Common renal issues explained This Quarterly Magazine Oct 2014

How the renal systems works and what are some common problems.

The renal (urinary) system consists of two kidneys, ureters, the bladder and the urethra. The kidneys consist of about  a  million  of  nephron  each, which is the functional unit of the kidney. Their main functions are removal of waste material and excess water from the body, blood pressure regulation and normalising electrolyte concentrations and blood pH. Urine formation and excretion involves filtration of excess water and waste material from blood in the kidneys. This travels through the ureters to the bladder, and is then expelled through the urethra. A healthy person generally produces about 1.5 litres of urine per day, although this varies. Because the kidneys have a large functional capacity, it is possible for a person to lose as much as 70% of kidney function without any symptoms. Here are four common renal problems.

Blood In the urine

Possible causes:
inflammation of kidney filters; stones, infections, cancers in the kidney or urinary tract; enlarged prostate in men or  physical injury to kidney

Symptoms: pink or red urine, or no symptoms (blood is only  visible  when  the  urine  is  examined  under a microscope)

Evaluation: requires blood and urine test. May need ultrasound, CT or M.R.I. scans of the urinary system; kidney biopsy or bladder scope may be necessary

Treatments: may require no treatment, medical treatment only or surgery

Impaired kidney function and/or proteinuria (protein leakage in the urine)

Possible causes: diabetes mellitus, hypertension, inflammation of the kidneys, urinary stone disease

Symptoms: none in mild cases, but in severe cases may have frothy urine, swelling, breathlessness, poor appetite, nausea, vomiting

Evaluation: requires blood and urine test to determine severity of the protein leakage and the stage of kidney impairment; may need imaging of kidney or kidney biopsy

Treatment: for patients with diabetes mellitus or hypertension, good control of blood sugar or blood pressure will help decrease proteinuria and delay the progression of kidney impairment; dietary change to help preserve kidney function as well; may need other medications to control the underlying disease and sometimes may need steroid and/or immune-suppressants. If more than 90% of kidney function is impaired, dialysis/kidney  transplantation is needed.

Urinary tract infection

Causes: bacteria

Symptoms: frequent urge to pass urine, pain or burning sensation while urinating, pain over the bladder area, fever or loin pain

Evaluation: may require urine and/or blood test; imaging of the urinary tract

Treatment: advisable to drink more water; may need antibiotic and other medications to help relieve symptoms

Urinary stone

Causes: usually occurs in those who excrete high concentratıon of calcıum and/or uric acıd ın urıne

Symptoms: back pain that may radiate to the front, blood in the urine, stones/gravel in the urine, symptoms of kidney impairment

Treatment: may need surgical removal or fragmentation by shockwave so that they can be passed out in the urine; specific diet or medication may help to prevent stone formation


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