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Treatment of Kidney Stones
Treatment of Blood in Urine
Treatment of Kidney Disease
Treatment of Frequent Urination Problems
Kidney Dialysis Treatment
Treatment of Fluid Retention
Kidney Stones Treatment
Treatment of Kidney Transplant
Treatment of Kidney Failure
Treatment of Kidney Diseases
Treatment of Nephrotic Syndrome
Kidney Transplant Treatment
Treatment of TB in Kidney
Treatment of Nephropathy
Treatment of Nephrolithiasis
Treatment of Nephronophthisis
Treatment of Bartter Syndrome
Treatment of Renal Agenesis
Treatment of Alport Syndrome
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Patient Review Highlights
The kidneys are responsible for the elimination of waste from the body. The blood is filtered in the kidneys and all toxic wastes are filtered out and excreted through urine. When this filtration does not happen effectively, a lot of waste can be found in the blood, which affects normal body function.
Kidneys may lose their functioning either due to age, injury, or disease conditions. Whatever the reason, when kidney function is hampered, the body suffers. If there was an injury or congenital problem, it could be unilateral and the non-affected kidney could still do the function. However, if it is infection or old age, normally both kidneys are affected and then replacement should be looked for externally. This is where a kidney transplant comes into the picture.
What is it?
It is a surgery where a healthy, functioning kidney is placed into the body. The donor could be
- Living: These donors have to be related or unrelated. Related is often termed someone, who is a family member and is willing to donate one kidney (one kidney is sufficient for normal, healthy individuals) to the diseased person.
- Cadaver: If a person is willing to donate kidneys post death, these are used for transplant, within a specified time.
Identifying the right donor and recipient:
- Blood type and tissue type should be matched; a good tissue type match improves the chances of success
- Overall health of the donor to ensure there is no heart disease, lung disease, or diabetes
- The recipient also should be healthy
What to expect during surgery?
- Once a donor is identified, in living donors, the surgery to remove the kidney and to transplant it are done simultaneously
- The surgery usually takes about 3 to 4 hours
- Antibiotics are given prior to the surgery to prevent infection
- The blood vessels and ureter are connected back to the kidney after the transplant
- Hospital stay can range from 5 days to 2 weeks, depending on the overall health of the patient and the anticipated risk of rejection.
- Most transplanted kidneys work effectively almost immediately. A kidney stored from a cadaver may take a little longer compared to a fresh kidney from a living donor
- People who have had transplants are put on immunosuppressants on a chronic basis to reduce chances of rejection. The new kidney will always be recognised by the body as a foreign body, and so this is essential.
Kidney transplant success rates are quite high, and more and more people are opting for transplants as opposed to dialysis.
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
List of foods to eat with kidney failure
Kidney failure creates different needs in the body for someone with healthy kidneys, and it therefore requires a special diet. Although following a diet can feel restrictive, by focusing on consuming foods recommended for people with kidney failure, you can enjoy a broad range of healthy, delicious foods. People with kidney failure should consult with their doctor and dietitian to get individualized direction on their diet. Many cookbooks and websites offer recipes
1- Dietary recommendations for kidney failure focus on limiting these five nutrients: sodium, potassium, phosphorus, protein and fluid. Food labels can help identify some appropriate foods. For sodium, look for foods that have a daily value of less than 20 percent per serving eaten. Potassium and phosphorus are not usually listed, but if they are, look for less than 20 percent of the daily value per serving eaten. For protein and fluid, there is no percent you should look for. A doctor or dietitian may make specific recommendations for protein and fluid intake.
Fruits and vegetables
Appropriate foods for kidney failure include low potassium fruits and vegetables. Low-potassium fruits include apples, pears, peaches, pineapple, strawberries, grapes, blueberries, blackberries, raspberries, apricots, mandarin oranges, plums, lemons, limes and cranberries. Low-potassium vegetables include green beans, raw cabbage, cooked cauliflower, celery, corn, lettuce such as iceberg and romaine, raw spinach, cooked sweet peppers, raw broccoli, cooked summer squash and onions.
