Kidney disease

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Kidney disease can be divided in to 2 broad categories. Acute and Chronic kidney disease.

Acute Kidney disease

Acute kidney failure is the rapid (less than 2 days) loss of your kidneys' ability to remove waste and help balance fluids and electrolytes in your body.

Causes

There are many possible causes of kidney damage. They include:

  • Acute tubular necrosis (ATN; damage to the tubule cells of the kidneys)
  • Autoimmune kidney disease
  • Blood clot from cholesterol (cholesterol emboli)
  • Decreased blood flow due to very low blood pressure, which can result from burns, dehydration, hemorrhage, injury, septic shock, serious illness, or surgery
  • Disorders that cause clotting within the kidney blood vessels Infections that directly injure the kidney, such as acute pyelonephritis or septicemia
  • Pregnancy complications, including placenta abruption or placenta previa Urinary tract blockage Illicit drugs such as cocaine and heroine
  • Medicines including non-steroidal anti-inflammatory drugs (NSAIDs), certain antibiotics and blood pressure medicines, intravenous contrast (dye), some cancer and HIV drugs

Symptoms

Symptoms of acute kidney failure may include any of the following:

  • Bloody stools
  • Breath odor and metallic taste in the mouth
  • Bruising easily
  • Changes in mental status or mood
  • Decreased appetite
  • Decreased sensation, especially in the hands or feet
  • Fatigue or slow sluggish movements
  • Flank pain (between the ribs and hips)
  • Hand tremor Heart murmur
  • High blood pressure
  • Nausea or vomiting, may last for days
  • Nosebleeds
  • Persistent hiccups
  • Prolonged bleeding
  • Seizures
  • Shortness of breath
  • Swelling due to the body keeping in fluid (may be seen in the legs, ankles, and feet)
  • Urination changes, such as little or no urine, urination that stops completely.

Exams and Tests

The health care provider will examine you.

Tests to check how well your kidneys are working include:

  • BUN
  • Creatinine clearance
  • Serum creatinine
  • Serum potassium
  • Urinalysis

A kidney or abdominal ultrasound is the preferred test for diagnosing a blockage in the urinary tract. X-ray, CT scan, or MRI of the abdomen can also tell if there is a blockage.

Other blood tests may be done to find the underlying cause of kidney failure.

Treatment

Once the cause is found, the goal of treatment is to help your kidneys work again and prevent fluid and waste from building up in your body while they heal. Usually, you will have to stay overnight in the hospital for treatment.

The amount of liquid you drink will be limited to the amount of urine you can produce. You will be told what you may and may not eat to reduce the buildup of toxins that the kidneys would normally remove. Your diet may need to be high in carbohydrates and low in protein, salt, and potassium.

You may need antibiotics to treat or prevent infection. Water pills (diuretics) may be used to help remove fluid from your body.

Medicines will be given through a vein to help control your blood potassium level.

You may need dialysis. This is a treatment that does what healthy kidneys normally do -- rid the body of harmful wastes, extra salt, and water. Dialysis can save your life if your potassium levels are dangerously high. Dialysis will also be used if:

  • Your mental status changes
  • You develop pericarditis
  • You retain too much fluid
  • You cannot remove nitrogen waste products from your body

Dialysis will most often be short term. In some cases, the kidney damage is so great that dialysis is needed permanently.

Chronic kidney disease

Chronic kidney disease (CKD) means that your kidneys are damaged and can't filter blood as they should. This damage can cause wastes to build up in your body. It can also cause other problems that can harm your health. Diabetes and high blood pressure are the most common causes of CKD.

The kidney damage occurs slowly over many years. Many people don't have any symptoms until their kidney disease is very advanced. Blood and urine tests are the only way to know if you have kidney disease.

Treatments cannot cure kidney disease, but they may slow kidney disease.

Symptoms

The early symptoms of CKD are the same as for many other illnesses. These symptoms may be the only sign of a problem in the early stages.

Symptoms may include:

  • Appetite loss
  • General ill feeling and fatigue
  • Headaches Itching (pruritus) and dry skin
  • Nausea
  • Weight loss without trying to lose weight

Symptoms that may occur when kidney function has gotten worse include:

  • Abnormally dark or light skin
  • Bone pain
  • Drowsiness or problems concentrating or thinking
  • Numbness or swelling in the hands and feet
  • Muscle twitching or cramps
  • Breath odor Easy bruising, or blood in the stool
  • Excessive thirst
  • Frequent hiccups
  • Problems with sexual function
  • Menstrual periods stop (amenorrhea)
  • Shortness of breath
  • Sleep problems
  • Vomiting

Symptoms

The early symptoms of CKD are the same as for many other illnesses. These symptoms may be the only sign of a problem in the early stages.

Symptoms may include:

  • Appetite loss
  • General ill feeling and fatigue
  • Headaches Itching (pruritus) and dry skin
  • Nausea
  • Weight loss without trying to lose weight

Symptoms that may occur when kidney function has gotten worse include:

  • Abnormally dark or light skin
  • Bone pain
  • Drowsiness or problems concentrating or thinking
  • Numbness or swelling in the hands and feet
  • Muscle twitching or cramps
  • Breath odor Easy bruising, or blood in the stool
  • Excessive thirst
  • Frequent hiccups
  • Problems with sexual function
  • Menstrual periods stop (amenorrhea)
  • Shortness of breath
  • Sleep problems
  • Vomiting

Exams and Tests

Most people will have high blood pressure at all stages of CKD. During an exam, your health care provider may also hear abnormal heart or lung sounds in your chest. You may have signs of nerve damage during a nervous system exam.

