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?

What is Diabetic Nephropathy?

Diabetic nephropathy (Diabetic Kidney Disease) is defined as the progressive damage to the kidneys caused by diabetes. It is characterised by the scarring of the glomeruli in the kidneys due to prolonged diabetes mellitus.

What Causes Diabetic Nephropathy?

Diabetes is a condition characterized by high concentration of blood sugar. Although the cause of Diabetes Nephropathy is not yet well defined, it is likely that the high sugar levels in the blood damage the blood vessels present in the kidneys that help to filter waste products, thus resulting in decreased kidney function and ultimately, kidney failure.

Not everyone with diabetes suffers from diabetic nephropathy. Although, factors that can increase your chances of getting diabetic neuropathy are-

Smoking

Poor control of blood glucose

High blood pressure

History of kidney diseases

What are the symptoms of diabetic nephropathy?

In the early stages, there may be no symptoms at all, but as the disease progresses, you may notice swelling in the extremities like your feet. Thus it is recommended to get your blood albumin levels tested on a regular basis. If it is diagnosed in early stages, the damage can be reversed. Other symptoms that can indicate damage to the kidneys are-

Severe malaise

Headaches

Nausea

Lack of appetite

Frequent voiding

Itchiness of skin

General feeling of illness

Diagnostic tests that can confirm diabetic nephropathy are-

Routine urine test (urinalysis) - Kidney diseases are detected by the presence of a protein in the urine called albumin and this condition is called albuminuria. Other parameters that must be regularly monitored are-

Blood pressure

Cholesterol levels in your blood

How can you treat/ manage diabetic nephropathy?

If this type of nephropathy is diagnosed in the early stages, the damage to the kidneys can be reversible. The key to managing diabetic nephropathy are-

Diet: Reduce the dietary intake of salt, phosphorous and potassium in the advanced stages.

Glycemic Control: Monitor your blood glucose levels regularly

Management of Hypertension: It is important to manage your blood pressure as it can have a direct effect on the coronary blood vessels which in turn pump blood to the various blood vessels of the body

Renal Replacement Therapy: In chronically ill patients, renal replacement therapy is the best option. This can include haemodialysis (a procedure to flush out toxins from the blood, such as urea), peritoneal dialysis or ultimately renal transplantation.

Diabetic Nephropathy - Causes, Symptoms and Treatments

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!

No Blood, No needle, No visit to hospital, you can do yourself at home with water. A thin layer of transparent screen like structure hangs in front of the abdominal muscles known as peritoneum. This peritoneum protects the abdominal structures and the muscle. This can also be used for performing dialysis which is carried out when the functioning of kidney gets affected. In peritoneal dialysis a thin and soft catheter is placed in the person s belly one week before performing the procedure.

The catheter has numerous holes in order to facilitate the transformation of fluids. Dialysis solution is prepared in a bag and the tubing is connected to the catheter placed in the abdomen thereby, the fluids absorb the waste materials from the body. The fluid is allowed to stay in your body for a particular period of time which is commonly referred as dwell time and later the fluid is drained out.

There are two types of peritoneal dialysis, continuous ambulatory peritoneal dialysis and automated peritoneal dialysis. This is the simple form of dialysis which anybody can perform after a short training period and this can be done anywhere in clean private place like hotels, home and even in office.

Procedure followed during Peritoneal Dialysis
All you need to perform a peritoneal dialysis is catheter and transfer set, cycler, dialysis solution and safety precautions materials to stay away from getting infections.
Step 1 - Perform a sterile aseptic technique. Wear a glove and surgical mask before connecting the catheters and transfer set. Clamp the tubing and remove the catheter once the dialysis solution enters your abdomen
Step 2 - Allow the solution to remain in your abdomen for a particular period of dwell time
Step 3 - Drain the fluid from the abdominal cavity into the drain bag. You may feel a mild tugging sensation when adequate amount of fluid is drained.
Step 4 - After drain close or clamp the transfer set and later flush a fresh solution directly to drain bag so as to remove the air from the tubing.
Step 5 - Close your drain bag and open your transfer set and refill your belly with fresh solution.

Make sure you perform without giving way for infection and excess fluid and dextrose absorption.

Peritoneal Dialysis - Procedure to be Followed!

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 pair of kidneys that human beings have, forms an important part in the excretory system. They perform specific and important functions. They excrete urine as well as help in eliminating the toxins, which accumulate in the body. Kidney stones occur when the minerals present in the urine without being discharged, keep on accumulating. This gives rise to an extremely painful and uncomfortable situation. Though sometimes the situation gets revoked all by itself, many a times it requires medical intervention. 

Some of the symptoms of kidney stones are: 
1.  Excruciating pain in the back
2.  Pain while urinating
3.  Tendencies to vomit
4.  Dizziness
5.  Fever 

However, there are several preventive measures which you can undertake in order to avert the situation. Some of them are:
1.  Drink lots of water
Kidney stone is one of those rare conditions that once occurred, always carry the latent threat of recurring again. Therefore, drinking water in large quantities becomes essential. The more you drink water, the more frequently you would urinate, thereby curbing the chances of the minerals settling in the kidneys.
2.  Avoid certain foods
Food like beets, spinach, those which are replete with calcium oxalate should be avoided in order to minimize chances of having kidney stones.
3.  Change your diet
If you are trying to avoid the eventuality of developing kidney stones, it is imperative that you change your diet a bit. It is recommended that you exclude animal protein as much as possible and assiduously avoid the intake of salt as much as possible.
4.  Take less calcium supplements
Calcium generally is considered a nemesis to your kidneys and is prescribed by doctors to be avoided. However recent research has thwarted this claim. Calcium does not pose a threat to kidneys. However calcium supplements definitely do and therefore, should be avoided.

All About Kidney Stones

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