Glomerulonephritis is a disease that is caused due to inflammation of the small filters that are present within the kidneys or glomeruli. Glomeruli eliminate the excess waste, electrolytes and fluids from the blood, discharged through urine. A glomerular disease can be either acute or chronic. If the condition arises without a combination of any other disease, it is termed as primary glomerulonephritis. Secondary glomerulonephritis is characterized by diabetes or lupus (an auto-immune disorder) being at the root of the disease. Prolonged or severe inflammation can take a toll on the kidneys.


Causes-


Nephrotic syndrome can be primary, being a disease specific to the kidneys, or it can be secondary, being a renal manifestation of a systemic general illness. In all cases, injury to glomeruli is an essential feature. Kidney diseases that affect tubules and interstitium, such as interstitial nephritis, will not cause nephrotic syndrome.


Primary causes of nephrotic syndrome include the following, in approximate order of frequency:
Minimal -change nephropathy
Focal glomerulosclerosis
Membranous nephropathy
Hereditary nephropathies


Secondary causes include the following, again in order of approximate frequency:
Diabetes mellitus
Lupus erythematosus
Viral infections (e.g., hepatitis B, hepatitis C, human immunodeficiency virus [HIV] )
Amyloidosis and paraproteinemias
Preeclampsia
Allo-antibodies from enzyme replacement therapy


Nephrotic- range proteinuria may occur in other kidney diseases, such as IgA nephropathy. In that common glomerular disease, one third of patients may have nephrotic- range proteinuria.


Nephrotic syndrome may occur in persons with sickle cell disease and evolve to renal failure. From a therapeutic perspective, nephrotic syndrome may be classified as steroid sensitive, steroid resistant, steroid dependent, or frequently relapsing.


Treatment-
Whether one is suffering from acute or chronic nephrotic glomerular , with symptoms moderate or severe, the treatment lies in treating high blood pressure and other underlying conditions of the disease.
Water pills help control sweating, thus increasing the fluid flushed from the kidneys.
Statins reduce cholesterol level.
Blood thinners such as anticoagulants lower the risk of blood clots.
Corticosteroids regulate the immune system and ease the inflammation that results from kidney disorders.
Incorporating certain lifestyle changes such as opting for lean proteins, cutting on the intake of fat in the diet and consuming lesser amounts of salt can treat inflammation and swelling.
For kidney failure, dialysis can come to the aid in eliminating excess fluids and regulating hypertension.


Nephrotic Syndrome: Causes and Treatment

Treatment for Kidney stones varies depending on the size and type of the stone or the symptoms caused by it. In case of small stones, medication and simple changes in lifestyle can be enough to treat it, but surgeries and extensive treatments are required if symptoms are severe. 

Following are treatment options for kidney stones:

Small stones with minimal symptoms 
1. Drinking water
Drinking around 3 liters of water a day will regulate your urinary system and can effectively eliminate small stones. Unless your doctor advices otherwise, drinking ample amount of fluids, usually water, is one of the commonest way to get rid of small kidney stones. 

2. Pain relievers
There might be a considerable amount of pain and discomfort associated with passing the stone through urine. Your doctor may recommend pain killers like Ibuprofen, Naproxen sodium or acetaminophen. 

3. Medical therapy
In order to eliminate the kidney stone, your doctor may administer medical therapy. Medication like alpha blocker helps in passing the kidney stone with least pain and more quickly. It relaxes the muscles in the ureter and makes the process relatively easy. 

Large stones with severe symptoms
 
1. Using sound waves to break up stones 
In this technique, a procedure called Extracorporeal Shock Wave Lithotripsy (ESWL), is employed. ESWL uses the help of sound waves to create vibrations which breaks the stones in smaller pieces. This procedure takes about an hour and can cause mild pain and discomfort. Your doctor may administer sedatives to reduce your sensitivity. ESWL has side effects like blood in urine or bruising in the abdomen. 

2. Surgical removal of kidney stones 
Surgical removal of stones is done with the help of a procedure called nephrolithotomy. It uses small telescopes and other instruments which are inserted in your back through a small incision. It is generally done in case of large stones and when ESWL fails. 

3. Ureteric Calculi (Using a scope to remove stones) 
A thin illuminated tube called ureteroscope is used to remove a comparatively smaller stone in the kidney or ureter. The ureteroscope is equipped with a tiny camera which determines the location of the stone which is then broken into pieces with the help of other instruments. It may require general or regional anesthesia.

Treatments For Kidney Stones

The condition of enlarged prostate occurs due to the enlargement of a man s prostate gland, with the passage in time. Also known as benign prostatic hyperplasia (BPH), it is more common in men over the age of 60. Some cases might have symptoms and others may be symptomless. Although the causes are relatively unknown, it is evident that BPH is not a form of cancer, neither does it cause cancer. The prostate is located below the bladder and is responsible for producing the fluid needed by semen. The growth of the prostate tissue that is associated with benign prostatic hyperplasia begins near the inner prostate which is a tissue ring around the urethra. Its growth is generally inward.

Causes
It is of common knowledge that in males, the urine originates from the bladder and flows through the urethra. BPH is a condition where the prostate experiences a benign i.e. non cancerous enlargement which leads to blockage of urine flow through the urethra (the urinary duct). The resultant enlargement, caused due to the gradual multiplication of cells, subjects the urethra to extra pressure. Further narrowing of the urethra causes more contraction of the bladder, resulting in the urine being forcefully pushed out of the body.

With time, the condition leads to the bladder muscles gradually becoming thicker, stronger and oversensitive. Contraction occurs even due to the presence of small amounts of urine, giving rise to frequent needs of urination. At one point, the bladder muscle is unable to overcome the effects of the narrowed urethra. Due to this, urine does not pass properly and the urethra is not emptied.

