Diabetes is a lifestyle disease that is very prevalent in the current generation. According to a report by the World Health Organisation (WHO), the number of people with diabetes has risen from 108 million in 1980 to 422 million in 2014. The global prevalence of diabetes among adults over 18 years of age has risen from 4.7% to 8.5% from 1980 to 2014. Diabetes should not be taken lightly as it can affect other body organs besides the pancreas, such as the kidneys. Diabetic nephropathy refers to damage to your kidneys caused by diabetes, and may also lead to kidney failure in various cases.

Causes of diabetic nephropathy
Not everyone who suffers from diabetes will suffer from diabetic nephropathy. The main function of the kidneys is to filter waste from your blood. However, this is not always the case. Due to high a concentration of blood sugar caused by diabetes, several blood vessels in the kidney are destroyed, thereby, preventing the kidneys from carrying out its job. Over time, the kidneys may stop working altogether, resulting in kidney failure. If you are diabetic, the probability of you suffering from diabetic nephropathy will increase if you smoke or have high blood pressure or high cholesterol.

Catching it early
Today, diabetic nephropathy is the leading cause of chronic kidney disease in the US and other western countries. Since the symptoms of this condition aren t visible in its early stages, you need to undergo urine tests on a regular basis. If detected early, the effects of diabetic nephropathy can be reversed. Common symptoms of this disease include the following:

Swelling in legs and feet
Detection of albumin in urine
Decline in glomerular filtration rate (GFR)
Elevated arterial blood pressure
What are the treatment options?
Medication to lower the blood pressure is the most commonly prescribed form of treatment suggested by doctors to prevent or slow the damage to your kidneys. There are other lifestyle changes that you may have to undertake in order to keep a check on the condition:

Limit sugar intake and keep blood sugar levels within the target range
Exercise regularly and work towards keeping your heart healthy
Limit protein intake, as it could put extra pressure on your kidneys
Limit salt intake to control blood pressure
Quit smoking and drinking
Diabetes is an unfortunate condition to have to live with. But don t let it bog you down! With these simple lifestyle changes and taking care of your general well-being, you can beat the disease and emerge a winner!

Diabetic Nephropathy - Who is at Risk of Acquiring it?

A kidney stone is like a small rock that forms in the kidney. Stones form when certain chemicals in the body clump together. A stone can either stay in the kidney or travel through the urinary system by passing though the urine and not causing any harm.

What are the symptoms?

Very small stones might pass through the urinary system without causing much pain. Larger stones can block the flow of urine if they get stuck in the ureters or urethra. Kidney stones do not usually cause any symptoms until they start to pass. Some symptoms might include:

Extreme pain in your back or side that will not go away

Nausea

Blood in your urine

Fever and chills

Who are at risk ?

Anyone can have a kidney stone, but it may be more likely if you:

Are male and are overweight

Have had kidney infections

Have a family member with kidney stones

Have had kidney stones before

Eat a lot of animal protein (such as meat and eggs)

Do not drink enough liquids

Have certain medicines which can cause kidney stones

How are kidney stones treated?

Treatment depends on the location and size of the kidney stone. Drinking plenty of water and taking some medicines can help a small stone to pass more easily. For problem stones, there may be a few options:

Lithotripsy uses shock waves to break a large stone into smaller pieces that can pass.

Ureteroscopic Stone Removal uses a small tool to get and remove stones stuck in the ureters.

Percutaneous Nephrolithotomy uses surgery to remove large stones from the kidneys.

Depending on the location of the kidney stone and many other factors the doctor decides on the most suitable procedure.

How can I prevent kidney stones?

If you have had kidney stones before, you are more likely to have kidney stones again. To help keep stones from forming, try to:

Drink 10 to 12 glasses of water each day

Eat less salt (sodium), meat and eggs

Find out what type of stone you have

Ask your doctor for a urine test

Talk to your doctor about your medicines and other tests for kidney stones

Do NOT reduce the calcium in your diet without talking to your doctor first! Studies show that limiting calcium in your diet may not stop kidney stones from forming and may harm your bones.

Kidney Stones - Are They Troubling You?

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

Urinary incontinence, commonly known as loss of bladder control can really cause embarrassment. The severity of this condition may range from once in a while leaky urine to the sudden and forceful urge to urinate, due to which you end up urinating before reaching the toilet.

Types of urinary incontinence-

Stress incontinence- when you feel the urge to urinate due to sneezing, coughing, laughing or while doing physical exercise
Urge incontinence- when you feel the urge to urinate, suddenly. This may occur during the day and even at night.
Functional incontinence- when you cannot reach the toilet on time because of a physical or mental impairment.
Mixed incontinence- when you involuntarily urinate due to more than one incontinence
Stress incontinence is the most common type in women. The activities which increase your risk, are:

You have had more than one pregnancy and vaginal delivery.
You have pelvic prolapse. This is when your bladder, urethra, or rectum slide into the vagina. Delivering a baby can cause nerve or tissue damage in the pelvic area. This can lead to pelvic prolapse months or years after delivery.
Female urinary stress incontinence is the involuntary release of urine during any physical activity that puts pressure on your bladder. This potentially embarrassing condition differs from general incontinence in that it happens when the body is under immediate physical stress. Activities that can put stress on your bladder include coughing, sneezing, laughing, lifting heavy objects, or bending over. This condition is particular to women, many of whom experience symptoms after muscles have been weakened due to a vaginal childbirth, following menopause, or during pregnancy.

