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?

Often, early stages of kidney diseases do not come with specific signs and symptoms and most people will remain unaware of their condition. However, certain symptoms may be perceived that may indicate that a person is suffering from early stages of kidney failure. When you are diagnosed with kidney failure (also known as renal failure) in the initial stages, certain measures can be taken to retard the progression of the renal disease. This can also help reverse the condition and improve the quality of life of the patient. On the basis of a typical cause, the symptoms of kidney failure are grouped into specific categories that are given below. If you notice any of the specified renal failure symptoms, it is recommended to immediately fix up an appointment with your doctor and get your diagnostic tests done. 

Symptoms of Renal Failure from the accumulation of waste products in the body: 

Metallic taste in mouth 
Nausea and vomiting 
Facing difficulty in concentrating 
Loss of appetite 
Aversion towards meat (protein aversion) 
Itching or pruritus 
Symptoms of Renal Failure from the accumulation of fluid in the body: 

Dyspnoea or shortness of breath (this happens due to the accumulation of fluid in the lungs).
Swelling is seen in the feet, hands or face. 
Symptoms of Kidney Failure from damage to the kidneys: 

The amount of urine production changes, though it is not a reliable sign Haematuria or blood in the urine (usually in microscopic quantity). 
Frothiness or foam in the urine (usually happens when protein is present in the urine). 
Symptoms of Kidney Failure due to decreased blood production (anemia): 

Dyspnoea or shortness of breath. 
Fatigue Weakness. 
Confusion If you happen to feel cold all the time. 
The following diagnostic tests will be performed by your doctor in order to determine whether the symptoms are the manifestation of a kidney failure or not: 

Urine analysis - In this test, a sample of your urine is tested to find traces of blood, white blood cells or proteins which may indicate a problem in kidney function. 
Blood Tests - This includes tests for BUN and creatinine in the blood which are usually removed from the blood if the kidneys function properly. 
Actions must be taken when you show signs and symptoms of kidney failure: 

It is common that the symptoms of early renal failure are not always prominent, but if any of the above symptoms are witnessed, it is recommended to met a physician to determine whether they are caused by a kidney disease. You can pen-down the symptoms that you feel are related and bring it to the doctor when you fix up the next appointment. It is essential to know about your disease at the earliest as it will give you time and the ease of taking measures to retard the damage process and will decrease or delay the probability of undergoing dialysis or kidney transplant.

Kidney Failure - What Should You Know About it?

The kidneys make urine, which is a fluid through which wastes from the body including urea are eliminated from the body. There are two kidneys on the right and left side, which make urine, and pass it down to the bladder through tubes known as ureter. The bladder acts as a reservoir of the urine that is formed in the kidneys. It is stored temporarily there before being excreted out of the body through the urethra. The urinary bladder is a highly muscular organ and has a rich connective tissue. 

Interstitial cystitis (IC) or painful bladder syndrome (PBS) is a very common condition, which affects females more than males. While the exact etiology is not known, it could be age-related and also lifestyle related. People who are used to controlling the urge to pass urine are highly likely to develop this condition. The simple logic is that there is additional pressure on the bladder from the urine that is contained for longer period of time. As such, the muscular wall stretches and begins to feel stressed.

When this habit continues over a period of time, the bladder wall may become irritated or inflamed or even scarred in severe cases. There is no role of bacteria in this condition, and antibiotics are of no help in managing this condition (though the name cystitis usually indicates infection).

The following symptoms are seen as a result of this constant irritation and inflammation.

One may suffer from pain and pressure in the bladder as it continues to collect more and more urine.
This pressure in the bladder also puts pressure on the surrounding tissues in the abdomen including the pelvis, urethra, abdominal organs, uterus, etc.
Women may experience pain in the vaginal tract including vulva and behind the vagina.
Men may experience pain in the area of the scrotum, testicles, prostate, and penis.
There is an increased urge to urinate, which may be as much as 9 to 10 times a day. As the condition progresses, there could be more visits, as many as 40 to 50 visits a day.
This tendency and urge to urinate increases during nighttime.
For women, this urge to urinate and other symptoms including pain are worse during menstruation.
There could be pain during intercourse for both men and women.
There could be pain even otherwise, which can range from a mild dull ache to a piercing pain.
At a structural level, this constant pressure leads to pinpoint bleeding (glomerulations) and sometimes even ulcers in the bladder wall.
There is no definitive treatment for IC or PBS. However, bladder distention and instillation are proven methods of increasing bladder capacity, which therefore helps in relieving symptoms.

Painful Bladder Syndrome - Know The Signs!

Kidney failure is happening even to 20-year-old Indians now! 4 Reasons why.

Usually more common in the elderly as a consequence of the chronic kidney disease, kidney failure is now increasingly becoming common amongst 20-somethings in the country. 

