Nephropathy is also known as renal disease. It is any type of damage or disease relating to the kidneys. Though not everyone with diabetes has nephropathy, however, diabetic nephropathy can cause kidney failure.

How does diabetes affect the kidney?
Kidneys are responsible for taking waste out from your blood. They have a lot of tiny blood vessels to do this. High blood sugar may kill such blood vessels. Once these blood vessels are destroyed, the kidneys may not function as well or it may even lead to kidney failure.

What increases your risk of getting diabetic nephropathy?
There are several factors which increase your risk of getting diabetic nephropathy including: \
1. High blood pressure
2. High cholesterol
3. Smoking
4. Being native american, african american or of hispanic origin, for whom risk factors have proved to be magnified
5. If you have family history of diabetic nephropathy

Symptoms and diagnosis:
There are very few noticeable symptoms, which appear when you have diabetic nephropathy, except swelling in your arms and legs. The diagnosis is done by checking for a type of protein in your urine known as albumin, which is not supposed to be there. Getting the diagnosis done early is crucial.

Preventive measures
You can prevent kidney damage by doing the following:
1. Keeping your blood sugar levels under control - keep hba1c &lt; 6-7%
2. Keeping your blood pressure under control in the range of 130/80
3. Eating healthy food
4. Exercising regularly
5. Not eating too much protein
6. Not eating too much salt
7. Reducing smoke or excessive tobacco usage

Medicines for treatment
If you do get diabetic nephropathy, here are some medicines, which can help cure it
1. Ace inhibitors which are also called angiotensin-converting enzyme inhibitors
2. Angiotensin ii receptor blockers (arbs)

Possible complications
1. Blood pressure may rise
2. Triglyceride levels and cholesterol levels may rise.

All About Diabetic Nephropathy

3 Causes of Acute Kidney Failure

You're said to suffer from the problem of acute kidney failure if your kidneys suddenly stop working and lose their ability to eliminate waste materials including excess fluids and salts from the blood. The condition usually develops quickly over a few days or even a few hours. When this happens, waste materials accumulate in your blood, disrupting the chemical balance of your bloodstream.

So, what causes this problem?

Acute kidney failure can occur because of any one of these reasons:

1. A drop or slowdown of blood flow to the kidneys - Adequate blood circulation to the kidneys is of great importance as without it the kidneys may end malfunctioning. If blood flow to the kidney is hampered, a part of or the entire kidney may die. You may suffer from acute kidney failure if blood flow to the kidneys gets impaired due to conditions like

-Heavy blood loss
-Sepsis (body's inflammatory reaction to an infection, which can bring about organ failure, tissue damage, and death)
-Injury
-Use of certain drugs
-Dehydration
-Burns
-Heart disease

2. Urinary obstructions - A sudden blockage that hampers your kidney's ability to eliminate urine can also bring about acute kidney failure. When this happens, it leads to a build up of toxins in the body, causing an overload of the kidneys. Conditions that bring about this urinary obstruction include:

-Cervical cancer
-Colon cancer
-Bladder cancer
-Kidney stones
-Enlarged prostate
-Prostate cancer

3. Disease within the kidneys - Even instances of clotting within the blood vessels of the kidneys can lead to acute kidney failure. This is because if the movement of blood cells within the blood vessels gets hampered, kidneys are not able to filter out toxins from the body. The conditions and diseases that may cause clotting, and subsequently damage to the kidneys include:

-Scleroderma (an autoimmune disease that affects connective tissues and skin)
-Build-up of cholesterol deposits
-Glomerulonephritis (an inflammatory condition of the kidney's ball-shaped structures called glomeruli)
-Hemolytic uremic syndrome (a condition that occurs due to untimely death of red blood cells)
-Lupus (a disorder of the body's immune system that brings about damage to the body's own organs and tissues)



3 Causes of Acute Kidney Failure

Often, early stages of kidney diseases do not come with specific signs and symptoms and most people will remain unaware of their condition. However, certain symptoms may be perceived that may indicate that a person is suffering from early stages of kidney failure. When you are diagnosed with kidney failure (also known as renal failure) in the initial stages, certain measures can be taken to retard the progression of the renal disease. This can also help reverse the condition and improve the quality of life of the patient. On the basis of a typical cause, the symptoms of kidney failure are grouped into specific categories that are given below. If you notice any of the specified renal failure symptoms, it is recommended to immediately fix up an appointment with your doctor and get your diagnostic tests done. 

