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?

A kidney transplant is a surgical procedure that patients of kidney disease go through in order to replace a non functioning kidney with a live one that is healthy and functions well. Other methods to treat this disease also include dialysis, which basically is an artificial way of doing what our kidneys are designed to do. When dialysis does not work, many doctors recommend a kidney transplant. A replacement or donated kidney can come from a living donor or a non-living donor. This new kidney will mostly work towards keeping the blood clean, which is a function that stops when the old and diseased kidneys fail.
 
So, here's a list of five essential facts that you need to keep in mind if you are looking at a kidney transplant:

1. Donors: While there are living and non-living donors, the doctor will have to ensure that your donor is someone who has no medical history of complications, kidney disease or any other medical condition like diabetes or hypertension. Also, the donor would have to have two proper functioning kidneys. Further, one of the most important factors is the blood group. The blood group of the donor and the patient must match for the transplant to be possible.

2. Procedure: During the surgery, the patient will be under general anesthesia. The surgeon will make an incision in the lower abdomen area and the blood vessels of the new kidney will be connected surgically with the vein and iliac artery of the patient. Thereafter, any excess fluid will be drained before wrapping up the surgery.

3. Rejection: The patient's body may also reject the kidney. The immune system of the patient may mistake the new kidney as an attacking body and its natural defenses may work against it, which will lead to complications. For this, doctors usually prescribe immunosuppressant medicines that will help in preventing such an eventuality. 

4. Longevity: While a living donor's kidney may last longer, a non-living donor's kidney will not enjoy such a long life. In such cases, a second transplant can be conducted.

5. Diet: After the transplant, the patient will be required to go through a number of measures like coughing to show that the lungs are clear, as well as administration of fluids and some amount of examination and dialysis. Also, the patient will have to have a special diet that includes raw fruits and vegetables, and plenty of non-fat dairy ingredients.

A kidney transplant is a major operation that can change your lifestyle in the long run. 

5 Things You Should Know About Kidney Transplant

When do kidneys need dialysis?

Kidneys are a pair of organs that are located on either side of the spine, each about a size of a fist. The kidneys help in purifying blood by removing toxins, waste materials and excess fluids from the human body. Disorders and dysfunctions of the kidney can lead to severe and often fatal consequences. When the kidneys stop functioning as they are supposed to, dialysis is performed to resume normal functioning in the body.

Dialysis is a type of treatment, which filters and purifies the blood with the aid of a machine. It is an artificial way of purifying blood. There are two types of dialysis, namely hemodialysis and peritoneal dialysis. Hemodialysis, the most common form of dialysis, which involves using a manmade kidney called a hemodialyzer, which removes toxins and waste materials from blood.

Peritoneal Dialysis, on the other hand, is a type of treatment which involves implanting a catheter in the stomach. During the procedure, a fluid called dialysate flows into the abdomen that absorbs all the waste material, which is consequently drained out of the body.

You may need a dialysis if:

- Your kidneys are dysfunctional
- When waste materials and toxins start to accumulate in the body
- In an event of an injury or accident to the kidney such as internal lacerations (wound caused by the tearing of a tissue)
- If the creatinine (a type of a chemical waste product) level falls to 10-12 cc/minute
- In an event where the kidneys aren't able to work properly leading to accumulation of toxins, irregular amounts of chemicals in the body and other dysfunctions

Weakening of the abdominal muscles and weight gain are some of the risks involved in dialysis. Dialysis is a temporary treatment and serves to function till the time the actual kidneys get repaired. In chronic cases of kidney disease, kidney transplant may perhaps be the last resort.



When Do Kidneys Need Dialysis?

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

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

A kidney transplantation is a surgical procedure where a diseased kidney is replaced with a healthy one.

Once the surgery is over and you are recuperating, it is very important that you make certain alterations to your diet to facilitate faster recovery. You need to maintain your weight and exercise on a regular basis.

What Does a Balanced Diet Include?

After the surgery, eat meals or food items that are low in sodium. A properly balanced diet should include ample amounts of fresh fruits, lean meats, fresh vegetables, dairy products that are low in fat. Drink sufficient amount of water (2-3 litres) to keep yourself hydrated.

Why Do You Need to Supervise Your Diet?

Post a kidney transplantation surgery the patient will need to take anti-rejection drugs which are also known as immunosuppressive drugs. These medications lower the risk of the new kidney being rejected by the body. On the flip side, these drugs suppress the immune system making you vulnerable to infections. A healthy diet will ensure that you don t fall ill.

What Food Items Should You Avoid?

  Consuming undercooked or raw meat, poultry and seafood such as squid, crabs or prawns.
  Consuming dairy products that have been made from unpasteurized milk such as yoghurt and cheese.
  Undercooked or uncooked eggs or any food items that might contain such eggs
  Fruits such as pomegranates or grapefruits
  Unwashed salads, sprouts and vegetables.

Restrain Caution when Consuming Carbohydrates:

When you are taking drugs, it is difficult for the body to utilize all the extra carbohydrates that you consume. This can lead to high blood sugar levels. Carbohydrate-laden food items come from starches and sugars and provide fuel for the body.

In short right after a kidney transplantation surgery, you need to make sure that you are following a diet that is high in proteins but low in sugar. In order to avoid developing diabetes or any associated disease during this phase consult with your healthcare provider and chalk out a proper dietary plan.

Nutrition After Kidney Transplant!

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