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 diseased kidney is one that has lost its ability to carry out the filtration process in a proper manner. This process of filtration usually sends the waste and toxins out of the body in a routine manner. In such cases, a kidney disease manifests which requires a number of treatment measures. Dialysis is something that enters the treatment plan at a later stage as chronic early stage kidney disease can remain in the patient s body for many years. When the kidney function comes down to 15%, then most doctors recommend the start of dialysis which is basically a process that removes the excess waste and fluid from the blood. This can be a process that will leave the patient fatigued and in a mental state that is not exactly stable and positive at all times. It is common to see dialysis patients battling depression due to the chronic nature of the treatment as well as the low chances of recovery.

So, let us find out how dialysis patients can cope with depression.

    Professional Help: Depression is said to be like a common cold when it comes to mental diseases. The state of a person s body can very well affect the balance in his or her mind and lead to depression. Starting from pressing circumstances to hormonal changes as well as chronic ailments, depression can affect people due to a number of reasons. Dialysis patients who are undergoing depression must consult a professional specialist like a psychiatrist who will help the patient understand and cope with the situation with the use of therapy based counselling.
    Medication: The patient can also be given medication that will prevent the build up of unnecessary stress by blocking the production of those hormones that result in a negative state of mind. This medication must be prescribed after speaking the patient s nephrologist about what kind of medication will suit the patient specifically.
    Psychotherapy: Long term psychotherapy is also known as talk therapy that can help the psychiatrist or clinical psychologist in talking the patient through the problems. Besides giving the patient the scope and platform to air out the problems and reach solutions regarding normal day to day functioning despite the troubles, this kind of therapy also aims at equipping the patient with a better perspective and improved attitude.

While going through this kind of therapy and medication, it is important to keep a team of nephrologists and psychiatrists in the loop so that the patient may reach out at any time in order to avail help in the most trying situations. This will give a blanket of security to the patient as well.

3 Ways a Dialysis Patient can Cope with Depression

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

What menstrual problems are to women, prostate problems are to men. The prostate is a gland in the lower abdomen that aids in the production of semen. The prostate is walnut sized in a young man, but can get enlarged with age. As it grows bigger, it can cause a number of problems. These are commonly seen after a man celebrates his 50th birthday.

There are three common prostate problems faced by men. Some of the symptoms that can tell if a man has a prostate problem are:

1. Difficulty faced while urinating
2. The urge to urinate frequently at night
3. Constant feeling of a full bladder
4. Pain while urinating
5. Blood in the urine

Prostatitis

This can be defined as inflammation of the prostate gland. In most cases the cause of this inflammation is unknown. However, there are two types of prostatitis; bacterial and nonbacterial. While the former reacts well to antibiotics, the latter is more difficult to control. Symptoms of this disease vary from one person to the next. Some of the factors that could trigger this disease are:

1. Chemical irritants
2. Past bacterial infection
3. Dysfunctional pelvic floor muscles
4. Sexual abuse
5. Chronic anxiety

Enlarged prostate

As mentioned earlier, as men get older, the prostate gland tends to grow in size. This growth is benign, but can block the bladder neck and prostatic urethra. This can cause problems urinating and lead to acute urinary retention. This can be very painful. Inserting a catheter can provide temporary relief and help release stored urine. Chronic retention is much less common and is associated with high bladder pressure and can damage the kidneys.

Prostate cancer

Advancing age and family genetic history are said to be the main triggers of prostate cancer. This type of cancer can remain restricted to the prostate gland in its early stages but may spread to the other glands as the cancer advances. This can also cause the growth of secondary tumors in the bones.

The only way to correctly diagnose a prostate problem is with a thorough physical examination. This includes a digital rectal exam where the doctor will insert a gloved finger into your rectum to check the size of your prostate, a blood test, mid stream urine tests and ultrasounds. In some cases a biopsy of the prostate may also be required. Depending on the diagnosis, your doctor may prescribe antibiotics, surgery, radiotherapy or hormone therapy to manage your prostate.

Are You at Risk of a Prostate Disease?

Nephrotic syndrome is a type of kidney disorder wherein, the body passes out excess amount of proteins through urine, owing to the damage caused to the tiny clusters of blood vessels in the kidneys. The symptoms include putting on excessive weight as a result of fluid retention, foamy urine and severe swelling around the region of the feet, ankles and eyes.

