Treatment for Nephrology Diseases

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Nephrology Disease

The urinary system consists mainly of the kidneys – filters that purify the blood (180 liters a day!) From water and chemicals, used cells and tissues, as well as residues from food “processing”. It is also a “factory” producing approx. 1.5 liters of urine a day, an organ that ensures the proper composition of body fluids, regulates the water, calcium-phosphate, sodium, and potassium balance. The kidneys produce compounds that regulate blood pressure and are involved in the formation of red blood cells. It is the kidneys that determine the balance of the internal environment of the human body. Kidney disease is very dangerous and can often progress unnoticed, causing changes that are irreversible.

Disturbing symptoms that may be a sign of kidney disease:

  • Eye swelling, swelling of the hands, feet, and ankles
  • burning sensation and soreness when urinating,
  • pollakiuria, nighttime urination or oliguria,
  • dark, bloody urine
  • cloudy urine with a sharp smell reminiscent of ammonia,
  • the appearance of “foaming in the urine”,
  • soreness below the ribs, not getting worse with movement,
  • high blood pressure
  • hyperactivity or apathy,
  • somnolence,
  • paleness,
  • peeling of the skin
  • headaches,
  • fever,
  • vomiting,
  • disgust and the smell of ammonia in the mouth. 

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It often happens that the kidneys get sick very acutely, but apart from feeling constantly tired or urinating at night, they do not give any clear alarming signals. Early detection and appropriate treatment alleviate the course of the disease.

Untreated chronic kidney diseases lead to the failure of this organ. As a result, the blood is less and less cleansed, more and more poisonous substances accumulate in the body, which disrupts the work of various organs: the brain, heart, liver, endocrine glands. If left untreated, they result in irreversible changes, sometimes so severe that renal replacement therapy may be necessary – dialysis or kidney transplantation.

The family doctor usually refers the patient to a top nephrologist in Coimbatore when the patient does not require surgery.

A doctor with a specialization in nephrology deals with functional problems, most often treated conservatively. However, it should be remembered that such therapy is only part of the treatment process, e.g. in the case of severe kidney diseases. 

Nephrologists often work very closely with urologists who specialize primarily in the invasive (surgical) treatment and together they lead a patient who requires both surgical and pharmacological treatments. A referral to a nephrologist does not mean a serious illness, but only a suspicion that it has occurred or may occur in the future. The nephrologist diagnoses not only on the basis of urine tests but also X-ray, ultrasound, scintigraphy, voiding cystography, etc. His tasks include not only treating seriously ill people, but also the observation of patients at risk of nephrological diseases. 

The diseases that the specialist deals with include: 

  • inflammation of the urinary system, 
  • neoplastic diseases, urolithiasis, 
  • nephrotic syndrome, 
  • kidney failure. 

The nephrologist also supervises the patient’s dialysis. In order not to overpay for the first visit to the nephrologist, take the test results with you. If you do not do this, the doctor will only indicate what tests should be performed during the first visit. By having the necessary results with you right away, you will save time and money.

Therefore, the first-time nephrologist consultation should take place only when the patient has:

  • abdominal ultrasound results (not older than 1 month),
  • laboratory analysis: creatinine, urinalysis, morphology, ionogram, glucose level.

If chronic kidney disease is suspected, an additional calcium test should be performed. The nephrologist will also want to see the blood pressure check chart (for one month you record your blood pressure each day as soon as you wake up). In recurrent urinary tract infections, the patient should have the results of urine culture and glucose level with him, and in the case of proteinuria, additionally the result of daily protein loss, cholesterol, and calcium tests. However, in the case of arterial hypertension, it is necessary to examine the fundus (an ophthalmologist visit is necessary).

Can kidney disease be prevented?

We can prevent urinary tract infections, but we cannot prevent glomerular diseases. However, we know how to prevent the development of this disease, the transition from the initial stage of the disease to complete renal failure, when the patient already requires renal replacement therapy. Urinary tract infections are most often caused by bacteria in the human digestive tract. 