Symptoms of Renal Failure from the accumulation of waste products in the body: 

Metallic taste in mouth 
Nausea and vomiting 
Facing difficulty in concentrating 
Loss of appetite 
Aversion towards meat (protein aversion) 
Itching or pruritus 
Symptoms of Renal Failure from the accumulation of fluid in the body: 

Dyspnoea or shortness of breath (this happens due to the accumulation of fluid in the lungs).
Swelling is seen in the feet, hands or face. 
Symptoms of Kidney Failure from damage to the kidneys: 

The amount of urine production changes, though it is not a reliable sign Haematuria or blood in the urine (usually in microscopic quantity). 
Frothiness or foam in the urine (usually happens when protein is present in the urine). 
Symptoms of Kidney Failure due to decreased blood production (anemia): 

Dyspnoea or shortness of breath. 
Fatigue Weakness. 
Confusion If you happen to feel cold all the time. 
The following diagnostic tests will be performed by your doctor in order to determine whether the symptoms are the manifestation of a kidney failure or not: 

Urine analysis - In this test, a sample of your urine is tested to find traces of blood, white blood cells or proteins which may indicate a problem in kidney function. 
Blood Tests - This includes tests for BUN and creatinine in the blood which are usually removed from the blood if the kidneys function properly. 
Actions must be taken when you show signs and symptoms of kidney failure: 

It is common that the symptoms of early renal failure are not always prominent, but if any of the above symptoms are witnessed, it is recommended to met a physician to determine whether they are caused by a kidney disease. You can pen-down the symptoms that you feel are related and bring it to the doctor when you fix up the next appointment. It is essential to know about your disease at the earliest as it will give you time and the ease of taking measures to retard the damage process and will decrease or delay the probability of undergoing dialysis or kidney transplant.

Kidney Failure - What Should You Know About it?

Our kidneys act as filters which constantly flushes out toxins and excess minerals with water in form of urine. Urine contains lots of minerals which may precipitate and form stones. Urine has lots of pro-precipitating agents and anti-precipitating agents. When their balance disturbs due to some disease, stones start forming. These stones may often lead to abdominal pain which is referred to as renal colic. 

What exactly is renal colic? 

Renal or ureteric colic is the term used for typical pain in one side of abdomen in flank region starting from back and radiating forward towards lower abdomen up to scrotum. This is usually associated with nausea, vomiting and urinary discomfort. There may be blood in urine. 

How kidney stones are related to renal colic? 

Kidney stones usually form inside kidney and lies there without causing any pain. But whenever they are dislodged and stuck at mouth of kidney (pelvis) or anywhere in ureter, they block the passage of urine of that kidney. This causes swelling in kidney termed as hydronephrosis. This swelling in kidney causes renal / ureteric colic. This colic is protective phenomenon and tries to push out the stones. Small stones do come out in urine by this natural process. This spontaneous expulsion of small stones is common and many local practitioners used to get credit of it feigning benefit of their medicine. However large stones need some form of intervention to come out. Otherwise, they do harm to kidneys in long term. 

Symptoms of kidney stones along with renal /ureteric colic - 

Most stones which are lying in calyces of kidney are asymptomatic 
Nausea & vomiting 
Frequent urinary tract infections 
Fever with chills 
Foul smelling urine 
Hesitency, frequency and burning in urination 
Blood in urine (urine with a reddish, pink or brownish hue) 
Passage of small stones in urine 
Treatment of renal colic 

Treatment of ureteric/renal stones involves control of symptoms and stone removal. 

