• Shruti GOCHHWAL

Kidney Diseases

The interesting thing about kidneys is that when functioning properly, they can hold about 22% of your blood supply at any given point, and within five minutes all of your blood will pass through your kidneys.

Kidneys are one of the most important organs in the human body. They are responsible for removing waste products like fluids and acids from the blood and maintain balance in the body’s fluid. In short, kidneys are the filter machines of the body.

In addition, they are also responsible for maintaining blood pressure by releasing important hormones.

In other words, without the kidneys, this filter would be lost and there would be a build up of fluid in the body.

Excess fluid in the body is dangerous as it causes complications like edema/swelling, fluid build up around the lungs and could also lead to heart problems.

Since normal absorption and reabsorption of vital ions is needed in regulated amounts in the body, it causes muscle spasm and arrhythmias.

Lastly, without the kidneys, there would be a loss of oxygen in the body cells as blood carries oxygen and if the blood pressure is not regulated, it will cause complications.

Kidney disease is a condition where the kidneys become dysfunctional and all their vital functions get compromised. 

Functions Of The Kidneys

A nephron is the basic unit structure of the kidney. The human kidney has about 1,000,000 nephrons and collectively they are responsible for separating water, ions and other molecules. Most importantly they restore the essential molecules back into the body. 

Caption : Pathway for the functioning of the neuron for flirtation and urine production.

A nephron consists of the following :

  1. Afferent arteriole: The blood vessels that carry oxygenated blood that has to be filtered out to the glomerulus.

  2. Glomerulus: The glomerulus filters out small molecules, fluid and minerals by letting it pass through its thin membrane and into the PCT, while the unfiltered blood leaves the glomerulus in the efferent arteriole.

  3. Proximal Convoluted tubule (PCT): It is responsible for water and ion reabsorption back into the body. Further, it removes toxins and maintains the PH.

  4. Ascending Loop of Henle: Reabsorption of sodium and chloride ions into the interstitial fluid.

  5. Descending Loop of Henle: Water passes into the interstitial fluid from the membrane of the loop.

  6. Distal Convoluted tubule (DTC): Secretes and absorbs different ions to maintain blood PH and electrolyte balance. The end product in the DTC after this is termed as urine.

  7. Collecting duct: The DTC joins a common collecting duct which continues to reabsorb water and ions that our body requires and the remaining urine leaves the collecting duct, enters the ureter and is eventually stored in the gallbladder and is released during urination.

  8. Efferent arteriole: This takes the unfiltered blood from the glomerulus and splits to form a network of capillaries that supplies blood to the entire nephron circulation. Then, it eventually joins back to form a venule, a vein with deoxygenated blood.

The venule eventually forms a renal vein with venules of other nephrons and finally leaves the kidneys.

Credits: Wikimedia Commons Caption: Nephrons

Common Symptoms Of Kidney Disease

They are the following:

  1. Trouble sleep

  2. Constant tiredness and distraction

  3. Dry and itchy skin

  4. Chapped lips

  5. Urine tinted with blood and is foamy

  6. Ankles and feet get swollen

  7. Puffy eyes and face

  8. Poor appetite

  9. Muscle cramping

  10. Constant need to urinate

  11. Shortness of breath

Credits : unsplash Alt tag : pain Caption: Muscle cramping due to kidney disease

Types Of Kidney Diseases

The chronic form of kidney disease is known as kidney failure and it could be triggered by other acute diseases like kidney stones, glomerulonephritis, polycystic kidney disease and urinary tract infections.

  1. Chronic kidney disease/ kidney failure

It is a long term condition in which the kidney slowly continues to deteriorate and eventually becomes non-functional over time.

There are many factors that lead to kidney failure but there are two main causes:

  1. High blood pressure: When the blood pressure is high the afferent arteriole, containing oxygenate blood, enters the glomerulus, it damages it’s thin and fragile tissue lining and eventually destroys it.

Due to this, the vital filtration process gets compromised.

  1. High blood sugar/Diabetes: The high sugar in blood damages the blood vessels and affects the concentrate, filtration and absorption process.

Once these damages take place the body will be loaded with toxins and the person will show signs of fluid retention, cardiovascular disease, weakness and anemia, aside from the common symptoms.

The only treatment option is either dialysis or kidney transplant.

  1. Kidney stones

When there is too much waste in the body compared to the amount of fluid present.

Hard and solid deposits will be formed in the kidneys due to waste buildup.

These structures are known as kidney stones.

The most common cause of kidney stones is due to insufficient water consumption, leading to decreased fluid levels in the kidneys. Other reasons include genetics, high sodium, protein or sugar diet, obesity and certain medications.

As a result, the person will experience pain while urinating or in the abdomen and the urine will also be tinted with blood.

They are various types of stones depending on the waste accumulated. These include calcium, uric acid, cystine and struvite stones.

Treatment

Usually, stones can be prevented and treated by simply drinking lots of water and fluids. However, in extreme cases stones can be dissolved or broken down through medical processes that include shock wave therapy and ureteroscopy. 

Credits: Wikimedia commons Caption : Uric acid kidney stones

  1. Glomerulonephritis

It is a condition in which inflammation takes place in the glomerulus. If left untreated, this condition eventually progresses into chronic kidney disease.