Grains and starches contain some sodium, potassium and phosphorus. When choosing grains and starches, choose low sodium, potassium and phosphorus grains such as bagels, white or whole-wheat bread, oatmeal, popcorn, pasta, white or brown rice, english muffins, and rice or corn-based, ready-to-eat cereals. Other grains and starches that are higher in sodium, potassium, and phosphorus may be eaten in smaller portions. Asking a doctor or dietitian can also help clarify which foods are appropriate.
Diary and nuts
Many dairy products, beans and nuts contain significant amounts of potassium and phosphorus. Sodium may also added to these foods as part of processing or seasoning. However, smaller portion sizes and eating these foods less often is appropriate for people with kidney failure. Some dairy substitutes, dairy foods that fit in a kidney diet are mozzarella and parmesan cheese, rice or almond milk, some brands of greek and regular yogurt and cottage cheese. Beans and nuts that are lower in potassium and phosphorus in small amounts and include macadamia nuts, sunflower seed butter, almonds, pecans and chickpeas
Protein foods are only limited in kidney failure when the person is not on dialysis. About 50 percent of protein intake should be from complete protein foods, such as meat, fish, poultry, eggs, dairy products, tofu, and soy products.
Beverages may need to be limited; water and other drinks still play an important role in a kidney-friendly diet, however. Apple, grape and cranberry juice are good options. Other drinks like herbal and iced tea, coffee and clear sodas are all acceptable for a person in kidney failure.
Six common myths about kidney disease:
Myth 1: kidney disease is a rare condition.
You may be surprised to learn just how common kidney disease is. In fact, one in seven american adults today is living with some level of kidney disease. What puts you at risk? having high blood pressure, diabetes, a family history of kidney failure, and being over 60 years are major risk factors for kidney disease. Being african-american/black, hispanic, asian, american indian, or pacific islander also increases your risk.
Myth 2: you will know if you have kidney disease.
Unfortunately, most people who have kidney disease don't know it. Why not? because in the early stages of kidney disease, most people do not have any symptoms. Symptoms may not appear until kidney disease is in the advanced stages. The best way to find out if you have kidney disease is to get tested—and once you are diagnosed there are many steps you can take to reduce the progression of the disease.
Myth 3: testing for kidney disease is a long and costly process.
Testing for kidney disease is surprisingly easy. It can be done with two simple, inexpensive tests during a routine visit with your healthcare provider.
• A simple urine test to check for protein in your urine. Having a small amount of protein in your urine can be a sign kidney disease.
• A simple blood test to estimate gfr (glomerular filtration rate). Your gfr number tells you how well your kidneys are working.
Myth 4: if you are at risk for kidney disease, there is nothing you can do about it.
Not everyone who is at risk will get kidney disease. You can help protect your kidneys. Eat healthy, get regular exercise, control blood pressure and blood sugar, keep a healthy weight, quit smoking, and don’t overuse pain medications like ibuprofen. All these steps will help you keep your kidneys healthy and lessen your chances of getting kidney disease.
Myth 5: no one knows what causes kidney disease.
The two most common causes of kidney disease are diabetes and high blood pressure. Both can harm your kidneys by causing damage to the tiny blood vessels in your kidneys. Many other conditions can harm the kidneys. These include:
• Heart disease
• Glomerulonephritis, a disease that causes inflammation in the kidneys
• Diseases you are born with, like polycystic kidney disease, which causes cysts to form in the kidneys
Myth 6: the only treatment for kidney disease is dialysis.
Not everyone with kidney disease needs dialysis. Kidney disease is a progressive disease. In its early stages, it is usually managed with exercise, diet, and medication. With this approach, most people can slow or stop the progression of kidney disease and enjoy a normal lifestyle. That’s why it’s so important to find and treat kidney disease early. Dialysis or a kidney transplant is only needed if your kidney disease gets worse and progresses to kidney failure.
