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?

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!

Screening for cancer of the colon or large intestine and rectum is a proven way of saving a person from the impacts of colorectal diseases. This is partly because colon cancer is something that can be prevented if detected at an early stage and the polyps which may advance to cancer are removed properly. Thus if you are turning 50 soon, be prepared to present yourself for a screening colonoscopy that will help you ensure good health and well-being. It may sound uncanny, but do you know that 50,000 people across the world die from colorectal cancer every year, and it is ranked second in terms of cancer-centric deaths.

Understanding the importance of having colonoscopy
You may wonder how a painful, invasive, embarrassing, uncomfortable and time-consuming health test may be called a present. There are reasons enough. A screening colonoscopy is able to expose a cancerous tumour that's presently under way and cast light on the chances and risk factors that may precede it. When you choose to intervene early, you have the power to nip those risks at their budding stage, much before those malicious cells become malignant.

Spreading of the colorectal cancer
Your large intestine is really a big and last organ of the gastrointestinal system where the small intestine discontinues. Its primary function is to remove the water out of the leftover solids of digestion and get rid of them in the form of stool. Cancer may start to develop anywhere within the tube that expands 5 feet long and squares the vacant area of the abdomen. The large intestine expands up towards the right side, i.e. the ascending colon and then turns left through the liver, i.e., the transverse colon, bending down right at the spleen on its left, i.e. descending colon and loops to the middle, i.e., the sigmoid colon before it runs across the rectum and ends at the anus.

People who need a colonoscopy
To simplify matters, it can be said that all adults are at a potential risk of the colorectal cancer, including those people who lead a healthy life. But some people are at a higher risk. Those individuals have a specific gene mutation that predisposes them to develop into numerous polyps. The risk is also high with people who are first-degree relatives of a person diagnosed with cancer before the age of 50. People with Ulcerative colitis, various types of inflammatory bowel diseases and Crohn's disease are also at a higher risk.

Colorectal cancer is a serious ailment and screening colonoscopy is a feasible means of detecting any polyps that may be cancerous in the future. Speak with a reputed gastroenterologist today to stay ahead of the disease.

When Should You Start Having Colonoscopies?

A kidney stone may not be as big as the stones in your garden, but can be quite a pain. Kidney stones are actually mineral crystals that are usually a combination of calcium and phosphates. The size of a kidney stone ranges from the size of a sugar crystal to a ping pong ball. While some kidney stones pass out of the body along with urine, others can block the urethra and become painful. 

In addition to being painful, a kidney stone can cause permanent damage to your kidneys. Since large kidney stones are usually painful, they rarely go undiagnosed. However, if a kidney stone is left untreated, it could cause the kidney to atrophy and lower the functionality of the kidney. Kidney stones that are related to an infection can also lead to chronic urinary tract infections and damage the kidney through scarring and inflammation. This could eventually lead to kidney failure.
 
Not all kidney stones need to be treated with surgery. If the kidney stone is very small, your doctor may prescribe plenty of water and medication to treat the pain. With plenty of water, you should be able to pass the stone in your urine. Ideally, you should take plenty of rest until the stone is passed. 

Larger kidney stones may need you to be hospitalized for treatment. These are:
- extracorporeal shock wave lithotripsy (eswl)
To begin this of treatment, a painkiller is administered. Ultrasonic waves are used to determine the location of the kidney stone. Shock waves are then passed through the kidney stone to break it into smaller pieces, which can then pass out of the body through urine.
- ureteroscopy
This is also called retrograde intrarenal surgery and is performed when the kidney stone is stuck in the ureter. A ureteroscope is passed through the urethra and bladder into the ureter. Laser energy may then be used to break the stone into smaller pieces to unblock the ureter. 
- percutaneous nephrolithotomy (pcnl)
This surgery is performed under general anesthesia. It involves a small incision being made in the back and a nephroscope passed into the kidney through it. Laser or pneumatic energy is then used to break up the stone into smaller pieces and pull them out. 