Their development is favored by all conditions that make it difficult to empty the bladder, including pregnancy. During this period, urine tests should be performed frequently, and in the last period, try to sleep (lie) on your side, so that the enlarged uterus does not compress the ureters and thus obstruct the outflow of urine. Infection should be cured until the end.

Women are more exposed to bacterial infections due to their anatomical structure because the short urethra makes it easier for the microbes to reach the kidneys quickly. For example, colon bacilli (Escherichia coli ). Many women ignore problems with urination or pain in the lower back, which are the first symptoms of infection, and every fourth woman gets them at least once a year. The number of people with kidney diseases is still increasing, among others due to the development of civilization diseases such as diabetes, atherosclerosis, and arterial hypertension. The kidneys are definitely harmed by the overuse of painkillers (especially ibuprofen and paracetamol). Experts believe that kidney disease is also favored by an excessive amount of protein in the diet, especially in the elderly. 

The most common kidney disease

Nephrolithiasis, also called urolithiasis, most often affects patients between 30 and 50 years of age. It is caused by the precipitation of organic and mineral components dissolved in urine. Kidney stones are formed, which, by pushing through the ureter towards the bladder, cause severe pain attacks.

Symptoms of kidney stones are:

  • renal colic – sharp and severe pain in the lumbar region, radiating towards the bladder,
  • feeling of urgency
  • hematuria,
  • nausea and vomiting
  • flatulence.

Urine tests, ultrasound examinations, and radiological examinations can be performed at the Multispeciality hospital in Coimbatore to diagnose nephrolithiasis.

In the treatment of nephrolithiasis, it is very important to have a proper diet, adequate hydration, and the use of pharmacological agents that, by expanding the urinary tract, will facilitate the flushing of the stones. Larger kidney stones are removed during lithotripsy, i.e. crashing with shock waves, or during surgery.

Kidney Failure

This disease means a loss of the kidneys’ ability to cleanse the body of toxic waste products, excrete water, and control homeostasis, i.e. balance within the body. Symptoms of renal failure appear when more than 60% of the renal parenchyma is damaged. The disease manifests itself in a marked reduction in the amount of urine excreted, or even the lack of it, and an increase in the symptoms of uremic intoxication of the organism. The two main types of kidney failure are:

  • acute,  develops when there is a sudden breakdown of the excretory function of the kidneys, e.g. as a result of intoxication or ischemia of the kidneys,
  • chronic,  develops slowly, usually as a result of a history of kidney diseases that damage the glomeruli or tubules, metabolic diseases, urinary tract defects and infections, and nephrolithiasis that lasts for many years. It can lead to end-stage renal failure manifested, among others, by weakness, cachexia, lack of appetite, anemia, hypertension, acidification (metabolic acidosis), bone pain, and a tendency to pathological bone fractures and bleeding, and in the most severe cases to uremic coma. A very characteristic symptom is a sweet and sickly smell from the mouth of patients, sometimes also persistent itching of the skin and morning vomiting.

The diagnosis of the disease is based on the results of laboratory tests such as urine test, blood test, urea, glucose level, ionogram, creatinine, as well as ultrasound examination of the urinary system with kidney evaluation, urography, and scintigraphy.

Renal failure is treated both pharmacologically and through the use of proper nutrition (determined by a specialist).

Kidney Cancer

It is located in the kidney tubules and initially shows no symptoms. It is most often detected after the age of 50, especially in men. Symptoms of the disease include:

  • palpable tumor in the abdomen,
  • pain in the lumbar region,
  • hematuria,
  • lack of appetite and weight loss,
  • hypertension,
  • night sweats
  • limb swelling,
  • enlargement of the lymph nodes,
  • constant low-grade fever or non-stop fever,
  • in men, varicose veins of the spermatic cord.

The cause of the disease is unknown, but it often develops in people with a family history of kidney tumors. It is also known that the incidence of kidney cancer is higher in smokers.

The diagnosis of the disease is based on ultrasound examinations of the kidneys, computed tomography of the abdominal cavity and pelvis, general examination of urine and blood, and a biochemical blood test.

Treatment is primarily based on the removal of the diseased kidney, which is an operation called a nephrectomy. Appropriate pharmacological treatment is essential.

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