Six-step guide to protecting kidney health
Chronic kidney disease (ckd) is a major public health concern. Ckd often goes undetected until it is very advanced (when someone would need dialysis or a transplant). But when it is diagnosed early through very simple tests, progression of ckd can be slowed or even stopped. Know your kidney score! regualar testing for everyone is important but it is especially important for people at risk. Follow these 6 steps to learn more about kidney disease, your risk, and how to prevent kidney disease.
Step 1: know these facts
6 things healthy kidneys do:
• Regulate the body’s fluid levels
• Filter wastes and toxins from the blood
• Release a hormone that regulates blood pressure
• Activate vitamin d to maintain healthy bones
• Release the hormone that directs production of red blood cells
• Keep blood minerals in balance (sodium, phosphorus, potassium)
8 problems ckd can cause:
• Cardiovascular disease
• Heart attack and stroke
• High blood pressure
• Weak bones
• Nerve damage (neuropathy)
• Kidney failure (end-stage renal disease, or esrd)
• Anemia or low red blood cell count
Step 2: assess your risk
4 main risk factors:
• Diabetes (self or family)
• High blood pressure (self or family)
• Cardiovascular disease (self or family)
• Family history of kidney disease or diabetes or high blood pressure
10 additional risk factors:
• African-american heritage
• Native american heritage
• Hispanic, asian, pacific islander heritage
• Age 60 or older
• Low birth weight
• Prolonged use of nsaids, a type of painkillers, such as ibuprofen and naproxen
• Lupus, other autoimmune disorders
• Chronic urinary tract infections
• Kidney stones
Step 3: recognize symptoms
8 possible trouble signs:
Most people with early ckd have no symptoms, which is why early testing is critical. By the time symptoms appear, ckd may be advanced, and symptoms can be misleading. Pay attention to these:
• Fatigue, weakness
• Difficult, painful urination
• Foamy urine
• Pink, dark urine (blood in urine)
• Increased thirst
• Increased need to urinate
• (Especially at night)
• Puffy eyes
• Swollen face, hands, abdomen, ankles, feet
Step 4: Get tested
If you or a loved one belong to a high-risk group, ask your primary-care physician about these tests—and be especially insistent about the last one. Your doctor may want to perform other tests as well.
4 simple, life-saving tests:
High blood pressure can damage small blood vessels (glomeruli) in the kidneys. It is the second-leading cause of kidney failure after diabetes.
Below 140/90 is good for most people. Below 130/80 is better if you have chronic kidney disease. Below 120/80 is best.
Protein in urine
Traces of a type of protein, albumin in urine (albuminuria) is an early sign of ckd. Persistent amounts of albumin and other proteins in the urine (proteinuria) indicate kidney damage.
Less than 30 mg of albumin per gram of urinary creatinine (a normal waste product)
Creatinine in blood(serum creatinine)
Healthy kidneys filter creatinine (a waste product from muscle activity) out of the blood. When kidney function is reduced, creatinine levels rise.
0.6 to 1.2 mg per deciliter of blood, depending on other variables
Glomerular filtration rate (gfr)
This is the most sensitive and accurate gauge of kidney function. Doctors measure blood creatinine levels and perform a calculation based on age, race, and gender.
Over 90 is good. 60-89 should be monitored. Less than 60 for 3 months indicates ckd.
Step 5: stay healthy
6 things people with ckd should do:
• Lower high blood pressure
• Keep blood-sugar levels under control if diabetic
• Reduce salt intake
• Avoid nsaids, a type of painkillers
• Moderate protein consumption
• Get an annual flu shot
9 things everyone should do:
• Exercise regularly
• Control weight
• Follow a balanced diet
• Quit smoking
• Drink only in moderation
• Stay hydrated
• Monitor cholesterol levels
• Get an annual physical
• Know your family medical history
My mom is undergoing dialysis. Completed 12 dialysis till now .AVF is done on 1 June 2017 from tomorrow we can start from that dialysis. Is sneezing is good for her health? Her bp is normal now.
