Causes and symptoms of acute tubular necrosis

Damage or destruction to tube-like structures known as tubules in the kidneys can bring about the development of acute tubular necrosis (ATN) and subsequently, acute kidney failure.

What causes acute tubular necrosis (ATN)?

A lack of supply of oxygen to the cells in the kidney is the most common cause of this condition. The reason as to why oxygen may not reach the cells and tissues of this organ could be restriction or blockage of the pathways. When this happens, the kidneys get damaged. Dehydration is the most important cause of ATN which may be because of loose motions, vomitings, heat stroke etc.

Health conditions such as diabetes, heart attack, and stroke can bring about a decrease in blood flow to the organs resulting in ATN and death of cells. Similarly, the presence of toxic substances in the blood can also lead to tubules damage and change the way the cells function in the tubules.

Other causes that may lead you to develop ATN may be medications, radiology dyes, anesthetics and chemicals that cause your body to react adversely.

In addition to these causes, a number of factors can put you at risk of ATN and there are:

- An injury to the body, more specifically your kidneys can cause clotting of the blood vessels
- An adverse response to blood transfusion
- Instances of septic shock can slow down blood flow to the organs
- A major surgery that can interrupt blood supply to the organs

What are the symptoms of the condition?

The symptoms associated with the condition can vary depending on the severity of the problem.

You may experience:

- Troubles in waking up
- Drowsy feeling even during daytime
- Feelings of lethargy
- Feelings of excessive thirstiness
- Problems with urination
- Fluid retention problems
- Instances of confusion
- Feelings of nausea



Can Acute Tubular Necrosis Cause Kidney Failure?

If your doctor ever diagnoses you with chronic kidney disease, he/she will give you two options to choose from. The first option is to undergo dialysis for the rest of your life, while the other option is to undergo a kidney transplant. While you may prefer avoiding a major surgery, such as a transplant, dialysis is not the best solution for your condition.

Here are some reasons why you should consider kidney transplant surgery over dialysis if you are looking for better health for the long-term:

1. Increases your life expectancy: What you may not know is that people on dialysis treatment have a severely reduced life expectancy. For instance, if you are 30 years old when dialysis starts, the treatment will keep you alive at most for 15 more years. Therefore, you may not even survive until your fifties with dialysis treatment for your damaged kidneys.

However, if you transplant a healthy kidney your life expectancy increases by 30 to 40 years. Keep in mind that kidneys from living donors are better and will help you live longer.

2. Eliminates the need for undergoing dialysis: If you choose dialysis over transplant surgery, you will need to undergo the treatment on a daily basis. This is not only costly but also affects your quality of life. For instance, a patient on dialysis will need to make special arrangements if he/she wants to go on a vacation with family so that his treatment continues even during the trip.

With a kidney transplant surgery, once you recover from the operation, you can live a normal life, without the need for daily treatment.

3. Lower cost of treatment: While you may think kidney transplant surgery is the costlier option between it and dialysis, you would be wrong to assume so. In kidney transplantation surgery, you pay a hefty amount at the time of the operation. However, in the case of dialysis, you pay smaller sums over very long periods. When you add up these small sums over 10-15 years of dialysis, you will find that transplantation is the cheaper option.

If you are young and have a long life ahead of you, kidney transplantation should be the first and foremost choice of treatment for chronic kidney disease. You can undergo dialysis while you wait for a donor and then receive a healthy organ.

Why Kidney Transplant Should Be Preferred Over Dialysis?

It is an extremely embarrassing situation to have a bladder leakage. Social life could be altered, with reduced socialising for fear of losing control in the presence of others. Though not discussed frankly, it is an extremely common issue and about 25 million people in the United States suffer from this, with 75% of these being women.

Treatment depends on the type of incontinence, such as stress, urge, overflow, functional, or mixed. It starts with least invasive methods like lifestyle changes moving over to surgical approaches.

Ways to manage it

With trips to the toilet increasing considerably when you have urinary incontinence, simple measures can help manage leakage.

