Nephrology deals with diseases affecting the Kidneys and the urinary system. Kidneys are a pair of organs situated in the lumbar area on either side of the vertebral column. 1 in 1000 people in the general population may be born with only one Kidney.
The main function of the Kidneys are:-
1- Excretion of waste products like urea and creatinnine from the body
2- Correction of acid-base balance in the body
3- Promote the formation of red blood corpuscles in the blood by secreting a hormone called crythropoeitin
4-Regulation of calcium and phosphorus levels as well as activating vitamin D
5- Regulation of water balance Kidney failure may be reversible or irreversible
Common causes of chronic Kidney disease are diabetes mellitus and hypertension. Diabetes mellitus commonly causes a condition called diabetic nephropathy, but people with diabetes can also have renal failure due to:-
1- Urinary tract infections
2-Other infections eg. respiratory tract, skin etc
3-Glomerulonephritis usually secondary to skin infections.
4-Block in the renal artery or vein
5- Medicines causing damage to the Kidneys
6- Contrast material used in CT Scans or angiography
7-uncontrolled diabetes and hypertension
Diabetic nephropathy
This is commonly seen in patients who have been diabetic for more than 5 years though nephropathy may be present in up to 30 percent patients at the time of diagnosis of diabetes.
The common symptoms are generalized swelling of the body, especially around the face and more on waking up in the morning. Patients may also have decrease in urine volume, breathlessness especially on exertion and on lying down, trotting of urine, visual disturbances and numbness of the legs.
More advanced disease may lead to nausea, vomiting, decreased appetite, abdominal distension and bloating and almost absent urine output,with severe breathlessness.
Treatment and preventive measures
Presence of micro albumin in urine is the earliest detectable abnormality in deabetic nephropathy.Initiation of treatment at this stage can prevent progression of the disease in more than half on the patients. There for a urine microalbumin test should be done at the time of diagnosis of diabetes and if negative, should be repeated yearly. In the next stage, there will be protein in urine or routine testing along with steady and progressive worsening of Kidney function.
Management of chronic Kidney disease
this involves the regular use of medications and adherence to a strict dietary regime. Patients who have swelling of the body should restrict their fluid intake to about 800ml/day. People should also generally avoid food with high potassium content like fruits, raw vegetables, tender coconut water, citrus fruits etc.
The use of animal protein should be restricted and use of soya protein may be increased. the intake of food with high phosphorus like cow's milk should be restricted to 1 glass/day. Along with dietary restrictions, regular medications and periodic follow up with a nephrologist are a must
Prevention
Patients with diabetes and hypertension should take care to maintain their blood sugars and blood pressure respectively in the prescribed normal range. Any infections, especially of the respiratory tract,skin or urinary tract should be treated promptly periodic health checkup should be done by a qualified medical practitioner. Also,one should avoid all over the counter drugs and painkillers and try to take only prescription medicines.
Early detection and prompt intervention may help in prevention of progression of Kidney disease leading to many more years of productive life ( Dr Manju Thampi,Nephrologist ,NIMS)
Prof. John Kurakar
The main function of the Kidneys are:-
1- Excretion of waste products like urea and creatinnine from the body
2- Correction of acid-base balance in the body
3- Promote the formation of red blood corpuscles in the blood by secreting a hormone called crythropoeitin
4-Regulation of calcium and phosphorus levels as well as activating vitamin D
5- Regulation of water balance Kidney failure may be reversible or irreversible
Common causes of chronic Kidney disease are diabetes mellitus and hypertension. Diabetes mellitus commonly causes a condition called diabetic nephropathy, but people with diabetes can also have renal failure due to:-1- Urinary tract infections
2-Other infections eg. respiratory tract, skin etc
3-Glomerulonephritis usually secondary to skin infections.
4-Block in the renal artery or vein
5- Medicines causing damage to the Kidneys
6- Contrast material used in CT Scans or angiography
7-uncontrolled diabetes and hypertension
Diabetic nephropathy
This is commonly seen in patients who have been diabetic for more than 5 years though nephropathy may be present in up to 30 percent patients at the time of diagnosis of diabetes.
The common symptoms are generalized swelling of the body, especially around the face and more on waking up in the morning. Patients may also have decrease in urine volume, breathlessness especially on exertion and on lying down, trotting of urine, visual disturbances and numbness of the legs.
More advanced disease may lead to nausea, vomiting, decreased appetite, abdominal distension and bloating and almost absent urine output,with severe breathlessness.
Treatment and preventive measures
Presence of micro albumin in urine is the earliest detectable abnormality in deabetic nephropathy.Initiation of treatment at this stage can prevent progression of the disease in more than half on the patients. There for a urine microalbumin test should be done at the time of diagnosis of diabetes and if negative, should be repeated yearly. In the next stage, there will be protein in urine or routine testing along with steady and progressive worsening of Kidney function.Management of chronic Kidney disease
this involves the regular use of medications and adherence to a strict dietary regime. Patients who have swelling of the body should restrict their fluid intake to about 800ml/day. People should also generally avoid food with high potassium content like fruits, raw vegetables, tender coconut water, citrus fruits etc.The use of animal protein should be restricted and use of soya protein may be increased. the intake of food with high phosphorus like cow's milk should be restricted to 1 glass/day. Along with dietary restrictions, regular medications and periodic follow up with a nephrologist are a must
Prevention
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| healthy kidney |
Early detection and prompt intervention may help in prevention of progression of Kidney disease leading to many more years of productive life ( Dr Manju Thampi,Nephrologist ,NIMS)
Prof. John Kurakar
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