Hi. My mom is undergoing dialysis .Is sneezing is good for her health? And say best diet for renal failure.
Had kidney transplant 8 months ago. i am all right very healthy. All report are ok .my bp is normal like 110/65.115/70 can I go jym or how much weight i can pick up?
According to the cleveland clinic foundation, diabetes is the cause of approximately 44% of all new cases of diabetic nephropathy. Nephropathy is a medical term for kidney disease. Diabetes can cause damage to the filters in your kidneys over time. As more damage occurs, chronic kidney disease (ckd) can develop. Ckd is a serious complication of diabetes. It cannot be cured, only managed. Getting an early diagnosis of nephropathy and treating your diabetes can help limit the kidney damage and may prevent kidney failure where dialysis becomes necessary.
An early diagnosis
An early diagnosis of diabetes can help your doctor treat the condition before it does more damage to your body. Type 1 diabetes (also known as juvenile or insulin dependent diabetes) is easily diagnosed in its early stages, before kidney damage occurs. However, type 2 diabetes (also known as adult-onset or non-insulin dependent diabetes) often goes undiagnosed for years. Many people who have type 2 diabetes do not realize it.
Because type 2 diabetes may have been present for many years before it is diagnosed, this means the high glucose (sugar) content in the blood has had time to damage the tiny blood vessels in the kidneys. When these blood vessels are damaged, protein that is meant to remain in the body can leak into the urine. This is a condition called microalbuminuria, and it is an early symptom of kidney disease.
If you have been diagnosed with type 1 or type 2 diabetes, you should have a microalbumin test done annually. This will help your doctor detect any kidney damage. If your urine tests positive for albumin (a protein), steps can be taken to help prevent more damage to your kidneys.
Control your blood glucose levels
Because the high glucose content in your bloodstream can damage the kidneys, controlling the level of glucose is an important step in keeping the kidneys healthy. This means following the plan your doctor recommends for treating your diabetes. For type 1 diabetics, getting regular insulin is crucial in keeping glucose levels in check. For type 2 diabetics, diet and exercise may be the primary treatments for lowering blood sugar levels.
Your doctor may have you test your glucose levels throughout the day. You may be referred to a dietitian, who can help you make healthier food choices. Lowering your intake of sugar is important, especially if you are insulin resistant. Your doctor may also want you to lose excess weight. Follow your doctor’s instructions regarding medicines and testing your glucose levels. If the levels are still too high, tell your doctor so adjustments can be made to your treatment program.
Control your blood pressure levels
If you are diabetic and have been diagnosed with high blood pressure (also known as hypertension), your kidneys have a greater chance of becoming damaged. Patients with high blood pressure and diabetes are more likely to develop nephropathy. This is because high blood pressure places added strain on the tiny blood vessels of the kidneys. Your doctor may prescribe a medicine called an ace inhibitor to bring down your blood pressure.
Even in diabetic patients who do not have high blood pressure, studies have shown that ace inhibitors are an effective treatment for kidney stone. Even though you may not have high blood pressure, your doctor may prescribe this medicine for you in order to prevent further strain to your kidneys. If you have any questions or concerns about any medicine that has been prescribed to you, talk with your doctor. Do not stop taking any medicine prescribed to you without talking to your doctor first.
Keep healthy habits
If you have been diagnosed with diabetes, your doctor may ask that you stop certain activities that could worsen your diabetes or lead to high blood pressure. Activities such as smoking and drinking alcohol should be avoided.
Exercise is an excellent habit. Your doctor may recommend exercise as part of your treatment. But before you start a program, ask your doctor if the activity may be right for you.
