Located right under the rib cage, kidneys are a very important organ of the body. They are not only responsible for purifying your blood from wastes and excess fluid but are also involved in maintaining electrolyte balance, regulating blood pressure and producing red blood cell in the body.

In many cases, due to some medical condition, one or both kidneys may stop functioning properly. If not treated in time, it may lead to complete kidney failure and if the kidneys fail completely, dialysis or transplant may be the only treatment options available.

Dialysis is a treatment in which the blood is filtered and purified artificially using machines. This process is beneficial for those whose kidneys are not able to do their job properly.

Need for dialysis

A functioning kidney prevents the accumulation of excess water, impurities, and wastes inside the body. They also work to maintain the blood pressure level and control the presence of certain chemicals like sodium and potassium.

When the kidneys fail to perform these critical functions, maybe because of some disease or injury, dialysis helps to keep up the healthy functioning of the body as much as possible. As without dialysis all the wastes and fluids will accumulate and poison the body, resulting even in death. However, it must be kept in mind that dialysis is not a cure for kidney diseases; it is just an alternative to their functions.

Types of dialysis
Dialysis is an artificial process of purifying your blood using machines. There are two types of dialysis:

Hemodialysis
This is one of the most common types of dialysis, where an artificial kidney, known as a hemodialyzer, is used to remove waste and chemicals from the blood. The doctor surgically creates a vascular access into the blood vessels allowing the artificial kidney to perform.

Peritoneal Dialysis
This is a surgical procedure, where a catheter is implanted in the belly area. The treatment involves a special fluid called dialysate which is flowed into the abdomen to clean the blood. Once the blood is cleaned, the fluid is drained from the abdomen. The benefit of this treatment is that you can perform it in your home, without going to a hospital.

Risks in Dialysis
Even though either of these two treatment procedures is life-saving and there is hardly any alternative, these two can also come with risks. The risks include peritonitis, abdominal muscle weakening, high blood sugar level, weight gain, low blood pressure anemia, muscle cramping, insomnia, itching, depression, increased potassium level and pericarditis. If you experience any of these symptoms of the risks involved, then immediately consult your doctor and explain in details.

A patient who is going through dialysis for a long time also has a chance of succumbing to the medical condition called amyloidosis. When the amyloid proteins, which are produced in bone marrow, collects in kidneys, hearts, liver and other organs, amyloidosis occurs. This results in joint pain, stiffness and even swelling. 

Dialysis May Save Your Life!

A lot of bad things can and do happen when the kidneys fail.  The kidneys are vital for proper bodily functioning because they filter liquid and solid waste products out of the blood and allow vital chemicals (which the body needs for functioning) to flow into the body through the bloodstream.  People can become very sick when the kidneys either fail to perform these functions or fail to perform them properly.  Many people will get chronic kidney disease, therefore, they need to know what the causes and symptoms are in order to treat, and even prevent these diseases from occurring.

People who suddenly experience the following symptoms should see a nephrologist as soon as possible for a medical examination:  blood or protein in the urine, kidney stones, acute kidney injury, kidney infections, and/or pain, and Hepatitis C and kidney disease.  

Blood in the urine can be a sign of kidney problems which can lead to kidney disease.  Additionally, people who urinate frothy or bubbly urine, or have swelling in the hands, face, and feet should see a doctor because this is a sign of protein in the urine.  Protein in the urine can be detected by a urine test.  Kidney stones can be very painful and are problematic.  They are caused by mineral buildup in the kidneys.  Men and white people tend to get kidney stones more, and they can cause blood in the urine, painful urination, sharp lower abdominal or back pain, and nausea and vomiting.

Acute kidney injury occurs when the kidneys stop functioning altogether in a short period of time.  Because this disease can be deadly, those with this disease should get immediate medical help.  Usually, the very sick patients in hospitals get this disease, but it can also be caused by certain medicines, injury, or infections.  This type of kidney disease is easily reversible.  

Symptoms include

Not passing enough urine when urinating
Leg, ankle, or feet swelling
Fatigue
Breathing problems
Confusion
Nausea, and chest pressure or pain. 
Kidney infections tend to be caused by bacteria that have spread from the urinary tract.  Women, because of their anatomy, tend to get kidney infections more than men. 

Symptoms include:

Fever
Vomiting
Back, side or groin pain
Chills
Nausea
Frequent urination
Frequent urges to urinate
Painful or burning urination
Pus or blood in the urine
Cloudy or foul-smelling urine
Kidney pain in the lower back or sides can signify more serious kidney problems.  They can be caused by urinary tract infections, polycystic kidney disease, kidney infections, blood clots, and/or bleeding in the kidneys.  
Hepatitis C is a disease that attacks the liver and can cause kidney disease.  

Symptoms include

Loss of appetite
Nausea
Fever
Fatigue
Vomiting
Dark colored urine
Grey colored stool
Joint pain
Yellow skin and eyes
While kidney diseases are at best unpleasant, and at worst, life-threatening, they can be avoided by drinking lots of water, eating a healthy low salt diet, and watching for any changes in health and urine over time.



What Happens When Kidneys Fail & Signs That Indicate It

Causes and symptoms of acute tubular necrosis

Damage or destruction to tube-like structures known as tubules in the kidneys can bring about the development of acute tubular necrosis (ATN) and subsequently, acute kidney failure.

