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Patient Review Highlights
With the advancements in technology, you have gained more and more comforts for life and with that the incidence of lifestyle diseases to have increased. Diabetes mellitus, commonly referred to as diabetes, has affected an approximate 422 million people across the world, and is continuing to affect a large number of people every year.
Insulin is a vital hormone in the body which regulates the level of sugar in the blood, and when this level is elevated, it can lead to issues in various parts of the body. Diabetes is a disease that doesn't allow the body to produce enough insulin or optimize the use of insulin produced in the pancreas, and thus impairs several organs and decreases the quality of life adversely.
What are the effects of diabetes on the kidneys?
- When a person has high blood sugar, the tiny blood vessels in the body are injured. When the blood vessels in the kidneys are damaged, the kidneys are not able to clean the toxins from the body properly. It results in the retention of water as well as salt in the body, which typically leads to weight gain and swelling in the ankles. Also, a person may have protein in the urine along with waste materials in the blood.
- High blood sugar can also lead to nerve damage in the body, causing difficulty in releasing the contents of the bladder. The pressure exerted from the bladder may back up and cause harm to the kidneys. Also, when the urine remains in the bladder for an extended period, one may develop infections from the rapid growth of bacteria in the urine owing to high blood sugar level.
- About 30 percent of people affected with Type 1 diabetes and around 10 to 40 percent of people with type 2 diabetes would eventually be affected by kidney damage.
What are the signs and symptoms of kidney damage due to diabetes?
- The earliest symptom of kidney disease due to diabetes is a rise in an excretion of the protein known as albumin in the urine.
- This increase in the protein is confirmed through various general tests. Therefore, it is essential to get these tests done on a yearly basis. In its early stages, it diabetes leads to weight gain and swelling in the ankles.
- There is an increase in blood pressure, and it causes frequent urination, particularly at night. If you are affected by diabetes, you should get your blood, urine and blood pressure checked at least once in every year.
- This can allow you to exercise better control of the disease and the early treatment of kidney disease. You should try to lower your blood sugar level to reduce the risk of severe kidney disorder.
In the advanced stage of kidney disease, the blood urea nitrogen will increase along with the level of creatinine in the blood. It will cause symptoms such as extreme fatigue, weakness, loss of appetite, vomiting, anemia, and muscle cramps. Your nephrologist will work with you and your dietician for reducing the blood sugar level and also keep the kidneys in working condition. In case you have a concern or query you can always consult an expert & get answers to your questions!
Nephrotic Syndrome is a condition which is characterised by the loss of protein into the urine (called proteinuria) as a result of increased glomerular permeability and oedema. This results in low protein level in the blood. The low levels of protein in blood result in the drawing of fluids into soft tissues. A severe form ‘hypoalbuminemia’ can cause scores of secondary diseases such as ascites (retention of fluid in the abdominal cavity), pleural effusion (build-up of fluids between the lungs and the chest), or high cholesterol. It can also result in retention of fluid in other parts of the body such as eyelids, lower extremities etc.
What can cause this?
Nephrotic syndrome is mainly caused by damage to the kidneys. This leads to an increase in the concentration of protein in the urine. In adults, it can be caused due to glomerulonephritis or damage to the glomerulus of the kidneys while in children it is likely caused by minimal change disease (kidney disease marked by the abnormal loss of protein through the urine).
The other common causes of nephritic syndromes are:
- Genetic disorder
- Immune disorder
- Use of specific drugs
- Certain diseases such as diabetes mellitus, lupus
- The incidence of this disease is seen more often in males than in females.
Diet that is recommended in Nephrotic Syndrome:
In patients diagnosed with Nephrotic syndrome, the intake of salt, fat and protein must be checked. There should be emphasis on the consumption of dietary fibres that are present in vegetables and fruits.
The intake of protein and fluid should also be monitored, but this solely depends on personal factors such as age, weight and condition of the patient. It is recommended to consult a renal dietician who can guide you appropriately.
- Sodium/salt intake: The sodium or salt intake must be restricted as it leads to high blood pressure and results in fluid retention in the body, thus causing oedema (build-up of fluids within the body cavities and tissues) in the body. Avoid processed food as it contains a lot of salt.
- Protein intake: Protein is an essential part of the diet as it helps in the general makeup of the body and development of muscles. The consumption of protein must be kept under check and it is the best to consult your dietician for this. Loss of protein in urine needs to be replaced by class 1 high quality proteins in nephrotic syndrome.
- Limit fat and cholesterol intake: It is always good to curb on bad cholesterol as it is the reason behind several heart diseases. But, with patients diagnosed with Nephrotic Syndrome, it is highly recommended to avoid food rich in fats. This means staying away from unhealthy fatty meat or junk food.
- Fluid intake: Fluid intake does not have to be necessarily reduced, but it is always good to consult your doctor for the same.