Common causes behind it

Minimal change disease (also known as nil disease) leads to the abnormal functioning of the kidneys
Excess deposit of amyloid proteins in the organs, thus taking a toll on the filter mechanism of the kidneys.
Diabetes affecting the glomeruli (capillaries present in the nephrons of the kidneys).
Systemic lupus  erythematous causing chronic swelling of your kidney.
Membranous nephropathy wherein the membranes in your glomeruli thicken.
Infections such as malaria, hepatitis C, hepatitis B and HIV.
Medications to combat infections and nonsteroidal anti-inflammatory drugs.
Treatment Available

Kidney Biopsy is an essential part of disease assessment.
Angiotensin-converting enzyme inhibitors bring down blood pressure levels as well as the amount of protein discharged from the urine.
Water pills help control sweating, thus, increasing the fluid flushed from the kidneys.
Statins reduce cholesterol level.
Blood thinners such as anticoagulants lower the risk of blood clots.
Corticosteroids regulate the immune system and ease the inflammation that results from kidney disorders.
Incorporating certain lifestyle changes such as opting for lean proteins, cutting on the intake of fat in the diet and consuming lesser amounts of salt can treat inflammation and swelling.

Nephrotic Syndrome - 9 Surprising Causes Behind it

Renal Tubular Acidosis is a medical condition. When the kidney is unable to acidify urine, it leads to the accumulation of acid in the body. Usually, when blood is filtered by the kidney, it passes through the tubules of the nephrons (the functional unit of the kidney).

Before it flows into the bladder from the kidney, the urine undergoes an exchange of salts, acids and other solutes. Renal tubular acidosis results in the formation of excessive amounts of acid because the kidneys cannot drain them. This may happen because the kidneys cannot reabsorb the alkaline bicarbonate ions from the urine in the early segment of the nephron or because of inadequate production of acidic hydrogen ions in the latter half of the nephron.

Renal Tubular Acidosis is simply associated with abnormal urinary acidification. Other functions of the kidneys remain unimpaired.
There are several different types of renal tubular acidosis-

  Distal Renal Tubular Acidosis (RTA)
This is the most fundamental form of RTA. It is characterized when the hydrogen ions are not secreted into the lumen of the nephron by the alpha-intercalated cells of the medullary collective duct of the distal nephron. When this happens the pH of urine cannot be brought down below 5.3. Renal excretion is inhibited and hydrogen ions are not eliminated which leads to academia. At the same time, Potassium ions cannot be absorbed by the cell which leads to hypokalemia. The end result is protein retention and potassium excretion. Distal RTA can lead to the urinary stone formation, calcium deposits in the kidney, rickets and osteomalacia and Sjogren s syndrome.

  Proximal RTA
When proximal tubular cells reabsorb 85% of filtered bicarbonates and 60% of filtered sodium from the urine, then this again leads to academia. The distal intercalated cells, however, function normally and so the academia is not as severe as in case of Distal RTA. The alpha-intercalated cells can acidify urine to a pH of 5.3 or less because they produce hydrogen ions. Proximal RTA is also associated with Fanconi Syndrome which is characterized by aminoaciduria, uricosuria, glucosuria, and tubular proteinuria.

  Combined distal and proximal RTA
Inherited carbonic anhydrase II deficit leads to combined distal and proximal RTA. This is accompanied by osteopetrosis, cerebral calcification, and renal tubular acidosis. Cases of combined distal and proximal RTA are very rare.

How is RTA understood?
The following steps are applied to analyze Renal Tubular Acidosis-
  Determining the anion gap in acidosis. The normal Anion Gap is 8-12 (4-6 mEq/L)
  Separating the renal from the extrarenal causes of normal anion gap acidosis
  Classifying the types of RTA
  If it is distal RTA, further tests will be necessary to support the diagnosis

How is RTA diagnosed?
Three types of tests can reveal if a person is affected by Renal Tubular Acidosis-
  Urine test
  Acid load test
  Physical examination

Treatment of RTA-
Doctors prescribe either or both of the following two types of therapies-

  Alkali therapy- The pH level of urine is restored and electrolytes are balanced
  Vitamin D supplements- If RTA leads to bone deformities or rickets, your doctor will prescribe vitamin supplements to strengthen your bones.

Timely diagnosis can prevent the effects of Renal tubular Acidosis from becoming compounded. With the right medication, a person can lead a healthy normal life.

What Should You Know About Renal Tubular Acidosis?

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