What causes acute tubular necrosis (ATN)?

A lack of supply of oxygen to the cells in the kidney is the most common cause of this condition. The reason as to why oxygen may not reach the cells and tissues of this organ could be restriction or blockage of the pathways. When this happens, the kidneys get damaged. Dehydration is the most important cause of ATN which may be because of loose motions, vomitings, heat stroke etc.

Health conditions such as diabetes, heart attack, and stroke can bring about a decrease in blood flow to the organs resulting in ATN and death of cells. Similarly, the presence of toxic substances in the blood can also lead to tubules damage and change the way the cells function in the tubules.

Other causes that may lead you to develop ATN may be medications, radiology dyes, anesthetics and chemicals that cause your body to react adversely.

In addition to these causes, a number of factors can put you at risk of ATN and there are:

- An injury to the body, more specifically your kidneys can cause clotting of the blood vessels
- An adverse response to blood transfusion
- Instances of septic shock can slow down blood flow to the organs
- A major surgery that can interrupt blood supply to the organs

What are the symptoms of the condition?

The symptoms associated with the condition can vary depending on the severity of the problem.

You may experience:

- Troubles in waking up
- Drowsy feeling even during daytime
- Feelings of lethargy
- Feelings of excessive thirstiness
- Problems with urination
- Fluid retention problems
- Instances of confusion
- Feelings of nausea



Can Acute Tubular Necrosis Cause Kidney Failure?

The ideal diet after a kidney transplant

A kidney transplant is a surgical procedure where your kidneys are cleansed and rebuild using the kidneys of a deceased person, in order to flush out the excessive waste fluids from the kidneys. It is of paramount importance and your dietary patterns and lifestyle should be altered after you go through a kidney transplant. Your dietician will help you out by preparing your diet chart to clearly list out the foods that you should consume and those which you should avoid after the surgery. The diet chart that would be prepared for you would be highly subjective and it would totally depend  on your lifestyle, medical history, family health records, genetically transmitted conditions and such others. Apart from improving the condition of your kidney and assisting your transplant, the diet chart will also help you to lose weight, boost your metabolism and enhance your immune system. Some of the most common recommendations that your dietician may give you are as follows:

-Eating at least 5 full servings of fresh fruits and vegetables each day as both are an important part of a healthy diet for a person who has just undergone a kidney transplant. The vegetables should mostly be eaten after cooking/boiling as per the suggestions of your dietician.
-Having enough of fiber rich foods in your daily diet is essential as it speeds up the process of digestion and prevents constipation by promoting frequent and easy bowel movements.
-If you are a non-vegetarian, then you should be going for lean meat alternatives which are low on fat and high on nutritional value. -Examples of such meat are fishes and poultry. Additionally, you should also avoid all kinds of red meat as it is high on fat.
-Consume low-fat milk and dairy products as they help to prevent the fat accumulation inside the body and also maintain an acceptable level of calcium and phosphorus inside your body.
-Maintain a low level of iodized salt in your meals, as it helps to keep your blood pressure under control.
Over the counter health supplements like vitamins and proteins can also be taken, if recommended by your dietician.

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The Ideal Diet after a Kidney Transplant

The kidneys are the purifiers of the body; they help in removing the waste from the body through the urine. In those suffering from kidney diseases, the function of the kidney is affected, and so their ability to clear out waste from the body is reduced and completely lost gradually. However, waste continues to form, and therefore, such patients have to undergo dialysis, where the blood is purified through an external device.

The frequency and duration of the dialysis would depend on how effectively the kidneys are still functioning and how much waste has been formed from the time of the previous dialysis session. The person s overall body mass index (BMI) and the water weight gained are also considered.

Once it is decided that a person s kidneys are damaged and dialysis is required, the person has to prepare for a long-term process. The following outlines what to expect before, during, and after the dialysis sessions. 

Before the session: 

Since most people prefer to get it done at a dialysis centre, it is preferable to plan for it, three treatments a week on an average, with each session lasting about 4 to 4 hours.

During the session: 

The blood flows through the dialysis device, which acts as an artificial kidney. The sequence of events are as follows:
The Weight is checked
Vital signs, including heart rate, blood pressure, breathing and pulse are checked.
The access areas are washed, and needles are used to connect these areas to the dialysis machine. Anesthesia may be used in the beginning to reduce the pain in this area.
The same access areas are used for each session, and over a period of time, buttonholes are formed which is like a small tunnel.
Though the session would last about 3 to 4 days, normal activities can be done, including reading, working on a laptop, watching television, or even sleeping.
Once the dialysis session is complete, the tube will be removed and a dressing is placed over the site.
After the session

The same site is used each time for the dialysis, so for the first couple of sessions, there could be discomfort. There could also be nausea, diarrhoea, cramping, and headaches.
The treatment needs to be adjusted based on symptoms, so please let the doctor know if you experience any symptoms.

Call the doctor if you are facing the following:

Bleeding from the access site
Inflammatory signs around the site
Persistent fever of over 104 degrees
Numbness or weakness in the arms
Confusion, drowsiness, or cognition problems
Though initially uncomfortable, once you get into the dialysis schedule, you will notice the difference of how cleansed you will feel after each session.

Undergoing Dialysis - What To Expect From It?

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

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