“You are what you eat”. Nephrotic syndrome can slowly progress to chronic kidney disease if the necessary steps are not taken to curb it in an early stage, and diet control is a major way to do so. In case you have a concern or query you can always consult an expert & get answers to your questions!
Simple renal cysts are often found even in normal kidneys. In fact, they are so common that they are rarely considered as a disease. Certain lifestyle traits or genetics can be the cause of renal cysts occurring in adults as well as children, though no conclusive reasons have yet been confirmed for the occurrence of the same. Medical imaging technology such as ultrasound, X-ray, and CT scanning are being extensively used to discover these lesions.
In various surveys of people undergoing ultrasound for evaluation of non-kidney-related problems, generally 15% men and 7% women over the age of 50 were detected with renal cysts. Once the radiologic imaging of the cyst is obtained, the doctor can determine what further examination will be required.
There are basically two types of renal cysts, simple and complex.
- Simple cysts are usually round, have a thin outer wall, are filled with fluid and are rarely required to be treated.
- Complex cysts, however, can have thicker walls with solidified mass or can also be a collection of small cysts. These are definitely required to be examined further as they can be cancerous.
With the latest radiological approach to renal cysts, i.e. the Bosniak classification, observation of lesions is preferred to biopsy. Even though biopsies nowadays are largely non-intrusive, they are still recommended under very specific circumstances.
This classification uses a complicated algorithm of CT scan features like size, density and perfusion and places cystic renal masses into one of the five different categories. Categories I and II are generally simple cysts, not requiring further analysis. Still, an ultrasound is repeated at intervals of 6-12 months to ensure that the cyst is not growing. However, Bosniak category IIF cysts indicate complex cysts which are required to be observed. Lack of change with time indicates that the mass is benign, while any increase indicates the possibility of cancer. Through observation, one can prevent unnecessary surgeries.
It is mostly recommended that lesions falling under Bosniak III category should be immediately surgically removed as 40-50% have the possibility of becoming cancerous. However, close follow-up with magnetic resonance imaging can be used to avoid unnecessary surgeries as it is useful for characterizing the internal content of a cyst which may be is indeterminate even after the ultrasound and CT scan. Category IV lesions necessarily require surgical removal of the kidney, as nearly 85-100% of these are cancerous. More than 90% of those diagnosed with renal cancer which is confined to the kidney can hope to become disease-free within five years after diagnosis.
Thus, complex renal cysts have a higher possibility of developing into cancer if they are found to be malignant during the period of observation and steps should be taken for immediate removal.
In case you have a concern or query you can always consult an expert & get answers to your questions!
Chronic kidney disease is an emerging crisis in India, people suffer from long-standing kidney problems that deteriorate the functioning of kidneys and ultimately lead to renal failure. There are a series of complications that come with chronic kidney disease (CKD) which include high blood pressure, complications with the heart, bone diseases, and even anemia. The symptoms don’t show in the early stages unless you get blood tests but even then you have to specifically look for it.
The symptoms start showing up eventually which include swelling of the leg, tiredness, puking and even fogging up of the mind and general weakness. You are more prone to CKD if it’s in your genetic makeup, as in if it runs in the family, or if you are obese and or diabetic. Yet, even if chronic kidney disease does run in your family, that is no reason to adopt a defeatist attitude towards your kidneys and if even if it doesn’t run in your family you should start take caring of your kidneys so that you can stave off the risk of it. Here are 5 easy ways to take care of your kidneys:
- Be active: You need to be active and avoid leading a sedentary life to keep your blood pressure in check. This includes regular and regulated amounts of exercise, which could just be simply walking for 30 minutes every day, or cycling or even jogging. Basically, indulge in regular physical activities that increase your heart rate.
- Check your blood pressure: Keep a look out for your blood pressure, and monitor it as often as possible, or as soon as you feel any sort of discomfort like dizziness or excessively tired or warm. Normal levels are 120/80. High blood pressure puts you in danger of kidney damage especially, when combined with other factors such as diabetes and high cholesterol.
- Hydrate yourself: Drink lots of water but try not to overdo it. Try to avoid drinking other liquids in place of water such as sodas. 1.5 to 2 litres of water is agreed upon to be the healthy limit. Drinking the required amount of water regularly helps the kidneys flush out the toxins from the body, helps in its proper functioning and thus lowers the chances of kidney damage and formation of kidney stones.
- Weight management: Keep your weight under control, being obese puts a lot of pressure on your heart and kidneys. Increase your intake of fruits and vegetables and decrease your intake of saturated fats and salt that is found in abundance in processed foods.
- Avoid smoking and drinking: Regulate your drinking and try to limit it to one or two glasses. Completely give up smoking and avoid it because smoke reduces the flow of blood to the kidneys and affects their normal functioning. It is also known to contribute to kidney cancer and increases the chances of the same by 50%.
In case you have a concern or query you can always consult an expert & get answers to your questions!