- open surgery
Open surgery is performed only in the case of an abnormally large stone or abnormal anatomy of the person. An incision is made in the back that allows the doctor to access the kidney and manually remove the stone.

Kidney Stones- Should It Be Removed

Colon polyps are growths that are typically found in the large intestine. Although the causes behind the occurrence of colon polyps are not known, this condition is usually seen to affect adults.
These colon polyps might turn into colon cancer over a period of time; the development of cancer can happen over a number of years.
Colon polyps are usually symptomless; hence it becomes difficult to diagnose the condition. They are commonly found as additional results of screening tests for colon cancers. Screening tests are conducted when there is a suspicion of a disease but it displays no significant symptoms. The symptoms can only be visible if the polyps are enlarged. Typical symptoms include:
Rectal bleeding.
Changes in bowel conditions such as diarrhoea and constipation.
Changes in urination patterns.
Change in appearance of stool.
As the presence of most polyps becomes evident only during colon cancer tests, it is recommended that regular tests for colon cancer be conducted for adults over the age of 50. Some of these tests include:
Colonoscopy: This is highly recommended for detecting colon polyps. A small tube used for viewing is inserted into the colon by the doctor.
Flexible Sigmoidoscopy: It is similar to colonoscopy with the only difference being that the tube is smaller.
Computed Tomographic Colonography (CTC): Also known as virtual colonoscopy, various computer systems and X-rays are used to create a detailed picture of the colon so that the doctor can search for polyps.
The size of the colon polyps helps to identify if the polyp is cancerous or not. Chances of the polyp being cancerous are high if the size of the polyp is higher than 1 cm or 0.4 inches. Hyperplastic polyps (smaller polyps) do not become cancerous and hence, do not need to undergo a colonoscopy. Another form of polyp is the sessile polyp which is usually a flat growth without a stalk and grows on the inner wall of the colon. Similar to other polyps, these polyps can be found and removed using a colonoscopy or a sigmoidoscopy.

Causes and Symptoms of Colonic Polyps

The kidneys are small organs that filter about 200 liters of water each day, removing out about 2 liters of toxins and wastes in a water medium as urine. In addition to maintaining the fluid levels in the body, they also produce hormones that regulate blood pressure, produce red blood cells, and play a vital role in maintaining bone health. Any problem with the kidney, infection or otherwise, can lead to its improper functioning, causing damaging results on the rest of the body organs.

While the bad news is that most diseases from infections to diabetes to hypertension and cancer have an adverse effect on the kidneys, there are signs that can be watched out for, which can indicate a problem with the kidneys and so further damage prevented. Read on to know some of the most common symptoms of kidney disease and how further progression can be prevented.

Change in urination process: Any change in the process of urination should be a warning for a test. It could be change in color or the appearance of the urine, painful urination, burning on urination, difficulty to start and stop a stream, or too frequent or infrequent urinations. These are usually the first symptoms of kidney disease and should be an alarm to get a kidney function test done. If you have hypertension or a strong family history of kidney disease, then getting a simple urine test to check optimal kidney function is definitely mandated. These could indicate conditions like infection, diabetes, kidney failure, or other conditions which can all be identified with further testing and then treated accordingly. The progress of the disease can be halted, which can help improve overall quality of life.
Fatigue, loss of energy: As noted above, impaired kidney function leads to other organs being affected and buildup of toxins in the body. There is also anemia which sets in due to decrease in red blood cells and therefore reduced overall energy levels, loss of sleep, and fatigue.
Swollen eyes, feet, and ankles: Reduced kidney function leads to fluid accumulation, sodium retention, loss of protein, which all lead to swollen eyes and ankles and feet. These are easy to identify and should ring a bell to get checked for kidney functions.
Muscle cramps: Improper electrolyte levels can affect muscle functioning, leading to painful cramps. Along with changes in the process of urination, this should be an indication of underlying kidney disease.
Keep a track of any above mentioned problems as they can help in saving not just the kidneys but all the vital organs.

Kidney Problems - 4 Signs to Watch For!

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