Glomerulonephritis is a disease that is caused due to inflammation of the small filters that are present within the kidneys or glomeruli. Glomeruli eliminate the excess waste, electrolytes and fluids from the blood, discharged through urine. A glomerular disease can be either acute or chronic. If the condition arises without a combination of any other disease, it is termed as primary glomerulonephritis. Secondary glomerulonephritis is characterized by diabetes or lupus (an auto-immune disorder) being at the root of the disease. Prolonged or severe inflammation can take a toll on the kidneys.


Causes-


Nephrotic syndrome can be primary, being a disease specific to the kidneys, or it can be secondary, being a renal manifestation of a systemic general illness. In all cases, injury to glomeruli is an essential feature. Kidney diseases that affect tubules and interstitium, such as interstitial nephritis, will not cause nephrotic syndrome.


Primary causes of nephrotic syndrome include the following, in approximate order of frequency:
Minimal -change nephropathy
Focal glomerulosclerosis
Membranous nephropathy
Hereditary nephropathies


Secondary causes include the following, again in order of approximate frequency:
Diabetes mellitus
Lupus erythematosus
Viral infections (e.g., hepatitis B, hepatitis C, human immunodeficiency virus [HIV] )
Amyloidosis and paraproteinemias
Preeclampsia
Allo-antibodies from enzyme replacement therapy


Nephrotic- range proteinuria may occur in other kidney diseases, such as IgA nephropathy. In that common glomerular disease, one third of patients may have nephrotic- range proteinuria.


Nephrotic syndrome may occur in persons with sickle cell disease and evolve to renal failure. From a therapeutic perspective, nephrotic syndrome may be classified as steroid sensitive, steroid resistant, steroid dependent, or frequently relapsing.


Treatment-
Whether one is suffering from acute or chronic nephrotic glomerular , with symptoms moderate or severe, the treatment lies in treating high blood pressure and other underlying conditions of the disease.
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.
For kidney failure, dialysis can come to the aid in eliminating excess fluids and regulating hypertension.


Nephrotic Syndrome: Causes and Treatment

Hunner's ulcers, simply put are painful ulcers in your urinary bladder. These ulcers are inextricably linked to another disorder called the painful bladder syndrome or intestinal cystitis. They occur in 10 to 15 percent of people with interstitia cystitis. These, in fact, are red patches or lesions on the bladder wall which can stiffen tissue and cause reduced bladder capacity. Hunner s ulcers bleed, ooze pus and can be of different sizes. The ulcers in the bladder can be extremely painful and uncomfortable.

These are called Hunner s ulcers because they were first described by Dr. Guy LeRoy Hunner, a Johns Hopkins gynecologist, in 1915. Since Hunner s ulcers are seen only in people with intestinal cystitis, it s important to know more about this painful life-altering bladder disorder before we can even understand how to deal with them.

Interstitial cystitis (IC)
IC is also called painful bladder syndrome. Another important thing to know about IC is that it strikes more women than men. IC is a chronic disorder and there s no cure for it. It causes recurring bouts of pain and pressure in the urinary bladder and the pelvic area. This is often accompanied by an urgent and frequent need to urinate. Sufferers may have to rush to the  loo  as much as 40, 50, or 60 times a day.

Diagnosis
Hunner's ulcers can only be accurately diagnosed by doing a cytoscopy which involves inserting a fibre-optic tube through the urethra to look at the bladder wall closely. During this procedure, a tissue sample from the bladder wall is usually also taken to rule out bladder cancer. Cytoscopy is usually done with hydrodistention under local anesthesia. This involves filling the bladder with a liquid for stretching it to provide a closer view of the bladder wall. Usually, a urologist performs this surgery along with a gynaecologist. IC and also Hunner s ulcers are both a diagnosis of exclusion. This means that they re diagnosed only after a number of other conditions have been ruled out.

Hence, the urologist will first take your thorough medical history, followed by a physical exam and a pelvic exam for women patients and perform tests for ruling out infection, and other disorders like bladder stones and cancer, kidney disease, multiple sclerosis, endometriosis, sexually transmitted diseases amongst others. Only after these tests are inconclusive or uncertain and if there is blood in urine, will the urologist go for cystoscopy.

Treatment
There's no cure for IC, but Hunner s ulcers can be cured by burning them off the bladder wall. Called fulguration, the process uses electricity or laser to burn the ulcers on the bladder wall. Resection is also used in which skin from around the Hunner s ulcer is cut for removing both the ulcer and the inflamed tissue around it. The problem is that ulcers may recur in the same location.
So, managing IC becomes critical. Your doctor can try to treat the patient with one treatment or with a combination of treatment depending on the condition of the patient.