Why?
Mainly because of their unhealthy lifestyle habits, they are falling prey to a disease that normally strikes later on in life. 

Kidney failure, also known as renal failure, occurs when the kidneys stop functioning properly, that is, they are unable to filter out waste and toxins efficiently from the body. It is the most severe stage of chronic kidney disease. To ensure that toxins don't build up in the body, treatment usually involves dialysis (process for removing excess fluid and waste from the blood) or kidney transplant, among others. It is said that about 1 million people all over the world are on dialysis or are surviving on transplanted kidneys. The condition is permanent and can occur either very suddenly or slowly over time. 

These frightening habits of the young are leading to the rise of the incidence of renal failure:
1. A sedentary lifestyle - A research conducted by the University of Utah School of Medicine suggests that if you spend 80 minutes a day sitting, you see a 20% increase in the risk of developing chronic kidney disease and, in turn, renal failure.Sedentary behaviour can also increase your risk of diabetes, hypertension as well as obesity (causes of chronic kidney disease).India is said to have about 60% of patients who suffer from hypertension and diabetes also suffer from kidney problem. 

2. Poor eating habits - Studies suggest that the right diet consisting of fruits legumes, nuts, and whole grains can help in preventing kidney disease.On the other hand, a diet that is high in processed meats; salt and sugar can worsen the vicious cycle of high blood pressure, high blood sugar, and kidney disease. Furthermore, a BMI of over 30 can increase your risk of developing common kidney ailments by two-fold. With the proliferation of fast food outlets and junk food due to lack of time, Indians are increasingly now at a risk.

3. Smoking - Smoking brings about a decrease in blood flow to the kidneys, rendering the organs inefficient. When you smoke, the arteries of your body harden and the blood vessels become narrow, leading to a worsening of conditions like high blood pressure. A study by the John Hopkins University says that smoking can increase your chances of developing kidney disease by about 60%. Many young Indians view smoking as fashionable and some even take it up to 'look cool', to beat stress or just to blend in with their peers. 

4. Drinking alcohol - Excessive alcohol consumption can bring about significant changes to the way your kidneys may function. Your kidneys end up becoming less efficient at removing alcohol from the blood due to regular drinking. Additionally, more than 2 drinks a day has been found to significantly increase your risk of high blood pressure, a common cause of kidney disease.



20-Year-Old Indians Experiencing Kidney Failure! 4 Killer Reasons.

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?

Many people are embarrassed to talk about their urine colour or urine problem with anybody, including their doctor. But, what people always forget is that strong smelling urine and the change in the colour of the urine is a serious issue. Your urine colour directly tells you about your health, especially your inner body. So, without being embarrassed you should consult a doctor, if and when, you find foul odour in your urine. Following are some of the reasons for the causes of strong smelling urine.

You are dehydrated: Urine is not supposed to leave odour. It should be odourless, but if you find strong smell in your urine, you should consult a doctor immediately. The most common reason of foul odour in your urine is dehydration. If the amount of water needed in your body is not enough then, there will be less water in your body as a result the waste products will not be diluted in water being more concentrated making the urine darker and more odour. But once you start drinking water, it should go normal. Normally, this kind of situations occur in early morning when your water intake is less or not at all. But drinking lot of water will solve this issue immediately.
More alcohol or caffeine intake: If you are habituated to drink a lot of coffee then it may happen that you find strong smell of coffee in your urine. Although it is not very problematic yet it is healthy if you reduce the intake of coffee in your daily life in order to have a healthy digestive system. Not just coffee but even alcohol could be the reason of irregular or need to urinate a lot more than usual.
Bacterial Infection: There could be bacterial infection or kidney infection which could lead to strong smell of urine. In order to ensure you should go to a doctor and get important tests done. Then the doctor can suggest treatment according to your results and if all the results are normal then you could be suggested to maintain a balanced diet on regular basis.
Imbalanced Diet: The problem can sometimes come from the use of certain vitamins from imbalances in your diet. There are substances like nitrates and phosphates in the urine which can give dark colour and odour. You should always have a proper diet and follow it in order to have a healthy digestive system. Eating lot of garlic and onion can also bring odour in your urine.
Diabetes: If you are diabetic, it may be possible that you find dark urine and odour in your urine. It indicates that your sugar level is not normal and gone much high than normal. If you are not diabetic then it may be a sign of diabetes so you should get diagnosed immediately with your doctor.
There are multiple causes of strong smelling urine but most of them could be cured easily if diagnosed immediately. But in order to avoid this issue it is better to be careful with your diet and drink a lot of water. At least three litres of water a day is an absolute necessity!

Strong Smelling Urine - 5 Common Reasons Behind it!

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