
- Generally, kidney transplant success rates are very good, with around 85-90% success rate for deceased donor transplant and 90-95% rate for live donor transplant.
- Almost 8-10% of the adult population suffers from some type of kidney damage.
- There are five stages of kidney disease, stage 5 being the End-Stage-Renal-Disease (ESRD), also known as kidney failure.
Causes of Kidney Disease
There are a number of conditions and diseases that can lead to CKD, such as diabetes, high blood pressure, polycystic kidney disease, interstitial nephritis, family history, etc. Out of these, diabetes and high blood pressure are two main causes contributing to around 2/3rd of all CKD cases. Kidney disease can make a person develop various health complications including weak bones, anemia, nerve damage, and heart diseases and stroke. Most often these problems manifest very gradually and therefore, aren’t easily noticed. As a result, chronic kidney disease can get significantly worse before it can be diagnosed and treated. In many situations, this can lead to kidney failure in the patient which can prove to be fatal without dialysis or kidney transplant.
Some of the other, less prevalent causes of CKD are glomerulonephritis (inflammations) or pyelonephritis (infections). CKD can also be caused due to inherited conditions (such as polycystic disease), enlarged prostate, kidney stones, malformations in a baby when in the mother’s womb, tumors, frequent urinary infections, lupus and other diseases that affect body’s immune system.
Certain drugs like analgesics (pain-killers), if taken over a prolonged period of time, can also lead to kidney disease.
Symptoms of Chronic Kidney Disease
Chronic kidney disease usually doesn’t present any symptoms until it has advanced to a much later stage. In the advanced stages, kidney disease can cause:
- Fatigue, weakness, lethargy
- Pain during urination
- Foamy/Pink/Dark urine (blood in urine)
- Need to urinate more often
- Fluid retention leading to swelling of ankles, face, hands, abdomen, ankles, feet, eyes
- Increase in thirst
- Loss of appetite
- Difficulty in concentrating
- Difficulty in sleeping
- Muscle cramps
- Dry, itchy skin
Diagnosis and Treatment
Chronic kidney disease can be diagnosed by means of certain tests and procedures such as:
Blood tests: These can include a blood creatinine test to determine the Glomerular Filtration Rate (GFR), a blood urea nitrogen (BUN) test, a fasting blood glucose test and some other tests that check for the amount of waste products and electrolytes in the blood.
Click here to learn more about GFR and its correlation to Chronic Kidney Diease.
Urine tests: These are used to measure the amount of protein in urine (ideally none), by means of Urinalysis (UA) and a urine test for microalbumin.
Imaging tests: A renal ultrasound and/or angiogram may also be conducted by the doctor to check any obstructions to the kidney or reasons for restricted blood flow.
Kidney biopsy: This procedure may also be used by the doctor to find out the reason for kidney disease, particularly after a kidney transplant if there is the possibility of organ rejection. The biopsy process involves removing a sample of kidney tissue by inserting a thin, long needle through your skin and into the kidney.
Early screening of kidney disease is recommended to those who are suffering from high blood pressure or diabetes. Unless the disease has reached the advanced stages, it can be managed by means of medications and leading a healthy lifestyle.
In patients suffering from either diabetes or high blood pressure, it is crucial to control the sugar levels and blood pressure respectively, in order to prevent further damage to the kidneys. By properly assessing the extent of damage to the kidneys as well as the contributory factors, the doctor will create a comprehensive treatment plan.
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Tips to help keep your kidneys healthy
Small hard deposits made of acid salts and minerals forms on the interior of Kidneys and are commonly known as Kidney Stones. There are many reasons for why this Stones are formed and it can have severe effect on the Urinary Tract System, Kidneys, and Urinary Bladder. Stones are formed when the Urine gets concentrated, allowing mineral to crystallize and later they stick together in their solid state.
As the Kidney Stone passes through the Urinary Bladder it causes immense pain. While it causes no permanent damage, it does pain a lot. A lot of water intake would help the Kidney Stone pass effortlessly.