Pain medicines are the first line of treatment to manage Hunner s ulcers and IC both, and many patients do go in for this. Patients also find relief by modifying their diet to remove foods and drinks like caffeinated beverages- tea, coffee, colas etc. Sodas, artificial sugars and fruit juices, especially Cranberry juice can trigger intense pain and discomfort, so these are usually contraindicated. Another important aspect is patient education about normal bladder function and tips on self-care and behavioural modifications like stress control to manage Hunner s ulcers.

Hunner's Ulcer In Urinary Bladder - How They Can Be Treated?

At a point when our bodies process the protein we eat, the procedure creates waste products. In kidneys, millions of tiny blood vessels act as filters since they have even tinier holes in them. As blood flows through these vessels, little molecules such as waste items may press through the gaps. These waste items turn out to be a part of the urine. Helpful substances, such as protein and red blood cells are too enormous to go through the gaps in the filter and stay in the blood.

Diabetes and kidneys: Diabetes can harm the kidneys. Abnormal amounts of glucose make the kidneys filter a lot of blood. After a couple of years, they begin to spill and helpful protein is thereby, lost in urine. Having low protein levels in the urine is called micro albuminuria.

Medication: When kidney disease is analyzed on time, during micro albuminuria, a few medications may keep kidney disease from getting worse. Having elevated levels of protein in the urine is called macro albuminuria. When kidney disease is looked up some other time during macro albuminuria, end-stage renal disease (ESRD) usually follows.

Causes: Strain on the organs may cause the kidneys to lose their filtering capacity. Waste items then begin to develop in the blood. Finally, the kidneys start to fail. This failure, ESRD, is intense. A patient with ESRD needs a kidney transplant or a blood filtration by a machine (dialysis).

Other complications: Individuals with diabetes will probably have other kidney-related issues such as bladder infections and nerve damages in the bladder.

Preventing complications: Not everybody with diabetes goes through a kidney disease. Elements that can impact kidney disease improvement include genetics, blood-sugar control and blood pressure. The more a person keeps diabetes and blood pressure under control, the lower the chances of getting a kidney disease.

Keeping your glucose level high can counteract diabetic kidney problems. Research has demonstrated that blood glucose control diminishes the danger of micro albuminuria by 33%. For individuals who suffer from micro albuminuria have now a reduced danger of advancing to macro albuminuria. Different studies have recommended that blood glucose control can reverse micro albuminuria.

Treatment: Essential treatments for kidney infection include control of blood glucose and blood pressure. Blood pressure dramatically affects the rate at which the condition progresses. Indeed, even a gentle increase in blood pressure can rapidly aggravate a kidney infection. Four approaches to bring down your blood pressure are:

Shedding pounds
Eating less salt
Maintaining a strategic distance from liquor and tobacco
Exercising regularly
A low-protein diet can decrease the amount of lost protein in the urine and increase the protein levels in the blood. Never begin a low-protein diet without talking to your physician or nephrologist.

Diabetes & Kidney Problems - Know The Complications!

The tube transporting urine from the bladder out of the body is known as the urethra. Under normal circumstances, this tube is wide enough for urine to flow freely but in some cases, one or more section can get narrowed and restrict the flow of urine. This may be diagnosed as a urethral stricture. This length of this stricture can range from 1 cm to affecting the entire length of the urethra.

This is caused by scar tissue or inflammation of tissue in the urethra. While this is a common condition that affects men, it is rarely seen to affect women. An enlarged prostate, exposure to STDs like gonorrhoea or chlamydia, suffering from an infection that causes urethral inflammation and irritation or having had a catheter recently inserted can increase the risk of suffering from a urethral stricture. An injury or tumour located near the urethra can also cause this condition. Hence, preventing this condition is not always a possibility.

Common symptoms to look out for include:

Inability to urinate
Reduction in the flow of urine
Increased urge to urinate frequently
Pain while urinating
Urinary incontinence
Abdominal pain
Swelling of the penis
Discharge from the urethra
Blood in the urine or semen
Dark urine
The bladder feeling gull even after urinating
A physical examination and tests that measure the rate of urine flow and chemical composition of the urine can help a doctor determine a diagnosis of urethral strictures. You may also need to undergo STD tests and a cystoscopy. An X-ray may also help locate the stricture. The treatment for this condition depends on the severity of the symptoms.

Non-surgical treatment for this condition involves using a dilator to widen the urethra. However, there is no guarantee the blockage will not recur at a later date. Alternatively, a permanent catheter may also be inserted.

There are two forms of surgical treatment for a urethral stricture.

Open urethroplasty: This involves removing the infected or scar tissue and restructuring the urethra. The results of this procedure depend on the size of the blockage. It is usually advised only in cases of long, severe strictures.
Urine flow diversion: In the case of a severe blockage and damage to the bladder, the doctor may advise rerouting the flow of urine to an abdominal opening. This process involves connecting the ureters to an incision in the abdomen with the help of part of the intestines.

Stricture Urethra - Signs You Are Suffering From It!

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 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

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