Bladder training: Train your bladder to control the urge for another 10 minutes. This happens by voluntarily contracting the muscles and holding up the urge to go to the toilet. Gradually, it will help increase the frequency of the visit to 4 to 6 hours.
Scheduled toilet trips: Whether or not there is an urge, visit the toilet every 4 to 6 hours.
Double emptying: Even after you have voided, force yourself to void one more time. The residual urine, which is almost always present in the bladder, also gets emptied.
Food/diet modifications: Stress incontinence is worsened by alcohol, spicy foods, acidic foods, and caffeine. Avoiding these can help reduce bladder leakage.
Kegel exercises: The simple repetition of contracting the pelvic floor muscles, holding it in place, and releasing it can do wonders for strengthening the pelvic floor. This can be done anywhere and any time of the day and is very effective for improving bladder control.
Catheters: These can be used if the incontinence is short-lived; the person would need to learn how to safely insert and remove it.
Absorbent pads and medical devices: The absorbent pads are helpful in preventing embarrassment during social situations. On the other hand, medical devices like pessary are inserted into the vagina to support the bladder neck and thereby prevent leakage from the bladder.
Drugs: Anticholinergics/antimuscarinics are useful to control a leaking bladder. Botox injections can help paralyse the overactive bladder muscles and provide a solution. Topical oestrogen may be used in small amounts to improve tone and reduce incontinence. Alpha blockers are also used in some people with good results. There are muscles that relax the bladder and increase the amount of urine it can contain.
Surgery: In the event that all these measures are not useful, surgical correction is possible. Sling procedure where an artificial mesh is used to support the urethra. Bladder neck suspension is where the bladder neck is given support to prevent leakage. If there is a pelvic organ prolapse, that is corrected to rectify the bladder leakage.

 Bladder Leakage - Solutions To Help You Manage It!

The presence of blood in urine is known as Haematuria. It is categorized under 2 types:

    Macroscopic haematuria, which means the patient has seen blood.
    Microscopic dipstick haematuria, which means blood is identified by urine microscopy or by dipstick testing either in association with other urological symptoms (symptomatic microscopic haematuria) or during a routine medical examination. It has been variably defined as 3 or more , 5 or more or 10 or more Red Blood Cells (RBCs) per high - power field.

Urological and other Causes of Hematuria

    Cancer: Bladder, Kidney and Prostate Cancer
    Stones: Kidney, Ureteric
    Bladder Infections: Bacterial tuberculosis, infective urethritis Inflammation
    Interstitial Cystitis Trauma : Kidney, bladder, urethra, pelvic fracture causing urethral rupture
    Renal cystic disease: (e.g. medullary sponge kidney)
    Other urological causes: Benign prostatic hyperplasia, vascular malformations
    Other medical causes of haematuria: anticoagulation therapy (e.g. asprin, anti platelet therapy) Nephrological Causes: more likely in children and young adults, proteinuria; red blood cell casts.
    Urological investigations: Urine culture, urine cytology, cystoscopy, renal ultrasonography and intravenous Urography and CT Urography.

Management of haematuria depends on the cause as determined by the urologist.

Causes and Treatment for Hematuria

Urinary tract infection (UTI) is usually caused by inflammation or bacteria in the urinary tract. Pregnant mothers are most susceptible to this infection, especially after the sixth week and before the twenty fourth week of pregnancy. This usually happens due to the alterations that take place in the urinary tract during pregnancy.

Also, a growing uterus can block the urine drainage from this part of the body, leading to the accumulation of bacteria which causes infection. The symptoms are uncomfortable and even painful. These include pain and burning sensation, frequent urination, fever and chills. So how can you prevent UTI during pregnancy? we have a few tips for you!

- Hydration: The best thing you can do to both prevent and treat a urinary tract infection is to start drinking at least six to eight glasses of water in a day. Another good way to prevent and treat UTIs is with the help of cranberry juice which has powerful antioxidants that flush toxins out of your system effectively. You will, however, need to ensure that the cranberry juice is fresh and natural, without any sweeteners.

- Hygiene: Keeping yourself clean is one of the most important ways in which you can avoid UTI. It is best to clean from front to back, rather than the other way, so that you drive away bacteria and dirt. Also, make sure that you wash your private parts with warm water infused with a few drops of normal liquid antibacterial, so that you can be sure that the bacteria do not get a chance to thrive and affect your system. Also, remember to use soaps, washes and creams that have a mild formula, rather than a harsh chemical concoction. Hygiene for this area of the body includes keeping it dry.

- Diet: Your diet should have plenty of fluids and lemons or other citrus food that are rich in vitamin c, as this is a good vitamin to keep bacteria at bay. Also, you should eliminate sweet and refined products to ensure that you do not contract UTI. Other foods to avoid include caffeine and alcohol.

- Clothing: Wear airy and cotton based undergarments that are breathable and have a soft texture. This non abrasive type clothing can also help in keeping the area dry, so that bacteria does not get a chance to develop, as they typically need a damp environment for growth. Change your undergarments twice a day, if need be, and avoid wearing trousers and shorts that are too tight.

These tips and many others including urinating as soon as the urge sets in, can help in fighting the risk of contracting UTI during pregnancy.

Tips To Prevent UTI During Pregnancy

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

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