There are instances wherein the Stones have to be removed with the help of a surgery. The type of treatment would depend on the doctor’s recommendation to reduce the risk of recurrent Kidney Stones and also to be away from the risk of developing it again.
SYMPTOMS OF KIDNEY STONE
A Kidney Stone shows no symptoms until it starts moving inside the Kidney or when it passes into the Ureter. Ureter is the tube connecting Kidney and Bladder and when the Stone touches the walls of Ureter, it causes various symptoms.
Following are the symptoms of Kidney Stones:
- Severe pain in the side and back, below the ribs
- Pain that spreads to the lower abdomen and groin
- Pain that comes in waves and fluctuates in intensity
- Pain on urination
- Pink, red or brown urine
- Cloudy or foul-smelling urine
- Nausea and vomiting
- Persistent urge to urinate
- Urinating more often than usual
- Fever and chills if an infection is present
DIAGNOSIS OF KIDNEY STONES
If you suspect a Kidney Stone, it’s better to get it diagnosed. It requires certain tests and procedures:
Blood Test: It determines the level of Calcium and Uric acid in the blood. Also it helps monitor the heath of Kidneys and diagnose its conditions.
Urine Test: It requires 24 hours collection of the Urine to know the amount of stones that the person is excreting through Urine.
Imaging Test: With the help of this test, one can see the amount, and size of stones, present in the Kidney. The person would have to undergo X-ray or CT scan that may reveal the required information. Normally, tiny stones are missed during an X-ray but CT scan would capture it all. Other imaging options include an ultrasound, a noninvasive test, and intravenous pyelography, which involves injecting dye into your arm vein and taking X-rays as the dye travels through your kidneys and bladder.
Analysis of stone: In this test, the person is asked to urinate through a strainer to catch the stones. A further lab analysis would reveal the make-up of this stones. Doctor would determine the causes of stones through this analysis.
More than 80% of the Kidney stones passes on their own but it has been observed that Kidney Stones often have high recurrence rate and the patient can develop another stones within 10 years of life span.
Once the type of the stone is determined, the risk of recurrence can be minimized. Analysis of the stone after capturing it would tell its type. In otherwise healthy patients, the major complications of a kidney stone is the potential for infection or the inability to control pain or nausea.
PREVENTING THE KIDNEY STONES
- Keeping yourself hydrated is the best way to prevent the Kidney Stones. One should be drinking adequate amount of water especially those who sweat more
- For those with underlying medical conditions, chronic medications are very important
- It is very essential to drink more water and urinate more for the stone to be excreted in the initial stages itself
Kidney Stone and Kidney Stone Surgery
At times a small Calcium Crystal Stone forms inside the part of the Kidney where the Urine is collected. The stones cause pain while urinating. The problem increases when Calcium Crystal Stones falls into the Ureter, a tube that drains the fluid from the Kidneys in to the bladder. There the stones prevent Urine from coming out of the Kidneys and causes severe pain.
Kidney removes waste from the body and filters the Blood to make Urine. The same Urine flows from the kidney into the bladder through the Ureter, a thin tube that connects the two. The Bladder empties through the Urethra, a tube much wider than the Ureter.
Urine from the Kidney excrete a variety of minerals and chemicals, when sometimes these minerals and chemicals combine to form stones. With the passage of time, the stones grow in size, sometimes almost an inch in diameter or even larger.
How are they formed?
The reason isn’t exactly known, but usually changes in the acid-base balance (pH) of the urine and the concentration of minerals and chemicals within the urine are all factors that can signify the formation of a stone. Concentrated urine often occurs during an episode of dehydration, setting the stage for the beginning of stone formation. The consequences of that stone, when it is large enough to cause an obstruction, may occur weeks, months, or years later.
