Kidneys and Kidney Diseases

The kidneys are organs which aim to filter out huge amounts of blood to produce 1-2 quarts of urine. They also perform the task of filtering out the excessive waste materials from the blood stream.

However, there can be cases when infection enters your bloodstream and affects your kidneys. This can cause serious kidney diseases such as cysts, stones and cancer.

Diabetes: What is it and how does it affect your kidneys?

Diabetes is a condition which is caused when the pancreas does not produce enough insulin (Type 1 Diabetes) or when your body doesn t react to the insulin in a normal way (Type 2 Diabetes). The sugar in your food cannot be broken down effectively which can result in problems in your kidneys.

The glucose content in your blood causes considerable damage to the filters in your kidneys. When the filters in the kidney are damaged, a particular protein called albumin releases into your blood and your urine. The damage in the kidneys can affect the kidney function and obstruct the filtering out of wastes from the blood.

Thus, diabetes could be attributed as a major cause of kidney disease.

Managing Diabetes-

Managing diabetes is crucial to avoid kidney diseases. However, diabetes doesn t have a proper cure which is why it is even more important to take care of your health in such cases.

Here are a few ways in which diabetic patients can aim to be healthy and prevent kidney diseases:

Quit Smoking: Smoking increases diabetic complications such as nerve damage and heart strokes which can in-turn affect your kidneys  functions adversely. Hence, it is advisable to quit smoking to keep diabetes under control.

Healthy Meals: Opt for healthy meals which are balanced and packed with nutrients as they help in increasing the insulin function in your body. Foods such as green leafy vegetables, legumes, fruits and lean meat should be included in your meals.

Engage in Physical Exercise: A diabetic person needs to engage in physical exercise in order to maintain a healthy lifestyle. Obesity can increase your chances of complications and can be detrimental to your kidneys as well.

How Does Managing Diabetes Help Your Kidneys?

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

Cystitis is a painful condition when due to the inflammation of the urinary bladder, an individual is unable to comfortably relieve himself/herself. Such conditions are often painful and cause irritation and frustration among the patients. But it should also be noted that cystitis is not an uncommon infection of the urinary tract and can be treated well. Furthermore, homeopathy tries to use the body s own defence to cure diseases and infections; thus this is a very natural form of treatment, which is used to cure cystitis.

The common symptoms of this disease include the urge to frequently relieve oneself, an increase in the number of times one goes to urinate, painful urination and at times all these are accompanied with vomiting and nausea.

Homeopathy treats the person as a whole. It means that homeopathic treatment focuses on the patient as a person, as well as his pathological condition. The homeopathic remedies for cystitis are selected after a full individualizing examination and case-analysis, which includes the medical history of the patient, physical and mental constitution etc. A miasmatic tendency (predisposition/susceptibility) is also often taken into account for the treatment of chronic conditions. The symptoms listed against each medicine may not be directly related to this disease because in homeopathy general symptoms and constitutional indications are also taken into account for selecting the homeopathic remedies for cystitis. 

Cantharis: When the main cause of your cystitis is an inflamed bladder, Cantharis is the best remedy. Such inflammations are often accompanied with burning sensations in the urinary tract apart from a frequent urge to relieve oneself. Cantharis seems to do wonders when it comes to treating any kind of inflammation or infection. As for the burning sensation, it provides immediate relief to this. It might take some time before the cystitis is completely cured with Cantharis, but at least the patient gets some relief, gradually leading to its complete cure. The urinary tract is a very sensitive area of the human body. Any infection or inflammation in the area should be dealt with carefully. Thus, an experienced homeopathic practitioner is the right person to come to your aid. Also, it needs to be seen first whether homeopathy suits you in general or not.

Apis Mellifica: Apis has more than one use when it comes to treating cystitis. First, it is seen that Apis helps in reducing pain and burning effect while urinating in this condition, which might give rise to corroded skin. Second, it is used to treat individuals of all ages. It can be administered in the right dosage to an infant who has problems in passing urine. It can also be given to young boys who have developed cystitis due to kidney infections. Moreover, it can be used to cure cystitis in any individual who is suffering from chronic inflammation of the bladder.

Thus, Cantharis and Apis are the two most effective homeopathic remedies to cure cystitis occurring in an individual. It is always recommended to consult a specialized homeopath before taking any medication.

How To Treat Cystitis With Homeopathy?

Causes of bladder control problems in women

Urinary incontinence is the term used to describe bladder control problems that affect several people. Many think it only occurs among older, menopausal women but it actually isn't uncommon amid young and active women.

Inability to control the bladder accompanied by pain can be symptomatic of various disorders ranging from a minor infection to cancer. Fortunately, bladder cancer is rare, and bladder pain is usually not serious.

The varied causes of urinary incontinence in women are as follows:

1) Urinary Tract Infection - This is the most common cause of urinary incontinence and it affects women more than men due to anatomical factors. It can also happen at any age.

2) Medicinal Side Effect: The inability to control one's bladder may be a result of the administration of certain medicinal substances such as alpha-blockers, antidepressants, sleeping pills and various narcotics.

3) Changes in the Reproductive System - Pregnancy and fluctuations in hormone levels can cause bladder irritation, which leads to urinary incontinence.

4) Impacted Stool - When stool gets tightly packed in the lower end of the digestive system and rectum, bladder control is affected. Chronic constipation and constraint strain on the lower intestines leads to the weakening of bladder muscles and hampers the bladder control.

5) Surgical Side Effects - Temporary loss of control of the bladder is often a result of prior surgery and radiation therapy in the pelvic region.

6) Nerve Damage and Neurological Disorders - Strokes and spinal cord injuries have a heavy impact on bladder control and amount to urinary incontinence. Diseases such as Alzheimer's disease, Parkinson's disease and multiple sclerosis also lead to the same.

7) Health Complications - Disorders such as diabetes and obesity directly affect the bladder and the ability to exercise control over it.

8) Disability and Impaired Mobility - For women who are physically impaired and suffer from problems of arthritis, urinary incontinence is a major problem as they are unable to reach the toilet easily.

9) Bladder Cancer - Even though it is extremely rare, bladder cancer affects a number of women every year and is treated through surgery and chemotherapy.



What Causes Bladder Control Problems in Women?

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?

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?

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