Diabetes does not necessarily have to lead to chronic kidney disease. An early diagnosis of kidney disease may help you and your health care team to prevent further damage. Keeping your diabetes in check may help keep your kidneys healthy for a long time.
Diet in ckd in non dialysis patients:
- We suggest the following dietary guidelines for most patients with egfr 60 ml/min/1.73 who are not on dialysis:
- A daily protein intake of 0.8 g/kg. We do not recommend very-low-protein intake (0.6 g/kg/day).
- A diet rich in vegetables.
The sodium intake varies depending on individual patient clinical features. Among individuals who are hypertensive, volume overloaded, or proteinuric, we suggest a sodium intake of 2 g/day (ie, 5 g/day of salt [nacl]).
For patients who are not hypertensive, volume overloaded, or proteinuric, sodium restriction to 2.3 g/day (5.75 g/day of salt [nacl]) may be of benefit. There are no convincing studies of the general population that have proven that lowering sodium intake to less than 2.3 g per day lowers cardiovascular outcomes or all-cause mortality. The institute of medicine has concluded that there is insufficient evidence to recommend a different sodium intake for ckd patients as compared with the general us population .
- The potassium intake should be guided by serum potassium levels. If the potassium concentration is normal, we do not restrict dietary potassium. If the potassium concentration is high, dietary potassium intake should be restricted.
- Some clinicians target a total calcium intake (both dietary and medication sources) ≤1500 mg/day, whereas others prefer a more stringent goal of ≤1000 mg/day.
- Maximum phosphorus intake of 0.8 to 1 g/day, even if the serum phosphorus concentration is normal; this is because some studies suggest that dietary phosphorus intake may alter circulating fibroblast growth factor (fgf)-23 concentration. The dietary phosphorus should be derived from sources of high biologic value, such as meats and eggs.
- Maximum caloric intake of 30 to 35 kcal/kg/day.
- Maximum fat intake - 30 percent of daily energy intake, with saturated fat limited to 10 percent energy.
- Daily dietary fiber intake for 25 to 38 g/day.
Prevention of Recurrent Calcium Stones:
● Prevention of recurrent calcium stones (which are usually composed primarily of calcium oxalate) is aimed at decreasing the concentrations of the lithogenic factors (calcium and oxalate) and at increasing the concentrations of inhibitors of stone formation, such as citrate. Achieving these goals may require both dietary modification and the administration of appropriate medications. Metabolic evaluation at baseline and during follow-up will help guide the choice of the optimal preventive regimen.
● A variety of dietary modifications and drug therapies can reduce the likelihood of recurrence of calcium oxalate stones. From the viewpoint of diet, increasing the intake of fluid, dietary calcium, potassium and phytate and decreasing the intake of oxalate, animal protein, sucrose, fructose, sodium, supplemental calcium, and supplemental vitamin c may be beneficial.
● Among those with calcium oxalate stones, drug therapy is indicated if there is continued stone formation or if there is insufficient improvement in the urine chemistries despite attempted dietary modification over a three- to six-month period. The aim of therapy is to prevent further calcium oxalate precipitation. Since dissolution of already existing calcium stones does not occur, passage of an existing stone does not necessarily reflect a therapeutic failure in a patient known to have renal stones prior to the institution of therapy. Initial drug therapy varies with the metabolic abnormality that is present.
● The 24-hour urine is an essential component of the initial evaluation and guides recommendations for prevention. The response to dietary or drug therapy is monitored by repeat 24-hour urine collections. The goal of therapy is to reverse the abnormalities detected during the initial workup (eg, low urine volume, hypercalciuria, hypocitraturia, and hyperoxaluria). We routinely obtain a 24-hour urine collection at six to eight weeks after therapy has begun to assess the impact of the intervention. Another component of monitoring is periodic imaging. Limiting radiation exposure is important, as individuals with recurrent stones often have undergone multiple imaging procedures around the times of acute stone events.