A urinalysis may show protein or other changes in your urine. These changes may appear 6 to 10 months or more before symptoms appear.

Tests that check how well the kidneys are working include:

  • Creatinine clearance
  • Creatinine levels
  • Blood urea nitrogen (BUN)

CKD changes the results of several other tests. You will need to have the following tests as often as every 2 to 3 months when kidney disease gets worse:

  • Albumin
  • Calcium
  • Cholesterol
  • Complete blood count (CBC)
  • Electrolytes
  • Magnesium
  • Phosphorous
  • Potassium Sodium

Other tests that may be done to look for the cause or type of kidney disease include:

  • CT scan of the abdomen MRI of the abdomen Ultrasound of the abdomen Kidney biopsy Kidney scanKidney ultrasound

This disease may also change the results of the following tests:Erythropoietin Parathyroid hormone (PTH) Bone density test Vitamin D level

Treatment

Blood pressure control will slow further kidney damage.

  • Angiotensin-converting enzyme (ACE) inhibitors or angiotensin receptor blockers (ARBs) are used most often.
  • The goal is to keep blood pressure at or below 130/80 mm Hg.

Making lifestyle changes can help protect the kidneys, and prevent heart disease and stroke, such as:

  • DO NOT smoke.
  • Eat meals that are low in fat and cholesterol.
  • Get regular exercise (talk to your doctor or nurse before starting to exercise).
  • Take drugs to lower your cholesterol, if needed.
  • Keep your blood sugar under control.
  • Avoid eating too much salt or potassium.

Always talk to your kidney specialist before taking any over-the-counter medicine. This includes vitamins, herbs and supplements. Make sure all of the providers you visit know you have CKD. Other treatments may include:

  • Medicines called phosphate binders, to help prevent high phosphorous levels
  • Extra iron in the diet, iron pills, iron given through a vein (intravenous iron) special shots of a medicine called erythropoietin, and blood transfusions to treat anemia
  • Extra calcium and vitamin D (always talk to your provider before taking)

Your provider may have you follow a special diet

  • Limiting fluids
  • Eating less protein
  • Restricting phosphorous and other electrolytes
  • Getting enough calories to prevent weight loss

Things you can do

You can take steps to keep your kidneys healthier longer:

  • Choose foods with less (sodium)
  • Control your blood pressure; your health care provider can tell you what your blood pressure should be
  • Keep your blood sugar in the target range
  • Limit the amount of alcohol you drink
  • Choose foods that are healthy for your heart: fruits, vegetables, whole grains, and low-fat dairy foods
  • Lose weight if you are overweight
  • Be physically active
  • Don't smoke

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Health science - Medicine - Nephrology - edit
Diseases of the glomerulus
Lupus nephritis | Post-infectious glomerulonephritis | Minimal change disease | Focal segmental glomerulosclerosis | Diabetic nephropathy
Diseases of the proximal convoluted tubules
Fanconi syndrome (Type II renal tubular acidosis) | renal cell carcinoma
Diseases of the distal convoluted tubules
pseudohypoaldosteronism (Type IV renal tubular acidosis)
Diseases of the collecting duct
Type I renal tubular acidosis
Tumours of the kidney
renal cell carcinoma | Wilms' tumour (children)
Diseases of the renal vasculature
renal artery stenosis | vasculitis | atheroembolic disease
Tubulointerstitial diseases of the kidney
Drug-induced interstitial nephritis | Obstructive nephropathy | Radiation nephritis | Reflux nephropathy | Sarcoidosis
Genetic diseases of the kidney/syndromes associated with kidney dysfunction
Alport syndrome | Polycystic kidney disease | Wilms' tumour (children)

von Hippel-Lindau syndrome | Hereditary papillary renal carcinoma | Birt-Hogg-Dube syndrome | Hereditary renal carcinoma

Genetic diseases of the kidney/syndromes associated with kidney dysfunction

Chronic Kidney Disease

Anemia in CKD | Causes of CKD | CKD Overview | CKD Tests and Diagnosis | Diabetic Kidney Disease | Eating Right for CKD | High Blood Pressure and Kidney Disease | Managing CKD | Mineral and Bone Disorder in CKD | Nutrition for Advanced CKD in Adults | Preventing CKD | Quick Reference on UACR & GFR

Kidney Failure

Eating and Nutrition for Hemodialysis | Financial Help for Treatment of Kidney Failure | Hemodialysis | Kidney Failure | Kidney Transplant | Peritoneal Dialysis

Other Kidney Topics

Acquired Cystic Kidney Disease | Amyloidosis and Kidney Disease | Diabetes Insipidus | Ectopic Kidney | Glomerular Diseases | Goodpasture Syndrome | Henoch-Schönlein Purpura | IgA Nephropathy | Kidney Dysplasia | Kidney Infection (Pyelonephritis) | Kidney Stones | Lupus Nephritis | Medullary Sponge Kidney | Nephrotic Syndrome in Adults | Pain Medicine and Kidney Damage | Polycystic Kidney Disease (PKD) | Renal Artery Stenosis | Renal Tubular Acidosis | Simple Kidney Cysts | Solitary Kidney | Your Kidneys and How They Work | Your Urinary Tract and How It Works

Adapted from NIH. Please join us in importing public domain information into the wiki and wiki enhance the content.

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