In chronic stages, the person will experience symptoms like lack of appetite, nausea, vomiting, tiredness, increased muscle cramps and high protein content in the urine known as proteinuria.

This condition is most commonly trigger by two factors:

  1. Infections:

Streptococcus, the infection that causes strep throat, and the endocarditis bacteria, that causes infection in the blood vessels of the heart, are the most common causes of glomerulonephritis.

Other viruses like HIV and Hepatitis can also trigger inflammation in the glomerulus.

  1. Immune disease:

Diseases like lupus, good pasture’s syndrome and IgA nephropathy cause also trigger glomerulonephritis.

Besides kidney failure, it could also lead to high blood pressure, scarring of the glomerulus, nephropathy and diabetes.

Treatment

Acute glomerulonephritis will go away on it’s own and also with the help of administered antibiotics when caused by infections.

In addition, the doctor may also administer calcium supplements, diuretics pills and advise a low potassium, salt and protein diet.

  1. Polycystic kidney disease (PKD)

It is a genetic disease that causes cysts in the kidneys. This condition could eventually lead to chronic kidney disease as these cysts damage the tissues of the kidneys and affect it’s proper functioning.

Cysts are basically fluid filled sacs that grow in the nephrons, the basic structural and functional unit of the kidneys. In chronic conditions they can weigh up to 35 pounds.

Since PKD is a genetic condition there are two types: Autosomal Recessive and Autosomal Dominant.

Dominant PKD occurs only in the kidneys whereas recessive PKD occurs in the liver and kidneys.

The person suffering from PKD will experience back pain, side pain, headaches and blood in the urine. It could also lead to other kidney diseases like urinary tract infections, kidney stones, colon problems, heart problems, liver and pancreas cysts and pregnancy problems.

PKD can be diagnosed by imaging tests and also genetic tests with the help of swab samples of the saliva or blood.

Treatment includes growth hormones, kidney transplant, antibiotics, blood pressure medicine or dialysis.

Credits: Wikimedia commons Caption: Cysts formed in the kidneys

  1. Urinary tract infection (UTI)

It is an infection of the urinary system that includes kidneys, ureters, bladder and urethra.

Women are most prone to this infection. This is because the bacteria E.coli that is found in the intestine can sometimes enter the urethra from the anus. Once they travel up the urethra and enter the kidneys, they can be extremely harmful. Thus, women are more prone to UTIs as they have a shorter urethra compared to men.

The infection is usually detected in MRIs, ultrasounds or CT scans.

Symptoms included burning sensation during urination, cloudy and dark urine production, fatigue, frequent urge to urinate, fevers caused due to infection, pain and pressure in the abdomen.

Urinary tract infections can be classified by their types and location:

  1. Cystitis: Infection in the bladder that causes pain in the belly and during urination.

  2. Pyelonephritis: Infection in the kidneys that causes fever, pain, nausea and vomiting.

  3. Urethritis: Infection in the urethra that causes abnormal and excessive discharge along with extreme burning sensation during urination.

Treatment

It is most commonly treated with administered antibiotics. Patients are advised to drink lots of water to flush out the bacteria.

Sometimes, vaccines are also used to prevent UTIs by boosting immunity.

Diagnosis

  1. Blood test: Levels of waste products like urea and creatinine are checked in the blood to analyze if the kidneys are efficiently filtering out toxins and waste products.

  2. Urine test: Helps check the consistency or components in the urine and identify kidney disease and its cause.

  3. Imaging test: Ultrasound helps look for stones or any abnormal structures in the kidneys or urinary tract.

  4. Biopsy: A small cell of the kidney is extracted and analysed to identify the cause and types of kidney disease and also calculated the amount of damage done.

Credits: foter Caption : Haemodialysis procedure

Haemodialysis

It is an artificial machine used to perform the functions of a kidney by filtering out blood and maintaining the adequate amount of fluids and electrolytes in the body.

However, instead of sending the waste to the bladder in the form of urine, the machine eliminates the waste products itself.

This machine is used when the kidneys are unable to successfully perform its function or has failed.

In this process, two needles will be inserted into the AV fistula and taped into place. Then, one needle will transfer the blood into the dialysis machine known as the dialysate.

The dialysate acts like the nephron with various membranes that filter out the blood. The filtered waste products are then passed into the dialysate fluid.

This fluid can be considered as the urine of the body. Once this dialysate fluid is removed from the machine the filtered blood is then transferred back into the body through the second needle.

This procedure is not painful and is commonly performed 3 times a week. They will usually feel very weak and dizzy after the procedure.

In general, Patients are allowed to consume only limited amounts of fluid intake.

Credits: unsplash Caption: Kidney transplant

Kidney Transplant

It is the surgical procedure in which the non-functional kidney is discarded from the body and replaced by a healthy donor’s kidneys.

It is the only alternative to dialysis for the survival of the human body after the liver has failed.

This process has a very long recovery period and during that time the patient will be very prone to infections.

Whenever our body receives any foreign substance, even if the kidney is a perfect match, the immune system starts to attack it. This is why immunosuppressants are administered to patients after a kidney transplant.

As the name suggests, immunosuppressants suppress the function of the immune cells and this is why the patient is highly prone to infection.

Thus, post surgery, they must be kept in isolation and avoid contact with anyone as much as possible.

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