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| Infection | Stones | Cancer | Failure |
Kidney Problems |
Your kidneys filter waste and excess fluid that your body
does not need. Their function is essential for good health. Many kidney
conditions may be painful, even life-threatening. Several of the problems
that affect the kidneys and their correspnding symptoms are covered in
detail below. Many treatment options and methods of prevention are available.
If you find that you experience many symptoms of kidney problems, you
should make an appointment to see a urologist.
| Kidney infections |
Symptoms
-
- Sudden onset of shaking, chills and a fever of more
than 102 degrees F
- Constant ache in the side
- Burning sensation when you urinate
- Urinating often
- Fatigue
- Nausea and vomiting
How do I get a kidney infection?
A kidney infection occurs when bacteria in the bladder spreads into the ureters and kidneys. Repeated infections can cause kidney damage and, later, kidney failure.
Treatment
The doctor can determine if you have a kidney infection by examining your urine for bacteria and pus cells. A kidney infection is usually treated by plenty of fluids and antibiotics. If the infection is severe, you may need to be hospitalized to receive intravenous antibiotics and fluids.
Prevention
To prevent kidney infections, drink plenty of liquids, including cranberry juice. Cranberry juice has chemicals that fight off all urinary tract infections. Wearing cotton underwear and loose clothing that does not trap heat and moisture is also a good prevention method of kidney infections. Practice good bathroom hygiene by cleaning thoroughly after using the toilet. Women should wipe from front to back to avoid spreading fecal bacteria to the opening of the urethra. Recurring infections may mean that there is an important problem with the kidneys and such cases should be evaluated by a urologist.
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Kidney stones |
Symptoms
-
- Severe pain in the lower back and groin
- Nausea and vomiting
- Blood in the urine, which might only be seen with a microscope
- Recurrent infections of the urinary tract
Exactly what are kidney stones?
Your kidneys filter out chemicals, wastes, and fluids that your body does not need. Some of these chemicals do not dissolve well and form crystals in the urine. Small crystals pass from the kidneys to the bladder. However, sometimes the crystals are larger, and cannot pass easily through the urinary tract. A clump of crystals of un-dissolved material in the urinary system is a stone. There are many substances that can make up a stone. A stone blocking the urinary system can be painful and dangerous.
Evaluation
A urologist can examine your urine under a microscope to check for blood, crystals, and infection. X-rays can help locate a stone and determine its size. X-rays without dye (contrast) can determine if the stone is blocking a kidney. An ultrasound exam can sometimes determine size and location of a stone. At other times, more complex tests may need to be done.
Treatment
Sometimes drinking lots of water and taking pain medication
will help you pass the stone. The success of this treatment depends mainly
on stone size and location. Smaller stones have an excellent chance of
passing themselves. Other times, kidney stones can be broken up with
an ultrasonic shock wave technique called a lithotripsy. This grinds
the stones into a powder to be passed more easily. This technique does
not require an incision and can usually be carried out without anesthesia.
Sometimes the lithotripsy is not an option for patients with large or
complex kidney stones. In these cases, the doctor would apply a laser
or more powerful ultrasonic form of energy directly to the kidney stone.
This is also a procedure that usually requires no incision.
In a few cases, surgical removal of the stone is needed.
Prevention
To prevent kidney stones, drink lots of fluids. The more fluids your kidneys filter, the less likely the chemicals and salts will form into stones. Avoid excesses of calcium in the diet if your stones contain calcium. For people who form many stones, evaluation by a urologist to determine the metabolic cause and possible treatment should be performed.
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Kidney failure |
Symptoms
- Urinating in small amounts
- Swelling of the body
- Nausea and vomiting
- Fatigue
- Confusion, convulsions and coma are late symptoms
Why is kidney failure so harmful to your health?
Your kidneys keep your body functioning normally. They filter out the wastes and toxins your body does not need. When the kidneys start failing, toxic wastes build up in the blood. Blood salts like potassium and sodium can not be regulated properly. When the kidneys are not able to cleanse wastes from the body, fluid and chemical imbalance occurs. This imbalance can lead to fluid retention, swelling, irregular heartbeat and death.
Acute kidney failure
This is sometimes a reversible condition. It can be caused by an infection, kidney inflammation, ingestion of poison, serious injury, massive blood loss, burns, or medicine.
