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?

Urinary incontinence is a common problem that afflicts many adults around the world. Stress related urinary incontinence is a fairly common problem that afflicts many as well. This form of incontinence is usually caused by physical activity, which exerts pressure on the bladder and may cause the leakage of small amounts of urine.

Triggers and Symptoms for stress urinary incontinence
In terms of urinary problems, stress is used to describe physical problems in particular and not mental stress. So the triggers or risk factors of it could be any of the following:
1. Exercise
2. Jumping
3. Sneezing
4. Coughing
5. Exercises
6. Sexual activity

This form of urinary incontinence is very common in women who are older or have already been through menopause. It may also be common for women who have recently given birth or are pregnant. The urethra or the bladder may become prone to external stress and then involuntarily leak out some urine.

Causes
The causes can be quite varied from patient to patient but are primarily attributed to the weakening of the pelvic muscles, bladder or the sphincter. If any of these muscles open involuntarily due to physical stress, it leads to urine leaking out. Some of the causes which may lead to this are:
1. Pregnancy and childbirth: Pregnancy or childbirth related problems may cause damage to the urethra or sphincter during childbirth; leading to stress urinary incontinence.
2. Surgery of the prostate: Another common problem, especially with men, is with surgical interventions to correct prostate problems.
3. Menopause: Many older women often complain about stress incontinence after menopause due to the weakening of the muscles.
4. Pelvic surgery: Any surgery to the pelvic area or illnesses which may cause the muscles to become relaxed or act involuntarily due to external stress, may cause incontinence.
5. Weakening of the pelvic muscles: Certain illnesses may cause the pelvic muscles to become weak and thus cause the sphincter as well as the bladder to react involuntarily. UTIs or urinary tract infections have also been known to cause incontinence due to the same reason.
6. Obesity: Obesity has been known to put stress on many of the bodily systems and it may affect the bladder and the urinary sphincters as well.

Causes and Symptoms of Stress Urinary Incontinence

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

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

What is diabetic kidney disease?
Diabetic nephropathy, also known as Diabetic Kidney Disease is a type of complication that occurs in people who are a victim to diabetes. That does not mean every individual with diabetes will have this disease, but if the necessary precautions are not taken, then it can lead to this disease. Diabetic Kidney Disease is characterised by excessive amounts of albumin as well as protein in the urine. In diabetics, certain chemicals in the kidneys shoot up and hamper the function of the glomeruli.

The glomeruli are the main units of kidneys that are responsible for the filtration. Diabetic kidney diseases result in the leakage of essential products like albumin and protein into the urine. When this happens, the protein levels in the blood reduce. If proper precautions are not taken and treatment is not done, then the disease may worsen and the condition will progress to  end-stage renal failure .

How to avoid diabetic kidney disease?
The best way to treat diabetic kidney disease is to prevent it in the first place. Foremost, you should prevent the risk factors in order to avoid coming down with Diabetic Nephropathy. The risk factors include high blood pressure, high levels of blood sugar, dyslipidemia and smoking. Avoid excess of following 5S Sugar, Salt, smoke, stress and sedentary life.

Intensive control over blood sugar
According to certain clinical trials, maintaining and keeping a good control over your blood sugar levels drastically reduces the risk of developing diabetic kidney disease. If you are diabetic, make it a point to get your regular checkups and maintain your diet to prevent the levels of sugar in your blood to shoot up. Other things that you must keep in your mind are to take proper medication that has been prescribed to you. You must adhere to your treatment plans and follow the guidelines that have been given to you.

Intensive control over blood pressure
Hypertension is common in patients who are diabetic. Hypertension alone can result in end-organ damage due to excess pressure build up in the blood vessels. Hypertension associated with hyperglycaemia (diabetes) is a ticking bomb for your kidneys. Hence it is advised to keep your blood pressure under control as well to prevent diabetic kidney disease.

Diabetic nephropathy is not something that happens to every individual with diabetes, so if you follow the above simple tips, the chances of the same reduce, and thus the quality of your life goes up. Many diabetics will get kidney failure due to causes other than diabetes and that may be treatable. Hence early consult with nephrologist is a must.

Diabetic Kidney Disease - How It Can Be Prevented?

There can be no better way to maintain a healthy lifestyle other than a regular exercise and fitness routine. Sometimes even after surgeries, doctors recommend exercise to the patients for a speedy recovery. A kidney transplant is one such surgery that requires you to follow a strict fitness regime after the operation process.

Importance of Exercise after a Kidney Transplant:

Exercise, as recommended by the doctor, should be an integral part of the lives of kidney transplant patients. The variations of exercise may differ depending on the age and general physical health of the patient. The need for exercise after a transplant is as follows  

  Helps to increase energy levels
  Increases overall physical strength and immunity
  Helps maintain a standard weight as an obese body is very harmful for patients suffering from kidney ailments
  Reduces stress, anxiety and depression
  Prevents after effects of kidney transplant like high blood pressure and cholesterol level
  Helps to strengthen bones
  Helps tone muscles and increases balance and joint flexibility
  Strengthens the heart and overall cardiovascular system
  Helps the patient to sleep better
  Boosts self-image and increases confidence

Types of Exercises that can be done:

  Stretching   Consistent stretching before any exercise helps increase muscle strength. It also prevents muscle strain and injury.
  Aerobic   Aerobic or cardiovascular exercises are generally recommended for younger patients. It includes moderately heavy exercises involving a greater number of muscles. This kind of exercise strengthens the heart and lungs and improves breathing. Aerobic exercises include walking, jogging, jumping rope, bicycling, skating, rowing and water aerobics. However, for most patients, brisk walking or jogging is recommended.
Ideally one should exercise for a minimum period of 20 minutes at least four times a week.

Things to Remember:

  It has been medically proved that patients who exercise regularly following a kidney transplant procedure are more likely to survive healthily for the upcoming 5 years compared to patients who lead a sedentary life.
  However one should not resort to heavy and strenuous exercises immediately after the surgery. It is advisable to start with mild forms of exercise like walking and increase the levels gradually depending on one s age.
  One should not eat a heavy meal just before exercising.
  It is important to stop for breaks in between exercise. The patient should not over exert himself.
  It is advisable to avoid lifting heavy weights like dumbbells.
  Stop exercising immediately if you experience chest pain, lightheadedness or pressure in chest, neck or arm.
  Consult the doctor for the kinds of exercises you can do depending on your condition.

With a healthy diet and regular exercise, there are fewer chances of reoccurrence of kidney ailments.

Fitness/Exercise/Games After Kidney Transplant!

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