A Kidney stone can infect the Kidney with Pyelonephritis, an inflammation of the renal parenchyma, calyces, and pelvis that is commonly caused by bacterial infection that can spread to the urinary tract or travel through the bloodstream to the kidneys.
When kidney stones pass from the urine collection system into the ureter, they can act like a dam preventing easy flow of urine from the kidney into the bladder. This causes urine to back up, increasing pressure and swelling within the kidney.
Pain in the process
Pain from the Kidney and as the stone passes through the Ureter, the pain increases. Kidney Pain is also known as renal colic Stone can be excruciating and its intensity is similar to that of pain experienced during a child birth. The pain starts from the lower back and radiates to the front of abdomen and in males, it may cause testicular or scrotal pain. It makes the individual totally uncomfortable. Kidney Stone has side effects like Nausea, Vomiting and Sweating.
If not treated the intense pain would be continuous and the pain would considerably increase. Once the stone is in the Bladder, the obstruction is relieved.
Passing of the stone
Since a Urethra is much larger in size than the Ureter, passing of the stone is an easy thing. It passes easily while Urinating and most patients cannot tell when they have eliminated the stone from their bladder.
The severity of the pain does not depend on the size of the stone, but it rather depends on the amount of obstruction and Kidney swelling. Many a times, when Kidney stone passes through the urine’s, a small amount of blood is visible.
In next article we will understand the symptoms and kidney stone surgery.
People suffering from Chronic Kidney Diseases suffer from a very subtle symptoms which often go unnoticed. The time period between Chronic Kidney Disease (CKD) and Kidney failure is undetermined. It may take years and also may happen soon, depending on case-to-case basis. Kidney failures can be determined with early stage symptoms which are necessary to be identified. Let us discuss the symptoms of kidney failures:
• The beginning is often asymptomatic which means there would be a very less amount of visible symptoms but as the disease advances the kidneys would be unable to regulate water, balance the electrolytes, remove the waste from the body, and produce red blood cells. Such a person would often undergo Lethargic behavior, uneasiness, weakness, short of breath, and general swelling.
• The body would be unable to manufacture bicarbonate due to which the body acidity increases. It is known as metabolic acidosis. Such body dysfunction would alter the enzyme and oxygen metabolism which would end with an organ failure.
• Kidney would not be able to excrete the potassium from the body thereby increasing its level in the serum and it causes fatal heart rhythm disturbance.
• Urea level rises in the blood and it affects various body organs like brain, heart, muscles and would also be responsible for low calcium levels in the body.
• Weakness may be due to anemia but in certain cases the red blood cell counts starts decreasing due to the lower level of erythropoietin which is caused due to the kidney failure. It reduces the oxygen carrying capacity of the blood and hence the body gets tired very soon.
• Loss of appetite and fatigue becomes regular and if it continues, it may affect the mental balance which may end up in comma.
• Rising blood pressure due to excess of fluid present in the body is another symptom for kidney failure and the fluid may start to deposit on lungs which ends with heart failure.
The symptoms of kidney failure would vary a lot depending on patient to patient and also it depends on what kind of treatment you undergo.
Test required to diagnose the Kidney Failure
• Kidney failures can be diagnosed with blood test. The buildup of waste product would determine the kidney failures. BUN, GFR, and Creatinine are essential factors to determine the condition of kidneys. When the BUN and Creatinine level rises up in the blood and the GFR level decreases, the kidney failure is confirmed. The above mentioned three factors determines the rate with which the blood is filtered through the kidneys. The rate would always differ depending on the age, gender, and race of the person.
• Urine can be used to determine the Kidney failure. With a urine test, the doctor would measure the amount of protein and the presence of abnormal cells in it. If protein is found in the urine, it points towards something abnormal in the body. Abnormally aggregated red and white blood cells in the kidney denotes the presence of Kidney Disease.
• Abdominal Ultrasound test can determine the size of the kidney. If any obstruction is seen in he reports, it denotes presence of Kidney Disease.
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