Chronic kidney failure
Chronic kidney failure can be caused by diabetes, high blood pressure, congenital kidney problems, recurrent kidney infections, kidney stones, or an enlarged prostate that blocks the flow of urine. In chronic kidney failure, kidney function is lost over a period of months or years. You may not notice the damage until it has been done. Damage from chronic kidney failure in most cases is not reversible.
End-stage kidney failure or renal disease
This means that the damage to the kidneys is severe enough that the kidneys are not working adequately. This is a permanent failure of the kidneys. The fluid and chemical imbalance in the body becomes serious when kidney damage is severe and must be treated.
Treatment
To treat reversible kidney failure, you must treat
the disease that is causing it. Examples of this are controlling diabetes,
better control of blood pressure, and intravenous fluids and transfusions
for kidney failure associated with severe blood loss. If the failure
is a result of an enlarged prostate or a kidney stone, then surgery may
be required to remove the obstruction.
In the case of end-stage kidney failure, permanent damage cannot be reversed.
Dialysis or a kidney transplant is required. Dialysis is an artificial
means of removing wastes in the blood when the kidneys can not do it
anymore.
Kidney transplants are another option. The United Network for Organ Sharing
reported that as of June 2, 1999 there were 42,071 people waiting for
a kidney transplant. In 1998, there were 11,990 kidney transplants done
in the United States. Of these 11,990 transplants, 4,016 of the transplants
were performed with living donors. The living donors are usually relatives
of the patient who volunteer to donate one of their own kidneys. The
chance of the body rejecting a kidney from a relative is less than with
an unrelated donor.
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Kidney Cancer |
Incidence
According to the American Cancer Society 2002 Statistics, neoplasms of the kidney account for 3% of all male cancers and approximately 2% of female cancers. There will be approximately 31,800 new cases diagnosed and 11,600 deaths from kidney cancer in 2002. The most common kidney cancers is renal cell carcinoma, Wilm’s tumor, transitional cell carcinoma, oncocytoma, and angiomyolipoma. Renal cell carcinoma which arises from the proximal tubular cell of the glomerulus is an adenocarcinoma and is by far the most common malignancy of the kidney. The classic triad of symptoms traditionally associated with renal cell carcinoma (which are hematuria, flank pain, and weight loss) are now rarely seen. It is much more common for renal cell carcinomas to be diagnosed incidentally during evaluation for abdominal pain or other abdominal complaint.
Diagnosis and Staging
Kidney masses are often detected by abdominal ultrasound or CT scan as an incidental finding while evaluating another condition or performing screening. The primary modality of diagnosis is currently abdominal ultrasound. Once a solid mass of the kidney has been identified, a CT scan is the most common study to elucidate the size and extent of the tumor. Renal cell carcinoma has as one of its prominent characteristics the tendency to invade its own venous supply. Therefore, the possibility of hematogenous metastasis is high even with relatively small tumors. The staging evaluation includes a chest X-ray, liver function tests, and in selected patients, a bone scan.
Treatment
For localized kidney cancer, it was previously believed
that the only curative therapy was radical removal of the kidney. While
complete removal of the kidney has long been the standard of care, increasing
attention is being paid to nephron-sparing procedures such as partial
nephrectomy, removal of the tumor only, cryotherapy (freezing) of the
tumor, or radio frequency ablation of the tumor are now viable alternatives
in selected cases. For small tumors which are peripherally located, this
may provide a result as good as radical nephrectomy. The tendency for
renal cell carcinoma to be multifocal and metachronous demands careful
long-term scrutiny in those patients treated with nephron-sparing techniques.
Innovations in the management of these tumors have included laparoscopic
(minimally invasive through small incisions or ports) nephrectomy for
selected cases of renal cell carcinoma.
Traditional multimodality chemotherapy has been disappointing, with only
a 20-30% response rate. Immunotherapy offers an alternative for those
patients who have advanced disease. Of the available immune agents, Interleukin-II
appears to have the greatest utility against metastatic renal cell carcinoma.
Unfortunately, the application of Interleukin-II has significant adverse
side effects, and the relatively high response rates must be balanced
against the morbidity associated with the treatment, as well as the relatively
short duration of response. Initial evaluation of chemoprevention of
renal cell carcinoma, as well as early detection by evaluating urine
and serum markers for this disease, are in progress.
You may find more information about kidney cancer at the American Foundation
for Urologic Disease at The American Foundation for Urologic Disease Web site.
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