Some of the common symptoms of enlarged prostate include:
1. Frequent urination
2. Urgency to urinate
3. Difficulty during urination
4. A slow or weak urinary stream
5. Requirement of extra effort to urinate
6. Interrupted sleep due to need of urination

Further risks
Sometimes, when the bladder is not emptied completely, a risk of urinary tract infections develops. Some other serious problems which can be a result of enlarged prostate include blood in urine, bladder stones as well as acute urinary retention (inability to urinate). In some rare cases, kidney and/or bladder damage might also result from such a condition.

Frequent Urination - Can it be a Sign Enlarged Prostate

People with chronic kidney disease notice that their bones tend to get weaker and more slender. They become painful and are bound to break more easily as a consequence of mineral loss. The most common kind of bone infections happen when:

There is a change in the balance between two essential minerals in your body - calcium and phosphate, which prompts loss of calcium from your bones.
Four small glands (parathyroid organs), which regulate calcium in your body, turn out to be excessively active.
There is a change in the way your body utilizes vitamin D, a mineral that is vital for healthy bones.
Every bone disease affects bones in different ways.

Phosphate is found in many food items you eat. Your kidneys normally eject whatever is not required in the body. At the point when your kidneys have stopped functioning properly, phosphate may develop in your blood. Excess phosphate in your blood prompts loss of calcium from your bones, which has a tendency to weaken them. Eating food items that are low in phosphate can keep phosphate from building up in your blood.
Since phosphate stays in your body when your kidneys are no more ready to remove it, four small glands in your neck (parathyroid organs) turn out to be excessively active. When this happens, calcium is expelled from your bones over a long period of time, making them weak.
Vitamin D is a vital vitamin, which affects the balance in the calcium content of your body. Typically, vitamin D is processed into a more soluble state by the kidneys and can be utilized by the body. In case your kidneys have deteriorated, they can no more do this critical job. Luckily, the dynamic type of vitamin D is accessible in the form of medications that can be prescribed by your specialist, if necessary. In case you have a kidney disease, it is vital to find a way to prevent bone illness. Some of the solutions are as follows:
Limit the amount of phosphorus you take in every day. Ask your specialist or dietitian to let you know how much phosphorus you need to have. You can likewise request a list of high-phosphorus food items.
Take a phosphate folio. This is a medicine that you bring with dinners to keep your body from taking in the phosphorus that originates from your food and beverages. This can keep phosphorus from winding up in your blood.
Take a calcitriol supplement. Your kidneys make calcitriol with the help of vitamin D that you get from food and the sun. When your kidneys are not working, they can't make calcitriol. A man-made type of calcitriol can help your body utilize the calcium and phosphorus it needs.
Exercise can make your bones more strong and keep them from breaking.
Try not to smoke or use tobacco. It can aggravate bone disease.
Take your medications the way your specialist instructs you to and do not skip dialysis medicines.
Even after changing your diet and taking medicines, if you still have an excess of phosphorus in your blood, your specialist may propose that you undergo further dialysis.

Kidney Disease - How It Affects Your Bones?

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

The kidneys are the main excretory organs and remove all toxins and wastes from the body in a liquid medium, the urine. The urine is normally straw coloured as there are filters which do not allow blood to enter the kidneys. However, due to various reasons, when there is a disease in the urinary tract, red blood cells can escape into the urine. The urine then assumes a pinkish tinge; the exact colour would depend on the amount of blood leaked. While the thought of pinkish urine is scary, it becomes a bigger concern when seen in children. Read on to know a little more about the types, causes, and ways to manage this condition. 

Types: 

Microscopic: When there is blood visible only through a microscope. This is quite common in children, and unless there is no accompanying kidney disease, it does not pose a problem when found occasionally. 
Gross: It is when the color of the urine changes to a pinkish tinge. This is of concern and requires immediate attention. 
Causes: 

There are various reasons and some of them are listed below 

Inherited causes: Conditions like sickle cell disease, polycystic kidney disease, Kidney stones and inherited nephritis. 
Structural causes: Cysts in the kidneys can cause hematuria 
Trauma: An injury (to the abdominal area) during sports should be ruled out, which could have damaged the problem 
Infections: Infections along the entire urinary tract right from glomerulonephritis to kidneys to bladder can cause blood in the urine 5.   Imbalances in minerals: High levels of serum calcium, which puts them at a higher risk of developing kidney stones later. Dietary calcium should be reduced. These children also could have a history of stones in the family. 
Idiopathic: When the cause of the hematuria is not known, it is termed idiopathic. 
Associated issues/Diagnosis: 

Hematuria is an indication or a symptom of an underlying medical condition (be it infection or trauma) and the underlying cause always needs complete evaluation. Accompanying symptoms can help narrow down the diagnosis. If any inherited cause is suspected, presence of hematuria should always be assessed in parents and grandparents. 

Check for history of trauma 
Known prior kidney disease 
Symptoms of infection 

Family medical history 
Urine tests to analyse its composition 
Urine culture, MRI, CT scanning, or biopsy may be required in more serious cases. 
When to worry? 

Associated proteinuria 
Microscopic hematuria which is persistent 
Kids with high blood pressure 
Kids with other existing kidney diseases 
Management: 

In most cases, no specific treatment for hematuria is required as the condition subsides after the underlying problem is addressed. For instance, once the infection clears, the hematuria also clears. Follow-up urine tests may be required to confirm that it is cleared. Blood in urine must always be evaluated by pediatric nephrologist as its causes range from very mild disease to rapidly evolving kidney failure, which may occur over days to weeks.

Blood In Urine In Kids - Know The Reasons Behind It!

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