Ensure that you consult a doctor-

If this condition hinders your day to day activities
If the urinary incontinence is the result of a serious underlying problem
Causes of urinary incontinence-

Urinary incontinence may be temporary or permanent. Causes for temporary incontinence are-

Alcohol
Caffeine and caffeinated drinks
Decaffeinated tea or coffee
Spicy and sugary foods
High intake of vitamin b or c
Urinary tract infection (uti)
Constipation
Causes for permanent incontinence are:

Pregnancy
Childbirth
Old age
Menopause
Hysterectomy
Prostate cancer
Enlarged prostate
Neurological disorders
Complications-

Chronic urinary incontinence can lead to certain complications like.

Skin problems- skin rashes and infections can develop around the vaginal area, because of the constant wetness one feels. It may also cause sores.
Urinary tract infections- urinary incontinence can also result in uti
Impact on personal and social life- urinary incontinence can lead to great embarrassment, thus affecting the social and personal life of an individual.
Treatment for female stress urinary incontinence-

There are several types of treatment available. Treatment options include lifestyle changes, medications, nonsurgical treatments, and surgeries.

Lifestyle changes: make regular trips to the restroom to reduce the chance of urine leakage. Drink fewer fluids and avoid activities such as jumping and running.
Medications: medications that reduce bladder contractions.
Nonsurgical treatments: kegel exercises strengthen your pelvic muscles. Done regularly, these exercises can strengthen your muscles, allowing you to control when urine is released from your body.
Surgery:

If other treatments fail, you will have to go for surgical treatment. Types of surgery include:

Injectable therapy, in which collagen is injected into your urethra to reduce incontinence
Tension-free vaginal tape (tvt) surgery, in which mesh is placed around the urethra to give it support
Vaginal sling surgery, in which a sling is placed around the urethra to support it
Anterior or para-vaginal vaginal repair surgery to repair a bladder that is bulging into the vaginal canal
Retropubic suspension surgery to move the bladder and urethra back into their normal positions
Some doctors even try electrical stimulation and medication. When the condition is highly advanced interventional therapies and surgery is recommended.

Some interventional therapies are-

1. Bulking material injections
2. Botulinum toxin type-a
3. Nerve stimulators.

All About Urinary Incontinence

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!

The kidneys make urine, which is a fluid through which wastes from the body including urea are eliminated from the body. There are two kidneys on the right and left side, which make urine, and pass it down to the bladder through tubes known as ureter. The bladder acts as a reservoir of the urine that is formed in the kidneys. It is stored temporarily there before being excreted out of the body through the urethra. The urinary bladder is a highly muscular organ and has a rich connective tissue. 

Interstitial cystitis (IC) or painful bladder syndrome (PBS) is a very common condition, which affects females more than males. While the exact etiology is not known, it could be age-related and also lifestyle related. People who are used to controlling the urge to pass urine are highly likely to develop this condition. The simple logic is that there is additional pressure on the bladder from the urine that is contained for longer period of time. As such, the muscular wall stretches and begins to feel stressed.

When this habit continues over a period of time, the bladder wall may become irritated or inflamed or even scarred in severe cases. There is no role of bacteria in this condition, and antibiotics are of no help in managing this condition (though the name cystitis usually indicates infection).

The following symptoms are seen as a result of this constant irritation and inflammation.

One may suffer from pain and pressure in the bladder as it continues to collect more and more urine.
This pressure in the bladder also puts pressure on the surrounding tissues in the abdomen including the pelvis, urethra, abdominal organs, uterus, etc.
Women may experience pain in the vaginal tract including vulva and behind the vagina.
Men may experience pain in the area of the scrotum, testicles, prostate, and penis.
There is an increased urge to urinate, which may be as much as 9 to 10 times a day. As the condition progresses, there could be more visits, as many as 40 to 50 visits a day.
This tendency and urge to urinate increases during nighttime.
For women, this urge to urinate and other symptoms including pain are worse during menstruation.
There could be pain during intercourse for both men and women.
There could be pain even otherwise, which can range from a mild dull ache to a piercing pain.
At a structural level, this constant pressure leads to pinpoint bleeding (glomerulations) and sometimes even ulcers in the bladder wall.
There is no definitive treatment for IC or PBS. However, bladder distention and instillation are proven methods of increasing bladder capacity, which therefore helps in relieving symptoms.

Painful Bladder Syndrome - Know The Signs!

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