Expectant Treatment or Medical Expulsion Therapy: Small stones of less than 4 mm size usually pass on its own and some medicines like alpha-blockers and steroid hasten up their expulsion. Medium size stone (4-6 mm), sometimes passes with aid of these medications. But stones larger than 6 mm usually require intervention. 
Lithotripsy: This method involves breaking of stones by shock waves into small dusty particles which pass through urine on its own. This is usually suitable for stones upto 1.5 cm and lying in kidneys. This is non-operative treatment which can be done on OPD or Daycare basis. 
Ureteroscopy (URS): This method involves entry of very thin semirigid scope through urethra into ureter. Stone is broken by LASER and removed. This involves single day admission and spinal anaesthesia. 
RIRS- Retrograde Intra Renal Surgery: In this method very thin flexible scope in maneuvered through urethra into the upper ureter and pelvi-calyceal system of kidney. Stones in kidney or upper ureter are broken by LASER and removed. This is also done under anaesthesia and requires a day admission. 
Mini- PCNL: This method is suitable for large renal stones. In this technique, a small hole is made into the kidney through back and tiny scope is entered into the kidney. Stones are broken by LASER and removed. This is done under anaesthesia and require two to three days admission.

Renal Colic - Ways it Can Be Treated?

One single kidney in place of two is a scenario which is often termed as solitary kidney.

Who has a solitary kidney?

Their body functions normally and are generally not unhealthy. This is also known as renal agenesis.
In some cases, people are born with two kidneys with just one of them healthy and fully functional. The other one does not function fully or partially. This condition is known as kidney dysplasia.
A person who had to undergo a kidney removal surgery (nephrectomy); such a surgery is conducted when a person has an infected kidney or diseased, malfunctioning/cancerous growths on the kidney.
A person who has donated a kidney to someone who required kidney transplantation.
What potential health risks does a person with a solitary kidney have?

Normally, a person born with a single kidney does not have any such potential health risks. They are generally healthy and lead normal lives.
Later in life, there may or may not be slight loss or degradation in the functioning of the kidney.
The life span of a person with a single kidney is normal. There is no apparent effect on the mortality rates.
What kind of special diet must a person with a single kidney follow?

There is no need of any such special diet for a person with a single kidney.
Normal healthy balanced diet with all the essential nutrients should suffice.
You must be careful about your animal protein intake and calcium supplements.
Drink sufficient quantity of water to remain hydrated all day and prevent the urine from turning acidic.
Controlled consumption of alcohol and caffeine is a must. It is also important to reduce the consumption of aerated drinks.
Exercises and Physical activities for a person with a single kidney:

A person with a solitary kidney can function like any other normal individual.
You may also participate in sports. However, you must take enough precaution to prevent injuries to your kidney. Proper padding and protection around your lower abdominal region and back is of utmost necessity.
You can hit the gym, run a marathon and nothing is impossible for you.

Living With Solitary Kidney - Things You Need to Know!

A kidney transplant is a procedure that employs an operation to transplant properly functioning kidney in the body. The main job of the kidneys is to remove the excess waste from a person s body with the help of a filtration process. When the kidneys stop filtering the toxins properly, they become diseased as harmful waste products and toxins begin to accumulate in the body. Following this, the patient has to go through treatment measures like dialysis or kidney transplant.

Read on to know the five things you should keep in mind about a kidney transplant.

Treatment: Transplant is one of the best ways to treat chronic kidney disease stage-V, until unless it is contraindicated. Life becomes near normal after transplant, though there is a possibility of rejection of transplant kidney. Patient has to take immunosuppressive medication life long. 
Medication: Medications are mainly for:
To prevent rejection: Patient takes immunosuppressive medications life long. 
Prevention of infection: Patient has to take care all the measures to prevent infections as they are more prone to infections. 
Other medication: To control diabetes, HTN etc. 
Family Only: The donors are from family or emotionally related or cadavers (after brain death). HLA-matched donors are better because of less chances of rejections and first reduction of immunosuppressive. 
Doing Your Part: Once transplant is done - patient becomes normal and he/she lives a normal life. However, they have to take regular medications and to protect themselves from various infection. 
End Stage Renal Diseases: These diseases includes diabetes mellitus, HTN, polycystic kidney disease, chronic glomerulonephritis or interstitial nephritis etc.
Consult your Nephrologist before going for renal transplant for detailed check up or line of action.

Kidney Transplant - 5 Things About it !

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